Shocked Out Of Depression
While it remains a controversial medical practice, electroconvulsive therapy is giving severely depressed patients and their families a new lease on life
By Alice Keesing
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From left, nurse Dwayne Fedalizo, Dr. Celia Ona and
nurse Ben Nelson prepare to give a patient
electroconvulsive therapy
A year and a half ago, Karin’s life began a scary descent into a pit of fear. Suffering from severe depression, Karin couldn’t eat or sleep. Every morning, she woke with fear in her stomach. Everything scared her, even the thought of getting out of bed, and the anxiety never went away.
She went through five jobs in a year, and her life began to unravel around her. Anti-depressants did nothing to help. And things only got worse when Karin went to a Mainland facility looking for help. Despairing that she would never get better, Karin thought often about swallowing an overdose of pills and killing herself.
It was only then, when she had hit rock bottom, that Karin finally agreed to try a treatment that she had been refusing for months: electroconvulsive therapy.
Shock treatment.
“It saved my life, it really did,” Karin says now.
Five months after she started her treatments she is back in the Islands and has picked up a normal, happy life. Monthly ECT treatments along with anti-depressants help keep her depression at bay.
“ECT has been just like a miracle for me,” she says.
Karin is one of a growing number of people in Hawaii turning to what used to be one of the most loathed treatments in medical history. These days, electric shock treatment has taken on a new light, as it is used to pull people from deep, life-threatening depression. But despite the good stories like Karin’s, there are still those who vehemently oppose ECT, saying it destroys minds and memories.
In 1995 it was estimated that 100,000 people underwent electroconvulsive therapy in this country every year. In Hawaii, Queen’s and Tripler both offer the treatment, and last year, the private psychiatric hospital Kahi Mohala opened an outpatient ECT suite specially dedicated to the therapy.
The concept of shocking patients to improve their mental health goes back to the 19th century, when doctors would place electric eels on patients’heads. The treatment was refined in the 1930s by an Italian scientist who, after experimenting on animals, began using electricity to successfully treat people with schizophrenia.
Shock treatment earned its shame in the mental asylums of the mid-1900s when it was used to control behavior rather than heal. Unwilling and fully conscious patients were shot through with electricity, convulsing their bodies sometimes to the point of breaking bones, leaving them with holes in their memories or rendering them into zombies. The Jack Nicholson movie One
Flew Over the Cuckoo’s Nest burned into the popular mind a picture of shock treatment that was horrifyingly cruel and inhumane, a misuse of power by men (and that awful Nurse Ratchett) in white coats.
By the mid-‘70s, shock treatment had fallen into disrepute, and doctors began to turn to new drugs to treat their patients. But the practice never entirely disappeared.
Those who continued to use it refined the procedures and applications and gathered data on its effectiveness, particularly in treating severe depression. In the early 1990s, electroconvulsive therapy, as it is now called, began its comeback.
The National Mental Health Association describes ECT as “the most controversial psychiatric treatment.” In 2000, the association called for “increased research and reporting on ECT, so that every person who chooses the treatment does so with a complete knowledge of the risks, without coercion, and only after all other treatment approaches have either failed or been thoroughly evaluated and rejected.”
Dr. Celia Ona, who brought the therapy to Kahi Mohala, stresses that this is not the ECT of the 1930s.
“This is 21st century ECT,” says Ona, who learned the practice while studying at the University of Rochester in New York.
Today’s brand of ECT is much more humane, she says. Patients are anesthetized so they feel nothing. They are given a muscle relaxant so the body doesn’t go into convulsions. And at Kahi Mohala, it is only offered after in-depth consultation and education.
And it works, Ona says. While one-third of patients do not respond to medications, she cites an ECT success rate of 80-90 percent.
Oddly, scientists aren’t sure exactly how or why the treatment works. Ona likens it to setting off chemical fireworks in the brain. These chemicals, or neurotransmitters, are the “feel-good” chemicals such as serotonin and dopamine; the same chemicals acted on by anti-depressants such as Prozac or Zoloft.
Study after study has showed that ECT is safe, Ona says.
“It is well-tested that it does not
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