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Default Sep 05, 2019 at 08:41 AM
  #1
Have you ever had ECT (Electroconvulsive Therapy)? How well did it work for you? What were your other experiences, related to ECT? Does anyone who hasn't had ECT have questions for those of us that have?

Depressions are episodes I have definitely had off and on throughout my life, since about 15 years old. However, I wouldn't say that depressions have dominated in my bipolar experience. I recall an inpatient psychiatrist recommending I have ECT about a year or so before I did (maybe nine and a half years ago). That was during a severe mixed episode. I refused, quite adamantly. It was only after the extended pure depression that followed that I agreed, and likely because my trusted private psychiatrist recommended it.

I had my first treatment outpatient. My husband took me. I was obviously scared, but the ECT psychiatrist had gone over many details. You can't eat for hours before the procedure, and shouldn't drink too much for at least an hour or so before. Therefore, the procedures were done in the morning. Where I was, there were several patients getting the ECT. We were almost set up in an assembly line in beds separated by curtains. People before me got the procedure. Soon before mine, they set me up with heart monitor, some kind of blood pressure sleeves on my arm and near my ankle (no socks on) and then the electrodes on head with a gel-like stuff under them. Very soon before, I was given the muscle relaxant and anesthesia medication intravenously. I became unconscious almost immediately. I had unilateral treatments (electric currents focus on one side of brain), while some people have bilateral (ditto but both sides of the brain). The unilateral is supposed to cause fewer memory issues than bilateral, but may be slightly less effective for some.

After my treatments, I would stay in the bed for a bit after regaining consciousness. Then I was led to the recovery room, where they gave me a beverage and snack and checked my vital signs again and asked me various questions to test my cognitive abilities. They generally want someone to take you home and be with you for hours after anesthesia.

I decided that I wanted to continue my ECT inpatient because my husband couldn't take the time off. I went in almost immediately after my first treatment. After the first, I remember having a sore throat. I'm not sure why. Maybe because of the intubation that helped me breath when unconscious and with the muscle relaxant. That's the only side effect I had THAT time.

After about three or four more treatments, given every other day, I did notice some memory issues, but very minor. By my fifth treatment, I noticed an improvement in my mood (less depression). I received two more (a total of seven) treatments inpatient. Then I went home. They wanted me to have "maintenance" ECT, but I confess that I refused because a) I felt much better, b) I still had no one to take me for outpatient treatments, and c) because my memory issues did become slightly disturbing.

My memory issues were not NOT bad. I definitely didn't forget anything in my life that happened prior to my first few treatments. The time during the remaining ECT treatments was fuzzy. Also, even after returning home some issues were noticed. Little stuff, though. For example, I forgot how my husband took his coffee. I forgot how to get to the place I got blood tests (hubby had to take me to remind me). Also, I forgot that I had stopped drinking alcohol. But in all of these cases, little reminders brought back the memories. My husband said that my minor memory issues lingered on for a few months.

I really should have gotten the maintenance treatments, because my depression slowly returned. But I was stubborn not to continue ECT. It took a while, but my psychiatrist did eventually find a whole new medication cocktail for me that finally worked. I believe that the ECT made that possible, but again, if I had it to do over again, I would have had at least a few more treatments.

I would have ECT again, if I was ever seriously depressed or in mental health crisis that was best helped by it. I do see ECT as a last resort treatment, though.

I look forward to hearing from others on this to learn about any differences or similarities in other experiences. If anything has changed in the ECT procedures, or I remember the experience a bit incorrectly, please say.
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Default Sep 06, 2019 at 07:37 AM
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I know other people here have had ECT. I'd love to hear other experiences. Or if you haven't had it, what do think about it?
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Default Sep 09, 2019 at 01:12 AM
  #3
I had 15 ect treatments spread out in two ip stays earlier this year. Never again! The memory loss was terrible. It wasn’t something I asked for. A new pdoc I didn’t know suggested it strongly for my depression bc nothing was helping med wise. I felt lost so I consented. Never again!

I hated it!
And it didn’t help me so I quit it. Their suggestions??! Oh
Just keeping getting treatments til you’re better. After all that I went back to my regular pdoc and within. Week of med chAnges I was stable.

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Default Sep 16, 2019 at 08:09 PM
  #4
I started ECT in March of 2015. To begin I had a couple weeks of treatments every other day for the intensive introductory series. It may even have been three weeks of that schedule, I don't remember. After that my schedule was increasingly spaced out to the point that now my maintenance treatments come every four weeks.

BirdDancer has described the procedure well. I would only add that since they are inducing a seizure in your brain they also monitor your brainwaves to determine the length of the seizure and thus the success of the procedure. In fact, I once had a seizure of only a few seconds, well under a minute, so my doc kept me hooked up and induced a second one. That one was closer to my usual 90 second response and she was happy with it.

The other thing that is different in my experience from BirdDancer's is the fact that I get bilateral treatments. Unilateral, when we've tried it, simply didn't do anything for me. Yes, bilateral seems to create more and bigger memory holes, but I consider that a reasonable trade-off.

