A Case for Electroconvulsive Therapy (ECT)

I went for a psychopharmacological consultation and was given three options: MAOI (another class of medication), transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT). I was terrified of ECT and did not want to deal with the dietary restrictions with the MAOI. I looked into TMS but learned that my insurance would not cover it. Before I could continue my research about TMS, I was hospitalized. My depression reached a severe point and I needed a higher level of care.

In the hospital I was given the same options that my consult gave me and after watching a DVD with my husband about ECT, we both knew I needed to begin this treatment. He just wanted his wife back; I just wanted to be myself again.

My experience of my first ECT treatment can be described in one word: terror. As a social worker, I was aware of the procedure but still had visions of torture from watching movies and TV shows that depict ECT in a punishing way. All of my fear was combatted by the warmest nurses I have ever encountered. It was over before I even knew it. I awoke from the anesthesia and felt proud of myself for taking a risk.

So, what happened after this first treatment? I had a euphoric response that evening where I felt things I had not felt in months. I was talkative and animated. I was allowed to go outside after dinner as I had that privilege and the sunlight on my skin felt unbelievable. That evening when I took a shower, the water felt like magic on my skin.

I did not have that type of response from any other ECT treatment. I have had a total of 23 ECT treatments from July 2014 to February 2015. I experienced the following as a result of these ECT treatments:

1. First and foremost, ECT was critical in saving my life. The last straw, which got me hospitalized, was me verbalizing to my therapist the specifics of my negative thoughts. While I believed them at the time, they did scare me.

2. Each treatment truly does build on one another. I was very aware of this process as it was happening. It kept me optimistic and hopeful.

3. While I have had some memory issues, the worst was about seven weeks into the treatment and it only lasted a few days. The best example of this experience was having a double session with my therapist and not remembering what we discussed during that hour and a half just two hours later. An ongoing issue has been finding words. I will be speaking and having a conversation and think of the word I want to say, but then lose it. This has been ongoing since that seventh week. It has improved over time.

4. My cognition has greatly improved since that first ECT treatment. Now, when my therapist is trying to reality-check with me, I can follow along and see different perspectives. I was unable to do that before treatment.

5. I can also recognize that I was severely ill. When I was in the depression, I knew I was sick but did not realize the extent. My negative thoughts became my new normal and I accepted them even though they also upset me.

6. I can “be with” people now. When I was sick I was unable to be present. I would read a book to my daughter but not really pay attention to her comments and questions. My mind was elsewhere. Now, I am experiencing “being with” in ways I was not able to practice before the ECT.

7. Not only is my cognition much improved, my ability to relate to others has, as well. I am able to accomplish so much in my therapy as we are working at such a high level. My psychodynamic therapy quickly became an analysis since the summer.

So what was most helpful for me during this experience?

1. I was included in discussions about my treatment and my thoughts and opinions mattered. I was an important part of my own treatment team and that felt empowering.

2. ECT itself is a safe and monitored procedure and should be advertised as such. My doctor in the hospital was very successful at promoting it this way.

3. Sense of humor can help. I was aware of what was going on around me and why I was going to receive ECT and any jokes I made about watching too many movies that depict ECT in a negative way were greeted with laughter from my doctor. His being laid back was very calming for me.

4. Use the statistics. My doctor was very clear about the percentage of patients who recover from depression after receiving ECT and this data was very helpful in making this treatment decision.

5. Work well with others. While I was hospitalized in CT, my therapist is in MA. They communicated well, which only benefited my getting well.

For me, the benefits of ECT have greatly outweighed my initial fears. I never imagined the positive results I would have in response to this treatment. Not only did it bring me out of a severe depression, it has benefited anyone I have a connection with as I am more communicative and involved in my relationships. Not only am I me again, I am a better version of me than I ever was before ECT.