ECT: A Life Saving Treatment
What really happens in Electroconvulsive Therapy?
For as long as I can remember, I’ve always said that ECT would not be a treatment I’d be willing to go through, no matter how deep the depression was.
So why have I now had 12 sessions of this therapy?
Last year I was admitted against my will, under Section 2 of the Mental Health Act, to a psychiatric ward following a serious overdose. I was extremely lucky to survive, though at that time I certainly didn’t feel lucky. I was still immensely suicidal and a huge danger to myself. My mind was completely consumed by depression and I wasn’t able to function or see any hope at all.
It didn’t take long for ECT to be mentioned as a treatment option, it was felt that it would be the fastest and most effective way to bring me out of this depressive episode.
“ECT should be used to gain fast and short-term improvement of severe symptoms after all other treatment options have failed, or when the situation is thought to be life-threatening.” (NICE 2010)
I clearly fitted into this guideline.
So eventually I consented. What did I have to lose? I was in hospital under a section, very unwell, extremely suicidal and completely at the end of my tether. Had I not consented, the team were looking into the path of going forward without my consent. I felt it was better that I consented rather than going down the forced treatment route, though in all honesty I did feel as though I was backed into a corner and didn’t have much fight in me to challenge anyone.
So what exactly is ECT?
“Electroconvulsive therapy, or ECT for short, is a treatment that involves sending an electric current through your brain, causing a brief surge of electrical activity within your brain (also known as a seizure).” (Mind 2019)
There are two types of ECT; unilateral and bilateral.
Unilateral means that the current only passes through one side of the brain and only that side is stimulated. Bilateral means the current passes through the whole brain. Both types causes a seizure. Bilateral is believed to be more effective however it may cause more memory problems and other side effects.
ECT has been around since the 1930’s, and when people have spoken to me about it the majority of them have expressed shock and said such things as:
“But isn’t it barbaric?”
“I didn’t realise they still did that.”
Or the classic:
“Isn’t that what they did in One Flew Over the Cuckoo’s Nest?”
Trust me when I say it’s come a long way from the way they used to practice it back in the day. There is however still a lot of controversy surrounding ECT because of its dark history and potential side effects. If you’re interested in the history and controversy surrounding ECT then you’ll find an abundance of material online.
How is ECT administered now?
I feel the best way for me to tell you about ECT is to walk you through my experience. I had it in the UK in a NHS hospital. Altogether I had 12 sessions of ECT; twice weekly treatments.
Before the procedure:
There are a few necessities to do before having the actual procedure, such as:
- Mood and memory assessments. These are done a few days before the first procedure and then weekly until the end of the treatments. This is so the team can keep track of changes in mood, suicidality and also monitor effects on memory and cognition.
- No eating or drinking after midnight the night before (sips of water are allowed).
- Consent forms need to be signed before each session. This includes signing to say that I would not be left alone, drink alcohol or drive for 24 hours post ECT.
- Blood pressure and temperature are taken on arrival at the clinic.
During the procedure:
Once the above is completed I would be called into a room with a bed and a team of professionals in. The Consultant would always have a quick chat with me about my mood and any side effects whilst the nurses and anaesthetist were prepping me on the bed.
I’d have an ECG connected, an IV line put in, my shoes taken off and a blood pressure put cuff on.
They would then put some gel on my head and attach the electrode pads. I was given bilateral rather than unilateral therefore they put pads on both sides of my temple.
I was then given a muscle relaxant through the IV and the anaesthetist would give me oxygen and administer the anaesthetic. The nurse would always say something along the lines of “think of something nice, we’ll look after you”; this really helped. I’d always think about the seaside or snow falling. I’d drift off quickly and the next time I am aware of anything I’m in the recovery room with the nurses.
My husband was allowed to come in with me for the first few sessions as this was something we agreed together along with the Consultant. Therefore he was able to tell me what happened once I was asleep. He told me they put a mouth guard in so I didn’t chomp down on my tongue and when they administered the shock the only things that moved were my feet. The shock would last for up to a minute.
The team monitored my brain activity on an electroencephalograph (EEG) and once the brain activity had returned to normal, after the seizure, they began the process of bringing me out of the anaesthetic. Overall I was only asleep for a few minutes.
After the procedure:
When I came round again I was in a different room with a couple of nurses. Most of the time I’d come round pretty quickly with no memory loss or other side effects present. Occasionally I’d wake up in hysterics and struggle to calm down and once I was crying uncontrollably and didn’t know who or where I was. That was pretty damn scary. Thankfully my memory came back pretty quickly and I was able to calm down eventually. The nurses were fantastic in helping me calm down and chatting to me. In fact, the whole team were incredible throughout. It made it easier that it was always the same professionals.
Once I’d come round I would be reunited with my chaperone (usually my husband). I would have a drink with a biscuit, have my final physical observations done and then I’d be free to leave the clinic if all was well. I’d always feel pretty groggy for the rest of the day and sometimes into the next day.
Complications:
I’m happy to say that I didn’t have any major complications or side effects from the treatment.
The first session I had left me waking up the next day in a huge amount of pain. You know when you go to the gym and do an exercise class and then the next day you wake up and ache all over? Well it was that kind of pain, all over and in muscles I didn’t know even existed. The next session they switched the muscle relaxant and I had no muscle soreness from subsequent sessions.
Also, I do have pretty awful veins, so trying to get an IV line in was a lot of effort and sometimes quite painful. There was one occasion that we thought the IV had gone into the vein and the anaesthetic was administered. I was told I should be getting sleepy but I remained wide awake. I panicked and informed them I was still wide awake and they weren’t to shock me (as if they would anyway haha). As I’d had the anaesthetic and it hadn’t gone into the vein I was unable to have ECT that day. Safe to say I slept the majority of the day after that and got a few nightmares with the scenario playing out differently. I really shouldn’t have read the literature on how they used to perform ECT…
One of the common side effects of ECT, which a lot of people understandably worry about is memory loss. I don’t think my memory has been impacted by having ECT. It was already slightly off from years of long, recurring depressive episodes. I haven’t noticed it getting any worse since the treatment.
Was ECT successful?
ECT isn’t helpful to everyone. Some people will have it and feel no difference whatsoever. Others may have it and suffer side effects that outweigh the benefits and choose not to continue. Everyone is unique and what works for one person doesn’t necessarily work for another.
I named this post “ECT: A Life Saving Treatment” because to me it really was. I can’t find the words to convey how much of a mess I was before this treatment. I can’t tell you how close I was to not making it through. When I say it’s a miracle I survived my overdose; I’m not exaggerating for dramatic effect.
It took around 6 sessions for my mental health team, the ECT team and loved ones to notice any difference. It took me 8–10 to notice a change.
It was a really weird feeling.
I all of a sudden didn’t feel suicidal anymore.
My fight and will to live came back.
Light came breaking through the darkness and the fog that had been there for so long started to disappear.
I could see colour again.
I could feel love and happiness again.
And I could feel hope again.
For me ECT was successful. It did exactly what it’s designed to do. It got me to a place where I could function again and try to get on the right treatment path for my disorder. It’s given me a second chance at life.
ECT isn’t a cure, I still have a long journey ahead of me. I was told to think of ECT as a reset button, it gets you to a place where you can function better, be safer and gives you a chance to find a treatment that’ll work long term. I still don’t know what that is, and I’m working with my mental health team to find that out.
I’m grateful I was given this treatment and for everyone who didn’t give up on me when I’d given up on myself.
