| Anna's ECT Diary | |
By Nancy Schimelpfening with "Anna"
Many of you have written to me with questions about Electroconvulsive Therapy (ECT). ECT is a highly controversial treatment for depression. Among the criticisms against it are:
(1) Its effects are short-lived, at best,
(2) It causes brain damage and memory loss, and
(3) Patients are not always completely informed about its risks.
While ECT clearly has its risks, there are times when it is necessary. According to a consensus statement released by the National Institute of Health, "ECT may be necessary when the patient has medical conditions that preclude the use of TCA, MAOI, lithium, and neuroleptics. ECT should be considered in patients with severe depression or psychosis during the first trimester of pregnancy." Further, "ECT should be considered when alternative pharmacological and/or psychotherapeutic treatments have been given an adequate trial without efficacious response. When a patient is nonresponsive to other treatments, factors such as severity of the illness, its natural course, and the risk of other treatments worsening the course (as, for example, antidepressant medications precipitating a manic episode) need to be taken into account."
When a patient becomes a candidate for ECT, these controversies can be very unsettling. While your physician can tell them about the risks, what to expect to happen during the procedure, etc., the one thing your physician cannot tell you is what it actually is like from the patient's point of view. This is why when I heard that a young lady named Anna had postedd a diary of her ECT experiences on the forum, I asked for her permission to reprint it here. I've left it just as she wrote it except for a few notes that I felt necessary to explain certain conventions that are used when posting to Internet or the time line of the diary. A word of caution is given to those who may be offended by graphic descriptions of suicide or off-color language. Here is Anna's ECT diary:
