I haven't had it but have been threatened with it. I know of others who have had it.
I personally wouldn't recommend it to anyone and think the treatment should be banned.
Are you considering having this treatment?
Well that's complex as I've known people who said they had treatment refractory depression and had tried to commit suicide and ECT helped them. It should be a person's decision and I believe in the United States it is. As I've said though in other posts, trans cranial magnetic stimulation is a new FDA approved option that has a safer long term side effect profile:
When it was in clinical study, I considered undergoing it for what was then treatment refractory schizophrenia. Now it is FDA approved for treatment refractory depression. For myself I know it is clinical study for tardive dyskinesia and it is shown to be effective for that I would undergo it. ECT and TCMS are however, options only considered after all known anti-depressents have failied.
I haven't had it, but a very close friend of mine had two rounds of uni-Lateral ECT.
He said the hardest part was that he had to be taken off all his meds for a couple weeks before the ECT. They don't want any meds in your system prior to the ECT.
It was really different in his case because even after the second round he only noticed a little improvement, but then when the ECT ended and he was put back on different meds.
The ECT really made it seem like his meds were working much better. That was a year ago and he is doing very well.
He told me that it's not like you feel better all at once but it takes time. He is still very sharp and personable and "not a Zombie" such as some may have you think.
His memory is very good although he did lose a little during the time of the treatments it all returned.
ECT is very ill regarded, mostly by people that have never had it. (you get what I mean)
I have found that for people who did have it the result was either 1. They said it didn't work and that it messed them up. OR 2. Prople said it saved their life and they were happy it was there for them.
I have found very few people that say anything inbetween.
My depression is very severe and chronic. About as bad as it gets on a HAMD scale and even I would not consider ECT unless I have tried every damn combination of meds on the market first.
Right now Protriptilyne, Lithium, and Lamictal seem to be working. (I am medication resistant) I will probably have to have ECT at some point in my life as meds never work that long for me, but it will be me with one foot in a coffin before I do it.
I will even try MAOI like Parnate before doing ECT.
I do not have any experience with ECT yet, but soon will. I have treatment resistant depression and have tried numerous treatments with no substantial benefit. I meet with an ECT doctor on the 19th. I will be recording my experience, good or bad in my journal on this website. Please feel free to read it.
I've not had it but I was told 10 years ago I had no other choice as it was the only thing that might help. I said yes but my partner researched it and I said no next time I saw the doc.
Note I was told, like you, that it was my last choice, option or chance. WHatever.
Well you can see I'm here today so it wasn't my last chance by any stretch of the imagination. I came back on meds. Took about 6 weeks from that first "last chance" to feeling like I had a shot again at life but what if I had ECT'd and lost memory? I'd be finished right?
Maybe it was fear of ECT that made the difference. I don't know. My own opinion is what helped the most was taking charge of my own treatment and saying no. My spouse obviously had to hold me up during that but it was my decision and it was right.
My memory is me, without it what are you? They can't be selective and just rub out the nasty bits, if they could I would have done it.
Doctors today do admit there are regular memory problems but they try to minimise those as well. They don't tell you about ANY other issue. Having met about 30 ECT ex patients I can say only 1 said it helped them long term. And he was sitting next to me in the mental hospital waiting his maintenance treatments. Yes, most need them, every 6 to 9 months I understand.
A treatment can consist of 6 - 18 seizures induced over a similar number of days usually. With maintenance say twice a year, how many times do you risk your memory before it's gone at least partially?
Believe me I know how desperate we get before they offer this miracle to us. I was ready to say yes if the doc had offered to garotte me on the spot. I truly was, just wanted it to stop.
Ask yourself why they wait that long. Ask yourself, if it is as succesful as the docs tell you, why it is not FIRST choice? You know why.
Ask yourself why you have to sign an indemnity form exonerating them from any costs should it go wrong. Again, you know why.
The people I've met and talked with tell me things like
: It helped for a while but then didn't, maintenance helped too sometimes but not all the time,
: Constant migraine from end of treatment with no depression relief,
. Memory loss was the biggest problem. Those that lost real chunks of long term memory were the angriest. One lady lost all the time around her marriage and doesn't know the guy who lives with her. As husband,
. Others said it gave them headaches, disoriented them for a couple of weeks and then they had problems with small memory things. Liveable but they got no relief at all either.
