Schizophrenia Support Group
Schizophrenia is a psychiatric diagnosis that describes a mental disorder characterized by impairments in the perception of reality and by significant social dysfunction. Untreated schizophrenia is typically characterized by demonstrating disorganized thinking and experiencing delusions or auditory hallucinations.
To Consider Before Getting Electroconvulsive Therapy
Steven J. Strnad
This essay is composed in order to better inform the person considering electroconvulsive therapy (ECT) so that they may better understand the range of possible consequences and adverse affects that shock can have on their life and thus be in a better position to decide if ECT is the right treatment for them. This paper is intentionally one-sided as the author hopes to, with the most sincere intentions, properly inform a person regarding the harm that electroconvulsive therapy can cause. To emphasis the negative possibilities is appropriate and necessary as psychiatry does not provide truthful information regarding the severity of the risks. ECT can and does often save lives. However, in many instances, since it was first introduced, it has had devastating consequences. This has been the case for numerous individuals even in the era named by proponents of this treatment as modified ECT.
Electroconvulsive therapy, also known as shock therapy, is a treatment used to temporarily provide relief in cases of severe depression, and sometimes in cases for catatonia and mania. In the administration of ECT, electrodes are occasionally placed on one side of the head (known as uni-lateral ECT) or more commonly on both sides of the head (known as bi-lateral ECT). After a patient has been given muscle relaxers, as well as anesthesia, a jolt of electricity is sent through the patients head inducing a grand mal seizure which usually lasts between forty to sixty seconds. Due to the use of anesthesia and muscle relaxants, the patient does not feel any pain during the treatment and is safeguarded from any violent convulsions which regularly occurred in the 1940s through the 1960s. An average course of ECT ranges from between six to twelve shocks over a period of two-four weeks.[1] Though the exact mode of therapeutic effect is unknown,[2] it has been suggested by some researchers that ECTs mode of success is through alternation of the chemical messengers in the brain known as neurotransmitters.[3]
Regardless of whether the chemical imbalance theory of ECT is correct, shock therapy is still a controversial treatment[4][5] largely due to the many patient testimonies as well as several scientific studies that have shown cognitive deterioration amongst patients who have received ECT. In recent years, the belief among opponents of ECT has been strengthened by several research studies that have indicated that ECT regularly causes permanent impairments in cognition. The relevant studies include before-and-after IQ scores which have revealed losses of up to 30 to 40 points[6], as well as large scale testing that has indicated permanent global cognitive deficits and memory loss.[7] Other indicators that ECT causes harm to the brain can be evidenced in the adverse effects that the patient experiences in the days, weeks, months, and sometimes years post-shock. Symptoms that nearly all patients experience during the course of treatment include memory loss, headaches, confusion, and in some cases nausea among other things which are undistinguishable from the effects of what a person experiences after suffering from insult to the brain.
A proponent of ECT, researcher Richard Abrams, observed and documented that after one or more treatments ECT routinely produces delirium or an acute organic brain syndrome. In his own words, a patient recovering consciousness from ECT might understandably exhibit multiform abnormalities of all aspects of thinking, feeling, and behaving, including disturbed memory, impaired comprehension, automatic movements, a dazed facial expression, and motor restlessness.[8] In July 2007, a second study was published concluding that ECT routinely leads to chronic, substantial cognitive deficits. The study found that patients treated with ECT for bipolar disorder showed a number of marked deficits across multiple cognitive domains. According to the researchers, "Subjects who had received ECT had further impairment on a variety of learning and memory tests when compared with patients with no past ECT. This could not, according to the researchers, be accounted for through the mental illness itself.[9]
Harold Sackeim, a leading ECT researcher described it as an almost a watershed moment for the field of psychiatry when at an ECT conference in California, two-thirds of a group of two hundred practitioners raised their hands when polled as to whether ECT causes chronic cognitive deficits.[10] Among a significant number of ECT practitioners, it is now no longer a matter of dispute as to whether the induced grand mal seizure through electrical shock is harmful to the brain. Rather the main question amongst many researchers and psychiatrists is whether the cost-benefit ratio weighs in favor of justifying the use of shock.
During ECT treatment the frontal lobes are the part of the brain that gets the most electricity. The frontal lobes contain most of the dopamine-sensitive neurons in the cerebral cortex and are also the part of the brain associated with reward, attention, short-term memory tasks, communication, planning, and drive. Though memory loss has been largely regarded as the most troubling negative side-effect of ECT amongst previous patients as well as those considering treatment, ECT patients have frequently reported difficulties with concentration, comprehension, planning, problem solving, communication skills, as well as having been observed to exhibit apathetic behavior.[11] These symptoms experienced by patients post-shock are consistent with injury to the frontal lobe[12] and may be permanent. It is important for a person considering treatment to recognize that ECT can have adverse effects in a number of cognitive domains besides just on memory. It should also be recognized that the induced amnesia can be anterograde (short-term memory) and/or retrograde (long-term memory) in nature, and both severe and chronic. Short-term memory impairment makes the forming of new memories difficult. Long-term amnesia is the loss of previously stored memory.
A definitive study conducted by Irving Janis[13] in 1950 is consistent with both modern studies and patient reports of permanent memory loss. Janis conducted detailed and exhaustive autobiographical interviews with 19 patients before ECT and then questioned the patients on the same information four weeks afterwards. People who did not have ECT were given the same interviews. According to his findings, "Every one of the 19 patients in the study showed at least several life instances of amnesia and in many cases there were from ten to twenty life experiences which the patient could not recall." Those who did not receive shock were consistently normal. Half of the 19 patients, after being followed up one year after ECT, had no return of memory.
It has been observed that patients have a great tendency to undermine long-term memory loss, especially with the passage of time. For example a patient in the Janis study pre-ECT reported that he had been unable to work for several months prior to hospitalization. This was confirmed by the family. However after 12 ECTs, he was unable to recall the period of unemployment. Instead, he claimed that he had worked right up to his hospitalization. Patients often do not complain to doctors about their memory loss. Instead, they are often convinced that their memory is more complete than it is in actuality.
Other studies have shown that patients are often unaware of the cognitive deficits induced by ECT.[14][15] In June 2008, a Duke University study was published assessing the neuropsychological effects in combination with the perception of patients after ECT. Forty-six patients participated in the study which involved neuropsychological and psychological testing before and after ECT. The study documented substantial cognitive impairment after ECT on a variety of memory tests, including verbal memory for word lists and visual memory of geometric designs. The study further showed that a significant number of the forty-six patients believed that their memory had improved after shock treatment despite the fact that neuropsychological testing clearly showed the opposite. According to the researchers, "There was a slight trend towards [patients reporting] improved memory functioning, despite the objective neuropsychological data indicating significantly lower recognition and delayed recall."[16]
Psychiatrists do not properly inform their patients of the devastating effects that shock may have not only on the patient but on the patients family. This is partly because practicing psychiatrists believe that ECT is life saving and in many cases that the patient is incompetent to decide for themselves if shock is best for them in their present state of mind. Secondly, some ECT practitioners truly do not believe that shocking the brain can cause permanent brain damage because they have been informed by research that is often misleading. This point is an important one and requires a lengthy explanation, one that will not be discussed adequately in this paper. However, if you or a loved one is considering ECT, a well researched explanation can be found in Linda Andres 2009 book, Doctors of Deception: What they do not want you to know about ECT, where she goes in depth to explain in detail how routine damage caused by ECT has been concealed by prominent researchers who have been profiting for years off the shock industry. In her book, Andre also recounts her own devastating experience with ECT, in which she suffered losses of forty points on IQ tests and had permanent amnesia that covered five years of her life, wiping out the vast majority of her college education. Andre in an Interview with the Los Angeles Times in 2003 in an attempt to inform the public of the damage caused by shock treatment commented on a British study that found that when patients helped design or conduct ECT surveys, only one third of the respondents claimed to find ECT helpful, but when doctors designed and conducted the surveys, three-fourths claimed to find ECT beneficial. In Andres words, "This is what happens when you ask patients what they think, you get a completely different story from the one psychiatrists are telling.[17] A third reason that a patient may not be fully informed concerning the risks of shock treatment is likely due in some cases to the financial interests amongst practitioners who in the words of ECT proponent Conrad Melton Swartz, a professor of psychiatry at East Carolina University, Psychiatrists don't make much money and by practicing ECT they can bring their income almost up to the level of the family practitioner or internist.[18] Both the hospital that practice, as well as the performing psychiatrist, in many cases, profit through the administration of ECT as an average course of treatment can range from anywhere between $4,200 to $12,000 ($700-$1000 per treatment). In one relevant study, only half of former ECT patients felt that they had received sufficient information about ECT and its side-effects. In this same study, approximately a third did not feel they had freely consented to ECT even when they had signed a consent form.[19]
If you have considered shock, you might have been told that permanent memory loss and cognitive impairments are extremely rare, that amnesia and confusion are short lived, and all of this is a small price to pay for relief from severe depression. It is important to understand that permanent memory loss and a diminished intellect are not nearly as rare as you will be told by your physician. A study published in 2004 in the Journal of Mental Health reported that 35 to 42% of patients responding to a questionnaire reported ECT resulted in loss of intelligence.[20] Granting that ECT routinely causes brain dysfunction, this is significant since it is widely known that victims of head trauma generally undermine the extent of their own deficiencies[21] suggesting that in actuality the percentage is higher. Further, it has been well established that ECT produces abnormal EEGs[22] in all patients and in many cases for as long as up to six months.[23] This highly suggests that shock therapy causes brain damage.
