In terms of traumatic impact, the ECT feels like a violence that was inflicted upon me, not a procedure done to help me.
Five years ago, I was in the throes of the third and hopefully last severe depressive episode of my life. I have always taken my medication as directed and regularly attended various types of therapy. None rescued me from the slow strangle of depression. I eventually ended up in the psychiatric ward of a well respected Chicago hospital where the lead doctor prescribed what I considered an alternative of last resort—electroconvulsive therapy (ECT), otherwise known as shock treatment. The outcome was disastrous.
When I say “ECT,” people tend to think of the barbaric applications in the 1950s and 1960s when electric currents were applied to the brain while patients were strapped down and wide awake. The process is much gentler now, as I was under general anesthesia for each of my half dozen or so treatments. The procedures were done in the very early morning and by 7am I felt fine.
The more humane protocol did not prevent the experience from feeling like an assault. While my signature on medical orders shows I fully consented to the process, I remember none of the discussion. The ECT destroyed my memories from the prior six months of my life. That time period is not a foggy remembrance, it is completely gone from my mind. In terms of traumatic impact, the ECT feels like a violence that was inflicted upon me, not a procedure done to help me.
Mild memory loss is a common side effect of ECT but mine was on the extreme side. As horrible as the repercussions were, my personal experience is not a global indictment of the treatment. All medical interventions have potentially harmful outcomes and their efficacy needs to be analyzed on a wide sample of patients. I certainly know of people who have benefited from ECT.
However, I have no such second thoughts about criticizing the way the mental health community minimized the harm done to me. Instead of helping me recover from the side effects, my doctor threw me back into the world with no preparation.
Even in the absence of ECT, severe depression creates cognitive difficulties. At the time of my hospitalization I was on leave from work because my inability to focus made my job as a data analyst impossible.
Depression also promotes isolation. Even trivial interactions with anonymous store clerks or passers-by required more emotional energy than I could muster. In my own home I avoided my partner, giving what minimal energy I had to our young son.
Then on top of this, six months of my life were erased by ineffective ECT treatments that did nothing to halt my free fall into depression. If they had helped me feel better, perhaps I could have navigated the memory loss. Maybe I would have considered it a fair trade. But as it was, I remained trapped in the Bell Jar.
Mental illness comes with a unique and crushing pressure to get well. If I sought treatment for a broken arm and it subsequently healed incorrectly, the doctors would show me an objective X-ray and prescribe a resetting or surgery. If fault was placed, it would be on the doctor for not properly casting my arm, not on my arm bone for not responding to the cast.
However, with mental illness, every failed treatment comes with the stink of blame. If medication doesn’t help, it’s likely because you aren’t taking it correctly. If psychotherapy doesn’t clear the fog, you aren’t opening up enough. ECT is a little more tricky because certainly the administration is solely the responsibility of medical personnel. So when the shock treatments failed to make me better, the medical staff attempted to gaslight me into declaring success.
I remember a discussion with a nurse that occurred after the second week of treatment. She asked me how I was feeling and when I testified to no improvement she told me “Oh no, you’re a lot better. Don’t you remember when you first came to us?”
When I told the psychiatrist about my memory issues, he answered that I might have some minor loss, but certainly not the massive blank space I reported. Plus he could see I was doing “so much better.”
My partner desperately needed me to be better. I desperately wanted out of the hospital and away from those continued treatments. From my perspective the doctor didn’t really care if I was better, he just wanted my testimony that the ECT had worked and the elimination of any pesky criticisms.
So I said I was better.
I went home and eventually went back to work.
How do you tell your boss you can’t answer questions about anything you have worked on in the last half year? That you don’t remember the clients you met or the names of the projects you worked on? How do you fake conversations with strangers you can’t recognize but who know you from the blank space in your life? Because, trust me, you don’t want to announce to the world that you had shock treatment. My cognitive difficulties and desire to isolate only increased as a result of the memory loss.
I got progressively more depressed. Months later, when I was admitted to a different psychiatric hospital I was diagnosed as semi-catatonic. It took weeks for me to recover enough to even do the psychotherapy and cognitive behavioral work needed to break the hold of the depression.
ECT is not solely responsible for my descent. There is no completely passive treatment for serious depression. Even with medical help, recovery requires the patient to make behavioral choices that assist healing. As the months had worn on, I stopped fighting for health. Part of this was the result of emotional erosion from months of horrible depression. But a fair part of it was a result of the cognitive stupor that was greatly exacerbated by the ECT.
What do I wish had happened? The hospital should have provided me with a safe landing after my memory loss. Instead of minimizing the damage done, the doctor should have helped me find outpatient support to aid my transition back to home and work life. When I repeatedly testified that my depression was not lifting, the medical staff should have considered stopping the shock therapy.
Most of all, the doctor should have protected his patient, not the reputation of the treatment.
I spent years analyzing what happened across the span of this, my last severe depression. For most of this time I have been blanketed in shame for not doing more to help myself.
However, slowly, I have rethought that perspective. My treatment at the hands of my ECT doctor felt like an assault. My doctor should have kept me safe until I was able to at least recover from the damage inflicted by his treatments.
The experience left me terrified of medical intervention beyond the established list of pharmaceuticals I have taken for years. The good news is that my fear led to dramatic changes in my lifestyle to help me avoid potential triggers for depression. My fear spurs an immediate reaction to even the hint of an onset of depression, when the emotion feels more like a blue mood than catastrophe and my cognitive abilities are still intact. This constant vigilance has helped me avoid another relapse and the need to rely on untrustworthy health care.
Unfortunately, many other people are still vulnerable to the sort of medical treatment that harmed me. Under extreme pressure to “get better” from families and friends and medical staff, people with mental illness opt in to treatment for which there is no safety net.
When we hear someone is depressed, our knee-jerk reaction is to make the vague statement that they need to “get help.” It’s not that easy. Navigating mental health services can be extremely treacherous, especially when one’s cognition is already compromised. Instead of stopping at hoping people “get help,” we need to support measures that ensure that help is sufficient.
Anne Penniston Grunsted writes about parenting, disability, and family life from her perspective as a lesbian mama. She has been published in The Washington Post, Brain, Child Magazine, Mamamia, and won the 2014 Nonfiction prize from Beecher’s Magazine. She lives in Chicago with her partner and son.