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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Danielle on May 10, 2000, at 23:37:34
Cam, my DH was admitted to the hospital last night, suicidal inclinations. They have added to the Celexa and Klonopin, Buspar. His pdoc has suggested ECT as a possible treatment option. I was unable to determine from your post on ECT your opinion of the procedure. Do you feel it is a viable option for a young man in his 30's? I am aware that there are usually 6-12 initial treatments, what is the time frame for the initials? How often are subsequent treatments required? And finally are the side effects as detrimental as I keep reading? Or are the patients that have been successfully treated too busy getting on with their lives to participate in discussions on this issue.
Thanks, Danielle
Posted by Cam W. on May 11, 2000, at 0:21:50
In reply to For Cam- ECT, posted by Danielle on May 10, 2000, at 23:37:34
Danielle - I have mostly heard good things about ECT. Most of the horror stories happened years ago. ECT is a little out of my league, but I believe the treatments are about 6 weeks apart. Someone else on this board should be more precise. While any treatment (medication, psychotherapy, surgery or ECT) all can have side effects and/or complications, I have been led to believe that they are minimal (not usually any long term problems) with ECT. •Again, I am no where near an expert in this field, so take this just as heresay on my part.• I guess I am for ECT if someone is not responding to regular treatments and especially if they are suicidal.
Posted by PaulS on May 11, 2000, at 1:48:38
In reply to For Cam- ECT, posted by Danielle on May 10, 2000, at 23:37:34
Danille, ECT treatments are usually done 3 times weekly over a period of 4 weeks. Nowadays they are normally a unilateral treatment which means they only apply the charge to one side of the brain. In more severe casess they may still use the bilateral treatment which increases the side effects...which is usually complaints about short term memory loss.
I have had both the unilateral and bilateral treatment and the foggy memory was much less with the unilateral treatment. At no time have I ever felt that permanent damage was done.
Having said that, I do not know that I can recommend ECT treatment because of the varied responses I have seen. Several people I have met said that ECT saved their lives, quite a few saw no benefit, and a few felt it damaged their memory long term. The last group is not to be taken lightly as depressed people who feel this way (rightly or wrongly) can become even more despondent if they think ECT has done them harm.
My own experience was that it neither hurt nor helped me.ECT still has a strong stigma about it so I would discuss it closely with his doctor...and a few people who have had the treatment if possible, and only go forward with the treatment if the patient is comfortable with trying it.
Hope this helps.
Posted by SLS on May 11, 2000, at 7:08:37
In reply to ECT Treatment, posted by PaulS on May 11, 2000, at 1:48:38
Hi Paul.
> I have had both the unilateral and bilateral treatment and the foggy memory was much less with the unilateral treatment. At no time have I ever felt that permanent damage was done.
A few questions:
- What is your diagnosis? What type of depression do you suffer from - melancholic, atypical, psychotic?
- In what year did you have your treatments?
- With unilateral treatment, which hemisphere did they stimulate?
- How did you respond? Are you on maintenance treatment?I have been diagnosed with bipolar disorder. I remain in a continual state of depression that has lasted for over twenty years. My depression presents as the atypical type, with hypersominia, hyperphagia/weight gain, anergia, slowed thinking, and slowed speech.
I underwent a series of ECT treatments in 1991. The first 6 were unilateral LEFT. Because I experienced no improvement, the next 6 were bilateral. Bilateral treatments definitely affected me more in terms of memory and cognition. It took about a month for these effects to disappear.
How would you compare left unilateral versus right unilateral treatments?
Thanks.
> Having said that, I do not know that I can recommend ECT treatment because of the varied responses I have seen. Several people I have met said that ECT saved their lives, quite a few saw no benefit, and a few felt it damaged their memory long term. The last group is not to be taken lightly as depressed people who feel this way (rightly or wrongly) can become even more despondent if they think ECT has done them harm.A friend of mine underwent several series of ECT without receiving much benefit. She did, however, complain that the treatments had irreversibly damaged her memory. This, of course, did cause her to become more despondent and demoralized. I often tried to console her that her perceived impairments of memory were most likely due to the depression itself. This notion was reinforced by her doctors, but she was convinced otherwise. Since memory disturbances become a more prominent feature of depression as one ages, it must surely have felt to her that her memory impairments had become worse than they were in those years prior to receiving ECT. It was wonderful to see all of her memory problems vanish when she finally responded to treatment. Well, at least she thought they did. She doesn't complain anymore.
This scenario regarding memory may not be universal, but I doubt that it is uncommon.
- Scott
Posted by Chris A. on May 12, 2000, at 0:55:20
In reply to For Cam- ECT, posted by Danielle on May 10, 2000, at 23:37:34
Danielle,
Please e-mail me if you want more info on ECT. It doesn't work equally well for everyone. I'm a veteran of at least forty treatments over a period of 23 years, the last one on Monday.Chris A.