One reason for discrepancies between the scientific literature and patient testimony is that many patients have reported that when they have confronted their psychiatrist concerning permanent memory loss and cognitive impairments their testimonies are ignored or completely disregarded. Often they are told that their apparent deficiencies are a result of their illness rather than shock. Second, patients are often unaware of the extent of memory loss and diminished intellect. This indicates that many individuals suffering from memory damage and cognitive impairment caused by ECT never have their deficiencies recognized and thus either their stories go unreported.
ECTs primary method of remedying depression often comes at the cost of permanent brain damage while in most cases giving a patient only a short period of relief from their illness, the patient usually relapsing by six months post-treatment.[24] According to researcher and psychiatrist Peter Breggin, the period of relief has not been scientifically shown to exceed four weeks. Breggin suggests that this is the case, since 4 weeks is the approximate time for significant recovery from the most obvious mind-numbing or euphoric effects of the ECT-induced acute organic brain syndrome.[25] It is also important for the patient to realize that ECT has not been shown to have a long-term protective effect against suicide[26][27] and has in some cases, due to the damaging effects, been a contributing factor in a persons decision to commit suicide. One study found that the suicide rate almost double for people undergoing ECT, a 14% death rate compared to about 7.5 % for non-ECT.[28]
There are claims by the psychiatric industry that ECT in its new and improved forms eliminates many of the risks involved with old ECT. The person considering ECT deserves to know how ECT has improved and also in what sense ECT remains to be an extremely risky form of treatment. In the modern use of ECT, the patient is administered anesthesia and muscle relaxants. Thus unlike older forms of ECT, the patient is unconscious throughout treatment. The muscle relaxers keep the patient from violently convulsing during treatment and so protecting the patient from fracture or dislocation of bones. He or she is also given a mouth guard to protect the patient from biting off the tongue or from cracking teeth. Also, artificial respiration is given to compensate for the paralysis of the patient's muscles used for breathing, keeping the patient from suffering from the effects of hypoxia. The physical risks have been greatly reduced; however the amount of electricity sent into the brain in modern forms of ECT is considerably higher than in older forms of shock therapy. Though the size of the electrical impulse has in most cases decreased, the total charge of electricity in modern ECT has greatly increased[29] since the electric currents must be more intense in order to overcome the seizure-threshold due to the anticonvulsant effects of the sedatives that are given during modified ECT.[30]
Patient Depictions
This portion of the essay is a compilation of patient perspective stories chosen for the purpose that the person considering ECT may have a better understanding of the possible risks that ECT can have upon a persons life. The stories recorded here are accounts of devastation caused as a result of ECT. Many more stories can be found upon minimal research of patient perspectives and it is essential that the person considering treatment is made fully aware of possible consequences before consenting to treatment. The number of stories similar to the ones listed below are numerous and thus it deserves to be reiterated that severe permanent memory loss and cognitive impairment are far more common then what you will in many cases be told by your practicing psychiatrist.
I just completed a series of 11 treatments and am in worse shape than when I started. After about 8 treatments I thought I had improved from my depression... I continued and my effects worsened. I began experiencing dizziness and my memory loss increased. Now that I had the 11th my memory and thinking abilities are so bad I wake up in the morning empty-headed. I don't remember many past events in my life or doing things with the various people in my family. It is hard to think and I don't enjoy things. I can't think about anything else. I can't understand why everyone told me this procedure was so safe. I want my brain back.[31]
As a result of these "treatments" the years 1966-1969 are almost a total blank in my mind. In addition, the five years preceding 1966 are severely fragmented and blurred. My entire college education has been wiped out. I have no recollection of ever being at the University of Hartford. I know that I graduated from the institution because of a diploma I have which bears my name, but I do not remember receiving it. It has been ten years since I received electroshock and my memory is still as blank as it was the day I left the hospital. There is nothing temporary about the nature of memory loss due to electroshock. It is permanent, devastating, and irreparable.[32]
In the Washington Post in December 2000, a letter was written to the editor by registered nurse Barbara C. Cody. She wrote that her life was forever changed by 13 outpatient ECTs she received in 1983. In her words,
"Shock 'therapy' totally and permanently disabled me. EEGs [electroencephalograms] verify the extensive damage shock did to my brain. 15 to 20 years of my life were simply erased; only small bits and pieces have returned. I was also left with short-term memory impairment and serious cognitive deficits. ...Shock 'therapy' took my past, my college education, my musical abilities, even the knowledge that my children were, in fact, my children. I call ECT a rape of the soul.[33]
The senior contributing editor of Philadelphia Weekly, Liz Spikol wrote of her ECT in 1996,
"Not only was the ECT ineffective, it was incredibly damaging to my cognitive functioning and memory. But sometimes it's hard to be sure of yourself when everyone 'credible' scientists, ECT docs, researchers are telling you that your reality isn't real. How many times have I been told my memory loss wasn't due to ECT but to depression? How many times have I been told that, like a lot of other consumers, I must be perceiving this incorrectly? How many times have people told me that my feelings of trauma related to the ECT are misplaced and unusual? It's as if I was raped and people kept telling me not to be upsetthat it wasn't that bad[34].
The letters listed below were written by patients and addressed to the FDA. Presently Electroconvulsive Therapy remains a class III device which is the classification for approved products that are considered high risk.
I had 20 electroshock treatments and I regret very much my decision to have any of these treatments. I had to retire from part-time work as a paraprofessional in a local high school and I doubt that I will ever be able to work again. I have forgotten how to weave, could not concentrate on anything, felt very little pleasure in life and still feel suicidal. I often dont remember people who speak to me, much of my past life is gone from my memory, I have cognitive thinking problems, fear being in any social situation, cannot spell, cannot remember factual information, and lead a rather hermit-like existence. I believe I have permanent brain damage as a result of ECT and I do not think I will ever again be as intelligent a person as I was before the electroshock treatments
Sincerely,
Theresa G. Blumen
June 14, 1990[35]
As a former recipient of ECT, I have longingly suffered from memory loss. In addition to destruction of entire blocks of pre-ECT memories, I have continued to have considerable difficulty in memory recall with regard to academic pursuits. To date, of embarrassing necessity, I have been forced to tape-record all education materials that require memorization. This has included basic classes in accounting and word processing materialsCurrently, I am finding it extremely embarrassing and hurtful when fellow classmates (however innocent) refer to my struggles in grasping my study materials, You are an AIR-BRAIN! How can I explain that my struggles are due to ECT? As far as the loss of childhood memories, I often feel as though a very vital part of my life died as a result of these treatments. In particular, when my family refers to specific earlier experiences, I feel a great sense of loss and grief because I cannot share their memories.
Felicia McCarty Winter
May 23, 1988[36]
Nearly twenty years ago, I underwent 30 shock treatments at the Institute of Living in Hartford, Connecticut. As a result I lost two full years of memory. I have one child, a daughter, and the two years that were wiped out of my memory, were the years when she was two and three years old; those memories are irreplaceableMy memories are clear and detailed back to age 2 . But when it comes to those two critical years before I received shock treatments, my mind remains a blankAs an advocate for over 8,000 mental health clients in Maine, I do have contact with many former ECT recipients. I have met many others who have lost of over 20 years worth of memory; I have talked to others who, after shock treatments, were unable to resume their former work and lifestyles because of short term memory damage. I am convinced that brain damage from ECT treatments is not only common, but it is the rule rather than the exception.
