Have you ever had Electroconvulsive Shock Therapy?

I did not have ECT, but something very similar. The idea was still to induce a seizure; it was just induced in a different way. But, the general procedure except for that--which happens when you're unconscious--is the same.

Are you looking for experience of the actual treatment itself? The cognitive side effects?

I had it 3 times a week. Sometimes it is 2, I believe. Always in the morning, and I was not allowed to eat or drink anything after midnight the night before--no breakfast.

They could do several people an hour--it is quite quick. In the actual treatment room there was the psychiatrist administering the treatment, the anaesthesiologist, and one or two nurses. You lie down on the bed, they set everything up, they put you under for about three minutes. Supposedly due to the muscle relaxant, the seizure looks like little more than a twitch.

Then when you wake up (if you're lucky, unlike me, and don't wake up too early), you've been wheeled into a recovery room of sorts where there are a couple nurses who check your vitals and just generally make sure you're doing OK. I'd stay there, on the bed, for another 20-30 minutes, and they'd give my juice and cookies if I wanted it. Additional patients would be wheeled in every 10 minutes or so.

I had it outpatient. Even after I left the initial recovery room, I had to wait an hour or two before they would let me leave, just in case. And then, I could not leave alone. Every week or so I would meet with the psychiatrist to see how it was going.

I could not tell if you all of that is standard or what; it is just my experience. Not ECT, but we'd all wait together with the ECT patients, and the general procedure for them was the same except for the actual treatment.

I think for ECT it is usually 6-12 treatments, and there are both unilateral and bilateral options. It was a little different for what I had.


My experience beyond that might not help you a great deal because:
1) I woke up too early multiple times (before the muscle relaxant wore off, i.e., while paralyzed) which badly traumatized me and colored my perception of the whole thing. (This is NOT common.)
2) The type of seizure therapy I had does not seem to have cognitive side effects, so I couldn't comment on those.
3) It was not successful for me. (Well, maybe it would have been if I'd had more treatments, but due to #1 I had bad anxiety, so, uhhh....)

If there is anything else you think I could answer, just let me know. But yeah, my experience was a little unusual and I did not exactly have ECT.

mfarraday said:

Have you ever had electroconvulsive shock therapy? I am thinking of having my character go through this experience, because his medication is not working and he is still suffering from delusions. Can anyone tell me what this is like?

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For realism, don't have any of your psychiatric professionals refer to it as electroconvulsive shock treatment. If your story is set in current times, the experience will be like this.

Character walks with nurse to ECT room. He lies down on a trolley. They put the cotsides up. They place a canula in a vein, probably one of the veins on the back of the hand. The anaesthetist gives him some anaesthetic. He wakes up when it's all over.

Maryn said:

I'm neither a medical pro nor experienced as a patient, but do they use this therapy for delusional patients? My understanding was that it was largely for depression which does not respond to other treatments and its flipside, manic states, not delusions, paranoia, or other mental states.

I would, of course, cede to anybody who can say for sure, but you'd want to check that before doing much more research.

Maryn, hoping this saves legwork

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You're pretty much correct Maryn. I have seen it used in cases of schizophrenia but not for ages and only rarely.

I've also seen it flip an eighty year old bipolar woman (back in the good old days when we called it manic-depressive psychosis) from the depths of depression to the heights of disinhibited, giggling hypomania.

A fellow I was in treatment with had had it done for depression. He was still in therapy because it wiped out his entire memory. One of those medical "oops" things.

shadowwalker said:

One of those medical "oops" things.

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Oops indeed. Do you know if his memory came back?

It's a weird thing with ECT. Sometimes there's no memory impairment. Sometimes there's short term impairment post ECT which may in some cases actually be the anaesthetic rather than the treatment itself. Maybe. Sometimes there's long term impairment of short term memory.

Many of my relatives have had this treatment for depression. My aunt swears it saved her life and was the only thing that helped. Given that depression causes memory loss anyway, it's hard to say what's the condition and what's the treatment. So my relatives say.

One thing my mother did say was that as she continued having the treatment, she would come back to herself earlier, by degrees. That is, she said she started being aware of being in the recovery room, which she couldn't remember ever having seen on earlier occasions.

There's an account of the treatment in Sylvia Plath's The Bell Jar. I think she had it both pre and post the time when they decided it would be better to give people anaesthetic first. AW's own Carolyn Kaufman goes into some detail about electroconvulsive therapy in her book The Writer's Guide to Psychology, which I have just been reading. It is used in extremis for psychotic patients, apparently, as a treatment of last resort. If you want to know how it's done, you could do worse than Carolyn's book.

