Posted by Ilene on March 2, 2003, at 11:51:17
In reply to Re: ECT - long and possibly very boring - sorry » ShelliR, posted by Bipolarsux on March 2, 2003, at 1:20:27
I wonder how well experiences of people here reflect the effectiveness of ect, because those for whom it *does* work are unlikely to be posting here. I mean, if you feel well, why hang out with sick people, when you can get on with your life? How well does ect actually work?
As my depression got worse and worse, and I started reading everything I could, ect inevitably came up. It's clearly controversial, but some psychiatrists assert it's the best treatment for depression. (I think for BP disorder and some other conditions, but I play for both teams. I'm not clearly unipolar or bipolar.)
But I wondered, if it's such a wonderful cure, why do people complain about it? Not just people who have a philosophical objection, or those who think "One Flew Over the Cuckoo's Nest" is realistic, but people who experienced it?
I hate the idea of having my brain rearranged by a literally convulsive jolt of electricity. And there is that incredible stigma attached to ect. So I freely confess I am predisposed against it. Even so, I want to investigate anything and everything that could help me. No sense in dismissing it out of hand.
The web is full of sites about how awful ect is, how it destroys your brain, and so on. I ignored those and went to medline and more respectable sites instead. What follows is the impression I got. Please don't take it as gospel, this isn't a scientific treatise, and I may have missed some things or misinterpreted them.
I wish I could find something that explains ect like the official package inserts required for prescription drugs!
The consensus is that ect is more effective and safer than other therapies for depression. However...most of us know that drugs and psychotherapy aren't always effective. Effectiveness is relative. "Better than placebo" is sometimes (often?) merely "better than nothing".
Many people are what is called treatment resistant. (The name implies that the *person* resists treatment, but it means we don't get better despite trying a bunch of drugs. Different sources use different numbers for the specific number of drugs.} Ect is less effective for treatment-resistent patients.
Another thing I found: it seems that many if not most people relapse. Doctors have been trying to prevent relapse with more ect, more drugs, more ect plus more drugs...I found only a few articles about what happens to people after a year or more, so it's hard to evaluate relapse rates.
Most doctors who like ect minimize the side effects. They say that memory and cognitive problems wear off, or people forget only what happened around the time of treatment. I think they assume if they can't measure these deficits "objectively", they don't exist. I haven't found anything that seriously questions the validity of the tests.
So--if you need more ect treatments to keep you from backsliding, wouldn't each one cause more and more fuzziness and forgetfulness?
The value of ect is that it *can* be fast and effective, which is gratifying to everyone concerned. A lot of people would gladly trade some memory for feeling human.
Personally, if my pdoc ever presents ect as a serious option, I want to ask her a lot of questions. Assuming I can think of the questions. (Posting messages is one of the few things I can do anymore. I don't know why, when I can't concentrate on day-to-day activities.)
Please, please, please, pretty please with sugar on top, don't rule out ect because of what I wrote here. I have a terrible time making decisions. I always want to gather as much information as I can. That's just me. Don't base your decision (it is *your* decision) on someone else's reservations.
Feedback please, if anyone bothers to read this far.
--I.
poster:Ilene
thread:201088
URL: http://www.dr-bob.org/babble/social/20030301/msgs/205271.html