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Question
Posted by: Hope* | 2009-03-24

Re: previous Q. ECT.

Hi again CS. I asked you earlier about ECT. If I may ask, in your experience as a psychiatrist, did you find this treatment to be helpful? I know its difficult for you to comment on my situation as you dont know me, but I would like to know what your general thoughts about this therapy is.

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Our expert says:
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I think jcat provides valuable comments based on direct personal experience. Personally, I haven't used or recommended ECT in people under my care for many years --- but then that depends in good degree on the nature of the people I work with. For instance, when I began doing increasing work with people damaged by trauma, ECT is not generally seen as of any value in such situations.
I would agree with jcat --- I don't think it should be used too readily --- I am really concerned about a couple of shrinks who seem to want to use it routinely in people in their first episodes of Depression, which I certainly would not recommend.
But in people who have had multiple episodes of severe depression, not sufficiently responding to medication and other treatments, it probably ought to be considered as an option, and some people find very considerable relief from it. Short-term memory loss early on is probably the most significant possible side-effect.
And the loss seems to be in memory for very recent events during the actual course of treatment, and while some people find that bothersome, I haven't come across any serious problems actually arising from it. Anxiety about this may in itself scramble your memory more than the ECT does --- when one panics about "I can't remember ANYTHING!" it becomes harder to remember anything, until one calms down. I find this in my own memory lapses. In your case, for instance, you happilly remember us on the forum, and how to log in to us and ask the question, and soon --- long-term memory, for things that happened and which you did before the ECT should be unchanged. I wouldn't expect the whole experience to improve your usual quality of memory, but what I suspect your psychiatrist meant is that this currently less than great level of short term memory function will improve.
It's like the guy who came to casualty with a broken arm, and asked the doctor who was putting on the plaster "Whill I be able to play the violin when this heals ?" The doctor said : "Yes, certainly !" And the guy said: "Gee, that's marvellous, I was never able to play the violin before, but I always wanted to !"
A broken bone, actually, can indeed sometimes heal to be stronger than it was previously ; memory at best returns to wherever it was

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Our users say:
Posted by: Hope* | 2009-03-25

Thanks so much Jcat for all the help.

Reply to Hope*
Posted by: jcat | 2009-03-25

Hi Hope*,

- glad I could hep a bit. Often memory can be affected by the various psych drugs as well, so that might be affecting you too.

I know other people who have had ECT and have remembered everything from the entire period, but for me it seems that I forget much of the two or three weeks over which it is spread.
And as CS says, it is short-term memory only, you will continue to remember all the major long term things, but you might forget some of what happens that day. Which, I figure is not that major because who really needs to remember lying around a hospital ward for the day :-) !

As far as improving your memory a bit, it might well do that. If you are feeling happier and more energetic, you might find all the cognitive stuff a bit easier.

Don' t be scared though. Basically, what happens mostly is that the pdocs schedule ECT for early mornings. So you head off to the clinic at sparrow-fart, check in, change into that sexy hospital gown and sit in bed for a bit while they ask the routine questions about previous anaesthetic etc. Then they take you off to theatre where you wait a bit more, and meet the anaesthetist who normally sets up a vein then. You go into theatre, get to see how funny your pdoc looks in a theatre cap, listen to pdoc and anaeth telling bad jokes and before you get to hear the punchline, you are asleep. As with all GA, they do check that you are awake before you leave the theatre, but most likely you will wake up properly back in the ward. They are normally keen that you have lunch before you go, and that someone fetches you. But those are standard for any GA, not because of the ECT.

And as I said, even in the series that didn' t make a huge difference, it didn' t make anything worse either. The times that it worked, it worked amazingly. Literally, within a few days, the whole suicidal depression lifted. Talk to your pdoc about how many he/she wants to do. It should be a minimum of 6, and some docs are keen on 10 to 12. However you feel though, complete the series - it does seem to make a difference.

Hope you are feeling better and happier soon.
Regards,
j

Reply to jcat
Posted by: Hope* | 2009-03-25

Thanks Jcat, its is really the memory problem that worries me the most. Already I can hardly remember anything. Psychiatrist says it may improve memory? She said in people who have a good memory it might cause a little memory loss. I' m confused and scared. Thanks so much Jcat, it is truly nice to hear from someone who has actually undergone this treatment. Regards, Hope*

Reply to Hope*
Posted by: jcat | 2009-03-24

hey hope*,

- I' ve had ECT a few times over the past 15 years of having major depressive interludes. Some of the times it has really helped a lot. And the times where it didn' t make a positive difference, it didn' t make things worse...

The only side effect for me is short term memory. I remember everything pre-ECT, I apparently function quite normally over the treatment period, and memory is normal after a week or two. But I don' t actually remember a lot of what happens around the time, although I did fine at work for most of it. The one funny bit was that I solved a really complex problem in the middle of one set of ECT, but when the problem happened again a year later I had no recollection at all of it ever happening before, never mind what I' d done to fix it then :-( !

There seems to be an lot of negative stuff written about ECT, and in the early days I think some of it was rather haphazardly administered. But of all the people I' ve met in the last decade or two who have had it, no-one has ever had any bad experiences, apart from the odd person who reacts badly to a general anaesthetic. And even they have said that the ECT itself has helped more than it has hindered.

Hope it has positive effects for you if you decide that' s the way to go.

Regards,
j

Reply to jcat

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