Given that unilateral has grown into the industry standard (though bifrontal is also gaining popularity) if anyone has questions about bilateral I'm happy to field them.

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Default Sep 17, 2019 at 05:26 AM
  #5
Thanks so much for sharing, Daonnachd and HALLIEBETH!
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Default Sep 17, 2019 at 06:01 AM
  #6
I haven't had ECT, but if I slam down into another depression this autumn like I did last year and ended up IP, I'm asking my pdoc to arrange ECT for me. I can't do another one like last year.

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Default Sep 17, 2019 at 06:52 AM
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Originally Posted by BethRags View Post
I haven't had ECT, but if I slam down into another depression this autumn like I did last year and ended up IP, I'm asking my pdoc to arrange ECT for me. I can't do another one like last year.
I hope it doesn't come to that, BethRags, but it's good to have a couple options on the table.
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Wink Sep 19, 2019 at 09:14 PM
  #8
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Originally Posted by BirdDancer View Post
I know other people here have had ECT. I'd love to hear other experiences. Or if you haven't had it, what do think about it?

I haven't had ECT but once while IP, I was told to get a shower quickly because they were taking me for ECT. As soon as I got the water on, he came back and said nevermind that they got the wrong person.

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Default Sep 20, 2019 at 07:13 AM
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I haven't had ECT but once while IP, I was told to get a shower quickly because they were taking me for ECT. As soon as I got the water on, he came back and said nevermind that they got the wrong person.
Oh my goodness! That's kind of scary that they might have made such a mix up, Moose. I'm glad they finally realized their mistake.
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Default Sep 22, 2019 at 04:38 AM
  #10
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I hope it doesn't come to that, BethRags, but it's good to have a couple options on the table.
Thank you, Birdie.

I hear a lot about the ECT memory loss, but meds cause memory loss, too. ECT still has so much stigma attached to it. Odd.

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Default Sep 22, 2019 at 12:28 PM
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Thank you, Birdie.

I hear a lot about the ECT memory loss, but meds cause memory loss, too. ECT still has so much stigma attached to it. Odd.
I think one major reason the stigma remains is One Flew Over the Cuckoo's Nest. That sequence showing Jack Nicholson being forcibly treated then coming out of it completely docile scares people. Sadly, the public doesn't stop to think about the fact that it's a film with an actor trying to make the scene more memorable. Real ECT is nothing like Nicholson's portrayal; the "aftermath" is like any other time you've awakened from anesthesia. Unfortunately, Nicholson is all (or about all) people know.

I think, however, that with the educational videos available online we'll start to see a change in attitude. Although Claire Danes didn't portray it accurately in Homeland, either. There are other depictions you can find on YouTube though

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Default Sep 22, 2019 at 08:54 PM
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Before I had ect they had me watch a video about it in ip

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Default Sep 25, 2019 at 05:08 PM
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How does a person know when it is time for ECT?

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Default Sep 25, 2019 at 05:28 PM
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How does a person know when it is time for ECT?
For me it had been a long road of ineffective meds and even a shot at TMS. I was quite reluctant to do it because I had been present in the '80s when they brought my sis out of treatment. Anesthesia wasn't used then so her experience was horrendous. I remembered what she had gone through and said, "No, thank you." Of course, eventually I changed my mind and opted in.

In general it's used for those patients who aren't responding to meds or for the patients they want a quick response from.

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Default Sep 25, 2019 at 05:37 PM
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How does a person know when it is time for ECT?
I'm sure this varies by person and situation, bipcyclist.

Speaking only for my own experience, I had once rejected the idea when first suggested to me, but then about a year or so later, I agreed to the ECT. The first time suggested, I was in a manic state with mixed features and it was proposed by an inpatient mental health practitioner that I didn't know. I knew very little about ECT at that time, and didn't trust the woman. Plus, being manic, I rejected all kinds of things. It was only after I had gone through the ringer of over 4 years of various manic type episodes, and then crashed into a months long pure depression, that I agreed. And that time it was suggested by my trusted long-time outpatient psychiatrist. The fact was, that I had been trialed on several bipolar medication cocktails, and had suffered some terrible side effects and poor results. ECT did seem like a last resort when I finally agreed, but I don't think it need be for everyone.

I imagine that ECT can seem appealing in cases where people just can't wait to find a good medication cocktail. I mean, what if you had to move somewhere or your employer was threatening that you get better quick or "get lost". The speed of possible ECT results can be appealing.

I have read that people who can't tolerate many medications or maybe women who are pregnant (in severe episodes) may choose ECT. Believe it or not, ECT is generally safe for pregnant women.

I imagine that if you've had a good experience with ECT in the past, you may feel quicker to try it again in the future.

Like many decisions in life, they become easier when we are at the end of our rope. Becoming very educated about a type of treatment (like ECT) can assist in such a decision.

Daonnachd is correct that the movie "One Flew Over the Cukoo's Nest" is a much dramatized and inaccurate presentation. ECT, though obviously scary before the first treatment, is usually regarded as less uncomfortable than a dental cleaning, though of course any procedure with general anesthesia is a serious one.
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Default Sep 26, 2019 at 10:19 AM
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Thanks for feedback, Daonnachd and BirdDancer. Basically. I'm having a ton of suicidal ideation and it is getting worse and my pdoc floated the clozaril idea. I am not real huge on the clozaril idea. So. I'm exploring ECT. We'll see where it goes.

