Electroconvulsive Therapy

[TiredSam]

Electroconvulsive therapy helps patients with their symptoms in more than 80% of cases – but its stigma means it may not be helping the people it could.

An interesting perspective on ECT, in which our good friend Edward Shorter gets a mention:

Despite such advances, ECT would fall out of favour after the 1960s. “It was as if penicillin had somehow vanished from the medical armamentarium and a generation’s memory of its very existence had been somehow erased,” wrote Edward Shorter and David Healy, two medical historians, in 2007.

This was partly due to the rise in prescription drugs – though these were often less effective in severe depression – and partly due to the bad press ECT received in books, films, and the mass media. In the 1970s, historians David Healy and Edward Shorter write in their book Shock Therapy, a growing anti-psychiatry movement spearheaded by the Church of Scientology claimed that ECT ‘destroys minds’.

http://www.bbc.com/future/story/20180502-the-surprising-benefits-of-electroshock-therapy-or-ect

 

[Milo]

Ugh.

 

[Arnie Pye]

I wonder when it will become compulsory for those with depression?

 

[Maria1]

Thirty years ago I trained as a mental health nurse. I was utterly against ECT. But then I saw it work for people who were very seriously depressed. Nothing else worked in some instances, but ECT did. I’m still not sure how I feel about it but I can’t deny the difference it made to people’s lives.

 

[adambeyoncelowe]

Thirty years ago I trained as a mental health nurse. I was utterly against ECT. But then I saw it work for people who were very seriously depressed. Nothing else worked in some instances, but ECT did. I’m still not sure how I feel about it but I can’t deny the difference it made to people’s lives.

But did it last or was it just a short-term thing?

 

[Sly Saint]

I was watching an Australia drama called 'A place to call home' set in the 1950s where they used ECT to cure a man from being gay......horrific:
"
Shunned, abused and tortured: David Berry portrays what many gay men endured in 1950s Australia
Shannon Molloy
ACTOR David Berry would be so traumatised by his television character some days that he’d break down in hysterics on set.

The 31-year-old star of A Place To Call Home would be totally inconsolable — a sobbing mess. And he began to take the heavy experiences of James Bligh with him at the end of a day’s filming."
"
Berry has heard from many of those men, who say seeing a familiar battle waged on the small screen has had a profound impact.

For many, it helped them to come to terms with the often barbaric events they lived through. A few said they felt closure — an inner peace.

“That’s humbling,” Berry said. “It’s also very scary. I owe these people — they’re invested in the character.”

Those investments include very vivid recollections of being held against their will in hospitals, electrocuted, pumped full of drugs and mentally abused."

http://www.news.com.au/entertainmen...a/news-story/fa3398c3c19c56d8edf1769b5dd9c042

 

[Trish]

It's possible it's the appalling misuse of ECT that gave it such a bad name, rather than the treatment itself which does seem to be helpful in some cases.

 

[adambeyoncelowe]

It's possible it's the appalling misuse of ECT that gave it such a bad name, rather than the treatment itself which does seem to be helpful in some cases.

This could be said of many things though. I bet ECT is, in most cases, inseparable from medicalised torture. The problem isn't the treatment, per se, but the people who use it--and I can bet they prefer to use it on patients who don't align with their view of what's wholesome or healthy. This has been the case so far. The vulnerable and minorities are the first to suffer.

 

[Arnie Pye]

I've had minor electric shocks before (from fences around fields to keep farm animals in). I remember how unpleasant it was. Nothing will convince me that passing an electric current through the brain is a) good for the brain) and b) doesn't cause long term damage. It simply makes no sense to me at all. I suspect the basis of the treatment actually "working" is probably that it damages memory. Perhaps people forget they are depressed? But what else do they forget? Well, they won't know, because they've forgotten it! Even though people are anaesthetised for it I still consider it to be an absolutely barbaric torture.

 

[Trish]

I don't know enough about ECT to be able to comment with any authority.

I have witnessed it once as a temporary assistant working in my university holidays at an expensive private psychiatric hospital in Australia in about 1970. It was done under general anaesthetic and to an observer looked like the patient was having a brief epileptic fit. It was described to me as having a similar effect to a fit of temporarily blanking out some short term memory. The patient chose to have it voluntarily as an alternative to powerful drugs for severe depression.

I was too young and naive to understand it fully, but it didn't look to me any more barbaric than other medical procedures, including another instance at the same hospital where I had to help hold down an out of control patient so he could be injected with a sedative.

If it does actually damage the brain, then that would be different - as I say, I don't know enough to comment on that. And of course I am completely against the use of such a procedure as ECT as a method of control of or harm to vulnerable people against their will.

 

[Arnie Pye]

From the link in the original post in the thread :

It has even shown great promise for pregnant women and the elderly, two populations that are at high risk of depression but often can’t take antidepressants.

My emphasis.

What kind of barbarian gives ECT to a fetus? The idea makes me want to vomit!

 

[Trish]

What kind of barbarian gives ECT to a fetus? The idea makes me want to vomit!

The article mentions it for pregnant women, not the fetus.

 

[Allele]

The article mentions it for pregnant women, not the fetus.

One and the same.

 

[Allele]

There is such an atmosphere of retrogression in western culture right now. We are truly in some hideous dark ages of human mind and culture, despite all our technological advances, which are far outstripping our capacity to use them wisely.

