I’ve been wanting to write on ECT for awhile now. It seems everyone has their own opinion about it, even if they haven’t experienced it. I say, unless you’ve tried it shut your face. This is my experience with it.
In case you didn’t know, ECT stands for Electroconvulsive Therapy (shock treatment.) Right, like in “One Flew Over the Cuckoo’s Nest” only not. ECT is used for severe depression when medications and other treatments haven’t worked, suicidal depression, psychosis, severe mania or catatonia. It may seem barbaric but it’s actually quite effective. Antidepressants have about a 30% effectiveness whereas ECT is about 70%.
I started ECT mid-November after 15 years of med changes and 13 hospitalizations. I wish someone had offered it to me sooner. 5 of my doctors worked together to make it happen. Here’s how it happened. I was given the option and information that I could sign only after having it for 24 hours. My doctors made sure my labs were good and I passed my EKG. I was evaluated by 2 doctors and then scheduled for my first session. I opted not to view the ECT video. I’ve seen it before. I’ve had many friends who’ve had ECT so I knew a bit of what to expect and considering I’d rather have been dead the outcome really didn’t matter.
I started ECT inpatient 3 times a week. The night before they give you a red wristband that means you can’t eat or drink after midnight until they take the band off (because of the anesthesia.) I got lucky for my first ECT and had my favorite nurse assigned to me. She came to get me super early in the morning when the ECT dept was ready for me and walked me down there. The nurse there greeted me with a smile and took my vitals. The nurse from my unit stayed with me until it was my turn. Then they took me back to meet my doctor in the treatment room. As soon as I go in, I sit down on the gurney (which is ridiculously soft.) The nurse on my left starts an IV in my left arm, the nurse on my right covers me with a warm blanket, the anesthesiologist is above my head and my doctor is either sitting at a computer on my right or standing at my feet talking to me. Someone puts electrodes on my forehead and right temple. I try to stay conscious as long as possible but inevitably mid-sentence my doctor grabs my right hand, smiles at me and says I’m going to get sleepy. The world gets a bit blurry, shakes back and forth two or three times and all goes black. The next thing I know I wake up in the recovery area. I still have no idea how I get there. When I wake up I feel happy and healthy, they take my vitals and someone gives me apple juice.
While I’m asleep they shock me on the right side and top of my head (unilateral), causing a seizure. In the IV they give me meds to paralyze my body so I don’t shake. Because of this, they breathe for me. They tape my eyes shut and put a mouthpiece in so I don’t grind my teeth. I don’t suggest keeping contacts in if you wear them. I did the first time and somehow lost one when they pulled the tape off. Don’t worry. They do it before you wake up and it doesn’t hurt at all or leave a mark. I have longer seizures than most people. Last week I had my longest yet – 148 seconds. The length of the seizure doesn’t seem to matter as long as it’s at least 20 seconds. Some people have bilateral ECT, which means they get shocked on both sides. That kind of ECT has more memory loss and side effects. They don’t seem to know how or why ECT works. I read an article last year that said it slightly damages the part of the brain that’s overactive in depression. Other sources say it basically jumpstarts the brain or changes the chemistry. Either way, it works.
My first ECT was the worst. They didn’t give me any extra meds because they didn’t know what I’d need. I had no idea where I was or who the people on my unit were. I was crawling on the floor nauseous with a HORRIBLE headache. I did at least remember my nurse, who I’ve known for years. My legs hurt SO bad for several days, which they told me was because they were super muscular and adjusted the anesthesia. They “stacked” my first two treatments – two days in a row. After the first one they started giving me Toradol and Zofran in the IV and I’ve had much less difficulty with pain and nausea. After the first treatment I felt joy, which confused but elated me. I didn’t know it was possible. I had 5 treatments inpatient and was doing so well that they discharged me without a plan for maintenance treatment. Then my therapist fired me and some other shit happened and I took a hard and fast dive towards death. So I decided to go back to ECT. Now I’m getting treatments once a week.
ECT has not been without side effects. After doing treatments three times a week I couldn’t drive for 2 weeks. Now that I’m doing it weekly I just can’t drive the day of or the day after treatment. About an hour after I wake up I get a headache and feel very nauseous. Sometimes I can stay up and work on the computer or write. Other days I just sleep. I have Tigan to take PO for the nausea. My memory is spotty and my cognition is definitely impaired. I have trouble remembering names, passwords, how to get places. My mind, which is usually chock full of thoughts and ideas, is often pretty blank. This is new for me but I don’t altogether hate it. There are certain things I don’t remember at all. I’ve gotten into arguments with people about things I apparently did but have no memory of. This is frustrating for me. Thankfully at least one of those people understands why. My mind is usually a steel trap. If I don’t remember it, it didn’t happen. But I guess now it might have. I’m learning. It’s like ECT as ERP. I’m learning to accept not knowing or remembering. I so often now hear myself saying, “I don’t know.” I also get very sore muscles for a few days after my treatment – sometimes my neck or shoulders, tongue, back. The soreness seems to travel but doesn’t show up until the second day.
I feel offended when people tell me I shouldn’t be doing ECT or when they hassle me about how many treatments I’m having. They say they’re concerned about my mind or the side effects. They fail to take into consideration that it’s saving my life. I KNOW I’m not the same. I’m aware that my mind is different. I’ve seen how it can ruin people’s minds. It’s not ruining mine. I trust my doctors and God has given me ECT. Maybe not for forever, but definitely for now. I finally found something that actually helps me. I do feel sad more often than usual, but I believe that’s because I’m actually feeling. I’m dissociating less, actually living in the moment. It’s new for me. I think it’s good. I intend to keep doing ECT until my doctors and I agree on stopping. Please don’t try to dissuade me.
If you’d like to talk about ECT, feel free to leave me a comment here or contact me personally if you know me. I’m not up for philosophical arguments but I’m willing to answer questions or help you out. It’s not as scary as it seems. I promise.
This is the Mayo Clinic article about ECT. Mayo Clinic – ECT
© Michelle Routhieaux 2015
I am happy for you, glad you’ve found an effective way to deal with the depression.
I am glad you’ve found some relief with ECT. I, too received ECT-bilateral and unilateral-treatments a little over a year ago. One of the benefits of ECT is it takes effect much more quickly than medications alone and can even synergistically enhance antidepressants. Even though I’ve experienced side effects from the ECT tx’s, some lingering too, it gave me hope when I needed it most. Thank you for sharing your experience!
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