Electroconvulsive Therapy ECT

Coinsias · 08-05-2018 3:53pm #1

I was wondering if anyone has had any experience with Electroconvulsive Therapy (ECT). I have depression and have been taking medication for years. They only work for a certain amount of time and the depression always comes back. Every time it's worse.

The Black Oil · 08-05-2018 8:50pm

I think it's a little stigmatised owing to negative press that it's somehow inherently bad, damaging and poorly administered. I saw a tweet the other day from professional speaking about its effectiveness. Is it something your treatment provider can advise on?

https://twitter.com/ProfJimLucey/status/992854335452340225

Freedive Ireland · 08-05-2018 10:55pm

Coinsias, sorry to hear what you are going through.

Ect has made a difference for some people, it has left others with differing types of memory loss. There are 9 approved centres in Ireland afaik but you'd need to be referred by your multidisciplinary team/psychiatrist. It's done under sedation and may also involve maintenance for a period of time. Personally I'd be skeptical as no one really knows how it works and long term efficacy is something of a misnomer in mental health for some reason. That said, I'm not in sure your shoes so I'd leave no stone unturned, just arm yourself with as much knowledge as possible to make an informed decision.

https://academic.oup.com/schizophreniabulletin/advance-article-abstract/doi/10.1093/schbul/sbx136/4201660?redirectedFrom=fulltext

https://journals.lww.com/ectjournal/Abstract/2003/03000/Long_Term_Maintenance_ECT__A_Retrospective_Review.2.aspx

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/492469

SuperRabbit · 09-05-2018 9:07pm

Hey! What about rTMS

ECT's less famous little sister, but with magnets. Like ECT it has been found to work for people for whom antidepressants and counselling didn't, but it has fewer side effects, and I don't think it has any serious ones, no memory loss. You can even drive home afterwards (assuming you can drive on your way in.. it doesn't teach you to drive).

The thing is I don't know how available / affordable it is in Ireland.

Anyone?

Coinsias · 09-05-2018 9:35pm

I've heard of rTMS but it seems to only be available in Dublin. As one of my problems is travelling (or even getting out of the house some days) that would be of no use to me as I live in Galway.

I really wanted to know if anyone has had ECT and if it worked for them and if they had any side effects. I'm terrified it will cause memory loss.

Thanks for all the replies.

Vela · 09-05-2018 10:48pm

Coinsias wrote: »

I've heard of rTMS but it seems to only be available in Dublin. As one of my problems is travelling (or even getting out of the house some days) that would be of no use to me as I live in Galway.

I really wanted to know if anyone has had ECT and if it worked for them and if they had any side effects. I'm terrified it will cause memory loss.

Thanks for all the replies.

I know a guy who had it. He didn't have any crazy side effects but he didn't find it helpful either.

lukesmom · 13-05-2018 11:21pm

I know a lady who had it done and it was a success. She was depression free for 10 years and had further ECT which was again successful. It was difficult after with significant memory loss and mild headaches. However she had exhausted every catagory of anti depressant treatment including the old maoi's. I know in order to get the ECT she had to apply for funding while being an inpatient. I think it cost somewhere in the region of 10,000 euros. Its always a last resort given the cost and the nature of the treatment although it is much less extreme and invasive as it used to be. I presume your psychiatrist has exhausted all other treatments before considering ECT?

Fathom · 15-05-2018 6:12pm

Mayo Clinic uses Electroconvulsive Therapy. Purpose outlined.

wexie · 19-05-2018 4:20pm

Very interesting article here : http://www.bbc.com/future/story/20180502-the-surprising-benefits-of-electroshock-therapy-or-ect

Fathom · 22-05-2018 4:46pm

wexie wrote: »

Very interesting article here : http://www.bbc.com/future/story/20180502-the-surprising-benefits-of-electroshock-therapy-or-ect

Statement from article: "No-one really knows how it works." This causes me to pause.

wexie · 22-05-2018 5:08pm

Fathom wrote: »

Statement from article: "No-one really knows how it works." This causes me to pause.

....Well....yes and no I guess. Personally I'd be less concerned with how it works and more with that it works. If you've been struggling with an illness and someone offers you something that may help but tells you : we don't really know quite how it works but we know that it works and we've seen it work on lots of other people'.....would you chance it?

I've spoken with my fair share of mental health professionals over the past few years and from what I understand it's not at all unusual for them to be able to test that something works without precisely knowing how it works.

