Wednesday, 31 July 2019

The Efficacy of Electroshock: a Personal Story

By Andrew Turman

Painting by the author.

In this day and age, it perplexes me as to why Electroconvulsive Therapy, or electroshock, still seems to get a bad rap. Some people not only question its use, but also call for the ban of this controversial treatment.

I, for one, can attest to the efficacy of its use for not only depression, but also mania. Just last week, I underwent shock treatment three times to control my mania, upon which the use of very dangerous psychotropic medications do not seem to have any effect.

The treatment itself has seen little change since it was first developed: it involves brief electrical stimulation of the brain while the patient is under general anesthesia. This stimulation induces a grand mal seizure in the patient, which under close monitoring, is harmless. This seems to “reset” the brain, much like rebooting a computer. Extensive research has found ECT to be highly effective for the relief of major depression, as well as being an effective treatment for mania and other mental health disorders.

It seems that people cannot get beyond the images of ECT portrayed in the movie, One Flew Over the Cuckoo’s Nest. In that film, the main protagonist portrayed by Jack Nicholson, was basically lobotomized by his treatment. This is an inaccurate depiction of the true effect of this therapy, at least in my experience, and I have had 126 treatments (and counting!). The worst side effects that I have experienced are nausea (from the anesthetic) and a slight headache. There was one time when I experienced some confusion, but I have continued to work with my psychiatrist, and have resumed treatment. My doctor is very responsive and checks on my mental state and clarity every time I am scheduled for a session. He is very professional and asks about my cognitive state as impairment can be a side effect.

To lessen the chance of cognitive impairment and unwanted side effects, I only receive unilateral, as opposed to bilateral, shocks. It is thought that only stimulating one side of the brain mitigates against the possible negative side effects or brain damage. It is only conjecture that this is true, as the how and why ECT works is largely unknown. Perhaps that is what gives people pause when this treatment is suggested. We simply do not know how or why Electroconvulsive Therapy works. It just does, and I can attest to the fact that this treatment has literally saved my life. I no longer ideate on completing suicide, unless I get psychotically depressed.

Certainly it is not a first line of treatment: the process involves going to a hospital and undergoing sedation. However, a muscle relaxer is also given, to safeguard against the side effects of enduring a grand mal seizure. When I wake up after treatment, groggy from being “put under,” I usually spend the rest of the day relaxing. The biggest side effect I feel is muscle tightness and soreness, a result of my body enduring the seizure. If need be, I can do anything I wish, it does not hinder my functioning. I prefer to hydrate (to flush the anesthetic from my system) and take it easy, but I have gone to work painting windows when I had to.

However, the efficacy of ECT is not in question. It works better than most treatments for depression, including medication. There are questions surrounding relapse, and often maintenance treatments are necessary. I have found that overall I need to have the therapy done every two weeks in order to be stable. Going without treatment longer than that tends to put me in a bad space; either I get manic or depressed.

Sometimes, however, I do need it more often. ECT is an effective tool against depression, but also against mania. Treatments can be given three times a week when my illness cycles out of control, in either direction.

What I hope to accomplish with this essay is a little bit of understanding. I am an advocate for the responsible use of this therapy, which includes informed consent by the subject. No one should be forced to endure electroshock against his or her will. However, people need to understand that it is safe and effective. No treatment is without its risk of side effects, and ECT is no exception. Memory loss is a real concern, to both my doctor and me. Measured against the effects of uncontrolled mania and/or depression, I am willing to take the risk. I am willing to endure the soreness and headaches.

I would like to say a little about my father’s role in my treatment. He would take his “telecommute Monday” off, to get me to my maintenance treatment. We would make a weekend of it, going to Pittsburgh the night before to the Holiday Inn downtown, where he would pay the “hospital rate.” He would get up early to take me to my treatment, take me to Cracker Barrel afterwards, then drop me off at my apartment before driving two and a half hours back to his house. No expense was too great for him to bear, no treatment too extreme, if I got the help I needed.

I am grateful for the profound impact ECT treatment has had on my life and the great relief it has provided, not to mention the improved functionality.

This article was originally published July 2019.

About the Author

W.A. Turman was an “Army Brat,” and that explains a lot. Man of no accent, but also of every accident. Life has not always been easy for the artist and writer we affectionately call “Zen Daddy T.” A gonzo journalist along the lines of Hunter S. Thompson, an artist well-versed in the school of Ralph Steadman, including favoring beers from the Flying Dog Brewery, Andrew is an acquired taste. His abstract expressionist works bleed protest and contentment. His recent series, “Art for Airports” has drawn critical acclaim. Here are his stats: hospitalizations—89; medications—75; suicide attempts—6; ECT treatments—128.

He can be contacted via his blog, on Facebook (Andrew Turman and Zen Daddy T), Instagram (zendaddyt), and Twitter (@ZenTurman).

 

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