Electroconvulsive Therapy (ECT)

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“Electroconvulsive therapy (ECT), formerly known as electroshock therapy, and often referred to as shock treatment, is a psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses” -Wikipedia

Basically, ECT is a treatment by which patients consent to have seizures intentionally triggered by electric shocks which are applied to the brain.

When you put it that way, it sounds barbaric and unnecessary.  Why would someone consent to have electric currents put through their brain under general anesthetic and undergo seizures?

The desperation and intense suicidal ideation that can accompany treatment resistant depression can be unbearable and even fatal.  Given the choice between suicide and ECT, some people choose ECT.  I was one of those people.

In 2011, I was caught in the grips of one of the worst depressive episodes of my life.  I was fighting off constant thoughts of suicide and severe self harm.  I was having difficulty functioning in my day to day life.  I had tried every medication known to human kind.  I was truly desperate and ECT was a last resort, something I hadn’t tried and something I hoped would provide even brief respite from my suicidal depression.

Over the course of about 8 weeks I received 15 electroconvulsive treatments.  This means I was put under general anesthetic 15 times and I had 15 seizures.  Some were unilateral (one side of the brain) and some were bilateral (both sides shocked simultaneously). I received the treatment as an outpatient, twice a week, Monday and Friday mornings at a hospital near my home.

Each morning I would report to the inpatient psychiatry floor around 6:30AM.  I would change into a hospital gown, remove my jewelry and be taken on a stretcher, by an orderly, down to the surgical area of the hospital.  I would wait in the semi-darkness, dimmed light of the surgical recovery room.  While in this room, nurses would place an IV into my hand so the necessary medications could be injected.  I was hooked up to heart rate monitor and other monitors.  There were usually 4-6 of us lying there, side by side, waiting our turn in the treatment room.  As I would wait, I would see the previous person being wheeled out of the treatment room, unconscious.  It was unsettling, as I knew my turn was coming soon.

The ECT room was a small procedure room attached to the surgical recovery room.  It was just large enough for a stretcher, the medical professionals and the necessary equipment.  It was bright and clinical.

Nurses and doctors began to work on me quickly.  I had the impression of an assembly line, a schedule being kept, patient in, treatment given, next patient in and so on.  My temples were wiped with alcohol swabs and electrodes attached.  The anesthesiologist talked to me about the medications he was going to administer.  A nurse would often hold my hand, there to keep me calm as everything was arranged.  The medications were injected one by one through the IV.  I could feel the cold fluid entering into the veins in my left hand.  I would keep my eyes fixed on the clock, trying to remember the time as I went unconscious, to later compare to the time on the clock when I awoke.  Sometimes I would lose no more than 15 minutes of time, the procedure was very quick.

I remember feeling afraid.  The nurse asked me to count backwards.  An oxygen mask was applied to my face and nose, ready to breath for me while I was unconscious.  The medications worked quickly and then nothing.  There was only one time of the 15 when I was aware of part of the process.  The medications they injected to relax my muscles began to act before I was unconscious, I felt like I was suffocating.  I couldn’t breathe and I started panicking.  I literally couldn’t breathe, but I was awake.  I could hear them talking and feel the next medication being injected and then nothing.

I would wake up 15 minutes later.  Back in a different curtained bay of the recovery room.  I could hear the nurses helping the other patients on either side of me, also recovering from ECT.   This was the part of the treatments that I hated most.  I had to stay in the recovery room for 30 minutes following the treatment, as they monitored my blood pressure and other vital signs.  I felt trapped.  I was hooked up to machines.  I often had a sense of panic and wanting to flee, to leave, to be outside.  Sometimes I would cry and I don’t think the nurses understood why.  Eventually the Doctor would come, talk to me briefly and I would be released.   The first time I could barely walk and the nurses wheeled me to the entrance to meet my family member.  I was usually home by 9 am.  The whole process taking 2-3 hours.

Usually I would stumble, drowsy and disoriented to the car.  I would be driven home and I would go straight to bed.  Usually I would sleep and rest for most of the day.  I lost a lot of weight over those few weeks because I ate so little due to missing breakfast and then being nauseous from the medications.  I also had severe headaches due to the shocks, and many side effects from the medications.  I felt like a zombie.  My short term memory was foggy as to the events during those 8 weeks.  During that time, my grandmother passed away and the experience was surreal through the state of mind I was in.  I have no memory of my own birthday that year, and few of my daughter’s.

In terms of long term side effects from the treatments, I found that the area of my brain which recalled the order of the months of the year and the seasons of the year were impacted.   If someone asked me “What season comes before Fall?”  I would feel confused and have to think very hard to answer “Summer”   Similarly with the months of the year and the order of the holidays in the calendar.

Overall I don’t think I suffered any major memory loss.   At the time I thought that the treatments helped my depression a little.

Sadly, I only realized about 9 months later that a large portion of my depression was situational, related to my abusive marriage.  In the end, the treatment for my depression was to move away from him.

If I’d realized this sooner, I probably would not have endured ECT.

