Bipolar 2 From Inside and Out

Photo by Mike T

In the course of dealing with my bipolar disorder, I had a near brush with electroshock. I managed to avoid it, but I did give it serious thought.

Now 60 Minutes has come out with a piece called “Is Shock Therapy Making a Comeback?” You can see the segment here: 60 Minutes.

ECT(electroconvulsive therapy, the modern name for the procedure), which is often done on an outpatient basis, works by inducing a brief seizure in a patient. The seizure, which lasts about a minute, releases multiple neurotransmitters in the brain, all at once. The patient is required to have someone to transport them to and from the appointment. Treatments are typically applied one or two times per week for 6-8 weeks.

In a brief article excerpted from the news show segment, Dr. Charlie Welch, of McLean Psychiatric Hospital, explains how ECT differs from how it was performed in the past: “What’s different first of all is that it’s done under general anesthesia with a muscle relaxant. So when the treatment is done, the patient is sound asleep and completely relaxed.” Call it a kinder, gentler shock treatment.

That was the procedure that my psychiatrist offered me after he had spent a number of years trying me on various medications that either didn’t work, or helped only partially.

My immediate reaction was negative. I recall thinking, “Fuck, NO! Keep away from my brain, you Nazi sadist!” After I calmed down a bit, I did some research.

ECT, my sources said, was a long way from the cruel, stigmatizing procedure portrayed in One Flew Over the Cuckoo’s Nest. The Internet was little help, though. The opinions and experiences of people who had undergone electroshock ranged from “It was hideous” to “It was a miracle.”

Truthfully, I was appalled by the notion of electrical jolts surging through my brain. My precious brain, which had both sustained me and betrayed me throughout my life.

Then I thought some more. So ECT sometimes causes memory loss. I already had that, thanks to some of my meds. I would be altering my brain with electricity. But hadn’t I been altering it for years with chemicals – medications that no one seemed to know how they worked?

So I went back to my doctor and said I would at least talk to the doctor who would perform the procedure. And I lined up a journalist friend to write about my experiences if her editor approved. (Note: In the 60 Minutes piece, former Massachusetts First Lady Kitty Dukakis gave permission to have her treatment filmed and broadcast.)

My psychiatrist, however, had one more medication that he wanted me to try before we took that next step. And it worked. So much for electroshock.

Now as to that side effect of memory loss – Dr. Sarah Lisanby of the National Institute of Mental Health in Maryland has developed a new treatment that seems to avoid that particular consequence.

The procedure is called Magnetic Seizure Therapy (MST) and it uses magnets (duh!) to stimulate more precisely focused seizures than ECT does. These focused seizures seem to avoid the parts of the brain associated with memories. As Dr. Lisanby told the 60 Minutes reporters, “For some people, ECT may still be needed. But if Magnetic Seizure Therapy could be effective without the memory loss who wouldn’t want to try that first?”

Would I try MST if I relapsed into treatment-resistant depression? I would certainly consider it, if it were out of the testing stage by then. And I’d do that before I signed up for ECT. While I have memories I’d prefer to forget, with my luck, those would be the ones left unaffected.

The cynical side of me says that these seizure-causing therapies are becoming more popular because insurance companies like the notion of a short course of 6-8 weeks of treatment instead of years of talk-and-medication. (Although Kitty Dukakis said that she has done ECT for years now and expects to continue into the foreseeable future.)

But I could be wrong. It is possible that some kind of treatment could be short in length but longer-lasting in effectiveness. I’m not ruling it out. At this point I’m not ruling out anything that could aid in my progress and my healing.

 

Comments on: "Would You Try Electroshock?" (19)

  1. I wonder if insurance companies would pay for MST? I’ve heard that they won’t pay for TMS (Transcranial Magnetic Stimulation). They used to pay for VNS (Vagus Nerve Stimulator), a device that stimulates the vagus nerve a little ways from the brain, but won’t anymore. My wife got hers when they’d still pay, and they were willing to replace it when the battery went dead because it was pretty much a life-saver for her, and cost a lot less than the many hospital stays she used to have. I understand that even so, they would not have replaced it if it had been implanted a few months later than it was. I hate insurance companies.

    Liked by 1 person

    • I am glad we have insurance because I can get my prescriptions for $4 apiece. But I stlll don’t trust insurance commpanies to do the right ting.

