![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 21 to 45 of 89. Go back in thread:
Posted by fred on May 9, 2000, at 19:27:01
In reply to Personality disorder is not so shocking anymore , posted by fred on May 9, 2000, at 18:26:06
> > > Hello Nancy,
> > >
> > > I agree that the mentally ill are, for the most part, an invisble group. I've spent an incredible amount of time and energy 'passing for normal', and hiding when I can't. The only people (I believe) who would know I was mentally ill would be other mentally ill people, and, of course, those people who have been close to me.
> > > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
> Hey I'm not mentally ill and I think I could spot you in a crowd. Narcissistic Personality Disorder walking- you're showing baby!!!
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Sorry I have to recall your diagnosis unless you want to be billed-then I guess I could explain my reasoning.I think the flip title of your post was uncalled for.
Minks are electrocuted with an electric probe in their anus. It is legal. It is also controversial. If you stick an electric curling iron up your ample bum and electrocute yourself,you may do it voluntarily,it may be legal, you may find it quite helpful (let us know). But it will still be controversial.
People who were and are being treated forcibly are human beings. Their opinions and lives and wishes are just as important as yours! Just because they don't buy into the mental health industry (much of whose resources are devoted to unhappy menopausal middle class women who make a career out of finding the happy pill and blaming everything on their chemical imbalances) doesn't mean they don't count!
I think this board systematically excludes anyone whose experience doesn't echo the majority. It terrifies me that people like you might be mistaken for the voice of people who haven't chosen mental illness as a lifestyle. Speak for yourself, not in sweeping generalities. ECT is shocking for many people now and all ways. Your heartlessness was also shocking and painful to me personally.
fred
Posted by Janice on May 9, 2000, at 21:24:03
In reply to Re: Janice, posted by fred on May 9, 2000, at 19:27:01
Sorry Fred if I was insensitive towards your experience. I meant to say, for the most part, as far as I know, ECT is not really controversial anymore, but, of course, there are exceptions--and you were obviously one of them.
This is still my opinion.
I could be wrong.
Janice
Posted by fred on May 9, 2000, at 22:22:08
In reply to Fred…, posted by Janice on May 9, 2000, at 21:24:03
> Sorry Fred if I was insensitive towards your experience. I meant to say, for the most part, as far as I know, ECT is not really controversial anymore, but, of course, there are exceptions--and you were obviously one of them.
>
> This is still my opinion.
> I could be wrong.
> Janice
```````````````````````````Janice the issue is FORCED treatment. That is controversial. ECT is also still controversial outside the mental health industry.
Lobotomies are also being done and possibly should be done for people who threaten murder and generally blame their violent behaviour on "seizures or illnesses". You are a victimizer not a victim. No wonder you can't understand.
It's about individuals NOT generalities. It's about the value of ANY innocent human life, not your insensitivity to my personal experience.
It's your opinion and your shame.
Posted by KarenB on May 9, 2000, at 22:49:59
In reply to Re: You Just Don't Get It Janice, posted by fred on May 9, 2000, at 22:22:08
Fred,
It is not required that everyone understand and feel your pain. What you endured was, I am sure, tragic and hideous but it is not Janice's fault that she misunderstood your point...and it is certainly not justifiable, the cruel insults you hurled her way. She is in no way deserving of such battering.
We are friends here. Lighten up. Consider an apology.
Karen
Posted by Cam W. on May 9, 2000, at 23:42:19
In reply to Re: Fred, posted by KarenB on May 9, 2000, at 22:49:59
While preparing for a presentation to public health nurses on depression during pregnancy and postpartum, I came across many journal articles, both for and against ECT. All of the latest ones (last 2 to 3 years) consider ECT to be the best and safest antidepressant therapy we have.
ECT is the treatment of choice in pregnant women with major depression. The high levels of cortisol in a pregnant mom's blood stream do more damage to the baby than either ECT (and it's prep meds) or the SSRIs. ECT is also the treatment of choice in the old-old (>75 yrs).
One article researched psychiatrists' views on ECT worldwide. The findings were that if a psychiatrist was trained in the U.S. in the 1970s, they were less likely to use or recommend ECT. European psychiatrists use it routinely.