Compared to a lot of other medical sciences psychiatry seems to still involve a lot of fumbling around in the dark. Also lots of interesting (promising) research being done with all kinds of substances. There's research being done with Ketamine in St. Patricks Hospital in Dublin. Some university in London did research with psilocybin (shrooms dude!).

http://www.bbc.com/news/health-41608984
http://www.bbc.com/news/health-36247599

Freedive Ireland · 22-05-2018 5:14pm

wexie wrote: »

Compared to a lot of other medical sciences

That's because psychiatry isn't a science.

SuperRabbit · 22-05-2018 5:17pm

Freedive Ireland wrote: »

That's because psychiatry isn't a science.

It's not a science? Then why do you need a degree in medicine to be a psychiatrist and why are all psychiatric drugs extensively tested in randomised controlled trials?

Fathom · 22-05-2018 5:18pm

wexie wrote: »

Compared to a lot of other medical sciences psychiatry seems to still involve a lot of fumbling around in the dark.

Agree. For example. Freudian and neo-Freudian at the individual unit of analysis. Case studies methods. Typically cannot generalize to populations. Also, sampling problematic for women patients. Freud only took those who could pay. Nonprobablistic convenience samples. Is today's psychiatry very different from earlier Freud's in terms of research methods?

Freedive Ireland · 22-05-2018 5:40pm

SuperRabbit wrote: »

It's not a science? Then why do you need a degree in medicine to be a psychiatrist and why are all psychiatric drugs extensively tested in randomised controlled trials?

Because it can't definitively test for something. One psychiatrist may diagnose you with one disorder and another with something else. It's subjective. Don't start me on RCTs:D The ICD and DSM are based on opinions and agreements, it's not a secret. We can test for levels and confirm diabetes, we can't (at present) test for disorders. Worm can opened, sorry.

http://jme.bmj.com/content/40/8/526

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843011/

wexie · 22-05-2018 5:49pm

Freedive Ireland wrote: »

Because it can't definitively test for something. One psychiatrist may diagnose you with one disorder and another with something else. It's subjective. Don't start me on RCTs:D The ICD and DSM are based on opinions and agreements, it's not a secret. We can test for levels and confirm diabetes, we can't (at present) test for disorders. Worm can opened, sorry.

They're very valid (and frustrating if you're dealing with it) points, but I don't know if that justifies calling it 'not a science'.

What you're saying really is : well we don't yet have all the answers (or the technology to even go looking for them) and therefor it's not a science.

But by that rationale you could also write physics off as a science?

By the way, just to clarify in case it wasn't abundantly clear, I'm neither a psychologist nor a psychiatrist, just a long suffering patient with a lot of questions and curiosity

Freedive Ireland · 22-05-2018 6:11pm

I'm neither either Wexie but have gone through my own battles and so armed with a little knowledge, could be a dangerous thing. Imho curiosity is a great thing to have, question things and hopefully find something that works for you. That could be medication, ECT, counselling, cbt, dbt, emdr, mbsr or a combination of things. Being informed gives you agency and if you have decided upon a course of action yourself it's more likely to work, regardless of the course/modality itself.
https://selfdeterminationtheory.org/SDT/documents/2000_RyanDeci_SDT.pdf

Google and/or google scholar is your friend. I'm sure not everyone will agree with me, so take all I say along with what someone else says in disagreement.
Best wishes.

SuperRabbit · 22-05-2018 6:18pm

Anything that carefully and consistently applies the scientific method at every turn is a science. Saying the fact there are still many unknown things disqualifies it from being a science is just not right.

But can we get back on topic? This is a thread where someone is looking for help with depression, not a silly semantic debate about how to categorise a field of medicine.

wexie · 22-05-2018 6:30pm

Well with regards to ECT I've never had any myself, would I consider it based on what little I know, yes probably. Almost certainly if it was suggested by someone I trusted enough.

I have seen and spoken to people who underwent ECT (for depression) and seemingly it helped them. Pretty flaky for a few hours afterwards but I understand that's more likely to have been from the sedatives rather than the actual procedure.

I don't know, however, if it's something you're likely to be able to avail of in anything than an inpatient setting.

So I guess really the only I can help you with is to confirm that it's available in Ireland.
(St. Patricks in Dublin)

Fathom · 26-05-2018 11:46pm

ECT per American Psychiatric Association. See page.

Electroconvulsive Therapy ECT

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