Sincerely,
Sally Clay
November 9, 1987[37]
I received over 20 ECTs when I was 17years oldI was told the memories would come back in 6 weeks. I was told that the shock treatments were no more powerful than the batteries in a flashlightI lost 95% of all my memories before the treatments. They never came back. I went back to high school. I did not remember my fellow students. I could not find my classes. It was awful. To this day I look at the school yearbooks hoping some of the pictures will spark a memory. I used to play the violin. I had won 2nd place in duets in the city of Cleveland. (The only reason I know this is because I have the medal in my drawer). I could not remember how to play my violin after the first series of treatments. I was devastatedMy doctor kept saying that one more series would make me wellI have trouble with my memory today. I have been told I have permanent brain damage due to the ECT treatment. My IQ was 120 before treatments and it is not anywhere near that now. I have trouble just trying to cook a meal. I do not work. I make lists so that I can try to remember what I need to do. ECT changed my life forever and not for the better. I wish no one would be given ECTs.
Sue Ann Kulcsar
November 9, 1994[38]
I am one of the many patients who cannot but suspect that ECT caused brain damageI am constantly reminded of what I cannot doalthough I could do it once. And what is it? I cant remember new information with the ease I could before ECT. Distractions and interruptions seriously interfere with information retentionany new bit of information may cancel out the bit that preceded it. My auditory and visual memory seem to function episodicallyenough so I know they exist and how well they functioned before ECT. How have these deficits, which developed immediately after ECT, affected my life?
1. When I returned to my 6th grade teaching job after ECT I could not remember how to teach. Therefore, 5 months after ECT, I attempted suicide.
2. For two and a half years I worked in a kitchen. The loss of income was dramatic but worse was the total loss of confidence and the perception that I was a complete failure.
3. When I dared to take a college course, even multiple readings of the same material yielded next to nothing.
4. In September 1987, I matriculated. However, because the information was complex and largely theoretical, and because I found it hard to remember instructions, I withdrew from school. I am very fortunate that I survived the subsequent depression.
5. Why am I not making the $40,000 I would be making if Id remained in teaching. Why am I praying that Ill find a job that pays me $16,000. Why am I likely to settle for less if it will make few demands on my memory? Im sure I need not answer why?
I had a B average in college. I remembered ideas better than facts. I was not a slave to my studies. One year six months later functioning like that was just a bitter memory. If ECT must be used despite its damaging effects, can we not develop cognitive training programs to help people adapt to their new deficits.
Soncerely,
Pam Maccabee
Janruary 20, 1987[39]
It is 5 and one-half years since my horrifying experience of awaking in a hospital after ECT, not knowing who I was, where I was, who my husband and children were, what were my likes and dislikes, what my family was all about, what classes my children excelled in, what the family liked and disliked, and where I stood in the life that I was supposed to be livingThe damage from ECT can be extreme and completely disabling, to a degree inconceivable except by those who have undergone this horror. A diagnosis of organic brain syndrome or senile dementia after ECT through neuropsychological testing is not taken lightly by a person who had once been an intelligent and fully functioning beingThe heartache and striving for health following brain damage is an illness itself after the damage from ECT.
Pat Gabel
January 25, 1990[40]
Before ECT, I studied math up through calculus. After ECT, I can just barely make change in a store. ECT gives a person a different brain from the one a person had. One never feels sure about his strange new head. Some things come back. A great deal of memory never returns. And one cannot retain new information, so ones future is DEAD.
June Bassett
May 2, 1983[41]
Authors Depiction
In the winter of 2011, at the age of 26, I went through a single course of ECT treatments. I was told by my psychiatrist that permanent memory loss was extremely rare and cognitive impairments were not something to be concerned about since ECT in its modified form was safe and that adverse affects were minor and short-lived. I was persuaded that my memory would return to baseline by six months post-treatment and that persisting memory impairment did not occur often. While hospitalized, I was given a pamphlet, as well as a video to watch that convinced me that there was no evidence that shock therapy caused permanent brain damage. I trusted my doctor that under the circumstances, ECT was the best option for me. If I had been aware of the likelihood of permanent brain damage, I would have never considered ECT as a treatment option.
After one course of ECT, I was extremely bothered when I realized how much it had affected my ability to think clearly as well as how much my memory had been affected. It was over the next couple of days that I realized that the long-term memory loss was much greater than I ever imagined possible and along with the realization that I was having difficulty with forming new memories and learning new information, it began to really concern me and stress me out. I soon realized that memory loss covered the majority of my four year marriage and even fragmented or faded many memories from several years prior to my marriage. It was all very frightening. All I had left were bits and pieces of events that I felt were part of the life of a different person. I knew within the first several weeks after my last treatment, that my brain had been damaged. Though not all of the memories over the period spanning my marriage were completely obliterated, the vast majority had been lost and many of the others remained too vague to be relevant. I had a library of books in a study that, after ECT, I knew almost nothing about. It was also extremely bothersome to recognize faces of people that I knew that were close friends while I had almost no record of our history. These relationships over the next couple months deteriorated because memory of our experiences had been almost entirely obliterated from my mind and I almost completely lost the ability to socialize with them. Also, impairments to thinking including disturbed short-term memory played a significant role in ruining what were dynamic long-term relationships. It was very depressing and frightening as well as considerably humiliating.
Feelings of dread and grief were elevated when I began to realize that the loss of long-term memory was more severe than I had initially realized and that they were not returning as my psychiatrist had told me. I noticed over the first few weeks after treatment that I knew very little about my wife. I had to relearn her birthday, our anniversary, along with lots of other information that was likely less embedded in my mind. She was something of a stranger to me and this was extremely damaging for me psychologically. I had a very poor knowledge of our past together. If I had lost data of something as imbedded in my mind as my wifes birthday, then I knew that memory must have been severely damaged. This was also very hard for her as well as on my immediate family.
Memory was simply gone, although I had pictures and writings that clued me in to what I had been doing over the last several years. Through reasoning from my inability to discuss issues and perform tasks that I was able to do with relative ease prior, I came to understand that the damage caused by ECT was significant and disabling. I did not know where I had previously worked over the last several years; I did not remember standing up in the weddings of two very good friends. I relearned of these events through secondary sources. ECT was damaging to my own sense of identity, as well as to a number of other aspects of my life.
As a result of the treatments, a number of important friendships were completely ruined. As bothersome as this was, the realization that I could tell it had significantly dulled my intelligence, was the most troubling. Forming new memories as well as learning new information is still extremely difficult. For a significant period of time, I could not justifiably have any confidence in my own short-time memory. ECT did not just ruin and eliminate old memories; it caused significant irreversible cognitive impairment. I presently have severe difficulties with reading comprehension for many genres of writing that I did not have pre-treatment and have tremendous difficulty with following conversations and my own train-of-thought. I frequently get lost while driving in the area that I have lived my entire life and previously knew very well. Not only will it take some time to relearn what I had previously known, it will likely take much longer than it originally took to learn since my short-term memory and my ability to concentrate are significantly worsened. Feeling empty-headed, often losing my train-of-thought, as well as experiencing regular headaches are now a regular part of my everyday experience.
The unfortunate reality is that the memory loss from ECT is not just mere forgetting but the complete obliteration of information and events that had occurred. In other words, numerous events are either faded or completely wiped out and to the person that has had them wiped out, it is the same as if they had never took place. A persons life experiences are a major part of what makes an individual the person that he or she is. If you lose enough life experiences, you lose your sense of self.
Presently (as of November, 2011), roughly ten months post-treatment, my memory of the preceding four years remains mostly blank. Very little memory returned. ECT nearly destroyed my marriage, several friendships, altered my personality, stole my knowledge of my past, and has made daily functioning much more difficult than it was previously. My emotions are blunted, feeling numb and as a result I have difficulty relating to others. I voluntarily hospitalized myself on two occasions since the ECTs because I was so disturbed by the results. I felt like a significant part of me died through losing the knowledge of important events and relationships that shaped me into the person that I was.
In September, 2011, I had neuro-psych testing at the University of Michigan which confirmed memory deficits as well as significant difficulties with the ability to retain new information. Presently, I have to keep a notebook in my back pocket in order that I can keep track of daily responsibilities. I regard ECT as the worst event that has ever occurred in my life. ECT damaged my brain and I was not made aware of the potential risks before consenting to treatment. I do not recommend this treatment to anybody that values their sense of self or their intelligence.