The stigma surrounding ECT comes from Hollywood. Movies like "One Flew Over the Cuckoo's Nest" and "Snakepit" paint a dismal picture of this treatment. Granted, in the past, currents were too high and muscle relaxants weren't used. Even today, seeing someone getting an ECT treatment gives me the shivers, but I am told (especially by the people with refractory bipolar disorder that I have presented to) that, other than some amnesia and sometimes a headache, this these treatments have literally saved their lives.
Fred, I am not trying to discount your experience, especially the part about 'forced treatment'. I have not heard of anyone in my area, who wasn't a danger to themselves and not refratory to all medication, to be forced to have an ECT. I actually have never heard of anyone being forced, but then again, I've never asked.
Fred, I really feel for you about your bad experiences. It must have been awful.
Sincerely - Cam
Posted by fred on May 9, 2000, at 23:58:52
In reply to Re: Fred, posted by KarenB on May 9, 2000, at 22:49:59
> Fred,
>
> It is not required that everyone understand and feel your pain. What you endured was, I am sure, tragic and hideous but it is not Janice's fault that she misunderstood your point...and it is certainly not justifiable, the cruel insults you hurled her way. She is in no way deserving of such battering.
>
> We are friends here. Lighten up. Consider an apology.
>
> Karen
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Karen you miss the point. My personal pain is not the issue. The issue is forced treatment.
I have nothing to apologize for.I have no intention of Lightening Up on an issue as serious as this.
My comments were thoughtful and well meant. It is certainly not my fault if you misinterpret them.
Friends don't call friends cruel. Lighten up. Consider an apology.
Violent and homocidal people should not be allowed to hide behind the label "mentally ill".
This is an opinion, not a battering. This is a position in favor of protecting the innocent not an insult.When people refuse to take a stand , it does become their fault. That is why I spoke out.
fred
Posted by Blue Cheer on May 10, 2000, at 1:00:15
In reply to Re: ECT literature search, posted by Cam W. on May 9, 2000, at 23:42:19
> While preparing for a presentation to public health nurses on depression during pregnancy and postpartum, I came across many journal articles, both for and against ECT. All of the latest ones (last 2 to 3 years) consider ECT to be the best and safest antidepressant therapy we have.
>
> ECT is the treatment of choice in pregnant women with major depression. The high levels of cortisol in a pregnant mom's blood stream do more damage to the baby than either ECT (and it's prep meds) or the SSRIs. ECT is also the treatment of choice in the old-old (>75 yrs).
>
> One article researched psychiatrists' views on ECT worldwide. The findings were that if a psychiatrist was trained in the U.S. in the 1970s, they were less likely to use or recommend ECT. European psychiatrists use it routinely.
>
> The stigma surrounding ECT comes from Hollywood. Movies like "One Flew Over the Cuckoo's Nest" and "Snakepit" paint a dismal picture of this treatment. Granted, in the past, currents were too high and muscle relaxants weren't used. Even today, seeing someone getting an ECT treatment gives me the shivers, but I am told (especially by the people with refractory bipolar disorder that I have presented to) that, other than some amnesia and sometimes a headache, this these treatments have literally saved their lives.
>
> Fred, I am not trying to discount your experience, especially the part about 'forced treatment'. I have not heard of anyone in my area, who wasn't a danger to themselves and not refratory to all medication, to be forced to have an ECT. I actually have never heard of anyone being forced, but then again, I've never asked.
