"They still do that"? Absolutely! I am coming out of the closet! I am an ECT nurse. I often answer questions and offer my support for people online who are considering ECT. I have decided to post some of my responses to questions and concerns about ECT as a means of educating anyone who happens upon my blog.
Today, I responded to a 50 someting male with treatment resistant depression. His psychiatrist is recommending either MAOI treatment or ECT. He is considering both and had some general questions about ECT.
My response:
You are quite accurate in your perceptions of ECT: it is anything from idealized to villified, depending on the source. I have to say that I have seen the miraculous,mediocre, and non- response to ECT. The vast majority of our patients get better with either complete or partial relief of symptoms. With 18 years in Nursing, I have never seen a more effective treatment. Much of your response to your treatment is determined by your appropriateness for the procedure. This refers to not only your diagnosis, but also your support system. You should receive at least an hour long evaluation by an ECT psychiatrist. After this eval, that doctor should be able to give you an idea of how likely it is that you will respond. Research shows that certain diagnosis aas well as illness features respond better than others.
In our program we assess multiple factors in deciding frequency of ECT (2 or 3 times a week): severity of illness, logistical concerns (is the person ABLE to be transported 3X week), risk of cognitive problems in the specific person (depending on age and pre-existing cognitive problems), medical risk factors, support system and more. There is an increased risk of memory problems with 3X weekly treatment once you get to around treatment 5-8 than there is with twice weekly ECT.
If you would like to continue working, a schedule of twice weekly ECT is preferred. It depends on the type of work you do whether or not we would recommend continuation of work. What is your occupation? Sometimes it is easier for a person to take a short-term disability leave and get 3X weekly treatments for the most rapid response possible. Others find a Monday, Friday schedule of treatments convenient. Some of our patients leave work early and receive Monday and Friday afternoon treatments.
One important thing I tell all of my patients. Communication is key throughout the treatment course. There are potential side effects from ECT. ALL of these side effects (including memory problems) can be managed in some way. We assess our patients for side effects and actively address each and every one of them: from headache to anesthesia side effects. This attention allows the person to have the least stress and discomfort regarding the treatments and makes it more likely that they will complete the course and possibly get relief from their distress.
In our program we assess multiple factors in deciding frequency of ECT (2 or 3 times a week): severity of illness, logistical concerns (is the person ABLE to be transported 3X week), risk of cognitive problems in the specific person (depending on age and pre-existing cognitive problems), medical risk factors, support system and more. There is an increased risk of memory problems with 3X weekly treatment once you get to around treatment 5-8 than there is with twice weekly ECT.
If you would like to continue working, a schedule of twice weekly ECT is preferred. It depends on the type of work you do whether or not we would recommend continuation of work. What is your occupation? Sometimes it is easier for a person to take a short-term disability leave and get 3X weekly treatments for the most rapid response possible. Others find a Monday, Friday schedule of treatments convenient. Some of our patients leave work early and receive Monday and Friday afternoon treatments.
One important thing I tell all of my patients. Communication is key throughout the treatment course. There are potential side effects from ECT. ALL of these side effects (including memory problems) can be managed in some way. We assess our patients for side effects and actively address each and every one of them: from headache to anesthesia side effects. This attention allows the person to have the least stress and discomfort regarding the treatments and makes it more likely that they will complete the course and possibly get relief from their distress.
I welcome comments and discussion!