Posted by PaulS on May 12, 2000, at 1:00:10
In reply to Re: ECT Treatment, posted by SLS on May 11, 2000, at 7:08:37
Concerning my ECT treatments, I had 12 bilateral treatments in the early '80s.....this was after years of tricyclic and MAOI treatments and psychotherapy. I was very ill and the ECT muddied my thinking for a few months but I admit my thinking was already very fuzzy and distorted by the illness.
As to my diagnosis, I've been labelled atypical, dysthymic, OCD with suicidal ideation and bipolar type II(not all at once though...lol). None of the labels matter to me...all I know is that my low mood has been an ongoing struggle for myself for 20 years also. My main symptoms are a heavy fatigue, hypersomnia and low mood. Amazing to me, is I managed to work full-time and function fairly normally (to the outside world at least) until the last several years.
My last series of ECT treatments was in 1998; I had six unilateral treatments on the left side and six bilateral.I saw no real improvement from them so I left the hospital and went back to my pdoc. As for maintainance treatment...my pdoc and I are experimenting with Celexa and Dexedrine at the moment. We are also considering ordering Adrafanil from the UK to see if we can hit my lethargy more effectively.
Posted by SLS on May 12, 2000, at 9:23:04
In reply to ECT follow up to SLS, posted by PaulS on May 12, 2000, at 1:00:10
> Concerning my ECT treatments, I had 12 bilateral treatments in the early '80s.....this was after years of tricyclic and MAOI treatments and psychotherapy. I was very ill and the ECT muddied my thinking for a few months but I admit my thinking was already very fuzzy and distorted by the illness.
>
> As to my diagnosis, I've been labelled atypical, dysthymic, OCD with suicidal ideation and bipolar type II(not all at once though...lol). None of the labels matter to me...all I know is that my low mood has been an ongoing struggle for myself for 20 years also. My main symptoms are a heavy fatigue, hypersomnia and low mood. Amazing to me, is I managed to work full-time and function fairly normally (to the outside world at least) until the last several years.
>
> My last series of ECT treatments was in 1998; I had six unilateral treatments on the left side and six bilateral.I saw no real improvement from them so I left the hospital and went back to my pdoc. As for maintainance treatment...my pdoc and I are experimenting with Celexa and Dexedrine at the moment. We are also considering ordering Adrafanil from the UK to see if we can hit my lethargy more effectively.
Thanks and good luck.Please post as to how you respond to adrafinil should you decide to try it. Our symptom profiles are very similar.
I, too, don't know how I managed to work for 13 years with this thing. For what it's worth, this illness, if not adequately treated, gets a bit worse over time. I wouldn't go searching for a recent appearance of character weakness should you be tempted to look for another explanation. This doesn't appear to be an issue with you, though.
Keep up the good work.
- Scott
Posted by Mark H. on May 12, 2000, at 20:48:39
In reply to For Cam- ECT, posted by Danielle on May 10, 2000, at 23:37:34
Dear Danielle,
I am relieved for your sake and your husband's that he has been hospitalized, which signals the severity of the situation that you have been reporting for weeks. Hospitalization will give him enforced rest and good motivation to work actively towards regaining his mental health. It will also let your family and friends know the seriousness of the situation, and hopefully they will be able to give you more support, too.
I do not believe that your husband has received enough different medication trials to warrant ECT at this time. Doctors want to "do something." The economics and social aspects of the practice of medicine are such that doctors experience a great deal of pressure to escalate treatment in response to patient or family complaints. I have no doubt whatsoever that if I went to my doctor every week complaining of stomach pain (whether I had any medically treatable condition or not), within two months I would be operated upon. To extend my analogy, ECT is what doctors "do" when the patient or family becomes desperate and the medications tried thus far have not yet worked. It may be, however, that your husband simply needs time and freedom from stress, and a chance to find the medications that will work for him, in order to begin his recovery.
The most important thing a spouse can do is to honestly ask herself whether she wants the treatment for him or for herself? It will "change" your husband, but will it make an improvement? You and your doctors can feel that you've "done everything" by giving him ECT treatments, but will it have been the right thing? Unfortunately, few people can answer these questions with any certainty.
Remember that in previous times, "the latest and best medical advice" for depression included throwing depressives into the North Sea for a nice chilly shock, giving them insulin overdoses to induce seizures, and even administering trans-orbital lobotomies, which was a nice way of describing slipping a sterilized icepick around the eyeball, whacking it through a thin part of the skull into the brain, and mushing things up a little bit with a wiggle of the handle. The main proponent of this technique actually won the Nobel prize, although his practices were later discredited as barbaric and bizarre. Just because this is the year 2000 is no reason to assume that ECT is a rational, reasonable treatment if you would rather try something else first -- including chicken soup and bed rest, neither of which has yet been discredited.