ECT is arguably the most effective treatment in the history of psychiatry, but efficacy isn't everything. I've been hospitalized for mania and depression for over 30 years, and have taken 55 Rx psychotropic drugs (56 counting one dose of topiramate). I've read literally hundreds of articles on ECT, from Dr. Max Fink's _Convulsive Therapy_ to articles in _Good Housekeeping. =) In fact, I just read one in the current issue of _Psychology Today_ (p. 23 or 28?). It describes a treatment-refractory bipolar patient who underwent a series of 18 ECT treatments, and now has difficulty remembering where she lives if she strays farther than 4 blocks from her home. Also, I've witnessed the results of ECT in acute-care psychiatric facilities as recently as 1995, and in long-term facilities from the 60's through the 80's. ECT advocates claim an 80% improvement rate as opposed to a 65% improvement rate for drugs -- in depression. My experience has been that approximately one in five improve, and not without sequelae. Although movies have depicted it as a barbaric assault, I'd rather weigh the risk/benefit ratio. Many treatments in medicine are theoretically unappealing (defibrillation of the heart), and not well understood, yet they can be life-saving, too. Although it's a powerful intervention in severe medicine-resistant mania, schizophrenia, and suicidal states (neuroleptic malignant syndrome, too), I'd only use it as a last resort for major depression. Even if it works, booster treatments are often required and sometimes fail. Then you're back to psychopharmacology -- square one. rTMS is an alternative and safer treatment. ~~~ Blue Cheer
Posted by Cam W. on May 10, 2000, at 6:36:49
In reply to Re: ECT literature search, posted by Blue Cheer on May 10, 2000, at 1:00:15
Thanks Blue - There was a time I was very skeptical about rTMS (about 4 months ago). Actually, last year (or was it the year before), the Skeptical Inquirer contained an scathing article against rTMS. I did a literature search for a doctor on it for a lady taking MAOIs (refractory to everything else) who had just become pregnant. They found someone who could give it and in a few treatments worked it like a charm. Placebo effect? I don't know?I still have my reservations, though. An eyewitnessed case report, does not a treatment make. One study I read used a placebo control trial (placement of paddle, fiddle with switches and even had an actual machine sound) and rTMS showed to be no better than placebo. Again, one study, does not a treatment make. I have read subsequent studies praising it's effects, so go figure. We have another treatment for depression that may or may not work (an all too familiar theme).
Thanks again B.C. - Cam
Posted by Janice on May 10, 2000, at 12:08:58
In reply to Re: You Just Don't Get It Janice, posted by fred on May 9, 2000, at 22:22:08
Janice the issue is FORCED treatment.
•Fred, your issue is forced treatment.I was responding to Nancy's thread about her school paper. I thought she had better hear another opinion of ECT, other than the one you gave her. The issue of the thread was not forced treatment or your personal experience. Maybe you should start a new thread?
ECT is also still controversial outside the mental health industry.
•If ECT is still controversial outside the medical community, it's probably because they are not educated about it.
Lobotomies are also being done and possibly should be done for people who threaten murder and generally blame their violent behaviour on "seizures or illnesses".
•If this is happening, please go out there and stop it Fred, but don't treat anyone the way you've treated me, they'd never listen to you!
You are a victimizer not a victim.
•I am neither victimizer nor victum. The world I live in is not this black and white.
No wonder you can't understand.
•You have no idea what I can and can't understand.
It's about individuals NOT generalities.It's about the value of ANY innocent human life, not your insensitivity to my personal experience.
•Sometimes you have to generalize to get anything said. You sure did when you were critisizing me! Maybe you should try stepping back and looking at the big picture every once in a while.
It's your opinion and your shame.
•You honestly don't have any idea about my opinions.
Considering how rude you've been, I most likely won't respond to anymore of your postings. Yes, I imagine, forced treatment would be a terrible experience. I' m sorry anyone has had to experience this.
Janice
Posted by fred on May 10, 2000, at 15:12:50
In reply to Fred, you just don't get it…, posted by Janice on May 10, 2000, at 12:08:58
> Janice the issue is FORCED treatment.
>
> •Fred, your issue is forced treatment.I was responding to Nancy's thread about her school paper. I thought she had better hear another opinion of ECT, other than the one you gave her. The issue of the thread was not forced treatment or your personal experience. Maybe you should start a new thread?
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I was responding to this post on May 8 at 9:22> > Thanks guys! All are great ideas. I like the forced treatment...mmm..that might be interesting to tie in with electroshock. Just a question, but has anyone had electroshock done?
I was discussing forced treatment specifically ECT and offering personal experience.
~~~~~~~~~~~~~~~~~~~~~~~
> •You honestly don't have any idea about my opinions.
> ~~~~~~~~~~~~~~~~~
All I know is what you've posted here.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I most likely won't respond to anymore of your postings.
~~~~~~~~~~~~~~~~~~~~~
I don't think there is anything to be gained from continuing this dialogue either, So at least we end on that note of agreement. Good Afternoon. fred
Posted by Janice on May 10, 2000, at 16:47:14
In reply to Re: one note of agreement /janice, posted by fred on May 10, 2000, at 15:12:50
i don't want 'to get your world'.
