Tag Archives: risk assessment

Risk, Stigma, and ECT

Last time I talked to you about why I chose to try ECT, or more specifically, my history of depression.  Many people called me brave, and I thank you for your kind words.  This made me consider, though, exactly what bravery is.  Most people think of brave people as those who take great risks.  There are many kinds of risk, but even in cases where a split second decision is required, you will rely on what you know.  You will make an assessment.  Is the risk I’m taking worth the possible costs?

For instance, you might decide you want to go bungee jumping.  What are the risks and what are the benefits?  Everyone’s different, but I’d probably look at it like this.

Risk: You could fall to your death and die.

Benefit: Wee, it’s fun!

I belieeeeeve I can fly!

In this case, I’d decide that no, jumping off a cliff, even with a rope tied around my ankle, is not worth risking my early demise for benefit of an adrenaline rush (I don’t even have to pay for those!). On the other hand, when I made a decision about getting ECT, I looked at the decision this way.

Risk: Very Expensive. Memory loss.  Cognitive problems.  Pudding brains.

Benefit: I might feel like living, and my life become more worthwhile, for myself and those who love me.

In order to make this decision, I did my research.  I can research the crap out of anything, taking hours to find out which shampoo brand is the best, which makes me a great librarian though sometimes an annoying person.  So after my psychiatrist asked his students in front of me what was available to those who didn’t respond to drugs, they said, as one example, ECT. When he asked them what it stood for, they hesitated, and I said “Electroconvulsive Therapy.”  Give me an A.

You might think my psychiatrist is mean asking his students these questions in front of me, but honestly I think he just loves to mess with them. The best way to learn is to do so in a real setting.  I could have refused the students had I wanted to, but it turns out I find their suffering entertaining as well.  Anyway, at first I said, “Yeah, nope”.  I’d heard plenty about ECT, and Sparky had always told me to watch myself around electricity, so this seemed a no-brainer.

My psychiatrist told me what ECT was like now, and how much it had changed from the days of “One Flew Over the Cuckoo’s Nest”.  He bemoaned the fact that there is so much stigma, and that this and politics often dictated whether a variety of treatments are available to patients.  For instance, ECT was once available near my home town, but it was taken away.  The closest hospital that offers ECT now is over a five hour drive from where I live.  “In the end,” he said.  “They take it away, and the patients suffer.”  He said he has seen it work because he’d administered it himself.  “I am convinced you could feel better in as little as two weeks.”

What exactly takes place during ECT?  I won’t know until I’m there, and even then I’ll be asleep most of the time, but I did find this video that shows the procedure.

A little disconcerting?  Slightly.  On the other hand, it’s also a far cry from what they did to Jack Nicholson.  As you can see, the actual shock lasts seconds, and only one part of the body shakes to show there is a seizure.  Oxygen is given, anesthesia, and something to stop the convulsions.  But just look at those people helping with the ECT, holding his hand, smiling gently.  Vultures!

By this point, as I said before, I’d been through years worth of drugs that eventually failed.  Some of them had dangerous side effects, just as dangerous as ECT’s side effects, or worse.  If you get right down to it, everything carries a risk of side effects.  Childbirth is risky, even if you’re young and healthy.  I know, because at 27, I had to wait two weeks for tests to find out if my baby was mentally handicapped.  She turned out healthy, but it did shock me into reality.  None of us is immune to tragedy.

So I researched, and so did my friends.  As I mentioned briefly earlier, I found a little straight forward information, and many, many websites full of warnings and sometimes near hysterical accounts from patients.  I realize that this treatment doesn’t work for everyone, but the success rate is listed at near 80 percent.  Even if that data is wrong, and it’s only 50 percent, or heck, 5 percent, is this something we should deny desperate people?  Chemotherapy kills your body’s cells, both healthy and cancerous, yet it is a common procedure for people with Cancer.  Rarely do I hear of someone cautioning a person “You know Chemo is barbaric.  Don’t do it!!!”  The reason you don’t hear this is because, unfortunately, for now it is one of the few treatments that have been shown to succeed.  It takes a terrible toll on the body, and it doesn’t always work.  But what else should a person do?  Take vitamins?  Smoke kale?  Tell me, what else should they do?

What else should terribly depressed people do?

That is why I don’t presume to tell others what to do with their own bodies.  Screaming that a treatment – whether pills, a medical procedure, or even eating kale (you might choke)- is barbaric, outdated, and cruel could scare people away from the one thing that might help them.  I did find one blog written by Natasha Tracy, advocate for mental health.  She had a terrible time with ECT.  But she fights for it to be available, because she knows that her experience is not what everyone will experience.  What helps you could hurt someone else, or vice versa.  I encourage you to visit her website; it is full of good information.  It is also full of really angry people in the comment section.  But she keeps writing.

I am aware that writing about this could open myself up to a lot of these same angry people.  But so many have helped me over the years, and I want to help someone else.  I want there to be more information about what ECT really is, and how it works.  I want people to find an account that is from a real person, but still factual.  Even if it’s a bad experience for me, I want to demystify this treatment for Depression.  That’s why I decided to write.  I weighed the risk (testing out the waters with a friend), and I made a decision.  Eventually you have to stop researching, and make a choice, just as I did to try ECT.

I have much more to talk about, but I’m running out of space.  I will tell of what the actual process of preparing for ECT entails (hint: you don’t walk right in and get shocked), and how I went about figuring out how I was going to get there in the first place.  The decision was one thing.  The execution of that decision, quite another.

Remember: Everyone is brave in their own way, just by getting up in the morning.

Stay tuned.

~Alice