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Re: ECT --another really long and possibly boring post » Ilene

Posted by Bipolarsux on March 3, 2003, at 5:18:40

In reply to ECT --another really long and possibly boring post » Bipolarsux, posted by Ilene on March 2, 2003, at 11:51:17

Hi Ilene

> I wonder how well experiences of people here reflect the effectiveness of ect, because those for whom it *does* work are unlikely to be posting here. I mean, if you feel well, why hang out with sick people, when you can get on with your life?

Yes. We are all here because we are not feeling well. Probably then we are not a "representative sample," since some people at least must get better!

> I hate the idea of having my brain rearranged by a literally convulsive jolt of electricity. And there is that incredible stigma attached to ect. So I freely confess I am predisposed against it. Even so, I want to investigate anything and everything that could help me. No sense in dismissing it out of hand.

Amen to that. I feel exactly the same. Sometimes though you must steel yourself and trust in the judgement of others (in this case my pdoc). Napolean Bonaparte said of his battle tactics, "On to the fight, then we'll see." It is sort of like that with ECT I guess.
Another one I like is Shakespeare's line about "it takes a storm to bring on clear skies" (or something like that). Time for my neurons to have a storm.


> The consensus is that ect is more effective and safer than other therapies for depression. However...most of us know that drugs and psychotherapy aren't always effective. Effectiveness is relative. "Better than placebo" is sometimes (often?) merely "better than nothing".

Very true.

> Many people are what is called treatment resistant. (The name implies that the *person* resists treatment, but it means we don't get better despite trying a bunch of drugs. Different sources use different numbers for the specific number of drugs.} Ect is less effective for treatment-resistent patients.

I have read that too, and it worries me. After all, once you've tried ECT, where do you go from there?? It is nearly always a last resort.

> Another thing I found: it seems that many if not most people relapse. Doctors have been trying to prevent relapse with more ect, more drugs, more ect plus more drugs...I found only a few articles about what happens to people after a year or more, so it's hard to evaluate relapse rates.

I would definitely relapse: I relapse immediately upon stopping medication. Unless ECT is somehow curative (which I have not seen any evidence for)my pdoc and I have already decided that maintenance ECT would be necessary (presuming it works in the first place).

> Most doctors who like ect minimize the side effects. They say that memory and cognitive problems wear off, or people forget only what happened around the time of treatment. I think they assume if they can't measure these deficits "objectively", they don't exist. I haven't found anything that seriously questions the validity of the tests.

I have given up trying to "predict" how it will affect me - I'm going to give it a try and see.

> So--if you need more ect treatments to keep you from backsliding, wouldn't each one cause more and more fuzziness and forgetfulness?

Like medication, I imagine you would reach a dose-dependent steady state - if you had to get lots of regular ECTs I imagine your "steady state" would be pretty hazy, but maybe less so if you don't need them as often.

> A lot of people would gladly trade some memory for feeling human.

Since considering ECT and its effects on memory, "Blade Runner" has suddenly become my favorite movie as it deals with memories and their central role to "feeling human"!


> Personally, if my pdoc ever presents ect as a serious option, I want to ask her a lot of questions. Assuming I can think of the questions. (Posting messages is one of the few things I can do anymore. I don't know why, when I can't concentrate on day-to-day activities.)

For me:
Medication = poor memory and concentration.
Poorly treated/untreated illness = poor memory and concentration.
ECT = ???
I have the daily problem with cognition as well and I know the pain it must be causing you. (Nevertheless, you write very fluently and coherently - not a bad sign!)

> Please, please, please, pretty please with sugar on top, don't rule out ect because of what I wrote here.

Don't worry. Your views almost match mine perfectly and I thank you very much indeed for your post.
But my mind is already made up: I'm going to trust my doctor on this one and go through with it. In the meantime I've just(!) got to withdraw from Klonopin and figure out a way to keep my job.

Thanks again Ilene.

BPsux


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