Electroconvulsive Therapy for Treatment Resistant Depression

Posted by Roxie43 @roxie43, Dec 3, 2011

Dear Readers,
How are you all? I am hoping that you are doing everything within your power to recover from whatever ails you because we all deserve to be at peace, live our life to the fullest and even get the best treatment possible for our illnesses. I am a woman in my 40’s with a chronic history of depression, anxiety, PTSD and recently became agoraphobic because I only felt safe at home.
I have tried so many medications, most did not even touch my depression, but one did (Remeron) and of course I gained over 30 pounds in 1 year so my medical doctor was not pleased. Then, a cruel person, or shall I say a person with her own issues became emotionally abusive with me and she stirred up so many unresolved feelings that I became very ill to the point of incapacitation.
I was really scared, desperate and almost gave up but my treatment team would not give up on me. The discussion of ECT came up and I thought that I was going to throw up. I have heard some horror stories about ECT so ambivalence and mistrust was my initial reaction. Then, I agreed to do it and after my physical exam cleared me for the procedures I did it. Now, I am a huge chicken when it come to dentist and being put to sleep. My first ECT visit……well prior to going, I genuinely thought that I was going to have a heart attack. However, I wanted to get better so I did it! This big chicken did it but before I did my doctor from Yale, Dr. Ostroff and his team explained everything to me. There are 2 ways to do ECT. One is bilateral where both sides of the brain receive the treatment and then there is unilateral which is only on the right side of the brain where there is minimal cognitive damage, less side effects and virtually no memory loss…..for me anyway. My only complaint would have to be headaches but this is questionable because I suffer from migraines and need a darn root canal.
Anyway, once you arrive for your session this is what happens;
1) You go to the ECT suite
2) Take off your shoes
3) Lay in bed
4) Vitals are monitered
5) If***heart rate is too fast due to nerves or other issues one is pre-medicated to control heart rate.
6) IV is put in as this is how you are put to sleep
7) You are then transferred to the small ECT room.
8) You are made comfortable with a small pillow
9) You are then asked are you ready?
10) You are then told..ok you are about to get very sleepy and have a funny taste in your mouth
11) You wake up, did not feel a thing, and feel sleepy
12) You are back in the ECT suite
13) Your vitals are being monitered again
14) You are given something to drink if you asked~no food or drinks after midnight the night before.
15) You are told to get up from the bed and sit in a small seating area where you put your shoes on.
16) After being observed for a few minutes, you are taken to the waiting area where someone should be waiting for you because you are not allowed to drive the day of the procedure. This is a wise thing to do because after the induced seizure, medications, and brief nap one awakes a little woozy and tired.
17) You leave with your next appointment in hand, go home, rest, eat, drink and can take ibuprofen a couple of hours after the treatment.
18) FYI**** After the first session, due to having your first seizure and muscle relaxants one can be a little sore but this is only after the first session.
It’s not the baberic treatment many report. I am not forced to have the procedures done and after 8 sessions I am no longer living in darkness. Yesterday, my memory was tested and I scored perfectly. The unilateral approach is the best approach for me because I want to return to work soon and need to be able to continue remembering things and focus on my work.
I have a wonderful treatment team. However, I won’t lie. I still get scared because no one really knows how the procedure really works but there is enough research that demonstrates that it does work. There is also word of mouth. I am proof that ECT works and although I don’t enjoy the feeling of being put to sleep, I know it is done safely and I know that slowly but surely I am recovering.
Recovery is our ultimate goal! I hope this was helpful. I understand not everyone has had my experience with this procedure but I must say people are tired of barely living because of their mental ilnesses and everytime I go, 3 x’s per week, there are 12-20 individuals waiting for their ECT treatments. If nothing else is helping you, please do not give up. If the biggest chicken on this planet can do it and reports an improved mood, no suicidal ideations, am cooking again and can laugh once again, it is at least worth discussing.
Best of luck to all & god bless you all during this holiday season and beyond 🙂

@useless

I’m going next week. Mine will be bilateral as they have found through research that unilateral isn’t as good. By the way, unilateral sides are based on whether you you are right or left handed. Memory loss is based on the individual not the specific course of this procedure. I’m looking forward to it.

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I am hanging in there. Please continue being kind…you are a blessing

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Hello Everyone,
It has been a while since I have connected with you all. I hope that everyone is ok and continuing to have faith in all the endless possibilities that are before us.
Take Care

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@edeleo

I enjoyed reading you your story. I admire that you chose unilateral ECT so that you can return to work. I too am an ECT success story. My experience of the procedure was virtually identical to what you describe. I want to clear up misconceptions about ECT, so anyone who reads this and has questions, please feel free to contact me.

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Roxie….after a year of searching, I have found the answer as to why my psychiatrist didn’t want to do more ECT’s because of the “euphoric reaction” I had.:

Mechanism of action

The aim of ECT is to induce a therapeutic clonic seizure (a seizure where the person loses consciousness and has convulsions) lasting for at least 15 seconds. Although a large amount of research has been carried out, the exact mechanism of action of ECT remains elusive. ECT doctors claim it may “jumpstart the brain”, helping boost neurotransmission, while others like Peter Breggin, claim it causes the “euphoric” effects similar to the effects found in “closed head injury” or people with fresh traumatic brain injury. The main reasons for this are that the human brain cannot be studied directly before and after ECT and therefore scientists rely on animal models of depression and ECT, with major limitations. While animal models are acknowledged to model merely aspects of depressive illness, human and animal brains are very similar at a molecular level, enabling detailed study of the molecular mechanisms involved in ECT.

There is a vast literature on the effects of Electroconvulsive Shock (ECS) in animals. In animal models of depression, particularly “learned helplessness” and “social defeat”, there is evidence of pruning of normally dense synaptic connections in the hippocampus, a richly connected area deep in the temporal lobe which is vital in controlling both mood and memory.

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@edeleo

I enjoyed reading you your story. I admire that you chose unilateral ECT so that you can return to work. I too am an ECT success story. My experience of the procedure was virtually identical to what you describe. I want to clear up misconceptions about ECT, so anyone who reads this and has questions, please feel free to contact me.

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p.s. I am close to tears…I KNEW something was wrong.

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Hi Friends,
I hope everyone is well and if not working really….. really……. hard to get better.
Hugs,
Rox

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If you are considering ECT please discuss maintenance sessions after your initial treatment. While ECT saved my life, I would have to admit that additional sessions are often needed if you are like me and have pharmacology resistant depression. Most, if not all, meds do not help me much so I am considering ECT again in the near future. So, remember ECT saved my life……..

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@edeleo

I enjoyed reading you your story. I admire that you chose unilateral ECT so that you can return to work. I too am an ECT success story. My experience of the procedure was virtually identical to what you describe. I want to clear up misconceptions about ECT, so anyone who reads this and has questions, please feel free to contact me.

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How are you Aspen? I hope you are feeling better. Have faith in yourself that you are strong enough to work hard on your recovery.
Hugs,
Rox

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Dear Roxie – Thank you for the reassuring post. I had ECT when I was just 20 and I had many bilateral treatments. I had some memory loss, but it all came back. I was not “brain damaged” as many people claim happens and which no medical research has ever shown. In fact, what I have found is that new neuronal growth or something of the sort can be stimulated. The real research is on the Internet in published and reliable medical journals where all the anti-ECT vitriole is not backed up by any scientific based publications. However, I think that it bodes well to make sure you have a competent and well-rated doctor.

I also feel that many of the people who are complaining about unremitting memory loss have probably not given it enough time to resolve it all. For me, I have found that after three years of chronic low-grade depression punctuated by the three of the most severe and prolonged depressive episodes I’ve ever had to date, have caused me some serious cognitive problems. From what I have read as well, untreated long-term depressive disorder can cause areas in the brain some potential atropy.

Being that I had ECT before, I wanted to add that I went on to college, graduated, and went on to get a graduate degree after that. So ECT did nothing to lower my intelligence nor my ability to think clearly and articulate well and write. I also never had another major out-of-the-blue panic attack for some reason. I can still get anxiety, but the full on panic attacks stopped after ECT for some reason.

Now I am about to turn 47 and over time and after many medications to try and keep the depression in control, as the ECT relief only last so many months, I am about to embark on another ECT journey after considering it seriously for three years now. I just can’t wait anymore. I want off Cymbalta, which may be making me more tired than I need. I stopped Adderall as well and I’m still bad off.

I get so depressed, I get severe “depression headaches” that cause me to feel suicidal and I just am tired of sleep walking in a fog of despair through my lie. I want to get well and get back to school or work somehow so I can get a life again and I feel strongly that getting a jump start and disrupting whatever horrendous jumble of crap is going on in my brain, is the only solution now. I do not want to mess with TMS even. I am out of time and have heard from other severely clinically depressed people that it didn’t help them and was not worth the cost.

I ended up on SSDI finally about six years ago and I want to get back to work badly. In retrospect I should have gotten this depression treated more aggressively a long time ago as it just got more and more severe over time, the past few years especially.

But mainly I am writing to see how you are doing now. Are you still in remission or have you found that meds now work better. I would love an update. Thanks!

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@edeleo

I enjoyed reading you your story. I admire that you chose unilateral ECT so that you can return to work. I too am an ECT success story. My experience of the procedure was virtually identical to what you describe. I want to clear up misconceptions about ECT, so anyone who reads this and has questions, please feel free to contact me.

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My husband is to the point where ECT is our final hope. He has been on every drug imaginable for TRD and at age 55 he is without hope. The one thing that concerns him the most at this time is his anxiety which goes hand in hand with his depression. Did you find any relief for that with ECT? We are resigned to the fact that he will have to continue maintenance treatment and an a drug regime. But the we just hope that some of his anxiety disorder will have some relief. Thank you for any words of wisdom you can share.