Looking back on the whole series of treatments, it feels unreal.  It feels traumatic.  It feels strange and difficult to process.

In what world does it make sense to further traumatize a traumatized brain?  But desperation will make a person take desperate measures.  I survived and that is what matters.

The leaving.

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When I was 19 years old, I made the biggest mistake of my life.

This mistake potentially changed the entire course of my life until my children are adults and possibly longer.  I was a teenager.  I was in fragile recovery from anorexia and depression and had not yet been correctly diagnosed with PTSD.  I was living in a city away from my family and the majority of my close friends.  I was happy that year, doing well and enjoying life. I had taken up swing dancing and I loved it.  I’d made some friends and we often went out dancing together.  Shortly before my 20th birthday I met him.  He proposed to me after 3 months.  It was one of the worst moments of my life.  I remember physically shaking, thinking frantically in my head “oh my god, this can’t be happening, why is this happening, why is he doing this, why, what should I do, what will I say, why is this happening right now!!!”  In the moment I didn’t want to break up with him, so I said yes.  I honestly figured I had lots of time to get out of the promise, but life didn’t turn out that way.

Thirteen years passed.

Three years ago this week I made the biggest and most complicated decision of my life.

Ironically, the things that ended my marriage came together in a culmination of empowerment and decision for me.  I’d been battling with thoughts of leaving for over a year, slowly gaining strength, processing the ideas and planning.

The soul crushing depression I’d been living with for a few years slowly began to lift about a year before I left him.  I began to see options for myself.

For many years I had seriously considered suicide.  After trying ECT (electro-convulsive therapy) and slews of meds, I believed I had exhausted all options for treatment resistant depression. I was ready to give up and only my children held me to this world.  I had irrational, almost psychotic thoughts, in the depths of that depression.   But in my mind, when I was thinking more clearly, I told myself that suicide was only an option for those who had literally tried everything, people who had no other option.  Sometime in summer 2012 I realized that wasn’t my situation:  there was something I hadn’t tried.

I hadn’t tried moving. Living in my own house away from my partner.  I hadn’t tried starting over, changing my environment, removing myself from the ongoing sexual abuse which I knew was both triggering me and traumatizing me in equal measure.

In 2012, I was experiencing terribly severe migraines which at times left me unable to function.  I remember throwing up in the parking lot of a restaurant on my daughter’s birthday.  I went to the ER at times to receive IV pain meds.  Around that time I began taking a medication called Topimax for the migraines.  And suddenly, my depression lightened.  My obsessive compulsive suicidal and self destructive thoughts relented almost immediately.  I never self harmed in a way that required medical attention again. My migraines improved.  I began to see colours again.  I noticed the world around me.  I began to re-emerge into the world of the living.  And I started to consider my options for leaving my partner

As I grew stronger over the course of the next year, I started talking to more people in my life about the abuse.  I chose very carefully.  I told people who didn’t live in my city.  I told counselors and doctors who were sworn to keep confidentiality.  I was careful, but I started to talk.

I had some good friends who began to tell me that what I was experiencing was not okay.  Friends encouraged me to leave, to tell my parents, to get more counseling and they empowered me.  I started volunteering at a women’s organization. It happened gradually, slowly, almost imperceptibly.

In the end, the last time we had sex was the end of that marriage.  I made the decision the next day and told him a few days later.  That night he initiated sexual touching while I was asleep and drugged.  I woke up with him touching my breasts.  Maybe he had been touching me for a while before I fully responded.  On that occasion I woke up and was lucid enough to respond.  Because he had been touching me (without consent), I said yes to sleeping with him.  I verbally said yes.  We had sex and I felt disgusted.   Even though I said yes to the sex, I knew in my mind that I had not consented to the touching. I knew if he had asked me when I was wide awake I would have said no.   I realized that even IF I said yes, I still wouldn’t feel safe, comfortable or at all okay.  I knew it was over.  I knew that would be the last time.  So many times, when I was lying awake at night after being assaulted, I thought to myself “this could be the last time, I could get up and walk away” but I never did.  I was always afraid and I didn’t want to leave my kids.

There are a lot of reasons why people who are being abused do not leave.

And at the end of the day, it only takes one reason to decide to leave.

Leaving an abusive relationship can’t be rushed or forced.  The person being abused has to hit a breaking point and decide that “enough is enough” and that point is different for each individual survivor.

This happened three years ago, but anniversaries are always difficult for me.  I feel it all again.  I have more nightmares, more anxiety and lower self esteem.  I don’t believe in myself.  I have difficulty trusting. I hate my body so intensely that I struggle to look in mirrors or wear certain clothes. I don’t feel safe or relaxed anywhere.  I return to the automatic living, zombie like state.  I have trouble remembering things and difficulty concentrating.  I sometimes wonder if it has been worth the fight.  The suicidal thoughts creep in suddenly, ambushing me in my day to day life.

But at the end of the day, I have to remember that there were only 2 options left for me:

  1. Leaving
  2. Suicide

As difficult as my life is, and as much pain as I’m in, I believe I made the right choice.

I’m still alive.