Answering Jim, professionally and personally – ECT

A few days ago, Jim, from blog, “I Don’t Want To Talk About It,” asked in his comment to my blog post,

What is your educated opinion about this?  A friend of mine is seriously considering this.

Jim was asking regarding ECT – electroconvulsive therapy.

021 Side Effect

021 Side Effect (Photo credit: Jester Jay Music)

Responding to a question that asks me to answer both personally and professionally is a little uncomfortable but this is my best effort.

…Alright, Provocateur Jim, I have been chewing my cheek on this, wanting to say something profound, considered “educated,” ūüôā yet not to turn anyone off with an up-tilted schnoz.

I do love ECT as a treatment option.

ECT is not for everyone of course, as nothing is, but consider it if you are looking for a treatment to work quickly and effectively .

Quickly is important.

  1. Can be life-saving, (“Timing is everything,” they say)
  2. Brain health short and long-term
  • less dementia,
  • less onset of other brain illnesses that come when one brain illness is not fully treated,
  • easier to respond to any future necessary treatments when we get more rapid and full treatment response to current illness episode,
  • ECT (as with medication therapy) that is done earlier in illness episode has a more robust response,
  • relapses are less severe, and we do not drop as rapidly when treatment is obtained more quickly for current illness episode

3. Quality of life,
4. Halt the damage to interpersonal relationships,
5. Diminish financial demise secondary to disability of brain illness,
6. Minimize side-effects,
7. Minimize medications.

Efficacy… do we really need to even say that the goal is to use a treatment that works?¬† ECT works more often and more thoroughly than any other treatment options.

Furthermore, we suffer less illness relapse when ECT is continued in maintenance.

Treatment response is much more robust when ECT is combined with medication.

Side Effects:

The side effects can only be measured on an individual basis, as qualified by the person going through them.

First off, there is no brain damage done by ECT, as seen in medical studies. This is a common fear.

Neither does ECT go through the body systems, it is not metabolized, and does not touch our body organs.  Yay, right!?  Medication side effects are a huge pill-dotted elephant in the room.  ECT does not touch the body (i.e. It is not a substance ingested or entered materially into the body,) all related potential side effects never happen.

The number one reason for relapse in brain illness is medication noncompliance.   This is due to many reasons, such as intolerable side-effects and the cascade of subsequent related issues.  Even dry mouth can lead to root canals.  We do not think of osteoporosis from serotonin agents.  Not taking our medication daily can be for more obvious reasons, like not climaxing during orgasm.

Zoloft Side effects in women

Zoloft Side effects in women (Photo credit: Life Mental Health)

Plus, it is just hard to remember.  Even the most consistent of us generally miss one to two days of medication a week or a month.  It is tough to be consistent.
ECT is less difficult to remember and maintenance ECT is much less frequent than taking pills every day.  Even when the ECT is combined with medication, if a day or two is missed, at least the ECT will be consistent as it has the support of the community of ECT staff and the transportation person to and from the surgery center.

In these regards, ECT has fewer barriers to treatment compliance that the majority of us suffer with medication therapies.  That is a big deal.

The side-effects of ECT are generally headache and temporary memory loss.

During index treatment, (about the first 3-4 weeks,) it is common to experience difficulty imprinting/recording memories. This typically takes about five weeks after the index treatment to return toward baseline. 80 years of data do not demonstrate that there is other memory loss but there are individual complaints of that.

Headaches are common for the the first couple treatments until the anesthesia becomes customized to the individuals experience. Generally after the first few treatments, the personalized anesthesia medications are able to resolve these from causing too much suffering. Not universally of course, but generally. Then once the maintenance treatments get going, memory loss and headaches are not common complaints.

…Big breath…

Did I do it? ¬†Any questions about this diatribe? ¬†ūüôā ¬†Thank you for your patience. ¬†I am trying… ¬†Please let me know. ¬†Keep on.

The Pleasure That Should Be Ours In Emotional Health

Cup of coffee with whipped cream

Image via Wikipedia

Some time, I’d like to come back to our bullying series as there is still some help to be had for us. ¬†However, today, my cherubs are asleep and it’s only seven PM. ¬†My feet are up. ¬†I’m sitting by lots of beauty colored in varied hues of sunset, shadow and dusk. ¬†Tonight will be short. ¬†I will let today end and indulge the coming together of these things. ¬†(I am even drinking reheated coffee with lots of whipped cream!)