Conclusion
Being that a person considering ECT likely suffers from a challenging mental illness, risking damage to an individuals sense of identity that often results from the obliteration of both key autobiographical events in their lives as well as other forms of impaired cognition puts the individual at greater risk for exacerbating psychological difficulties in the future. In the long-term, as the therapeutic effects of ECT are known to be short-lived, ECT may do more harm than good.
One of the most common symptoms that a person suffering from severe depression experiences, well known by all educated psychiatrists, is the difficulty he or she has in making decisions about relatively trivial matters. This is for patients the time when they will often have ECT suggested to them as a treatment option oftentimes while in a delusional state or so severely depressed that they have severe difficulties with very basic thinking. ECT is no small decision. It may have negative repercussions that permanently affect the rest of a persons life, the patient being possibly both psychologically devastated as well as having to suffer from permanent brain damage. Patients at the very least deserve truthful informed consent concerning the reality that ECT causes abnormalities in the brain. Granting that a patient is suffering from severe mental anguish and is being told that permanent adverse effects of ECT are non-existent except in very rare cases, the patient often consents only to awake feeling deceived and in further mental ruin than they did previously. This has been the case in numerous occasions.
Proponents of ECT often suggest that negative depictions exist due to either mal-practice cases, misinformation by activist groups, or due to depictions given prior to modified ECT. The reality is that modified ECT is still an assault on the brain and still regularly devastates lives through damaging a persons understanding of his or her identity. Permanent memory loss and permanent cognitive impairment are still fairly common. Many individuals who have endured a course or several courses of ECT even in its modified form continue to regard ECT as traumatic and extremely damaging, often communicating that it was the worst choice that they had ever made and the most difficult and damaging event to ever have occurred in their lives.[42]
Again, ECTs mode of success is presently unknown.[43] However considering what we presently do know, it is reasonable to believe that when ECT does work, its primary method of success is through damaging a persons brain. The evidence suggests that shock detaches an individual emotionally and intellectually from their phase of depression.
Oftentimes it has been suggested that ECT is analogous to merely rebooting a computer. It has been said, nine out of ten times, all you have to do is reboot it and the problem is solved. From my first-hand experience, a more appropriate analogy would be to say that ECT is like turning off a computer, throwing it down a flight of stairs, and then rebooting it. You may have fixed a particular problem, but in so doing you may very well have created a number of new ones.
Presently, no cognitive rehabilitation is offered to the patient after undergoing a series of ECTs. Long-time opponent of ECT, Peter Breggin explains, If a woman came to an emergency room in a confusional state from an accidental electrical shock to the head, perhaps from a short circuit in her kitchen, she would be treated as an acute medical emergency. If the electrical trauma had caused a convulsion, she might be placed on anticonvulsants to prevent a recurrence of seizures. If she developed a headache, stiff neck, and nausea a triad of symptoms typical of post-ECT patients she would probably be admitted for observation to the intensive care unit. Yet ECT delivers the same electrical closed-head injury, repeated several times a week, as a means of improving mental function.[44] Often a patient is released from psychiatric care immediately following treatment. The person is not given any medical care for the electrically induced seizure. Employed persons are often unable to return to their former work, writers often can no longer articulate, musicians often cannot play their instruments, relationships are destroyed through social impairment and memory dysfunction, and as a consequence, lives are ruined. I will close this essay with an observation of researcher Robert F. Morgan. He writes, even one or two ECT treatments risk limbic damage in the brain leading to retarded speed, coordination, handwriting, concentration, attention span, memory, response flexibility, retention, and reeducation.[45] Much more could be said regarding possible negative consequences of ECT and the author of this essay strongly advises the person considering treatment to consider as best as they can the real potential for severe and permanent negative repercussions.
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7. Sackeim HA, Prudic J, Fuller R, Keilp J, Lavori PW, Olfson M (January 2007). "The cognitive effects of electroconvulsive therapy in community settings". Neuropsychopharmacology 32 (1): 2447.
8. R. Abrams, Electroconvulsive Therapy, 3rd edn, Oxford University Press, New York, 1997.
9. MacQueen G., et al. (2007). "The long-term impact of treatment with electroconvulsive therapy on discrete memory systems in patients with bipolar disorder". Journal of Psychiatry and Neuroscience 32 (4): 2419.
10. The Awakening; Harold Sackeim (You Tube)". 2004. Retrieved September 22, 2009.
11. http://www.sntp.net/ect/breggin1.htm
12. http://www.neuroskills.com/tbi/bfrontal.shtml
13. http://www.ect.org/effects/headinjury.html
14. Feliu M, et al. (June 2008). "Neuropsychological effects and attitudes in patients following electroconvulsive therapy". Neuropsychiatric Disease and Treament 4 (3): 61317.
15. Coleman EA, Sackeim HA, et al. (March 1996). "Subjective Memory Complaints Prior to and Following Electroconvulsive Therapy". Biological Psychiatry. 39 (5): 34656.
16. http://www.ect.org/news/posta.html
17. Therapy and the Brain' Los Angeles Times, November 11, 2003
18. Philpot M, Collins C, Trivedi P, Treloar A, Gallacher S, Rose D: Eliciting users views of ECT in two mental health trusts with a user-designed questionnaire. Journal of Mental Health 13(4): 403413, 2004
19. http://www.neuroskills.com/whattoexpect.shtml
20. http://bjp.rcpsych.org/content/186/1/54.full
21. Feliu M, et al. (June 2008). "Neuropsychological effects and attitudes in patients following electroconvulsive therapy.". Neuropsychiatric Disease and Treament 4 (3): 61317.
22. Electroshock: The Case Against, 1999, pg. 35
23. Blaurock, M., F. Lorimer, M Segal et al. 1950. Focal electroencephalographic changes in unilateral electric convulsion therapy Arch. Neurol. Psychiatry 64: 220-226.
24. Prudic J, Olfson M, Marcus SC, Fuller RB, Sackeim HA (2004). "Effectiveness of electroconvulsive therapy in community settings". Biol. Psychiatry 55 (3): 30112.
25. http://www.sntp.net/ect/breggin1.htm
26. Surgeon General (1999). Mental Health: A Report of the Surgeon General, chapter 4.
27. http://www.ect.org/resources/suicide/suicide.html
28. Black, D. W. et. al. (1989). Does treatment influence mortality in depressives: A follow up of 1076 patients with major affective disorders Annals of Clinical Psychiatry, 1, 3, 165-173.
29. Cameron, D.G. (1994). ECT: Sham statistics, the myth of convulsive therapy, and the case for consumer misinformation. The Journal of Mind and Behavior, 15 (1, 2) Winter, Spring 1994.
30. P.R. Breggin, Electroshock: Its Brain-Disabling Effects, Springer, New York, 1979.
31. http://www.ect.org/effects/headinjury.html
32. http://www.ect.org/effects/headinjury.html
33. Cody, Barbara (Approximately 19952006). "Letters in response to "Shock Therapy: It's Back (Wash. Post, 1996-09-28)"". Washington Post (at HealthyPlace.com. Archived from the original on 2000-12-01.
34. Spikol, Liz (2006-12-22). "Funday: ECT study shocks. Ha ha.". The Trouble With Spikol. Philadelphia Weekly. http://trouble.philadelphiaweekly.com/archives/2006/12/funday_ect_stud.html.
35. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 306.
36. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 306.
37. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 307.
38. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 308.
39. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 309-310.
40. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 312.
41. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 313.
42. www.ect.org/1stperson/index.shtml
43. Rudorfer, MV, Henry, ME, Sackeim, HA (2003). "Electroconvulsive therapy". In A Tasman, J Kay, JA. Rudorfer, MV, Henry, ME, Sackeim, HA (2003). "Electroconvulsive therapy". In A Tasman, J Kay, JA
44. http://www.sntp.net/ect/breggin1.htm
45. Electroshock: The Case Against, 1999, pg. 19
Steven J. Strnad
This essay is composed in order to better inform the person considering electroconvulsive therapy (ECT) so that they may better understand the range of possible consequences and adverse affects that shock can have on their life and thus be in a better position to decide if ECT is the right treatment for them. This paper is intentionally one-sided as the author hopes to, with the most sincere intentions, properly inform a person regarding the harm that electroconvulsive therapy can cause. To emphasis the negative possibilities is appropriate and necessary as psychiatry does not provide truthful information regarding the severity of the risks. ECT can and does often save lives. However, in many instances, since it was first introduced, it has had devastating consequences. This has been the case for numerous individuals even in the era named by proponents of this treatment as modified ECT.
