Posted by Adam on April 2, 2001, at 1:58:41
In reply to Re: Any POSITIVE experiences with ECT? » Thrud, posted by kazoo on April 2, 2001, at 0:49:48
> ^^^^^^^^^
>
> I have read your previous posting re. the problem(s) with medication. What disturbs me the most is this recent fanatical interest in ECT, which has been a common topic of discussion here lately. From what I know of ECT, it is not a walk in the park, nor like a trip to the dentist.I'm in total agreement here. But neither is long-term, refractory depression. Cost-benefit, that's the key.
>This is a serious undertaking, not to be taken lightly or accepted as a panacea for any kind of depression.
Nothing is, unfortunately.
>By virtue of the fact that you're able to analyze your situation and post intelligently about it indicates to me that you are probably not the "ideal" candidate for this procedure.
During my most serious episode, I had experiences that, in retrospect, seem borderline psychotic, and I think that may have something to do with a particularly bad drug combination (for me), and, probably, a particularly bad doctor. Anyway, I certainly never lost my ability to think with intelligence, and it was during a frank time of self-analysis and assessment of my life that I agreed to try ECT, which I did not have to do. I believe this has a great deal to do with the fact that I am still alive now, because if I had lost these abilities, which, according to you or your source, would have made me an "ideal" candidate, I'd be dead by my own hand. I felt considerably better even after admitting myself to the hospital, and thought much more clearly after A) I had had some time to rest, and B) I was taken off the idiot drug regimen I was on. I do not know what the basis is for this statement (though I am quite curious), and I'm inclined to strongly disagree with it.
>Remember: ECT is a serious, end-of-the-line, last-resort procedure indicated for only a small percentage of those who are totally unable, and incapable, to help themselves out of depression so profound that hospitalization is usually indicated. Despite a recent revival of interest in ECT, the jury is still out as to its longitudinal efficacy, not to mention damage.
>
> A word to the wise is sufficient.
>
The procedure is reasonably safe, according to the AMA. It carries with it all the usual risks associated with medical procedures involving anaesthesia, etc. There have been some reports of brain damage, but most reports indicate that there are no lasting sequelae, and strongly refute the former. Is the jury still out? Depends on who you ask. The same could be said for medications. There are bright people who consider antidepressant drugs to be absolute last-resort interventions, so, in the minds of some, all the tools of psychiatry are to be used only in the direst need. I do not know for certain who is right, but the preponderance of evidence states that ECT carries acceptable risks.You may note that several studies have demonstrated that the stress that accompanies depression is itself harmful to the brain. One very interesting study has noted the normalization of neuro-stem-cell growth in those treated with ADs (including ECT), which has directly measureable affects on the hippocampus, a vital portion of the brain for memory. I am, myself, of two minds about this phenomenon, but, in the absence of evidence that it is harmful (and there is none), what we see is what appears to be a return to a normal rate of repair of brain tissue, and hence an avoidance of the very thing those who fear ECT most worry about: damage to the brain.
In the most pessimistic assessment of ECT, the worst I can say, then, is choose your poison. At least one has the potential to relieve the symptoms of a dibilitating disease.
poster:Adam
thread:58232
URL: http://www.dr-bob.org/babble/20010327/msgs/58410.html