My Experience with Electroconvulsive Shock Therapy
What ECT is really like, from a patient’s perspective
tldr: ECT saved my life, putting my treatment resistant depression in remission. This post focuses on what the experience of ECT is like from the patient’s perspective, and does not go into the history of ECT, the benefits and drawbacks, etc.
I am not a doctor. If you are interested in ECT, I encourage you to speak with your doctor or a licensed professional.
What Is ECT?
Electroconvulsive shock therapy, better known as ECT, “involves a brief electrical stimulation of the brain while the patient is under anesthesia”, according to psychiatry.org. Or, in layman’s terms, it’s a therapy where the patient’s brain is intentionally given a seizure while the patient is asleep, under anesthesia.
A brain seizure? Sounds pretty terrifying, right? I thought so! Yet undergoing ECT is what finally helped me, lifting the gray veil of my illness when nothing else would. It quite literally saved my life. Because of that, and all of the false understandings of what ECT is or is not, I want to share the details of what my actual experience at the ECT clinic was like. But first I’ll answer the burning question of why I decided to give ECT a go.
Why ECT?
Like most folks, I only turned to ECT when I had no other choice, all options having failed. This includes multiple medications and combinations, two hospital stays, and even IV ketamine therapy over a sustained period of time. Ketamine did help a bit, but nowhere near enough.
I was terrified of ECT, having only the scene from Requiem for a Dream as reference, but felt I had nothing to lose. So, at my doctor’s recommendation and support system’s request, I went for it.
What Getting ECT Is Really Like
Thankfully, the actual experience of ECT is nothing like the scene in Requiem. Within the world of hospitals and medicine, I would go so far as to say it is even pleasant. I received my treatment at University of Michigan Hospital and consider myself incredibly fortunate to have access to such renowned care.
The hospital is gigantic, resulting in a ten minute walk through various wings and corridors before arriving at the ECT Clinic. After checking in my mom and I would take a seat in the waiting area. Shortly thereafter a nurse would open a door to a room off of the waiting room and wave us in for my intake evaluation. This evaluation is something the patient undergoes at each treatment, not just for the initial. It is used to track the patient’s progress, as well as how severely the treatment is impacting short term memory.
You may notice that I said wave “us” in. That was intentional, as it’s helpful for the care team to hear not just from the patient but from those who spend a lot of time with the patient. This is not only because none of us can report fully accurately on our own moods and behaviors, but because the patient may have forgotten much of what happened in between their ECT sessions. Having someone else there can help to properly report how the patient has been between treatments.
Upon waving us in and shutting the door behind us, my interviewer would begin the evaluation. We would go through a series of questions about how I was doing before I would have to complete a memory test. My answers were then plugged into an algorithmic system that spits out a score, making it easy to see how I am trending over time.
After we finish the questions and memory test the nurse who performed them asks if we have any questions. We always do. And we were always met with a warm smile and comprehensive answer. Once we were done talking, the nurse marks me as ready to go back. My mom and I would return to the waiting area until someone came and got me. They‘d bring me back to the nurses station while someone else set my mom up with a pager.
The nurses at Michigan Medicine were some of the kindest, warmest, most authentic professionals I have met. Though other staff revolved, it was always the same nurses. I am admittedly unsure why that is, but I appreciated it as it’s easier to feel comfortable when things feel familiar.
The nurse who had walked me back would point to one of four beds telling me it’s mine. If I hadn’t passed a pregnancy test yet that month, they would direct me to the bathroom where they had placed a hat to collect my urine. After using the restroom I would go back to ‘my’ bed, put my stuff down, and be greeted by my nurse who took my shoes, coat and purse to bag them. The large, clear, plastic bag would be placed in a hollow opening underneath my bed to remain with me at all times. I would then give a verbal inventory of my belongings to be recorded and lie back in the bed.
Once laying down the nurse would check my name and date of birth before someone came over to start an IV. They somehow got a vein on the first try every time, a thing practically unheard of in my life. A bag of fluids would be started as I accepted the warm blanket offered and worked to get as comfortable as possible. The nurse would take my vitals before someone from anesthesia came out to introduce themselves.
The anesthesia personnel would ask a few questions, including if I have any for them, and make me show them my teeth before saying “ahhh”. With that they’d leave the nurses station.
As I began to feel better I made more conversation with the nurses, all of whom were wonderful humans who excelled at their jobs. Until then, I would lie in silence from the time someone from anesthesia came out until another nurse (I think? She might have been a doctor!) came to roll me back for the procedure.
When she did come to take me back, the first thing she always did was pump my bed up higher and lower my head so that I was lying flat. Then she would push my bed through the corridor until we arrived at the operating room. She would then reposition the bed so that I entered the room backwards, head first. She was a lovely woman who held my hand when I was scared and celebrated my recovery with me in real time.
Once in the room all of the doctors and anesthetists would introduce themselves to me. They’d verify my name and date of birth and that I was there for ECT. That’s about the time my heart starts to beat through my chest. Luckily it’s also when they start the anesthesia and put an oxygen mask over my mouth and nose. I would be told to take a few deep breaths with which I’d wander off. I think my last thought was usually something along the lines of “there’s no way they can knock me out right now! My heart’s…”
Next thing I knew I was awake asking when I go back. I would be assured that the treatment was complete and I was now in recovery. My recovery nurse would introduce themselves and point to their name badge in case I forgot (a common side effect following treatment). They would offer me something to eat and drink, and I most often opted for a diet Pepsi. The anesthesia usually gave me cottonmouth. The nurse would take my vitals every few minutes and, once they determined I was ready to be released, hit the button to ping the pager they had supplied my mom with. It is required for the patient to be accompanied for ECT as you cannot drive for the rest of the day afterward.
Still woozy, I would wake up more by the minute and half greet my mom when she appeared in the recovery room. She and the nurse would help me move both myself and my things to a wheelchair which my mom would push through the maze of hospital until we reached the valet parking station. How she remembered the way is beyond me. I would stay in the wheelchair until the car pulled up, then walk unaided out to the vehicle once it pulled up.
That’s that. It’s over and I was free to do whatever I wanted the rest of the day, barring operating a car or machinery of any kind. And no exercise that day. Some people get tired. I did sometimes, but not always. I was usually confused and out of it the rest of the day though, so I spent treatment days at home watching mindless tv. I often made the mistake of trying to read, which was next to impossible and extremely frustrating.
At the beginning I went to ECT three times a week. This then went down to two and eventually one. All in, it took only a few weeks to complete 12 treatments, the standard course for my disease. ECT, like other medications, can cause withdrawal and it’s important to taper off. Luckily I did not experience withdrawal symptoms.
ECT was not nearly as scary as I thought it would be. Sure it sucked and I never desire to go back, don’t get me wrong. But I would imagine that’s true for most treatments. Take chemo for example. What ECT was is life saving. It gave me myself back, and for that I will be forever grateful to myself, my partner, my family, and last but not least, Michigan Medicine.
Olivia Woods is a new writer for Medium, having debuted her first post on February 1, 2024. Olivia has a background in Corporate Communications, Big Tech & Startups. She lives with her husband and her cat. Show a new writer some love and follow Olivia now!