Janice
sorry fellow psychobabblers for having to see me stoop to these low levels. I don't know if it's a maturity issue, impulse control, or I am right. Please forgive my pettiness. Janice
Posted by fred on May 10, 2000, at 18:55:05
In reply to You finally get it Fred…, posted by Janice on May 10, 2000, at 16:47:14
Please forgive my pettiness. Janice
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Consider yourself forgiven :)
fred
Posted by Vesper on May 11, 2000, at 17:26:04
In reply to Electroshock is not so shocking anymore…, posted by Janice on May 9, 2000, at 17:55:06
There is a button in my car labelled "ECT"
When you press it, you change the shifting pattern of the automatic transmission.It is supposed to stand for Electronically Controlled Transmission, but every time I press it I expect a little jolt followed by memory loss.
Posted by claire7 on May 11, 2000, at 20:45:51
In reply to Re: Electroshock/My car(they are related, really!), posted by Vesper on May 11, 2000, at 17:26:04
> There is a button in my car labelled "ECT"
> When you press it, you change the shifting pattern of the automatic transmission.It is supposed to stand for Electronically Controlled Transmission, but every time I press it I expect a little jolt followed by memory loss.
> Outsider, here. Eavesdropper, if you will.
Beenreading this board for a week or so. Janice, to an outsider, you are the bully here. I recognize you because I;m a bully, too. I think you got into this innocently enough, but once you were called on it, the hairs on your neck stood up and you went into attack mode instead of stopping to think about experience different from yours. If you could perhaps let down your defenses for a moment and REALLY think about what
Fred's experience has been, maybe you'd learn something. (I admit I'm not impartial. My Mom had ECT back in the 60's, it took her years to overcome the horror of it. Now that she's 79 she's having it every 3 weeks. At present I think (i KNOW) it's a lifesaver, but back then, and for anyone for w2hom it is or feels forced, it's a hell I doubt you can imagine. Could YOU try to be a little more compassionate? )
Posted by quilter on May 11, 2000, at 23:37:19
In reply to Re: Electroshock/My car(they are related, really!), posted by claire7 on May 11, 2000, at 20:45:51
> > There is a button in my car labelled "ECT"
> > When you press it, you change the shifting pattern of the automatic transmission.It is supposed to stand for Electronically Controlled Transmission, but every time I press it I expect a little jolt followed by memory loss.
> >Thanks for the giggle, Vesper! I can relate. Quilter
Posted by Dr. Bob on May 12, 2000, at 4:00:49
In reply to Personality disorder is not so shocking anymore , posted by fred on May 9, 2000, at 18:26:06
> I think I could spot you in a crowd. Narcissistic Personality Disorder walking- you're showing baby!!!
> If you stick an electric curling iron up your ample bum...
> I think this board systematically excludes anyone whose experience doesn't echo the majority.
> You are a victimizer...
> I have nothing to apologize for.
This board more or less systematically excludes anyone whose behavior is repeatedly uncivil. I'm going to try to block you from posting.
Bob
PS: I hope this new registration system makes it easier than last time...
Posted by Greg on May 12, 2000, at 8:09:49
In reply to Re: Electroshock/My car(they are related, really!), posted by claire7 on May 11, 2000, at 20:45:51
While I am an advocate of free speech, and believe that EVERYONE is entitled to their opinion, I think this whole discussion has gone too far. If I were a new person to this board and the first post I read was this one, I would leave and never return! And that would be a crying shame. I think we're all here to get support, not to take each other's inventory.
Just my humble opinion.
Peace,
Greg> > Outsider, here. Eavesdropper, if you will.
> Beenreading this board for a week or so. Janice, to an outsider, you are the bully here. I recognize you because I;m a bully, too. I think you got into this innocently enough, but once you were called on it, the hairs on your neck stood up and you went into attack mode instead of stopping to think about experience different from yours. If you could perhaps let down your defenses for a moment and REALLY think about what
> Fred's experience has been, maybe you'd learn something. (I admit I'm not impartial. My Mom had ECT back in the 60's, it took her years to overcome the horror of it. Now that she's 79 she's having it every 3 weeks. At present I think (i KNOW) it's a lifesaver, but back then, and for anyone for w2hom it is or feels forced, it's a hell I doubt you can imagine. Could YOU try to be a little more compassionate? )
Posted by SLS on May 12, 2000, at 9:02:26
In reply to Re: ECT literature search, posted by Blue Cheer on May 10, 2000, at 1:00:15
Hi Cam. Hi Blue Cheer.