Electroconvulsive therapy, also known as shock therapy, is a treatment used to temporarily provide relief in cases of severe depression, and sometimes in cases for catatonia and mania. In the administration of ECT, electrodes are occasionally placed on one side of the head (known as uni-lateral ECT) or more commonly on both sides of the head (known as bi-lateral ECT). After a patient has been given muscle relaxers, as well as anesthesia, a jolt of electricity is sent through the patients head inducing a grand mal seizure which usually lasts between forty to sixty seconds. Due to the use of anesthesia and muscle relaxants, the patient does not feel any pain during the treatment and is safeguarded from any violent convulsions which regularly occurred in the 1940s through the 1960s. An average course of ECT ranges from between six to twelve shocks over a period of two-four weeks.[1] Though the exact mode of therapeutic effect is unknown,[2] it has been suggested by some researchers that ECTs mode of success is through alternation of the chemical messengers in the brain known as neurotransmitters.[3]
Regardless of whether the chemical imbalance theory of ECT is correct, shock therapy is still a controversial treatment[4][5] largely due to the many patient testimonies as well as several scientific studies that have shown cognitive deterioration amongst patients who have received ECT. In recent years, the belief among opponents of ECT has been strengthened by several research studies that have indicated that ECT regularly causes permanent impairments in cognition. The relevant studies include before-and-after IQ scores which have revealed losses of up to 30 to 40 points[6], as well as large scale testing that has indicated permanent global cognitive deficits and memory loss.[7] Other indicators that ECT causes harm to the brain can be evidenced in the adverse effects that the patient experiences in the days, weeks, months, and sometimes years post-shock. Symptoms that nearly all patients experience during the course of treatment include memory loss, headaches, confusion, and in some cases nausea among other things which are undistinguishable from the effects of what a person experiences after suffering from insult to the brain.
A proponent of ECT, researcher Richard Abrams, observed and documented that after one or more treatments ECT routinely produces delirium or an acute organic brain syndrome. In his own words, a patient recovering consciousness from ECT might understandably exhibit multiform abnormalities of all aspects of thinking, feeling, and behaving, including disturbed memory, impaired comprehension, automatic movements, a dazed facial expression, and motor restlessness.[8] In July 2007, a second study was published concluding that ECT routinely leads to chronic, substantial cognitive deficits. The study found that patients treated with ECT for bipolar disorder showed a number of marked deficits across multiple cognitive domains. According to the researchers, "Subjects who had received ECT had further impairment on a variety of learning and memory tests when compared with patients with no past ECT. This could not, according to the researchers, be accounted for through the mental illness itself.[9]
Harold Sackeim, a leading ECT researcher described it as an almost a watershed moment for the field of psychiatry when at an ECT conference in California, two-thirds of a group of two hundred practitioners raised their hands when polled as to whether ECT causes chronic cognitive deficits.[10] Among a significant number of ECT practitioners, it is now no longer a matter of dispute as to whether the induced grand mal seizure through electrical shock is harmful to the brain. Rather the main question amongst many researchers and psychiatrists is whether the cost-benefit ratio weighs in favor of justifying the use of shock.
During ECT treatment the frontal lobes are the part of the brain that gets the most electricity. The frontal lobes contain most of the dopamine-sensitive neurons in the cerebral cortex and are also the part of the brain associated with reward, attention, short-term memory tasks, communication, planning, and drive. Though memory loss has been largely regarded as the most troubling negative side-effect of ECT amongst previous patients as well as those considering treatment, ECT patients have frequently reported difficulties with concentration, comprehension, planning, problem solving, communication skills, as well as having been observed to exhibit apathetic behavior.[11] These symptoms experienced by patients post-shock are consistent with injury to the frontal lobe[12] and may be permanent. It is important for a person considering treatment to recognize that ECT can have adverse effects in a number of cognitive domains besides just on memory. It should also be recognized that the induced amnesia can be anterograde (short-term memory) and/or retrograde (long-term memory) in nature, and both severe and chronic. Short-term memory impairment makes the forming of new memories difficult. Long-term amnesia is the loss of previously stored memory.
A definitive study conducted by Irving Janis[13] in 1950 is consistent with both modern studies and patient reports of permanent memory loss. Janis conducted detailed and exhaustive autobiographical interviews with 19 patients before ECT and then questioned the patients on the same information four weeks afterwards. People who did not have ECT were given the same interviews. According to his findings, "Every one of the 19 patients in the study showed at least several life instances of amnesia and in many cases there were from ten to twenty life experiences which the patient could not recall." Those who did not receive shock were consistently normal. Half of the 19 patients, after being followed up one year after ECT, had no return of memory.
It has been observed that patients have a great tendency to undermine long-term memory loss, especially with the passage of time. For example a patient in the Janis study pre-ECT reported that he had been unable to work for several months prior to hospitalization. This was confirmed by the family. However after 12 ECTs, he was unable to recall the period of unemployment. Instead, he claimed that he had worked right up to his hospitalization. Patients often do not complain to doctors about their memory loss. Instead, they are often convinced that their memory is more complete than it is in actuality.
Other studies have shown that patients are often unaware of the cognitive deficits induced by ECT.[14][15] In June 2008, a Duke University study was published assessing the neuropsychological effects in combination with the perception of patients after ECT. Forty-six patients participated in the study which involved neuropsychological and psychological testing before and after ECT. The study documented substantial cognitive impairment after ECT on a variety of memory tests, including verbal memory for word lists and visual memory of geometric designs. The study further showed that a significant number of the forty-six patients believed that their memory had improved after shock treatment despite the fact that neuropsychological testing clearly showed the opposite. According to the researchers, "There was a slight trend towards [patients reporting] improved memory functioning, despite the objective neuropsychological data indicating significantly lower recognition and delayed recall."[16]
Psychiatrists do not properly inform their patients of the devastating effects that shock may have not only on the patient but on the patients family. This is partly because practicing psychiatrists believe that ECT is life saving and in many cases that the patient is incompetent to decide for themselves if shock is best for them in their present state of mind. Secondly, some ECT practitioners truly do not believe that shocking the brain can cause permanent brain damage because they have been informed by research that is often misleading. This point is an important one and requires a lengthy explanation, one that will not be discussed adequately in this paper. However, if you or a loved one is considering ECT, a well researched explanation can be found in Linda Andres 2009 book, Doctors of Deception: What they do not want you to know about ECT, where she goes in depth to explain in detail how routine damage caused by ECT has been concealed by prominent researchers who have been profiting for years off the shock industry. In her book, Andre also recounts her own devastating experience with ECT, in which she suffered losses of forty points on IQ tests and had permanent amnesia that covered five years of her life, wiping out the vast majority of her college education. Andre in an Interview with the Los Angeles Times in 2003 in an attempt to inform the public of the damage caused by shock treatment commented on a British study that found that when patients helped design or conduct ECT surveys, only one third of the respondents claimed to find ECT helpful, but when doctors designed and conducted the surveys, three-fourths claimed to find ECT beneficial. In Andres words, "This is what happens when you ask patients what they think, you get a completely different story from the one psychiatrists are telling.[17] A third reason that a patient may not be fully informed concerning the risks of shock treatment is likely due in some cases to the financial interests amongst practitioners who in the words of ECT proponent Conrad Melton Swartz, a professor of psychiatry at East Carolina University, Psychiatrists don't make much money and by practicing ECT they can bring their income almost up to the level of the family practitioner or internist.[18] Both the hospital that practice, as well as the performing psychiatrist, in many cases, profit through the administration of ECT as an average course of treatment can range from anywhere between $4,200 to $12,000 ($700-$1000 per treatment). In one relevant study, only half of former ECT patients felt that they had received sufficient information about ECT and its side-effects. In this same study, approximately a third did not feel they had freely consented to ECT even when they had signed a consent form.[19]
If you have considered shock, you might have been told that permanent memory loss and cognitive impairments are extremely rare, that amnesia and confusion are short lived, and all of this is a small price to pay for relief from severe depression. It is important to understand that permanent memory loss and a diminished intellect are not nearly as rare as you will be told by your physician. A study published in 2004 in the Journal of Mental Health reported that 35 to 42% of patients responding to a questionnaire reported ECT resulted in loss of intelligence.[20] Granting that ECT routinely causes brain dysfunction, this is significant since it is widely known that victims of head trauma generally undermine the extent of their own deficiencies[21] suggesting that in actuality the percentage is higher. Further, it has been well established that ECT produces abnormal EEGs[22] in all patients and in many cases for as long as up to six months.[23] This highly suggests that shock therapy causes brain damage.