In the sixties, a friend's mother was sectioned against her will vindictively by her abusive husband. (In the sixties men still had "authority" over their wives--women couldn't even get a bank account w/out a man's sign-off.) She was given many rounds of ECT, and my friend remembers that when she came back, she couldn't remember simple things like what to do with the laundry when it was done, or what a toothbrush was for. My friend, who was a child under ten at the time, had to help her re-learn these day-to-day things.

I know they are branding it differently now, but there has GOT to be a better way. I can say for sure for myself that a round of effing GET would be less deleterious than ECT, which is maybe the point of dragging it out again? Making SSRIs and GET seem like the lesser of evils? Choose none of the above and you're "noncompliant." Chose one and roll the dice.

Sorry, woke up cranky today!

 

[Arnie Pye]

The article mentions it for pregnant women, not the fetus.

If the electric current applied to a patient's head has the effect of making the feet twitch (as mentioned in the original article), then the current must be going through nerves in the pelvis and then into the legs to have that effect. It seems unlikely to me that such a current would conveniently bypass any fetus.

 

[Trish]

I do understand the great level of disquiet about this, but we need to be careful to get our biology correct.

I'm pretty sure it's not biologically accurate to say that the feet moving shows the electric current that has been applied to the brain is passing directly along the nerves in the way suggested. Nerves transmit their signals along their axons by tiny electric impulses, then across the synapse biochemically. It's not like an electric wire. The feet twitching would be a result of the stimulated brain sending messages along the nerves to activate the muscles.

The current will pass across the brain from one electrode placed on one side of the head to the opposite electrode, not through the rest of the body.

When people are electrocuted by an electric current passing through the body, it travels between the wire you've touched, through the body, to the earth which acts as the second electrode.

My science is pretty rusty, but I think I've got that right. Do correct me if I'm wrong.

 

[Allele]

I do understand the great level of disquiet about this, but we need to be careful to get our biology correct.

I'm pretty sure it's not biologically accurate to say that the feet moving shows the electric current that has been applied to the brain is passing directly along the nerves in the way suggested. Nerves transmit their signals along their axons by tiny electric impulses, then across the synapse biochemically. It's not like an electric wire. The feet twitching would be a result of the stimulated brain sending messages along the nerves to activate the muscles.

The current will pass across the brain from one electrode placed on one side of the head to the opposite electrode, not through the rest of the body.

When people are electrocuted by an electric current passing through the body, it travels between the wire you've touched, through the body, to the earth which acts as the second electrode.

My science is pretty rusty, but I think I've got that right. Do correct me if I'm wrong.

I'm sorry but a pregnant woman going into convulsive seizures for any reason, let alone electrically induced ones, is not going to do any favours to a growing fetus. I don't require science to explain the risks yea or nay.

 

[Trish]

You may well be right @Allele. I would take a lot of convincing that ECT could ever be right for a pregnant woman. I was just trying to get the electricity science clearer.

I agree a major convulsion in the mother sounds like a pretty bad thing for the foetus, but then so is a major psychoactive drug, which may be seen as the only alternative.

Our problem here is that we are discussing something beyond the knowledge of most of us here, so can only express opinions and gut feelings not facts.

I was actually quite moved by the author of the article's statement at the end of the article:

Interest in ECT is returning. According to a recent report, a growing number of people are deciding to undergo the treatment. Between 2015 and 2016 in the UK, 22,600 sessions of ECT were performed, an 11% increase over the previous year. And ECT has been joined by more selective forms of electric therapy such as Deep Brain Stimulation (DBS) and Transcranial Magnetic Stimulation (TMS), both of which are growing in support and popularity in the treatment of depression, Parkinson’s disease, and other mental disorders.

In my case, I am comforted by the fact that there are promising alternatives if my antidepressants start to fail and my condition deteriorates.

 

[arewenearlythereyet]

I like most feel revolted (excuse the pun) by the thought of this and it seems inherently wrong to even think about such a treatment.

However most of us are familiar with a tens machine and how this can help temporarily with pain so I should keep n open mind. I keep thinking of Carrie Fisher and her treatment ...she seemed to say she benefited from it but then later she was still depressed and didn’t she suffer memory problems afterwards ? (May be other things of course)

I think the main thing I find disquieting is the quality of medical professional that seem to want to use it....physchiatrists and neurologists...do we really want the scum of the medical world in control of the switch? It’s not like they would care about the harms caused long term to bother checking.

So forgive me for being biased but I would want to see a lot of due diligence on the long term effects of such treatments ...neurologists in particular have an extremely bad track record for not doing this ...e.g. the prescribing of AEDs to epileptic women with no warnings about how these could affect the unborn foetus ...let alone the long term effects of all the other drugs they prescribe.

 

[James Morris-Lent]

From cursory research, it seems like a valuable tool that may well be disproportionately difficult to access for the less affluent.

In pregnancy, you wouldn't use this unless the baby is at risk from the mother's behavior stemming from the severe depression or psychosis. If the mother is suicidal, or catatonic and not eating/drinking, ECT could help turn things around enough to give the baby (and mother) a chance, without the fetal toxicity of antipsychotic medication. That would seem highly ethical.