Making our way through the questions on ECT – Top 3 Reasons for Being an Advocate

  1. How do you address the issue of cognitive and memory impairments?
  2. What are your top 3 reasons for being an advocate for ECT?
  3. What are the differences between ‘old’ ECT and ‘modern’ ECT?

fancy

Ooh La La!

So much fun to play dress up! When I was a scrub, a solid big boned unkempt of the Cleveland National Forest bordered lemon groves, when I walked barefoot, disappeared for the entire day in the rattlesnake infested chaparral, when I followed my brothers around like a desperate child, I still liked to play dress-up. I would sneak into my mother’s long closet, a dressing room really, with folding doors. I could hide behind her dresses, or climb up onto her shelves and be nothing more than luggage. But mostly I remember staring at her clothes and shoes. I remember one of her all time best outfits – a blue knit bell-bottomed jumper. A wide white belt with a hand-made gold buckle was an excellent accent. Yes, it would drag down below, but all the better to cover my brown feet.

When I think of my top three reasons for being an advocate for ECT, I think of dress-up. There are so many great options to put on, and I can and do exchange them with aplomb, as Fancy Nancy would say. That’s a French word for poise. It’s fancy. If you catch sight of my brown feet here and there, well, you can’t take the hills out of the psychiatrist I guess.

For today, Reason Numero Uno, (Fancy for #1, in honor of the second language I wanna-be speak):

  • It works most consistently, and most quickly of any treatment available. One must pick her fights after all, mustn’t she?

Reason Ithnān, (Arabic for two, in honor of my fancy mother):

  • It doesn’t touch “the body,” i.e. metabolics. Clean.

Reason Trois, pronounced I think like, twa, (Fancy Nancy’s favorite language. Need anyone explain? “French is fancy”):

For example, just by requiring someone to help with transportation, it’s built in. That thereby inherently increases community awareness of mental illness, something we rarely speak of with each other.

Then there is the medical staff. Our nurses are every patient’s advocate. Our masseuse increases oxytocin and other healing neurotransmitters when the patient’s get their massage waiting for treatment and then when in recovery. Our anesthesiologists are knowledgable, see the patient in their “whole person,” often picking up other issues that then will get the patient to receive treatment and improve the patient’s quality of life (QOL); such as hypertension, obstructive sleep apnea, etc…

There’s more, but basically in ECT, none of our patient’s are alone. That stands.

Question: What are the top three reasons you prefer the treatments you engage in? 

Self-care Tip: It is always helpful to write out why you are doing what you are doing, when it comes to medical treatments.

What are you up to?

Image

Hello Friends,

What are you up to?

Lately, I have been working on getting our ECT book done.  I am spending more time with the kids, exercising less, quilting more, and eating tons of fruit as it is always in season and “going to waste” (which guts me to see) around our little property.  I am still listening to tons of books from audible and I think that my portrait would show me anywhere anytime with earbuds in.  It must annoy others. …What was that?

Let us know what you are doing.

Be a friend to yourself.  Keep on.

Tower-of-Babel Syndrome

COMPLETION-OF-THE-TOWER-OF-BABEL-GENESIS-XI9-2-Q6503

From time to time, I hear complaints that someone’s brain illness got better with medications and/or ECT, but just came back when they stopped. This almost always happens when a patient never transitioned to maintenance ECT and/or medication therapy.

I dub this, the Tower-of-Babel Syndrome.  We all suffer from it at some point in life, trying to be like God.  Or maybe a lesser god?  During this Tower-of-Babel Syndrome, after we have paid the price, after we have complied with the many hard tasks, after we have built ourselves up into something glorious, we are cured from illness. Right? Once we stop perceiving it, illness that is, we are closer to God, more like Him/Her, perhaps more perfect, when we feel better and do not need medical care. Little gusts of wind are all it takes to fill our wings and off we go, living life free from disease laden earth.

But this is a mistaken expression of freedom.

The number one reason for relapse is…? You remember.  Treatment noncompliance. Is relapse most often due to life stressors? There are so many. No. All those reasons for why we think we feel what we feel and do what we do, all those forces acting on us from the outside in, they are not the reasons we relapse most often.

There is something like a super-bug growing amongst us who engage in treatment on and off. We do it four or five months out of seven. We skip here and there and do not “over-react” if we do. “They don’t control me, after-all.” We apperceive the situation. We think we, by not being consistent with medical treatment, demonstrate our freedom. We are free when we engage in medical treatment or when we do not. We are free because we are human.

The super-bug in brain illness is a progression of disease process heightened and sharpened by treatment noncompliance. A growing resistance to treatment and an acceleration of our falls, how long it takes for us to drop into a relapse and how hard and far we fall.

Let us work together to take away barriers to consistent treatment.  You may laugh when you hear about the Tower of Babel.  You can laugh.  A bonus.

The Tower-of-Babel Syndrome is familiar to those of us who stop any variety of medical treatments on our own, excluding our treatment team members, (such as our physician, Wink! Wink!) in our decision to end treatment.

By stopping medical treatment, many of us have this sense of eliminating the reason we started in the first place.  Take treatment.  Disease continues.  Stop treatment.  We are superior.