What I have thought of to share with you my friends, as I’ve enjoyed its friendly work on me today, is the pleasure that should be ours in emotional health.

Bad things will come. ¬†We will have anger, lower communication and such. ¬†We will wish we hadn’t pushed the call button on the phone by accident when yelling. ¬†BUT. ¬†But (“Mommy you said a potty word!”). ¬†But it will pass. ¬†It will not define our day or our perception of self. ¬†We won’t¬†catastrophize and we will trust ourselves to show love and mercy to Me in our weakness. ¬†This is a pleasure to experience. ¬†This is what comes when we have brain health.

If this is what has always been your reality, well great. ¬†BUT. ¬†But (“Mommy! ¬†Why did you say that?). ¬†But, many of us know what it is to crave for days when we can say that the blow-ups, outs and ins don’t blot out the sun. ¬†They shouldn’t. ¬†The pleasure comes with health. ¬†Go for it! ¬†You are worth it. ¬†You were made to feel pleasure.

Questions: ¬†When was it that you realized that your emotions and behaviors didn’t rule you or someone you love any more? ¬†What did/does that mean to you? ¬†Please tell me your story.

(Ah!  There goes the last of the sun and the trees are now silhouettes.)

Self-Care Tip #257 – Go for the pleasure of trusting yourself to respond with healthy emotions and behaviors.

Check Your Read. Even When You Feel Shame, Bullied and Herded, You Are Free.

Eve covers herself and lowers her head in sham...

Image via Wikipedia

Self-Care Tip #219 РCheck your read.  Be a friend to yourself.

I’ve been reading the comments on suicide, thinking and reading and starting who knows how many posts for today, but just couldn’t pull it together. ¬†I spent my time rather drawn to¬†the same words that I hear so many others say as well in clinic, in church, on the street, in the home. ¬†Instead of seeing them find their place in me like I normally do with this kind of crowd, the words kept their space; word-snobs – crutch, selfish, dependent, moral and other words, dusting and reapplying in their reflection.

I had to think, “Why? ¬†Why am I staring like this?” ¬†And so the rest of the day, I¬†perused¬†those thoughts, licked my finger, flick, next, paper-cut and so on. ¬†After all, this is SELF-care I’m talking about, implying I am starting with me.

At last, after rereading yesterdays and past comments, I found the shame I was avoiding. ¬†Why I feel shame about these things isn’t important in this post. ¬†(Maybe another post. ¬†So if you have nothing else to keep you reading, you’ll have that dish to bait you.)

Shame comes when implied or direct judgment creeps into our space.  It herds us.  We are bullied and lose our personal boundaries.  It touches and violates.  That is what shame does.  Any time our perception of freedom feels threatened, it is normal to want to defend ourselves.  Separating from stigma is a normal response.

Claiming the shame, however, isn’t forced on us. ¬†It is our choice. ¬†Once we own the shame, then wanting to get away from reminders of it, of course, is natural for anyone. ¬†But jog back and see. ¬†The perception of shame was never forced on us. ¬†We are free. ¬†We are free to feel, to perceive, to believe, to choose or to stop rubbernecking at the sparkling drama.

He made me so mad…!

She really hurt me.

You ruined my life!

I don’t want to take medications because my husband makes fun of me.

I take Prozac but I don’t have mental illness. ¬†I’d be ashamed to…

It is a normal response to not want to be in the space where we feel these things. ¬†That is natural and what many have thought worth fighting for. ¬†But what if our perception, our Sixth Sense, wasn’t getting a good read? ¬†A war might have been avoided. ¬†Our lives might be lived differently.

We really are free, already, to choose.

Question:  How do you see shame affecting your ability to be friendly with yourself?  Or others?  How have different perceptions put you in a place that felt more free and safe?  Please tell me your story.

Bring Your Separate Selves Together – Personal Journey

National Museum, Czartoryski Collection

Image via Wikipedia

Self-Care Tip #199 – Bring together what you are naturally inclined to do with what you spend your energies on.

When we do what we like to do, what is congruent with our hard-wiring, what is naturally inspiring, fatigue becomes part of our pleasure in my life.  Cliché,

Enjoy the burn,

…is common for a reason. ¬†There are times when pain, fatigue, difficulty and hard-surfaced days are bits of what make life journey one of richness, rather than diminished. ¬†I was reminded by Jaclyn Rae’s Blog-post today,¬†that when we can say,

I’ve¬†learned that I’m tired but still want to do what I do,

…we are paddling the same river our life is floating down. ¬†When we by mental illness,¬†misfortune, choice or neglect, don’t – we are more observant of our lives rather than participants to them. ¬†We find being present in the process difficult. ¬†It’s not something everyone can do in all aspects.