On the other hand, if your husband is ready, willing and able to kill himself, and he himself wants to try ECT, then it is an option, however risky, that is certainly better than the alternative. If you're ready to throw it all away, what's a few brain cells and memories?
Are the kids helping you yet? My heart goes out to you.
Best wishes,
Mark H.
Posted by Danielle on May 12, 2000, at 23:33:33
In reply to Re: For Cam- ECT, posted by Mark H. on May 12, 2000, at 20:48:39
Mark,
Gosh, Thanks for the help! I was shocked when I called the hospital to check on him, they had told me(the day before) they would call me about visiting. When I called I was informed he didn't want to see me nor have any information relayed to me. WOW, I have been right beside him through all of this, it truely surprised me. I gladly respected this wish and hoped that it was a sign he was taking responsibility for his illness. Wrong, he called tonight to tell me he didn't want to see me and that everything was my fault. He would call when ready to come home. Could someone please explain to me what depression feels like? How does it make one hate those who love them the most? I want to understand his pain, but it is hard to really grasp how horrible it must be. Perhaps this is why he is so mean to me- trying to allow me feel his pain.
Joyfully,
Danielle
Posted by Mark H. on May 13, 2000, at 13:53:16
In reply to Re: For Mark H, posted by Danielle on May 12, 2000, at 23:33:33
Dear Danielle,
That really hurts -- I am so sorry for you that your husband blames you for his depression. I hope the program he is in is good enough to help him come to the point of taking responsibility for his healing. I say "his healing" and not "his illness," because I don't know whether his spiritual beliefs and thinking are such that he perceives his illness as the outcome of past experiences (whether situational or karmic, for instance) , or whether he thinks of himself as an out-and-out victim of the disease. Either is OK, but the focus should be on healing and improving rather than blaming or self-pity.
Your husband's depression is different from mine, but these are my personal answers to your question of what it's like for me. (In other words, please don't assume that everyone experiences depression the same way I do.)
I call depression "the selfish disease," because when I'm severely depressed, I am constitutionally incapable of recognizing or responding to other people's needs and suffering -- I lose my capacity for compassion and understanding. From a Buddhist perspective, few things could be worse.
Depression doesn't "feel" like anything -- even great sadness and uncontrollable weeping is quite a ways up from depression for me. There is a loss of the ability to experience pleasure in even the simplest things, like good food, a beautiful sunset, the laughter of children, or a friendly touch. This is something that no one can imagine who has not experienced it. One example is that a full-body massage from even the most delightful and skilled person would be irritating, unpleasant, and a waste of time and money.
One of the few things that can lift a person out of the mental lethargy of depression is adrenaline -- the body's response to anger or fear -- so it was common for me to look for things to be deeply insulted or enraged about, not realizing that I was basically addicted to the powerful stimulant produced by my own body and just trying to stave off the dulling assault of depression.
Eventually, however, my body ran out of adrenaline, and I would fall into an even deeper depression. It took a long time to realize that I was creating the external circumstances for my rage. Today, when I start getting angry and fearful, the first thing I do is look at the calendar. If it's June, it may be a valid feeling. If it's late August (deep into my depressive cycle), I know to cut the other person a lot of slack, because it probably has nothing to do with that person.
I would suggest you put a large sign on your refrigerator that says, "It's not about me." You need to remind yourself of this several times a day, and so do your kids. One or more of your children may think that just by being alive they may have been the stressor that pushed your husband over the edge and into the hospital. They need to be reassured that they are loved, needed and cherished -- and that their prayers for their father and support for you in getting through each day is important and appreciated.
At 16, I came within a hair's breadth of killing myself because I felt I had heaped too much sorrow on my parents through my impulsive and irresponsible behavior. At that age, it didn't occur to me that I was deeply loved and even more precious to them than their most closely held values. Depression runs in families.
If you can open your heart enough to accept whatever you imagine to be the most awful outcome of this experience -- death, long-term mental illness, divorce, a husband who blames and despises you -- then you will be ready to face whatever actually happens with positiveness and courage. You can and will survive it, and so will your children. Your husband may or may not survive it, or may not be able to continue living with you, or may never take responsibility for his healing. If you accept these possibilities now, you will be ready for anything.
If your school or church or community health center has a counseling or mental health program available, now is the time for you and all of your children to get support. You cannot carry the load for everyone. You cannot afford to have a mental breakdown yourself at this time (you have to take turns *grin*). Embrace humility and courage. Ask for help. Accept it gratefully. Empower your children to help with their own physical and mental and emotional survival and healing.
I think I've said this before, but in a very strange and seemingly perverse way, this has the potential to be the best thing that will ever happen to your family, at the same time that it is also the worst. Do you believe in angels? Do you believe that you can be a conduit for something completely perfect and powerful that is much bigger and wiser than yourself?
Remember, "IT IS NOT ABOUT ME."
Much love and very best wishes,
Mark H.
This is the end of the thread.
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