      Liked by 1 person

      • Yes, insurance is sure better than nothing. My wife and I had Medworks, a kind of Medicaid for people who have disabilities and work. We’d speak for NAMI (In Our Own Voice) for $30 a presentation. Not much, but it qualified us for Medworks. Then we came into some money that put us over resources and NAMI started limiting the program so that we could only do presentations here in town, and we had to have 10 people or more in each audience. We could only get about 5 or 6 per presentation. Without Medworks, we just had Medicare, and the copays and extra med costs were fast using up all the money we’d gotten (although I got a nice truck out of it first), and when that was out we’d be really sunk. So we both got jobs, I’ve worked 4 hours now, and she just got hers yesterday and hasn’t worked yet. We’ll have to put the money that’s left in a trust where we can’t easily access it (which I hate) and try to get my truck not counted as a resource since we need two vehicles for each of us to go to work. I’m afraid that the stress of working is going to destabilize me, but then again, it might not, I am more stable than when I went on disability. At least I got a fun job, selling tools part-time.

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      • Our insurance is through my husband’s job, which is not great but steady. I’m fortunate to be able to work from home, because I couldn’t handle a 9-5 office job without melting down. Some months we make enough to pay the mortgage and some months we don’t. I wasn’t able to get disability because my part-time work-from-home paid too much. I know a lot of people in the same boat, bailing frantically.

        Liked by 1 person

  2. ECT is repetitive Craniocerebral trauma paired with grand mal seizures. It is electrical injury that can cause brain damage, permanent memory loss, and cognitive dysfunction.
    60 minutes did not represent a balanced report. Where was the interview with a person devastated by ECT. Doctors and neurologists who opposed ECT?
    “Memory loss” can be decades wiped out and include an inability to make new memories. There was no mention of increased agitation, anxiety, and depression, triggered mania, trauma, personality changes…
    The 60 Minutes show misleads the public.

    Liked by 1 person

    • The 60 minutes piece was relentlessly positive and, as you say, presented no alternate views. They should probably have another segment on ECT, but probably won’t.

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    • Hey Truth! I just wanted to let you know I’m doing really well. I finished my memoir. It was published by Post Hill Press and it has received wonderful reviews, endorsements, and feedback.

      I was honored Janet mentioned “Birth of a New Brain” in one of her blog posts about mental health books and she wrote some very kind words about my writing, too. (Thanks again, Janet!)

      And to think NONE of that would have happened unless I had lifesaving rounds of unilateral ECT after my father died and bilateral ECT after I went off meds.

      My adorable girls & husband of 20 years and our dog are very happy I’m still here too.

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      • Hello Dyane,

        It is good to hear you are doing well. I have read some of your articles and reviews of your book. You are a dynamic, talented writer with a wonderful sense of humor. You have much to offer those individuals living with bipolar disorder and other mental health issues. You have a beautiful and loving family and a really cute dog. I agree that you were “extremely lucky” regarding your experience with ECT.

        I was not so lucky. I lost 15-20 years of memory, 27 IQ points, my 31 year teaching career, my ability to make new memories or to learn new information. I have PTSD and severe anxiety I did not have before shock. There are 300 ppl in a electroshock survivors group who have variations of
        my outcomes.
        My adorable children are heartbroken at the loss of the smart, bubbly, outgoing, loving, multi-tasking mother they knew for 25 plus years, replaced by a shell, a zombie.
        Anyone “agreeing” to ECT needs to be informed of both possible outcomes.

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      • Im so sorry you had this result. Did you have memory checks before and after each treatment and evaluation daily? Im just trying to figure out what went so horribly wrong so I can be better informed about outcomes different than mine. I signed the whole “I understand there a range of extremely rare complications including death” thing but was under the impression that was mainly due to anesthesia, not treatment, so now I count myself as lucky for having the care I did. Again, I cant imagine your experience, Im so sorry.