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hi, i have a history with major depression for ~20 years. I’m 41 now. a few years ago it got so bad i went into the hospital and there i had ect treatments. they helped! a few months later the depression returned and i had another set of ect treatments and a few maintenance ones (~1/mo) for a few months after. I was well for almost three years. the last several months i have gotten increasingly down though. i am functional as in still going to work but very lackluster and worried about my performance. i have trouble getting out of bed and though i never have had great confidence i feel particularly awful about myself. i know i am not as bad as i was when i went to the hospital a few years back. i’ve been back on meds a few months now w/o much effect. i am considering ect again but not even sure if i’m a candidate w/o being suicidal or unable to function. i still see friends, try to exercise.. it’s tough but i *can.* still, i really want to snap out of this. I seem to have no ambition. I feel weak considering such a major thing to snap me out of being down, but i’m worried how long this will last. ok i’m rambling but needed to talk and appreciate finding this thread. not sure if anyone’s still on it and i hope the best for all of you as i imagine you all have been there. ECT was so helpful when I was so so down before, but is it right now? I see the dr. next week we’ll see what he thinks. Discussion should anyone be on here might also help.

Liked by Roxie43

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@eeyore

hi, i have a history with major depression for ~20 years. I’m 41 now. a few years ago it got so bad i went into the hospital and there i had ect treatments. they helped! a few months later the depression returned and i had another set of ect treatments and a few maintenance ones (~1/mo) for a few months after. I was well for almost three years. the last several months i have gotten increasingly down though. i am functional as in still going to work but very lackluster and worried about my performance. i have trouble getting out of bed and though i never have had great confidence i feel particularly awful about myself. i know i am not as bad as i was when i went to the hospital a few years back. i’ve been back on meds a few months now w/o much effect. i am considering ect again but not even sure if i’m a candidate w/o being suicidal or unable to function. i still see friends, try to exercise.. it’s tough but i *can.* still, i really want to snap out of this. I seem to have no ambition. I feel weak considering such a major thing to snap me out of being down, but i’m worried how long this will last. ok i’m rambling but needed to talk and appreciate finding this thread. not sure if anyone’s still on it and i hope the best for all of you as i imagine you all have been there. ECT was so helpful when I was so so down before, but is it right now? I see the dr. next week we’ll see what he thinks. Discussion should anyone be on here might also help.

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I am considering ECT again myself. I am totally disabled now. I am not suicidal but ECT maintenance sessions are very important to our recovery. Especially, if our illness does not respond to medications. I am proud of you for continuing to work and considering more ECT. For me, it’s really what worked the best but the headaches (only complaint) were difficult. Take good care of yourself 🙂

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@catw1101

Dear Roxie – Thank you for the reassuring post. I had ECT when I was just 20 and I had many bilateral treatments. I had some memory loss, but it all came back. I was not “brain damaged” as many people claim happens and which no medical research has ever shown. In fact, what I have found is that new neuronal growth or something of the sort can be stimulated. The real research is on the Internet in published and reliable medical journals where all the anti-ECT vitriole is not backed up by any scientific based publications. However, I think that it bodes well to make sure you have a competent and well-rated doctor.

I also feel that many of the people who are complaining about unremitting memory loss have probably not given it enough time to resolve it all. For me, I have found that after three years of chronic low-grade depression punctuated by the three of the most severe and prolonged depressive episodes I’ve ever had to date, have caused me some serious cognitive problems. From what I have read as well, untreated long-term depressive disorder can cause areas in the brain some potential atropy.

Being that I had ECT before, I wanted to add that I went on to college, graduated, and went on to get a graduate degree after that. So ECT did nothing to lower my intelligence nor my ability to think clearly and articulate well and write. I also never had another major out-of-the-blue panic attack for some reason. I can still get anxiety, but the full on panic attacks stopped after ECT for some reason.

Now I am about to turn 47 and over time and after many medications to try and keep the depression in control, as the ECT relief only last so many months, I am about to embark on another ECT journey after considering it seriously for three years now. I just can’t wait anymore. I want off Cymbalta, which may be making me more tired than I need. I stopped Adderall as well and I’m still bad off.

I get so depressed, I get severe “depression headaches” that cause me to feel suicidal and I just am tired of sleep walking in a fog of despair through my lie. I want to get well and get back to school or work somehow so I can get a life again and I feel strongly that getting a jump start and disrupting whatever horrendous jumble of crap is going on in my brain, is the only solution now. I do not want to mess with TMS even. I am out of time and have heard from other severely clinically depressed people that it didn’t help them and was not worth the cost.

I ended up on SSDI finally about six years ago and I want to get back to work badly. In retrospect I should have gotten this depression treated more aggressively a long time ago as it just got more and more severe over time, the past few years especially.

But mainly I am writing to see how you are doing now. Are you still in remission or have you found that meds now work better. I would love an update. Thanks!

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Hi CatW,
I am doing ok. I have to continue with maintenance sessions because although ECT has been found to be my best form of treatment once a person stops some symptoms can resurface. I still feel that ECT is the best treatment for chronic depression not relieved by medications. The headaches (I suffer from migraines) are uncomfortable but Imitrex and muscle relaxers can ease this discomfort.
I hope you are well and aggressively working on your recovery.

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