I have found in between people. There's many strong anti, few strong pro and the strong pro generally have said it stopped helping. One strong pro, still on maintenance.
Most very angry and worse off than pre ECT.
Glad to hear the meds are doing OK for you right now. It's time you got a break mate.
Like you ECT is always on the menu. My doc today is the one who first said it was my only choice. He mentions it about once a year and laughs. He administers it every day and tells me it works well. Having spent 2 weeks in the hospital where he works I met those succesful patients. And they were indeed zombies during the time they were there. That's normal and I don't know how they came up later on of course.
I must add lastly though, despite my own anti ECT opinion that I could never tell anyone else what to do or not to do. It is a personal decision and only for one person. But it would be good if it was a truly informed decision wouldn't it?
I think your story is like many. The doctors say it's your last resort and that you need to have it, but in reality what do they mean by last resort.
I thought I was out of options too, untill I met my new Psychiatrist that told me he could tweek my meds and find new med combinations to make me feel better. He was right and he did.
Some doctors think that just because you have failed on 6 different meds that you should have ECT. I don't agree with that. I think trying multiple combinations of meds at the right dosages should be tried first.
Fo me Last resort means when I have been thru 30 different combinations of meds and the oppinion of at least 3 different Psychiatrists. Maybe then it's time.
I even think MAOI should be tried before ECT. I might almost go as far as to say that Opiates even be tried before ECT (Opiates can have a positive antidepressant effect)
Then......Well then it's time if all that failes and I will get ECT. I'm glad ECT is there as an option, but too many doctors jump the gun on ECT when far from enough has been tried first.
I also think that many bad experiences with ECT are the result of patients having it done long before they were ready for it because it was pushed on them way too early.
I've come to the view on ECT that it's just off the list for me. Why risk it any more than we do with meds?
You mention opiates.
Over the last few years when my doc, a good guy despite doing ECT, raises ECT as an option I ask him why he can't actually prescribe me something that REALLY makes me feel good, or at least feel no pain. He admits opiates are likely to achieve that but of course it's a big NO NO for a society so committed to alcohol, tobacco and meds that don't cure us or always help at all.
I find it amusing though to watch the current trend towards trying to restrict or even ban booze. Being an ex drinker it's OK by me now. Selfish of course but it really is creeping through the media and society. Here in OZ anyway. Just like they did with tobacco, one little step at a time.
Perhaps people don't understand that if it feels good people will always do it, regardless. I watch with amusement.
I find the use of Opiate based drugs for severe depression very interesting. Obviously this would not be an acceptable treatment for people that can get relief from Psychotropic meds, but some people just don't respond to them.
There has been a lot of psychiatric study done regarding the use of Opiates for treatment resistant depression. I have read a lot about it and experienced it myself no long ago after a doctor prescribed me Vicotin for pain.
After taking it I noticed something that a non-depressed person never would have noticed...A real sense of normalcy. (not something I am used to feeling)
This Opiate made me feel just like I felt 20 years ago before getting very sick with depression. I kept scratching my head and wondering, Why did this drug have that effect on me. I wasn't high from it or anything like that.
There is something very powerful that Opiates do for a depressed brain.
Unfortunatly Tolerance is built up very fast with Opiates and addiction can occure, but then again are we not addicted to our antidepressants? Maybe in a different way, but addicted just the same.
I think more research need to be dome on the antidepressant properties of Opiates.
Sure it's an addiction problem but, after 20 years for you and 48 for me, who gives a toss, right?
It does seem much the same really in some ways. A/D's etc aren't physically addictive but if you can't go without them what is the difference? None. They both reach tolerance levels requiring more which destroys the benefits etc but, to a trial, research, my hand is way up there.
I have a chronic pain problem too and take Tramal for it, a mild pain med. It holds the pain at bay but doesn't hide it and it is getting worse. A small touch of the green baccy takes that away, only for a few hours etc and same issue with tolerance but hell, why does society just ignore some drugs and love others? I only go green about once a year as it's not real good full time and harder to find as you get older too. Maybe that's why old guys hang around school yards today? For drugs, not kids. Jest a joke.
In the end, it's gotta be whatever works is what is needed. Maybe society will become more tolerant? Yeah, right, something about hell freezing over.
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