> > ECT is the treatment of choice in pregnant women with major depression.How prevalent is the practice of choosing ECT as the first treatment? Is there any difference in the rate of ECT usage between different countries? Sometimes, the treatment of choice of clinical researchers is not the treatment of choice of the local practitioner.
> > The high levels of cortisol in a pregnant mom's blood stream do more damage to the baby than either ECT (and it's prep meds) or the SSRIs.
Does ECT exert a greater effect on HPA function than do antidepressants?
> > but I am told (especially by the people with refractory bipolar disorder that I have presented to)
Is success rate of ECT as high for bipolar depression as it is for melancholic and psychotic depressions?
> > Fred, I am not trying to discount your experience, especially the part about 'forced treatment'. I have not heard of anyone in my area, who wasn't a danger to themselves and not refratory to all medication, to be forced to have an ECT. I actually have never heard of anyone being forced, but then again, I've never asked.
If someone is committed to a hospital for schizophrenia, psychotic mania, or psychotic or suicidal depression, is it not common for him to be forcibly treated with medication or placed in restraints? I'm not saying that this is a bad thing. Why would ECT be exempt from this sort of rationale? After all, it is effective. Neuroleptics are not without side effect liability, either temporary or permanent.
> ECT is arguably the most effective treatment in the history of psychiatry, but efficacy isn't everything. I've been hospitalized for mania and depression for over 30 years, and have taken 55 Rx psychotropic drugs (56 counting one dose of topiramate). I've read literally hundreds of articles on ECT, from Dr. Max Fink's _Convulsive Therapy_ to articles in _Good Housekeeping. =) In fact, I just read one in the current issue of _Psychology Today_ (p. 23 or 28?). It describes a treatment-refractory bipolar patient who underwent a series of 18 ECT treatments, and now has difficulty remembering where she lives if she strays farther than 4 blocks from her home.
How long has this condition persisted? This is not unusual with bilateral treatments, but is usually temporary. I experienced this for about a month after a series of 6 unilateral followed by 6 bilateral treatments. In addition, the period of time during which a course of treatments is given is sometimes lost from memory, similar to an alcohol "black-out".
> Also, I've witnessed the results of ECT in acute-care psychiatric facilities as recently as 1995, and in long-term facilities from the 60's through the 80's. ECT advocates claim an 80% improvement rate as opposed to a 65% improvement rate for drugs -- in depression. My experience has been that approximately one in five improve, and not without sequelae.
Non-response to antidepressants is a prognosticator of poor response to ECT.
> Although movies have depicted it as a barbaric assault, I'd rather weigh the risk/benefit ratio. Many treatments in medicine are theoretically unappealing (defibrillation of the heart), and not well understood, yet they can be life-saving, too. Although it's a powerful intervention in severe medicine-resistant mania, schizophrenia, and suicidal states (neuroleptic malignant syndrome, too), I'd only use it as a last resort for major depression.
I didn't know it was used for neuroleptic malignant syndrome. In what ways is it helpful? How long does the therapeutic effect last? Are maintenance treatments necessary?
> Even if it works, booster treatments are often required and sometimes fail. Then you're back to psychopharmacology -- square one.
This would not be square one if previous pharmacological intervention had not initiated a response. Often, it takes ECT to bring someone out of a pharmacologically treatment-resistant depression, whereafter, they can be maintained on the same drugs that they were previously unresponsive to.
> rTMS is an alternative and safer treatment. ~~~ Blue Cheer
rTMS has proved to be disappointing. On the other hand, vagus nerve stimulation (VNS) seems to be providing some impressive results. To me, this treatment seems very similar to the implanted portable defibrillators used for cardiac conduction disorders.
It is refreshing to encounter a discourse that is not polarized. (I am not in a position to cast the first stone). Thanks guys.
