What electroconvulsive therapy is like.

I recently made the decision to try and battle a lifelong struggle with depression with ECT, or electroconvulsive therapy. Because it’s such a hot-button issue in the field of psychiatry and there are many conflicting reports out there on the internet, I thought I would write, from the patient’s point of view, what getting an ECT treatment is all about.

In the interest of full disclosure, I would like to mention that I’ve only received one treatment so far. I’m hoping to use this blog to talk about my experiences as I go through them in the next few weeks while I’m getting the remainder of the treatments.

For a full description of ECT and information on if ECT is for you, this is an excellent article.

In preparing for the treatments, you will go through a number of medical tests to ensure that you are healthy enough to undergo treatment. This included, for me, an EKG (a procedure that’s incredibly easy-little round pads are placed on various parts of your body and are hooked up to a machine so that the may record your heart rate on a strip of paper which a Cardiologist then reads) and a series of x-rays of the spine and chest area.

Additionally, they did a blood test to screen for various issues and a urinalysis and an STD blood test. I’m actually not sure why they needed to do some of these screenings.

The night before the treatments, you will be asked to drink or eat nothing after midnight. This is because of the anesthesia and to ensure you won’t aspirate during the treatment and is a standard practice when undergoing many medical tests and procedures.

The morning of the treatments, I was asked to put on a hospital gown and was taken to the area of the hospital where they do preparation for surgery. This, in this particular hospital, is where the treatments take place, and I wasn’t moved from there until after the treatment was done.

Preparation takes a little while. Your vitals will be monitored constantly with a blood pressure cuff and a monitor that will tell them your blood oxygen levels that slips over your finger. An IV will be started-really the only uncomfortable part of the treatments. Technicians will place pads on several parts of your body-for me it was on my chest, head and one leg. These will be wired to a machine that will monitor you during the ECT.

I told everyone that I saw that this was my first treatment and that I was really quite scared, and the staff was sensitive to that. If you are also scared, don’t be afraid to speak up.

Two bigger pads were placed on my temples. This is where the treatments are administered. There are two types of ECT-bilateral and unilateral. I’m going to let a section from the article I mentioned above detail the differences:

There are primarily two types of electrode placements used for the delivery of ECT. Differences between these two techniques include the area of the brain stimulated, timing of response and potential side effects.

Right Unilateral Placement

To generate a seizure with a right unilateral treatment, one electrode is placed on the crown of the head and the other on the right temple. Those receiving the right unilateral treatments may respond somewhat more slowly than those who receive bilateral treatments. This difference is usually no greater than 1 to 2 treatments. Right unilateral treatment is typically associated with less memory side effects. Patients who do not respond to right unilateral treatments may require a switch to bilateral placement.

Bilateral Placement

Bilateral ECT treatment involves placing the electrodes on both temples. This treatment may be associated with more acute memory side effects than right unilateral treatments. Bilateral ECT is indicated for severe mental illnesses including depression with psychosis, manic episodes of bipolar disorder, psychosis related to schizophrenia and catatonia.

The hospital I was in uses bilateral ECT. It’s at this point that I was given some oxygen-and the anesthesiologist actually helped me relax a bit by giving it to me earlier than they normally would and by talking me through thinking of something pleasant.

Then, the medication was given that made me go to sleep. This is given in the IV and is painless minus a slight burning. It takes only a few seconds for it to work. I wasn’t even really able to panic about it, it happened so quickly.

As I understand it, this is when a muscle relaxant is given to prevent muscles from twitching severely. They helped me to breathe by inserting something in my mouth and throat-which I think is also used to help keep the teeth from clenching.

It’s at this point that the ECT treatment is given, under the supervision of a psychiatrist who monitors the machines that will determine if a seizure has occurred.

And then you wake up. I had a little issue with the thing they put in my mouth, which I’m guessing is not something most people go through. Honestly, it’s a little scary to wake up with something going down your throat, and this was, by far, the only really troubling part of the whole thing for me, and in the upcoming treatments they are planning on using a different thing, which hopefully won’t bother me as much as the first one did.

One of the things that’s most scary for people about the treatments is the memory loss. I experienced no memory loss with the first treatment whatsoever. But it isn’t unusual for some to lose memory of the hours before the treatments. It IS unusual, but not unheard of, for someone to lose more significant amounts of memory-up to six months prior to the treatments. But it is very, very rare for that to happen.

Additionally, the short-term memory of some is affected, but it’s not common. This would mean it’d be a little hard to remember small things like phone numbers. But frankly, with the memory loss that comes along with depression I have problems with that anyway, so I considered it an acceptable risk, particularly given that it’s a somewhat rare phenomenon.

And that’s it. They took out the IV and monitored my blood pressure for a little while and I was done.

It’s the day after my first treatment, and the only side effects I’m having are sore muscles (which is common). I had a bit of a headache yesterday but it is now gone. I’m also a little hoarse and sore in my throat from the intubation.

It isn’t uncommon for some people to be really tired following the treatments, and I can say I was pretty groggy. Be sure to schedule the treatments when you can get some rest afterwards.

It will take several treatments, as I understand it, to feel much relief. So don’t expect to come out of the first one feeling markedly better. I’m not sure if I feel much better yet…I’ve also started some new medications recently so any improvement I’m feeling may be a result of that. I am hopeful, though, that I will be feeling improvement soon.

If you are reading this and are curious about treatment, considering treatment and have questions or are nervous about it, feel free to leave a comment for me and I’ll answer your questions as best I can. I did a lot of research before doing this, and on top of the depression I suffer from terrible panic, so really no matter what you might be feeling about going in for treatment I’ve probably also felt it and have thought about it.