One reason for discrepancies between the scientific literature and patient testimony is that many patients have reported that when they have confronted their psychiatrist concerning permanent memory loss and cognitive impairments their testimonies are ignored or completely disregarded. Often they are told that their apparent deficiencies are a result of their illness rather than shock. Second, patients are often unaware of the extent of memory loss and diminished intellect. This indicates that many individuals suffering from memory damage and cognitive impairment caused by ECT never have their deficiencies recognized and thus either their stories go unreported.
ECTs primary method of remedying depression often comes at the cost of permanent brain damage while in most cases giving a patient only a short period of relief from their illness, the patient usually relapsing by six months post-treatment.[24] According to researcher and psychiatrist Peter Breggin, the period of relief has not been scientifically shown to exceed four weeks. Breggin suggests that this is the case, since 4 weeks is the approximate time for significant recovery from the most obvious mind-numbing or euphoric effects of the ECT-induced acute organic brain syndrome.[25] It is also important for the patient to realize that ECT has not been shown to have a long-term protective effect against suicide[26][27] and has in some cases, due to the damaging effects, been a contributing factor in a persons decision to commit suicide. One study found that the suicide rate almost double for people undergoing ECT, a 14% death rate compared to about 7.5 % for non-ECT.[28]
There are claims by the psychiatric industry that ECT in its new and improved forms eliminates many of the risks involved with old ECT. The person considering ECT deserves to know how ECT has improved and also in what sense ECT remains to be an extremely risky form of treatment. In the modern use of ECT, the patient is administered anesthesia and muscle relaxants. Thus unlike older forms of ECT, the patient is unconscious throughout treatment. The muscle relaxers keep the patient from violently convulsing during treatment and so protecting the patient from fracture or dislocation of bones. He or she is also given a mouth guard to protect the patient from biting off the tongue or from cracking teeth. Also, artificial respiration is given to compensate for the paralysis of the patient's muscles used for breathing, keeping the patient from suffering from the effects of hypoxia. The physical risks have been greatly reduced; however the amount of electricity sent into the brain in modern forms of ECT is considerably higher than in older forms of shock therapy. Though the size of the electrical impulse has in most cases decreased, the total charge of electricity in modern ECT has greatly increased[29] since the electric currents must be more intense in order to overcome the seizure-threshold due to the anticonvulsant effects of the sedatives that are given during modified ECT.[30]
Patient Depictions
This portion of the essay is a compilation of patient perspective stories chosen for the purpose that the person considering ECT may have a better understanding of the possible risks that ECT can have upon a persons life. The stories recorded here are accounts of devastation caused as a result of ECT. Many more stories can be found upon minimal research of patient perspectives and it is essential that the person considering treatment is made fully aware of possible consequences before consenting to treatment. The number of stories similar to the ones listed below are numerous and thus it deserves to be reiterated that severe permanent memory loss and cognitive impairment are far more common then what you will in many cases be told by your practicing psychiatrist.
I just completed a series of 11 treatments and am in worse shape than when I started. After about 8 treatments I thought I had improved from my depression... I continued and my effects worsened. I began experiencing dizziness and my memory loss increased. Now that I had the 11th my memory and thinking abilities are so bad I wake up in the morning empty-headed. I don't remember many past events in my life or doing things with the various people in my family. It is hard to think and I don't enjoy things. I can't think about anything else. I can't understand why everyone told me this procedure was so safe. I want my brain back.[31]
As a result of these "treatments" the years 1966-1969 are almost a total blank in my mind. In addition, the five years preceding 1966 are severely fragmented and blurred. My entire college education has been wiped out. I have no recollection of ever being at the University of Hartford. I know that I graduated from the institution because of a diploma I have which bears my name, but I do not remember receiving it. It has been ten years since I received electroshock and my memory is still as blank as it was the day I left the hospital. There is nothing temporary about the nature of memory loss due to electroshock. It is permanent, devastating, and irreparable.[32]
In the Washington Post in December 2000, a letter was written to the editor by registered nurse Barbara C. Cody. She wrote that her life was forever changed by 13 outpatient ECTs she received in 1983. In her words,
"Shock 'therapy' totally and permanently disabled me. EEGs [electroencephalograms] verify the extensive damage shock did to my brain. 15 to 20 years of my life were simply erased; only small bits and pieces have returned. I was also left with short-term memory impairment and serious cognitive deficits. ...Shock 'therapy' took my past, my college education, my musical abilities, even the knowledge that my children were, in fact, my children. I call ECT a rape of the soul.[33]
The senior contributing editor of Philadelphia Weekly, Liz Spikol wrote of her ECT in 1996,
"Not only was the ECT ineffective, it was incredibly damaging to my cognitive functioning and memory. But sometimes it's hard to be sure of yourself when everyone 'credible' scientists, ECT docs, researchers are telling you that your reality isn't real. How many times have I been told my memory loss wasn't due to ECT but to depression? How many times have I been told that, like a lot of other consumers, I must be perceiving this incorrectly? How many times have people told me that my feelings of trauma related to the ECT are misplaced and unusual? It's as if I was raped and people kept telling me not to be upsetthat it wasn't that bad[34].
The letters listed below were written by patients and addressed to the FDA. Presently Electroconvulsive Therapy remains a class III device which is the classification for approved products that are considered high risk.
I had 20 electroshock treatments and I regret very much my decision to have any of these treatments. I had to retire from part-time work as a paraprofessional in a local high school and I doubt that I will ever be able to work again. I have forgotten how to weave, could not concentrate on anything, felt very little pleasure in life and still feel suicidal. I often dont remember people who speak to me, much of my past life is gone from my memory, I have cognitive thinking problems, fear being in any social situation, cannot spell, cannot remember factual information, and lead a rather hermit-like existence. I believe I have permanent brain damage as a result of ECT and I do not think I will ever again be as intelligent a person as I was before the electroshock treatments
Sincerely,
Theresa G. Blumen
June 14, 1990[35]
As a former recipient of ECT, I have longingly suffered from memory loss. In addition to destruction of entire blocks of pre-ECT memories, I have continued to have considerable difficulty in memory recall with regard to academic pursuits. To date, of embarrassing necessity, I have been forced to tape-record all education materials that require memorization. This has included basic classes in accounting and word processing materialsCurrently, I am finding it extremely embarrassing and hurtful when fellow classmates (however innocent) refer to my struggles in grasping my study materials, You are an AIR-BRAIN! How can I explain that my struggles are due to ECT? As far as the loss of childhood memories, I often feel as though a very vital part of my life died as a result of these treatments. In particular, when my family refers to specific earlier experiences, I feel a great sense of loss and grief because I cannot share their memories.
Felicia McCarty Winter
May 23, 1988[36]
Nearly twenty years ago, I underwent 30 shock treatments at the Institute of Living in Hartford, Connecticut. As a result I lost two full years of memory. I have one child, a daughter, and the two years that were wiped out of my memory, were the years when she was two and three years old; those memories are irreplaceableMy memories are clear and detailed back to age 2 . But when it comes to those two critical years before I received shock treatments, my mind remains a blankAs an advocate for over 8,000 mental health clients in Maine, I do have contact with many former ECT recipients. I have met many others who have lost of over 20 years worth of memory; I have talked to others who, after shock treatments, were unable to resume their former work and lifestyles because of short term memory damage. I am convinced that brain damage from ECT treatments is not only common, but it is the rule rather than the exception.
Sincerely,
Sally Clay
November 9, 1987[37]
I received over 20 ECTs when I was 17years oldI was told the memories would come back in 6 weeks. I was told that the shock treatments were no more powerful than the batteries in a flashlightI lost 95% of all my memories before the treatments. They never came back. I went back to high school. I did not remember my fellow students. I could not find my classes. It was awful. To this day I look at the school yearbooks hoping some of the pictures will spark a memory. I used to play the violin. I had won 2nd place in duets in the city of Cleveland. (The only reason I know this is because I have the medal in my drawer). I could not remember how to play my violin after the first series of treatments. I was devastatedMy doctor kept saying that one more series would make me wellI have trouble with my memory today. I have been told I have permanent brain damage due to the ECT treatment. My IQ was 120 before treatments and it is not anywhere near that now. I have trouble just trying to cook a meal. I do not work. I make lists so that I can try to remember what I need to do. ECT changed my life forever and not for the better. I wish no one would be given ECTs.