When my son was about one year old, he learned that if he turned his head away from you, it was as good as denying your existence.  Turn.  You are gone.  Turn back.  You reappear.  Turn.  And just like that, you have been eliminated.  Even now, remembering it delights me.

Not so cute however, is disease relapse.  Maintenance ECT and/or medication therapy has a protective effect on the brain, prophylactic against further insult. It does not increase the distance between Me and God.  It does not increase a mislabeled dependency on treatment.  Maintenance therapy is part of our life journey.  It is part of our ability to be present with ourselves.  It is friendly.

Questions:  What keeps you in treatment?  Do you feel more diseased when taking maintenance therapy?  How do you manage that?  Please tell us your story.

Self-Care Tip:  Stay in maintenance therapy.

More videos showing ECT and discussions around the globe

The Mayo Video uses a cartoon to show the procedure

MSNBC… not a full treatment, but a “demonstration”

Here is a VERY dated video… but it includes Max Fink (the master) the the full procedure

I often recommend this TED Talk to patients.  It doesn’t show the procedure. “Sherwin Nuland:  How electroshock therapy changed me.”

The BBC in the UK showed this video of a real patient getting ECT.

Questions:  What is your evolving opinions about treatment options for brain illnesses?

Value Yourself

tiger cat

The room is dark, shades drawn for hours. Sandra stays unwashed in her blanket.  Around her are gathering piles of laundry and stale air.  Pictures have fallen over in their frames.  Sandra hears her daughter, “Mommy, please get up now.  Let’s get up Mommy.  I want you to get up.”  Sandra’s body feels like a bag of concrete and she tries to explain this to her seven-year-old.  “I’m just so tired, Honey.  You go play.”

Days and then months go by, like this.  Some of them, Sandra is up and functioning.  But mostly just.  She finds her thoughts are not clear.  It is hard to find words, let alone anything around the house.

“Who is this person?” Sandra thinks about herself.  She wonders if her husband will leave her.  He is trying to have sex less and less.  They do not talk and she is pretty sure her last real orgasm was a year ago, Thursday.  She cannot believe he even likes her when she dislikes herself so much.

Sandra is not treating anyone very well.  She has lost what was in her bank and cannot account for her own value.

Our value is not a very politick thing to celebrate, to speak of, or to put at the front of the line, but we, individually are worth it.  Sandra is worth it.

You are worth it.

Sandra was having trouble like this.  She had been missing more and more work, for “sick days” and she was worried she would be replaced.  “Who are these people?” she wondered about her colleagues, whom she used to enjoy, joke with, and compete with.

It occurred to Sandra, at last, that everything that was worth living for was only insecurely hers.  She thought, if she lost them, she would die.  She needed to get better.  She wanted to get better.  All the way better, back to herself, funny and sexy and showered.  That would be real nice.

Sandra took, what for her felt like, a desperate action.  Sandra went to see a psychiatrist.  It was not easy understanding her treatment options but basically they came down to, medications, psychotherapy, and stimulation therapies of which electroconvulsive therapy, or ECT, is the gold standard.

To grasp what these options meant, Sandra needed to think about how long it takes to respond to treatment, the chance of responding to treatment compared with not responding, either at all or only partially, and side effects.  Because of knowing she was about to lose “it all,” (home, marriage, employment, possibly parenting rights, and more,) she decided she needed treatment that was the most likely to work and work fast. (ECT can be up to 90 percent effective in reducing the severity of symptoms.)  Sandra did not want to gain weight.  “I would rather die,” she said.  And she did not want to get other medical problems from trying to treat another.  (We call these iatrogenic, when a medical treatment causes another disease, such as an antidepressant causing obesity.)  Because ECT allowed for all these, Sandra launched her ECT index treatment.  She started in treatment even before she started having hope.  Sandra took the action she was able to, toward her value.

This a a short story about Sandra, but her story goes on in a much richer, and pleasure filled way.  I wrote her story to give you an idea of how someone who has never tried medication therapy may decide on choosing ECT as their first treatment effort when struggling with brain illness.  Because of her value.  Because of our value.

Question:  When you explore your value, what would you like to do that more directly honors you?  What does valuing yourself do for those you value outside of yourself?  How can you show that you value others but caring for yourself?  Please tell us your story.

Self-Care Tip:  Care for yourself to care for others.

Treating Depression with Electroconvulsive Therapy

mcfadden-moMaureen McFadden, a two time Emmy Award winning journalist, at WNDU.  In November 2007, she documented a winning medical series called Rewiring the Brain. 

  See part of the Emmy award winning story on a local man’s path to a better life in the series “Rewiring the Brain.”

I am sharing my response to Ms. McFadden with you, my friends, colleagues, and community, because I choose you for company.  Thank you for that.

Hello Ms. McFadden,

Thank you so much for your work increasing community awareness of ECT and diminishing social stigma.  Thank you for having a life-work, such as this, for obtaining a powerful voice that people want to listen to, and doing what you have done to get attention.  Your influence, hard-earned, is collateral and that you spent it “here” is huge.  I am so grateful.
I am a psychiatrist.  It is difficult for me to work with these, community awareness and social stigma.  I am not special in this difficult experience, of course, and I know that the bummer feeling that I am “alone” in it is a distortion.  Thank you for your company and illuminating presence.  Keep on.
Sana Johnson-Quijada MD