- Scott
Posted by boBB on May 12, 2000, at 20:13:27
In reply to Re: here we go again (sigh), posted by Dr. Bob on May 12, 2000, at 4:00:49
The curling iron/ample bun comment was clearly out of line in civil conversation, and the claim to be able to diagnose an individual in a crowd, on site alone, is poor practice of a diagnostic method that is widely questioned anyway.
Dr. Bob, or the university, owns the site and the hardware that serves it. By reading ISP numbers and setting cookies, he likely knows more than the rest of us do about how this individual has previously behaved here.
I advocate for clear rules of dialogue, which bar threats or implications of personal injury, and which bar malicious, demeaning and derogatory comments. But it seems problematic to allow relatively anonymous individuals to offer diagnoses while at other times an offer of a diagnosis is considered to be derogatory.
Minimizing someone’s experience of oppression further victimizes the person. Fred may use poor style to write “you are a victimizer” but he might accurately write “you are a person who victimizes.” I wonder if it is fair to exclude him (on this charge) simply because he does not know how to verbally parry and fight using the editorial style of the American Psychology Association.
Psychiatry has a long and rich history of abuse, torture and self-service. The father of modern pshyc was a reputed cocaine addict. Institutions tend to constantly claim their past problems were recently solved, and seldom recognize and account for how their problematic past contributes to current decisions.
In a legal system that claims to allow free speech, and that allows some licensed companies to push psychotropic drugs through persuasive, motivational advertising, while other non-licensed individuals are locked up for life or even threatened with lawful execution for selling very similar drugs, we should be very cautious about who we exclude from public discourse about psychotropic meds and other treatments.
The University of Chicago is a public institution. While Dr. Bob does us all a favor by maintaining this site, his effort also serves his professional purposes by providing proof of public service as is required of tenured members of major academies.
Though I lack detailed knowledge of the University’s history, I suspect it involves large grants of land and other wealth that came over to Anglo-Europeans by divestiture of older, and (I believe) wiser cultures. Even the wood frames of the buildings that house the University was likely hauled down from northern forests which were taken by dubious treaty from Chippewa, Osage, Mennominee and other nations.
My point is that, regardless the letter of the law, or the nuance of administrative rule, this site and this discussion is a public franchise.
Well, I aim to prove Fred wrong on one point. This board has not yet systematically excluded me, and I definitely do not echo the majority. I don’t want to see Fred’s perspective cut out simply because he has not had the same opportunity as I have to make his controversial arguments in an articulate voice.
Okay, back to the discussion of depression...
Any recent regular reader knows I think most depression is situational. I think our culture, with the loss of community, destruction of species and long term ruin of the climate is something worth being depressed about. I think anyone who is not affected by sorrow for the resources we wantonly consume is both sick and morally weak.But out of deference to the medical model, and out of sincere admiration for the practice of science, I wonder what research is being done into depression and the role of amino acids that are precursors of the neurotransmitters associated with depression, specifically, (I think I recall) tryptophan and lysine.
I know that, at a time when a situation was driving my routinely dark mood to an untenable depth, my use of a protein supplement rich in these amino acids correlated to an improvement in my outlook.
Posted by Cam W. on May 12, 2000, at 22:37:02
In reply to Re: ECT literature search, posted by SLS on May 12, 2000, at 9:02:26
Hi Scott
> How prevalent is the practice of choosing ECT as the first treatment [in pregnancy]? Is there any difference in the rate of ECT usage between different countries? Sometimes, the treatment of choice of clinical researchers is not the treatment of choice of the local practitioner.
I was paraphrasing from a study I had read. If a pregnant woman were taking an MAOI, after failing other ADs, I believe that many docs would opt for ECT rather than risking damage to the fetus. Granted, SSRIs have supplanted ECT in North America. I am not sure what Europe is doing. A quick search on Pub Med gives mixed reviews. Case reports of complications interspersed with articles stating the safety of ECT in pregnancy. The article I have at work wasn't listed.
> Does ECT exert a greater effect on HPA function than do antidepressants?Most definitely!
> Is success rate of ECT as high for bipolar depression as it is for melancholic and psychotic depressions?I don't know for sure, but I do know that it is used quite extensively in refractory cases of bipolar disorder, psychotic depressions, and atypical depressions.