Sue Ann Kulcsar
November 9, 1994[38]
I am one of the many patients who cannot but suspect that ECT caused brain damageI am constantly reminded of what I cannot doalthough I could do it once. And what is it? I cant remember new information with the ease I could before ECT. Distractions and interruptions seriously interfere with information retentionany new bit of information may cancel out the bit that preceded it. My auditory and visual memory seem to function episodicallyenough so I know they exist and how well they functioned before ECT. How have these deficits, which developed immediately after ECT, affected my life?
1. When I returned to my 6th grade teaching job after ECT I could not remember how to teach. Therefore, 5 months after ECT, I attempted suicide.
2. For two and a half years I worked in a kitchen. The loss of income was dramatic but worse was the total loss of confidence and the perception that I was a complete failure.
3. When I dared to take a college course, even multiple readings of the same material yielded next to nothing.
4. In September 1987, I matriculated. However, because the information was complex and largely theoretical, and because I found it hard to remember instructions, I withdrew from school. I am very fortunate that I survived the subsequent depression.
5. Why am I not making the $40,000 I would be making if Id remained in teaching. Why am I praying that Ill find a job that pays me $16,000. Why am I likely to settle for less if it will make few demands on my memory? Im sure I need not answer why?
I had a B average in college. I remembered ideas better than facts. I was not a slave to my studies. One year six months later functioning like that was just a bitter memory. If ECT must be used despite its damaging effects, can we not develop cognitive training programs to help people adapt to their new deficits.
Soncerely,
Pam Maccabee
Janruary 20, 1987[39]
It is 5 and one-half years since my horrifying experience of awaking in a hospital after ECT, not knowing who I was, where I was, who my husband and children were, what were my likes and dislikes, what my family was all about, what classes my children excelled in, what the family liked and disliked, and where I stood in the life that I was supposed to be livingThe damage from ECT can be extreme and completely disabling, to a degree inconceivable except by those who have undergone this horror. A diagnosis of organic brain syndrome or senile dementia after ECT through neuropsychological testing is not taken lightly by a person who had once been an intelligent and fully functioning beingThe heartache and striving for health following brain damage is an illness itself after the damage from ECT.
Pat Gabel
January 25, 1990[40]
Before ECT, I studied math up through calculus. After ECT, I can just barely make change in a store. ECT gives a person a different brain from the one a person had. One never feels sure about his strange new head. Some things come back. A great deal of memory never returns. And one cannot retain new information, so ones future is DEAD.
June Bassett
May 2, 1983[41]
Authors Depiction
In the winter of 2011, at the age of 26, I went through a single course of ECT treatments. I was told by my psychiatrist that permanent memory loss was extremely rare and cognitive impairments were not something to be concerned about since ECT in its modified form was safe and that adverse affects were minor and short-lived. I was persuaded that my memory would return to baseline by six months post-treatment and that persisting memory impairment did not occur often. While hospitalized, I was given a pamphlet, as well as a video to watch that convinced me that there was no evidence that shock therapy caused permanent brain damage. I trusted my doctor that under the circumstances, ECT was the best option for me. If I had been aware of the likelihood of permanent brain damage, I would have never considered ECT as a treatment option.
After one course of ECT, I was extremely bothered when I realized how much it had affected my ability to think clearly as well as how much my memory had been affected. It was over the next couple of days that I realized that the long-term memory loss was much greater than I ever imagined possible and along with the realization that I was having difficulty with forming new memories and learning new information, it began to really concern me and stress me out. I soon realized that memory loss covered the majority of my four year marriage and even fragmented or faded many memories from several years prior to my marriage. It was all very frightening. All I had left were bits and pieces of events that I felt were part of the life of a different person. I knew within the first several weeks after my last treatment, that my brain had been damaged. Though not all of the memories over the period spanning my marriage were completely obliterated, the vast majority had been lost and many of the others remained too vague to be relevant. I had a library of books in a study that, after ECT, I knew almost nothing about. It was also extremely bothersome to recognize faces of people that I knew that were close friends while I had almost no record of our history. These relationships over the next couple months deteriorated because memory of our experiences had been almost entirely obliterated from my mind and I almost completely lost the ability to socialize with them. Also, impairments to thinking including disturbed short-term memory played a significant role in ruining what were dynamic long-term relationships. It was very depressing and frightening as well as considerably humiliating.
Feelings of dread and grief were elevated when I began to realize that the loss of long-term memory was more severe than I had initially realized and that they were not returning as my psychiatrist had told me. I noticed over the first few weeks after treatment that I knew very little about my wife. I had to relearn her birthday, our anniversary, along with lots of other information that was likely less embedded in my mind. She was something of a stranger to me and this was extremely damaging for me psychologically. I had a very poor knowledge of our past together. If I had lost data of something as imbedded in my mind as my wifes birthday, then I knew that memory must have been severely damaged. This was also very hard for her as well as on my immediate family.
Memory was simply gone, although I had pictures and writings that clued me in to what I had been doing over the last several years. Through reasoning from my inability to discuss issues and perform tasks that I was able to do with relative ease prior, I came to understand that the damage caused by ECT was significant and disabling. I did not know where I had previously worked over the last several years; I did not remember standing up in the weddings of two very good friends. I relearned of these events through secondary sources. ECT was damaging to my own sense of identity, as well as to a number of other aspects of my life.
As a result of the treatments, a number of important friendships were completely ruined. As bothersome as this was, the realization that I could tell it had significantly dulled my intelligence, was the most troubling. Forming new memories as well as learning new information is still extremely difficult. For a significant period of time, I could not justifiably have any confidence in my own short-time memory. ECT did not just ruin and eliminate old memories; it caused significant irreversible cognitive impairment. I presently have severe difficulties with reading comprehension for many genres of writing that I did not have pre-treatment and have tremendous difficulty with following conversations and my own train-of-thought. I frequently get lost while driving in the area that I have lived my entire life and previously knew very well. Not only will it take some time to relearn what I had previously known, it will likely take much longer than it originally took to learn since my short-term memory and my ability to concentrate are significantly worsened. Feeling empty-headed, often losing my train-of-thought, as well as experiencing regular headaches are now a regular part of my everyday experience.
The unfortunate reality is that the memory loss from ECT is not just mere forgetting but the complete obliteration of information and events that had occurred. In other words, numerous events are either faded or completely wiped out and to the person that has had them wiped out, it is the same as if they had never took place. A persons life experiences are a major part of what makes an individual the person that he or she is. If you lose enough life experiences, you lose your sense of self.
Presently (as of November, 2011), roughly ten months post-treatment, my memory of the preceding four years remains mostly blank. Very little memory returned. ECT nearly destroyed my marriage, several friendships, altered my personality, stole my knowledge of my past, and has made daily functioning much more difficult than it was previously. My emotions are blunted, feeling numb and as a result I have difficulty relating to others. I voluntarily hospitalized myself on two occasions since the ECTs because I was so disturbed by the results. I felt like a significant part of me died through losing the knowledge of important events and relationships that shaped me into the person that I was.
In September, 2011, I had neuro-psych testing at the University of Michigan which confirmed memory deficits as well as significant difficulties with the ability to retain new information. Presently, I have to keep a notebook in my back pocket in order that I can keep track of daily responsibilities. I regard ECT as the worst event that has ever occurred in my life. ECT damaged my brain and I was not made aware of the potential risks before consenting to treatment. I do not recommend this treatment to anybody that values their sense of self or their intelligence.
Conclusion
Being that a person considering ECT likely suffers from a challenging mental illness, risking damage to an individuals sense of identity that often results from the obliteration of both key autobiographical events in their lives as well as other forms of impaired cognition puts the individual at greater risk for exacerbating psychological difficulties in the future. In the long-term, as the therapeutic effects of ECT are known to be short-lived, ECT may do more harm than good.