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  3. I had a series of ECT treatments. I didn’t complete the whole 8 weeks. After the first one, I didn’t recognize my husband at first. When he got me home I didn’t recognize our house or anything in it. That passed, but I had to learn to cook all over again. I still have some residual memory loss and have a hard time telling my husband what a book I just read is about. I read but retain little information. Yet I can learn people’s names most of the time and remember if I see them from time to time, but it does take effort. It’s blocks of information that I have trouble with, like a long article or a book. My memory isn’t as quick. Granted, some of my cognitive problems are due to my medication, but ECT was a bummer for me. They’re not supposed to do it until your body is free of Lithium. I was hospitalized due to a serious depression when I first had it done and don’t think the lithium was completely out of my system yet–I could be wrong. I have no way of proving that. That was my experience. I’ve heard other people say it worked well for them without any residual side effects. If you do choose to try it, if you take lithium, make sure it is completely out of your system. I wish you well.

    Liked by 1 person

    • I’ve had cognitive difficulties from my meds, but have never taken lithiun. I hope I won’t need to make the choice again, but I do sometimes fear I could relapse into a major depressive state.

      Liked by 1 person

    • Don’t think it has anything to do with the lithium. ECT just causes brain damage, period. Some ppl given fewer number or only ultra brief pulse unilateral have less damage than those given more, higher viltage, BILATERALS, and so on. This lunatic assault isn’t regulated. Outcomes vary- like bad plastic surgery…
      It must be banned. Giving people brain damage is not a “treatment”.

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  4. I had a doctor that wanted me to do ECT. I declined. I wouldn’t do it. It terrifies me.

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  5. Great, comprehensive, very well-written post, Janet! I’m happy you wrote about this topic.

    I’m not sure if you ever saw my HuffPost article “How ECT Helped Me Survive to Battle Bipolar Depression” – here’s the link in case you want to take a peek:

    https://www.huffingtonpost.com/dyane-leshinharwood/how-electroconvulsive-therapy-ect-helped-me-survive-to-battle-bipolar-depression_b_9455412.html

    In my book, I went into greater detail. I’d do ECT again in a heartbeat; I know I was extremely lucky to have such a great experience and minimal side effects.

    Take care & have a good Sunday! 🙂

    Dyane

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  6. I avoided reading this post for awhile bc I had to sort out what to say to the title question. I have had ECT, and I credit it with saving my life. I was so depressed I couldn’t even bother to kill myself, and my (very trusted) psych dr convinced/told me she had tried everything and this was the last resort. I am lucky to live only an hour from the Pennsylvania Psychiatric Institute in Harrisburg, PA, and my mother took me in and helped me through the process. They had 2 MD/PhDs running the ECT program who specialized in only that and were experts. I dont remember the initial meetings bc I was so “out of it” depressed it was like listening to Charlie Browns teacher, but my mother advocated for me and trusted them. I went 3x/week for essentially 5 min treatments. We all had our own personal nurse assigned to us, which made me feel safe. The only thing that troubled me for years after (and this may be just me bc the part of anesthesia that blocks the time BEFORE going under doesnt work on me, but worth mentioning in an honest reply) is that when i was in “holding” next to the procedure room, i could always remember hearing the buzz of the electricity and seeing the person before me wheeled past holding to recovery still jerking from the induced seizure. However, in the 3 years since my experience, TONS of clinical research has come out suggesting that ECT should actually be the FIRST line of treatment for major depression, not the last, and that the issue is mainly horror stories of how it used to be done in the 40s, One Flew Over the Cookoos Nest, etc. I did have side effects of short term memory loss of things happening during the 5 weeks or so of treatment and of some things before, mostly “trivial and temporary” as the Drs predicted, I personally think things I still dont remember are trauma blackouts as opposed to side effects. I said after though it saved me I dont think I could do it again,but a few months ago when I was becoming unstable the first thing I asked my Dr was if I could go get maintenance treatments (ended up not being necessary). Oh, and at the time my only insurance was Medicaid, and it paid for every cent, but insurance through employers are usually way more stingy and have higher deductibles. My advice is to do your research about facilities that provide any such treatments, ask around to drs that refer ppl there, etc. I hope this helped and youre able to find relief.

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    • Thank you SO much for sharing your experience. I found relief through a medication change. My psychiatrist who suggested ECT was great – didn’t push it too hard, was ready to set me up with the local doctor who performed ECT for an interview, when he had the idea of another med. We waited to see if it helped, and it did, a great deal. I don’t rule out the possibility that I might again consider ECT if my meds stop working. I don’t ever want to feel that way again.

      Like

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