A Shocking Treatment – ECT

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I missed the @WeMHNurses chat the other evening but I thought I would share my experiences of Electro Convulsive Therapy (ECT). I don’t mind as I feel there are a lot of myths to dispel around this, in my humble opinion, amazing treatment.

Several things about ECT are controversial, one of the main things being no one is exactly sure how or why it works! It was explained to me in simplistic terms that if a computer crashed the first thing most of us would do would be to turn it off and back on, reboot it. If we think of our brain as a computer and with mental illness it ‘crashes’ then ECT reboots it. I liked that explanation, it makes it seem logical somehow.

Another reason it is controversial is it’s history, it was given against patients will, without consent in the past and was not monitored and regulated as closely as it is now in the UK. I firmly believe that the patient should give an informed choice for any treatment if they are able to , which I recognise once ECT is an being explored isn’t always the case, but I also include medication in that which is something I feel psychiatry is less good at (rant for another blog!).

When ECT was first suggested to me I was horrified, I thought it was something from the history books. Something I had heard of happening in the 1950’s but this was 2006! I was severely depressed with a decreasing ability to even care for myself without even thinking about my new born baby. I was suicidal and a considerable danger to myself, I was willing to try anything. The pleading but very tired look in my husbands eyes told me I needed to give this a go. I had six unilateral sessions and began to recover quite dramatically. The results were phenomenal, someone had indeed rebooted my brain.

The process itself is not an uncomfortable one, the first time I was treated I used to walk along to the ECT suite twice each week with a nurse who stayed with me throughout. I would lie on the bed whilst the treatment nurses gave me ‘an NHS facial’ which is how they described preparing my head for the paddles used to conduct the shocks. I was then given anaesthetic and knew nothing more until I woke up in recovery. After the first treatment they knew my seizure threshold so it was even quicker and I was always given a muscle relaxant so although my brain had a seizure my body didn’t shake.

Most recently I had ECT as an outpatient, my husband holding my hand for each stage except the actual treatment. I knew the nurses who were treating me as they have treated me during all the episodes, I now knew them as colleagues too. The care and compassion delivered to me by those nurses is not something my husband and will forget.  My depression had led to psychosis on this occasion and although I don’t remember why I was terrified by a mirrored window in the nursing office, they held my hand an talked me through this whilst directing me to sit with my back to it. My husband was exhausted so knowing in those few minutes I was in their care meant a lot, the ECT suite was about more than simply ECT.

Having taken medication and experienced some vile side effects from it I am firmly of the opinion that I would have ECT again if it was clinically indicated. I have had three courses now when needed over the past decade and a bit, would I have it again? Yes if needed.

During the second episode I had ECT I had come off medication and my mood had declined to a level where again I was struggling to function. I did the right things and asked for help, only to be turned away. Eventually the depression developed to a severe point again and my husband pointed out to mental health services that I had written an advance statement when I was well asking that if I ever became that depressed again ECT would be my treatment of choice. They agreed that my mood was now too low for other intervention and that ECT was indicated however after first saying I could have it as an outpatient they changed their mind and I was admitted.

In 2016 I was to commence my 3rd (and lets hope final) course of ECT I was so poorly that my skin was peeling off as I wasn’t remembering to drink, my cognitions were so poor that a simple yes or no answer would take about five minutes to process before I could answer, my head was just so slow, I hadn’t brushed my teeth in weeks, depression IS barbaric. I have heard people describe ECT as inhumane and barbaric, they have obviously been fortunate enough never to have suffered severe depression as leaving me that was would have been barbaric and inhumane, ECT is neither of those things. The only downside I have come across is the memory loss but I am happy to forget the worst months of my life, I guess we all have different thresholds on what we will accept as side effects whether ECT or medication.

I have written this blog to try and dispel some myths around ECT, I can understand how the general public have such strong feelings about this ‘inhumane’ and ‘barbaric’ treatment of giving the brain electric shocks however feel that a heart attack needing defibrillation is perfectly acceptable. How are they different?

The fear around ECT is shocking not the treatment 🙂

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