However, we don’t have to be defined by those particulars, choosing instead to do the hard work of processing our choices, our energy and where it comes from, our emotions and see how they weave into our constitution. ¬†Then, some time when breathing hard, limping and spent, we will remember this and reconnect the experience with the choice and the emotion a little quicker. ¬†We will less often separate from the water our life is traveling. ¬†Not become observers but participate more often, more actively, more tangibly with that¬†kernel¬†in us that stays, our essence. ¬†(See blog post, My Essence.)

In the marvelous work,¬†‚ÄúHis Dark Materials‚ÄĚ trilogy,¬†Philip Pullman describes us as split persons, a body and a spirit (“demon”) that might be parted by neglect, carelessness, abuse, or other¬†disasters. ¬†But when it is separated, the body suffers and is disconnected from it’s life purpose, what brings pleasure and presence in the world around. ¬†(See blog post, Soul and Body.)

There are medical illnesses that do this, as mentioned above, and in those cases, perhaps all to do is get medical care, heal, treat and get on with life.  Other times, it might be that we forgot ourselves in the midst of caring for children, a demanding job, an opinion that victim-hood defines our life possibilities or what not.  We have options.

As Jjen reminded us some days ago,

The bad doesn’t disappear but it is not a qualifier for the rest of life’s potential.

Questions:  How have you reconnected to your life journey?  Your essence?  What is constant about you in your changing self?  Please tell me your story.

Just to Feel Pleasure


Image via Wikipedia

Self-Care Tip #189 – Heal for yourself, and you’ll see that also, everyone heals.

The best thing I ever did was go on antidepressants.

Bianca sat, but her whole body was talking.  She was telling me about her changing life.  She had read some of her journal from a year ago when she pounded on herself for her behaviors.  She thoroughly grieved the time with her children when they heard her scream about small things that kids do.  She told me about her sons face when she was irritable.  He showed all the waiting tension that an open child will when waiting for Mom to lose it.  She was trying to push it aside and think rather about how she now could finally enjoy them.  Bianca said,

I just had no idea before how much better life could be.

Bianca’s face became tight and she didn’t make eye-contact,

There’s no way to describe what it’s like to not enjoy your kids – My own kids! – for most of their born lives and then wake up and experience something different. ¬†I just can’t explain what it means to now actually like being with them. ¬†I’ve always loved them but I didn’t feel the pleasure and I hate that. ¬†I want that time back but I can’t have it and I can’t give it to them either.

I’m so scared it will end, the pills will stop working and I’ll lose this new life.

Before her medication, Bianca worked hard at taking care of herself.  She was a check-list of responsible self-care.  Bianca thought it was important that I knew this.

  • Aerobic exercise – check!
  • Healthy diet – check!
  • Sleep hygiene – check!
  • Bianca talked about God but things got confusing for her there. ¬†She didn’t like to think about Him being on “a list.” ¬†He was in her life and didn’t feel He failed her even though she couldn’t feel pleasure or joy.

Still, she continued to coil up and release hard punchy words at her kids and then hate herself for it. ¬†She had prayed so much about this and wouldn’t even mind if God had to puppet her, if that’s what it took, in order for her to treat her kids better. ¬†She could not stop herself from being what she called,

Crazy Mommy.

But now, after she was treated, Crazy Mommy was gone.

Aside from dropping the shame, the best thing for Bianca was knowing that her kids could trust her, felt safe with her and that she felt safe with herself.  Everyone was healing subsequent to Bianca healing.

How many of you have told us a similar story.  A similar rescue.  Yet, never-the-less others of us are afraid to go there.

Question: ¬†How are you present with others who don’t understand your rescue story? ¬†How do you stand beside someone who needs medical help for emotional illness but won’t accept it secondary to stigma? ¬†Please tell us your story.

Waiting For Self-Care to Start

Self-Care Tip #176 – Don’t wait to start caring for your self. ¬†

I’ll get to it when things slow down for me.

I can’t handle one more stress on top of the kids and all the people who take, take, take.

Don’t take this away! ¬†It’s my only vice!

I don’t have time because I’m working so much.