> If someone is committed to a hospital for schizophrenia, psychotic mania, or psychotic or suicidal depression, is it not common for him to be forcibly treated with medication or placed in restraints? I'm not saying that this is a bad thing. Why would ECT be exempt from this sort of rationale? After all, it is effective. Neuroleptics are not without side effect liability, either temporary or permanent.I have since talked to a couple of psychiatrists at work and yes, ECT without patient consent (but usually with family consent) is sometimes necessary, when traditional treatments aren't working.
Making a long thread even longer - Cam
Posted by Kim on May 12, 2000, at 22:53:28
In reply to Re: here we go again (sigh), posted by boBB on May 12, 2000, at 20:13:27
At the top of MY babble page it says "This is a board for mutual education and support." Some of the postings on this particular thread have been neither educational nor supportive.
Having had extensive experience with the issue of "free speech" in the context of my professional life, I will add the following in a spirit of education: "FREE SPEECH" is subject to restrictions on the time, place, and manner in which it is presented. (Classically, you may not yell "fire" in a crowded theatre.)
Similarly, I do not believe it is appropriate to allow anyone to repeatedly violate the supportive atmosphere which has been created on this board. As posters to this board, we have created a society which has proved to be remarkably well mannered in dealing with differences of opinion. Strong opinions can be offered without resorting to name-calling or personal attacks.
The vast majority of the members of this board strive to keep this a safe, civilized forum. And the majority of us feel some degree of vulnerability due to our situation. It would be unjust (and very, very sad) if we need to weigh the danger of being attacked before participating in Psycho-Babble.
IMHO
Kim
Posted by bob on May 13, 2000, at 1:54:51
In reply to Free Speech, posted by Kim on May 12, 2000, at 22:53:28
well said, kim
Posted by Phil on May 13, 2000, at 6:10:09
In reply to Re: Free Speech, posted by bob on May 13, 2000, at 1:54:51
> well said, kim
>>I second that.
Posted by Elizabeth on May 13, 2000, at 13:35:31
In reply to Re: here we go again (sigh), posted by Dr. Bob on May 12, 2000, at 4:00:49
> [foulness snipped]
>
> This board more or less systematically excludes anyone whose behavior is repeatedly uncivil. I'm going to try to block you from posting.
>
> Bob
>
> PS: I hope this new registration system makes it easier than last time...Dr. Bob saves the day again. :-)
Posted by Elizabeth on May 13, 2000, at 13:48:49
In reply to Re: ECT literature search, posted by SLS on May 12, 2000, at 9:02:26
> > > ECT is the treatment of choice in pregnant women with major depression.
>
> How prevalent is the practice of choosing ECT as the first treatment? Is there any difference in the rate of ECT usage between different countries? Sometimes, the treatment of choice of clinical researchers is not the treatment of choice of the local practitioner.I don't know the answers to these questions (and I would like to -- they are good questions), but my guess is that SSRIs have more or less replaced ECT. They seem to be perfectly safe (though if I were in that situation I might want to see if I could get through the 1st trimester without the SSRI, just to be extra cautious).
I'd be kind of worried about exposing the fetus to the general anasthetics and neuromuscular blocking agents used in ECT, personally! Not sure this is justified, it's just my gut reaction.
> If someone is committed to a hospital for schizophrenia, psychotic mania, or psychotic or suicidal depression, is it not common for him to be forcibly treated with medication or placed in restraints?A person should not be committed for any of those things. AFAIK, a particular diagnosis is *never* a sufficient reason to commit someone involuntarily (in any of the 50 States, anyway).
> I'm not saying that this is a bad thing. Why would ECT be exempt from this sort of rationale? After all, it is effective. Neuroleptics are not without side effect liability, either temporary or permanent.
Indeed, I think it's safe to say that there is no such thing as an active drug that has no side effects and no risks!
> Non-response to antidepressants is a prognosticator of poor response to ECT.
It's true. There's a selection bias at work, in that people who have ECT are usually those who've failed multiple antidepressants. Also, sometimes it's used as a last resort for conditions for which it's not necessarily indicated, such as severe nonmelancholic depression; this further affects the apparent success rate.
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