ETA: just for clarity, Carolyn's book describes the procedure, not what it's like to be on the receiving end. The Bell Jar is from the receiving end.

Note when you're doing research that how ECT is administered has changed substantially over the years, and assuming your story is set in present day, I would not pay much attention to accounts from several decades ago. Certainly not to anything where the patient did not have muscle relaxants + anaesthesia. Also, the cases where people have had severe memory loss are rare, but these people are quite vocal. This is not to say that having some memory problems isn't common. But losing all your memories is unusual. The ECT psychiatrist I saw described your memory as being like Swiss cheese when receiving the treatment and for several months after perhaps, but it is quite variable from person to person.

When ECT was brought up as a possibility for me, it was emphasized, by multiple medical professionals, that it is not as barbaric as most people imagine. (i.e. not like in One Flew Over the Cuckoo's Nest, although I have never seen this movie and it came out quite a while before I was born. But it was always mentioned.)

I do not know much about using it to treat anything but depression. It is quite effective for depression with psychotic features. I am not sure for your case. Also when you say "his medication is not working" I assume you mean multiple medications have been tried...

Rufus Coppertop said:

Oops indeed. Do you know if his memory came back?

It's a weird thing with ECT. Sometimes there's no memory impairment. Sometimes there's short term impairment post ECT which may in some cases actually be the anaesthetic rather than the treatment itself. Maybe. Sometimes there's long term impairment of short term memory.

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He came to our area almost six years after the 'mishap', and still only knew his family because they'd been introduced to him, and hadn't improved when I left therapy two years later. (He was in therapy mostly to learn how to deal with the memory loss and living, in general.)

I knew several people who'd had ECT and suffered the short-term memory loss, and a couple others who also had memory gaps - nothing as drastic as this poor guy, though.

My uncle has had long term consequences from ECT--big memory gaps. He knew the risks because he is a physician (surgeon). It was worth it to him because he was suicidal and no meds would work for him anymore. He had dealt with depression his whole life, but at age 60 he had to stop performing surgery due to issues with his fine motor skills and eyesight. The loss of his work triggered a deepening of his depression. He is still glad he did it, even though he struggles with blanks in his memory, as if a chunk of his storage was simply erased.

I was with a daughter who had them about fifteen years ago. She was a minor at the time and needed a parent present through most of the procedure. My daughter was delusional at the time. She did not recognize me or her father. She thought I was her Government teacher. She had some frightening episodes while delusional. Before that she had taken a reaction to lithium and ativan that sent into a catatonic state. The first round of shocks did not take. I think because they did not give her the full set. She became even more delusional in a few weeks. The second set did work.

I didn't want to agree to the second set of treatments because by that time I was thoroughly frightened, not to mention heart broken, but my husband insisted that they were the only chance to get our, bright, intelligent daughter back. I was frightened because my grandmother had gone through them in the sixties and was never quite the same--not delusional but always sad and withdrawn.

The second set did work and my daughter is on medication, Depakote, now. Athough there have been some close calls and a few asylum visits, nothing like that first breakdown has ever happened. She managed to graduate college--although it was difficult for her to read that first summer. (She just finished a course in Children's Literature this winter--so no long term effects with reading.) There were memory gaps at first. They seemed to clear up after two years. She would forget to shut her car door. She once packed only hangers for a trip. That doesn't happen anymore. she does go to therapy still. She was on Zyprexa for a time. It was a brand new drug back then and it, along with the shock treatments, made all the difference.

One weird thing--one of her delusions was that her father was dead. Right after the first course of shock treatments, for almost 30 minutes she insisted that her father was dead and she had been at his funeral. He was sitting at her bedside. She would hug him and sob when she realized he was there, fall back asleep and then wake up saying "Mom, Dad died! I'm so sad!" I would say "Dad is right here."

She would Say "No. I was at his funeral." He would speak up, she would hug him again. About an hour after the treatments she had a nice lunch--before that she would not eat on her own. She looked at a card from her little cousin and said "Oh. I remember Gabey!" after that she began to remember her sisters and aunts and uncles.

That was the last time she had shock treatments. That was January, 1998. In April--the 22nd to be exact--her 48 year old father died, very unexpectedly. Make what you will of it, that is what happened. --s6

shadowwalker said:

nothing as drastic as this poor guy, though.

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That's the most drastic case of memory loss I've ever heard of from ECT.