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Default Sep 26, 2019 at 12:30 PM
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Thanks for feedback, Daonnachd and BirdDancer. Basically. I'm having a ton of suicidal ideation and it is getting worse and my pdoc floated the clozaril idea. I am not real huge on the clozaril idea. So. I'm exploring ECT. We'll see where it goes.
I sort of see clozaril as a last resort kind of medication, given all of the blood tests involved (I think more than for Lithium) and other risks. I have heard it can be a real weight gainer, as well. Please do research both thoroughly, and measure the pros vs. cons. I will say that I've heard that clozaril does have a great reputation in terms of efficacy, but its cons are significant. However, like all medications, I've heard some people sing praises of clozaril, and dido for ECT.
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Default Sep 26, 2019 at 09:07 PM
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Thank you, @BirdDancer. That's sort of how I see this whole clozaril thing, too. It just seems like a pretty big burden to take on. Not sure I want to do that. On the other hand, can't continue with this worsening ideation situation, either. That is not tenable.

I'll do some more reading and see how it all shakes out. Thanks for the thoughts!!

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Default Oct 15, 2019 at 06:19 PM
  #19
I have had ect treatments two different times since being diagnosed 17 years ago. Both times saved my life. I received ect for drug resistant psychosis, i dont know if that is a real thing but my psychosis resisted all the drugs. The first time I got treatments i had been in psychosis for 2 years with no break, they were preparing to send me to an institution....ect saved me. It took probably two months going into ect 3 days a week before i decided to just stick with medication. I did take medication throughout ect as well. I became lucid shortly after treatments began..maybe two or three treatments and my thoughts were clear. I still had other manic symptoms for maybe three weeks or so later.

The second time i had ect treatments was a few years later....here's the thing, i dont think this is ect related because it didnt start happening until years after and another long lasting psychosis episode, but the memory of that time in my illness and treatment is next to nil. I will get to what i think about memory loss due to ect and this illness as well, but now i will try to piece together my second major episode that led to ect. I believe this episode was Mixed to begin withI had manic aspects; I was easily agitated, I become mean to my oldest daughter, i just recently learned this by talking with her...I find this odd because in my episodes I trust her most. I think because I also expect her for some reason to understand me, unfortunately this started when she was only 10 and no one could understand me.....Sorry got side tracked, back to other signs i was having...I had need no sleep for days, etc. I also was experiencing looping suicidal thoughts and ideations, and eventually comes delusions, hallucinations leading to psychosis that this time lasted about a year and half. I am always trying the medication route first and I did this time but it didnt take long till i chose ect again...it was harder this time because i was touch and go with reality so they needed me to be clear enough to concent. Once again a couple of treatments and i was out of psychosis and no longer delusional, I kept going to ect for about six to seven months, before deciding i was done. ( each time i chose to stop it was with the pdocs ok)

ECT is an effective treatment, I am alive and but for one more major episode involving psychosis (the length of psychosis was shorter but psychotic features existed for about a year. This epoisode I chose to treat with medication alone and eventually it worked. Though effective there is one major side effect that you are warned about prior to treatment is the short term memory loss. this lasts on an average of a couple months, I did experience this, I experienced lots of things with my memory and mind. Would or will I get Ect ever again because of this? HELL YES! I have a theory about my memory and mind that has caused far more harm than ect did, unless perhaps ect is a part of it (still pro ect), I am brain damaged. It took the last episode free years to learn this mostly by my own experiences and a little research in the internet. Bipolar in itself has been proven to cause brain damage throughout its progression and prolonged psychosis is also known to cause brain damage. Aha!

I dont know if ECT treatments can lead to other forms of memory issues, but i have issues with my memory in general now and thought processes, there is no proof that ect causes this but... as i elluded to earlier it could be a result of all three, ect/bipolar/psychosis, that I have these issues. I would like stated in an earlier post, strongly recommend ect to someone but i would use it as a near last option.

Interesting fact ECT has the least amount of side effects of any other treatment.

OH I forgot,i major side effect i get is a horrific migraine as i am coming out of anesthesia,,,my docs put migraine medicine in my iv prior to starting the procedure and have a pain med for me when i open my eyes....i believe they used unilateral on me because of these migraines, because they had tried bilateral in the beginning.

thanks for your time

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Default Oct 16, 2019 at 12:39 PM
  #20
Thank you so much for sharing about your experiences with ECT, @bpktvikesfan ! I'm happy to read that they served you well. Your situations did sound extreme. It is important for people to know that there is an option beyond medications, when medications fail us.

I, too, have read about and believe experienced the negative effects of bipolar episodes and psychosis on the brain. I experienced memory lapses from severe episodes. I think it's because such severe episodes are traumatic. When we experience trauma, the brain tries to almost "hide" some of it from us for perhaps our sake. Regardless, I was affected from my severe episodes, but I also healed in various ways with time.

I hope you continue to heal. Be well!
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