There are so many good reasons to wait for self-care. ¬†I don’t belittle them. ¬†I do them too. ¬†There’s a reason we here at call self-care the hardest work. ¬†It is not for anyone who isn’t willing to go through the fire of putting themselves first.

“The fire,” you say? ¬†Yes. ¬†Fred taught me that. ¬†He was down twenty pounds, working out almost every day with aerobic and¬†anaerobic¬†exercises, putting his ear-plugs in when sounds escalated his nerves, more motivated, interested and active. ¬†Fred was growing again. ¬†He said that it had been years since he’d done any of these things for himself and couldn’t believe what the world looked like when he felt so good.

Fred was sad though. ¬†Not depressed. ¬†No, he hadn’t been depressed for at least a year on his medication and even less so since he was taking care of himself physically. ¬†But sad. ¬†His wife wasn’t interested in his changes, she was disconnected emotionally, and more so every day it seemed to him as he began to change physically, emotionally and behaviorally. ¬†His friends were growing distant. ¬†He wasn’t interested in office politics either. ¬†It was a simultaneous coming together of life in himself and a falling away of the life connection in his “previous life,” as he called it. ¬†Surprisingly, the people he loved the most weren’t so happy for him. ¬†Weren’t supportive of him. ¬†He was sad for that. ¬†There are never gains without losses.

This is not to forget the new relationships he was growing.  There was new life all around him and he still maintained hope for the connections he had before.  But those people who he had called his own for years were the ones who gave him all the reasons to wait for self-care.  He was way past waiting.  He was already on the other side enjoying the sun.

Question:  What have you overcome to get at your own self-care?  Is there anything your are still waiting to do?  Please tell me your story.

*Art work (assumed) courtesy of

Know What You Are Fighting For – Your Right To Journey.

You Should Be Living

Image via Wikipedia

Self-Care Tip #162 РKnow what you are fighting for.  Be a friend to yourself.

Bridget told me,

I felt free to do something creative without having to feel guilty about it.

She had read the blog post, “Self-Care is Freedom, is Democracy, is Because We Are Accountable.” ¬†I was just starting to think about other good places to go with that but before I got too far she hit me with,

I just hate myself!

Hearing those words is like watching squishy and partly moldy tomatoes hit the wall. ¬†It’s messy. ¬†It’s dirty. ¬†No one’s excited about dealing with it. ¬†And, there is something negative that brought it on. ¬†Readers, you’ll remember this¬†countertransference when you’re the counsellor in some other situation and think, “Darn that Quijada!”

My thoughts bumped and piled up. ¬†Stopped, until they started pulling themselves off of each other. ¬†I tried to put these disparate bits of Bridget’s narrative together. ¬†And I wasn’t alone.

I don’t get it! ¬†Why do I feel this way?

Who doesn’t have conflicting feelings about themselves? ¬†Bridget perceived and celebrated her freedom to self-care, yet was betrayed by her own, just when she was reaching for it. ¬†Is that ok?

What strikes me about Bridget is her journey. ¬†She has struggled with anxiety and depression for many years. ¬†I know with me, she’s been in treatment for five of them. ¬†During that time, she has been lovely although not perfect. ¬†She does her hair, glossy blond in large waves, trim body frame and polite like no one I’ve met. ¬†Many medications have failed her and she has taken those failures and claimed her future over again. ¬†The intense forward movement of her inner self has never been muted, even when she has had thoughts of wanting to die.

I have learned what she values, what she’s willing to let go of and what she isn’t. ¬†Her appearances matter. ¬†She is artsy and gets energy from being alone. ¬†She loves people. ¬†Her marriage is rocky. ¬†She struggles with parenting. ¬†She loves her husband and her children. ¬†Bridget’s journey is a journey of imperfection, beauty and courage.

And here she is again. ¬†Conflicted self, ill, hopeful and claiming her future. ¬†Bridget is right on her course. ¬†I wish I could help more. ¬†I wish she wasn’t still ill. ¬†But I can at least be as courageous as she is. ¬†I can hope with her. ¬†I can stand with her or walk. ¬†I know that put to the question, Bridget prefers this journey than losing the right, the¬†privilege, to journey at all. ¬†Bridget is free. ¬†Many of us are not as free as she is, who knows what she is fighting for.

Question:  What are you fighting for?  If nothing were to ever change for the better in your life, what makes your journey worth it?  Please tell me your story.