One of the most common symptoms that a person suffering from severe depression experiences, well known by all educated psychiatrists, is the difficulty he or she has in making decisions about relatively trivial matters. This is for patients the time when they will often have ECT suggested to them as a treatment option oftentimes while in a delusional state or so severely depressed that they have severe difficulties with very basic thinking. ECT is no small decision. It may have negative repercussions that permanently affect the rest of a persons life, the patient being possibly both psychologically devastated as well as having to suffer from permanent brain damage. Patients at the very least deserve truthful informed consent concerning the reality that ECT causes abnormalities in the brain. Granting that a patient is suffering from severe mental anguish and is being told that permanent adverse effects of ECT are non-existent except in very rare cases, the patient often consents only to awake feeling deceived and in further mental ruin than they did previously. This has been the case in numerous occasions.
Proponents of ECT often suggest that negative depictions exist due to either mal-practice cases, misinformation by activist groups, or due to depictions given prior to modified ECT. The reality is that modified ECT is still an assault on the brain and still regularly devastates lives through damaging a persons understanding of his or her identity. Permanent memory loss and permanent cognitive impairment are still fairly common. Many individuals who have endured a course or several courses of ECT even in its modified form continue to regard ECT as traumatic and extremely damaging, often communicating that it was the worst choice that they had ever made and the most difficult and damaging event to ever have occurred in their lives.[42]
Again, ECTs mode of success is presently unknown.[43] However considering what we presently do know, it is reasonable to believe that when ECT does work, its primary method of success is through damaging a persons brain. The evidence suggests that shock detaches an individual emotionally and intellectually from their phase of depression.
Oftentimes it has been suggested that ECT is analogous to merely rebooting a computer. It has been said, nine out of ten times, all you have to do is reboot it and the problem is solved. From my first-hand experience, a more appropriate analogy would be to say that ECT is like turning off a computer, throwing it down a flight of stairs, and then rebooting it. You may have fixed a particular problem, but in so doing you may very well have created a number of new ones.
Presently, no cognitive rehabilitation is offered to the patient after undergoing a series of ECTs. Long-time opponent of ECT, Peter Breggin explains, If a woman came to an emergency room in a confusional state from an accidental electrical shock to the head, perhaps from a short circuit in her kitchen, she would be treated as an acute medical emergency. If the electrical trauma had caused a convulsion, she might be placed on anticonvulsants to prevent a recurrence of seizures. If she developed a headache, stiff neck, and nausea a triad of symptoms typical of post-ECT patients she would probably be admitted for observation to the intensive care unit. Yet ECT delivers the same electrical closed-head injury, repeated several times a week, as a means of improving mental function.[44] Often a patient is released from psychiatric care immediately following treatment. The person is not given any medical care for the electrically induced seizure. Employed persons are often unable to return to their former work, writers often can no longer articulate, musicians often cannot play their instruments, relationships are destroyed through social impairment and memory dysfunction, and as a consequence, lives are ruined. I will close this essay with an observation of researcher Robert F. Morgan. He writes, even one or two ECT treatments risk limbic damage in the brain leading to retarded speed, coordination, handwriting, concentration, attention span, memory, response flexibility, retention, and reeducation.[45] Much more could be said regarding possible negative consequences of ECT and the author of this essay strongly advises the person considering treatment to consider as best as they can the real potential for severe and permanent negative repercussions.
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4. Philpot, M; Treloar, A; Gormley, N; Gustafson, L (NaN undefined NaN). "Barriers to the use of electroconvulsive therapy in the elderly: a European survey". European Psychiatry 17 (1): 4145.
5. Whitaker, Robert (2010). Mad in America : bad science, bad medicine, and the enduring mistreatment of the mentally ill (Rev. pbk. ed.). New York, NY: Basic Books. pp. 102106.
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22. Electroshock: The Case Against, 1999, pg. 35
23. Blaurock, M., F. Lorimer, M Segal et al. 1950. Focal electroencephalographic changes in unilateral electric convulsion therapy Arch. Neurol. Psychiatry 64: 220-226.
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34. Spikol, Liz (2006-12-22). "Funday: ECT study shocks. Ha ha.". The Trouble With Spikol. Philadelphia Weekly. http://trouble.philadelphiaweekly.com/archives/2006/12/funday_ect_stud.html.
35. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 306.
36. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 306.
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38. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 308.
39. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 309-310.
40. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 312.
41. Andre, Doctors of Deception: What they Dont Want You to Know About Shock Treatment, 2009 pg. 313.
42. www.ect.org/1stperson/index.shtml
43. Rudorfer, MV, Henry, ME, Sackeim, HA (2003). "Electroconvulsive therapy". In A Tasman, J Kay, JA. Rudorfer, MV, Henry, ME, Sackeim, HA (2003). "Electroconvulsive therapy". In A Tasman, J Kay, JA
44. http://www.sntp.net/ect/breggin1.htm
45. Electroshock: The Case Against, 1999, pg. 19
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My 6mo twin DD's are EBF and just started rice cereal on the first. Everything has been going fine except this morning one of them had a diaper rash (lots of redness around her anus). I read this as one of the signs of an allergy. BUT I did just buy a different brand diaper yesterday (which they have used randomly before w/no issues). Do you think its the cereal or the diaper? Im ready to start...
Performed on a regular basis in a number of hospitals around WA - in 2009-10, 429 patients underwent the procedure - modern electroconvulsive therapy (ECT) has come a long way since its chilling portrayal in the movie One Flew Over the Cuckoo's Nest.
More than 50 years on, it remains an important last-line treatment for severe depression, schizophrenia, bipolar disorder and psychosis.
Clinical director of ECT services at Hollywood Clinic Mathew Samuel said ECTessentially "reset" the brain by giving patients under general anaesthetic a small electric shock which induced a generalised cerebral seizure.
The reasons why the treatment was effective remained unclear but one theory was that it helped increase the production of chemicals known as brain-derived neurotropic factors, which are low in a person with depression, bipolar or schizophrenia.
Dr Samuel said ECT, which had a 60-70 per cent success rate, could very quickly improve a patient's quality of life and shorten their stay in hospital.
"It is actually a labour-intensive, well-modulated and well- controlled treatment with strict guidelines in terms of how you can do it and how you can't do it," Dr Samuel said.
Patients usually receive 12 treatments over four weeks. The procedure itself takes only about five minutes.
"It's an instant treatment, in the sense that you go through the process and you get the result - you don't have to wait for weeks and weeks for (drugs to have an effect). Either it works or it doesn't work," he said.
Short-term side effects include headache and in the long term, patients can suffer memory loss for the period just before and just after the procedure.
"(For those for whom it is successful) the general rule is . . . one-third will get better and not need ECT again at all, one-third will need ECT again two or three times in their lifetime, and one-third will need it on a continuous basis, but they may choose not to have that," Dr Samuel said.
"If you want an instantaneous result and to reduce the risk involved and improve the quality of life, ECT always stands out as the foremost in terms of treatment.
"Cognitive behaviour therapy (a mainstay treatment for depression) takes a long time and . . . it also depends on the severity of the depression."
Controversially, ECT is also, on rare occasions, performed on children aged under 16 and in early-stage pregnancy - occasions when drugs are likely to cause harm or take too long to take effect.
"We have to give ECT in children less than 16 sometimes because that may be the only thing that works for that person," Dr Samuel said.
"Medications are an unknown entity in children because of the side effects and what it could do to the developing brain - from a safety point-of-view, it would be safer compared to medication."
Dr Samuel said the scientific community was running out of options for treatments with medications. He expected in the next 10 years there would be a move away from chemicals to a new focus on stimulating the brain by other means.
One area of research showing promising results was a procedure that might one day eclipse the benefits delivered by ECT.
Known as repetitive transcranial magnetic stimulation (rTMS), the procedure tries to stimulate cerebral activity by applying magnetic radiation to the brain via a magnetic coil placed near the scalp.
"It is comparable to ECT and even better than ECT," Dr Samuel said. "Instead of an electric shock, you try to stimulate cerebral activity by applying magnetic radiation to the brain. This will have less impact in terms of issues with anaesthesia because with ECTone of the risks is giving them anaesthesia, with rTMS, you don't need anaesthesia."
A Health Department spokesman said approximately 50 patients had participated in the study of rTMS at the Centre for Clinical Research in Neuropsychiatry in Perth since 2009.
"RTMS studies from around the world and in other centres within Australia show some potential evidence of benefit in certain groups with depression," he said.
http://au.news.yahoo.com/thewest/lifestyle/a/-/lifestyle/9992168/therapy-resets-brain-instantly/