Surfacing After Silence

Life. After.

Things That May Be Difficult to Discuss

5340545-Tangled-wires-as-connection-and-network-concept-Stock-Photo-tangled-wire(please remember that this is my own personal experience, and I do not have an MD in either neurology or psychiatry.  Do not take my opinion as fact.  Take my opinion as an opinion.)

It’s not often I’m scrolling through my news feed and up pops an article written by someone who receives ECT, or electroconvulsive therapy, previously known as “shock therapy” or “shock treatment.”

I appreciate how the author points out that she’s not the “typical ECT patient.”  Just because movies and books may feature some middle-aged patient with long, stringy grey hair in a straight jacket in the corner of an empty room, does not mean this is normal.  Also keep in mind that today is 2018; it is not 1923.  When ECT was first used as treatment, it was also used as a punishment for symptomic behaviors, not an effective form of treatment.  It would physically subdue the patient without curing the underlying problem.  That is not how this treatment is used today.

I am not the stereotypical madwoman talking to herself in the corner.  (Although I do talk to myself.  And my cats.)  I am a just-about-40-year-old college professor who receives ECT as a maintenance form of therapy for the Bipolar Disorder I.

When ECT is used in an appropriate and careful manner by knowledgeable doctors with an appropriate candidate, ECT can be the best form of treatment for that individual.  With any form of treatment, you have to consider how the treatment was administered and whether or not the patient is a viable candidate–and, of course, do not  forget that each patient is unique (emotionally and physically), and may or may not have a positive response.  But–I wouldn’t trust my psychiatrist to diagnose and treat my cardiac illness.  I trust my cardiologist who specializes in electrical conditions of the heart and who has done a fair amount of research concerning my particular, rare, illness.  (In other words–ask questions, do research, and talk to an appropriate doctor whom you trust.)

So let’s address a couple of common myths and urban legends.  One: I am anesthetized while receiving said treatment and, therefore do not feel a thing and my body does not go into convulsions.  The ECT itself is extremely brief–a matter of seconds.  Two: I don’t wake up not knowing who I am or where I am.  I am aware before the short-acting anesthetic, and I am aware after I wake up.  While some confusion is normal when first awakening–that’s from the anesthesia and not the treatment–and it disappears quickly.  Three: While I am not allowed to drive that day, I can go about my daily activities and work with only some minor fatigue.  I can still teach and can still officiate, as long as I have transportation to get there–again, typical of restrictions after any course of anesthesia.  The day following the treatment is when I experience a headache or muscle fatigue, but I rest and take what usually is just a single dose of ibuprofen, and the headache is gone.  Four: There is not just a single one-size-fits-all approach to ECT.  There are different forms of ECT, depending on where the doctor chooses to place the nodes and if he uses one or two nodes and the duration of each session.

Memory can be a tricky mistress, however.  When I was in college (for my first bachelor’s), I had a course of ECT over three weeks.  I don’t remember anything from that time period or anything right before and right after those weeks.  This makes me rather uncomfortable, knowing that there is a period of time when the words in my journal entries from that time are unfamiliar.  So when, fifteen years later, a psychiatrist suggested ECT, I balked.  But that psychiatrist also had been treating me for longer than my first bachelor’s degree took, whereas the doctor from my college days only treated me when I happened to be inpatient.  Being the research freak I am, and since I was inpatient and couldn’t get to a library, I asked him to show me some legitimate articles or papers, and then we had an open, honest discussion about predicted results and side effects–both in terms of the immediate future and long term future.

I chose ECT.  After my cardiac diagnosis, I went through a very severe and lengthy depressive episode, and because of my heart, I cannot take a large number of medications.  I was exhausted and my mind was strung out, and I knew I couldn’t be discharged in the state I was in.

By the time I left that particular psychiatrist to move back to the eastern parts of the country, we had figured out that most of my medication was not helping.  My psychiatrist in MO found me a psychiatrist in NY, and the two of them consulted and discussed my treatment–and allowed me in on the discussion.

Over the previous three years, we’ve taped off old medications that proved to be ineffective, figured out which medications are effective, and I now am receiving ECT once every four weeks.  If I start to slip at all in those weeks, I call my psychiatrist and we talk about whether or not I should have an earlier, extra, treatment or if I am coping quite well and should see how things go.

During this time, I have been a college professor, a NYS Track and Field Official, an NCAA Volleyball Judge, a writer, and a friend and family member.  My memory has some glitches–but that could also be from the depression itself or, well, the fact that I’ll be forty in a week.  It’s not enough of a problem to hamper my lifestyle or consider terminating treatment.

I continue to reevaluate everything as new knowledge is produced in the scientific world of research, and I continue to reevaluate my pattern of symptoms, and discuss these with my treatment team.  Given everything–my past, my present, my physical limitations regarding medications, and my response to ECT–the most effective treatment for me is ECT.

 

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May 28, 2017 Posted by | addictions, bipolar disorder, Communication, coping, death, depression, Eating Disorders, ECT, health, heart, progress, recovery, relationships, shame, suicide, therapy, treatment | 3 Comments