ECT must be outlawed — now
If you arrived at A&E with the same symptoms as ECT produces, you'd be rushed to Intensive Care. Why does this barbaric practice, masquerading as ‘treatment', continue in use? Michael Corry says it should be outlawed
Mary, a 66-year-old woman, was one of 859 patients who in 2003 received Electroconvulsive therapy (ECT) in this country. Two years later, she has trouble remembering how many shock treatments she received, can't remember what time of year she was in hospital, or how many weeks she spent there. "It's all a blur". One thing Mary is certain of is that her memory is greatly diminished: "I feel as if I'm suffering from dementia. I can't remember things, and I keep losing the thread of conversations and I'm always forgetting where I left things. I have to look at old photographs to remind myself of the life I had".
Mary is a retired school teacher whose husband was killed in a road traffic accident in 2002. Her grief was overwhelming, and her adult children were so worried about her living alone that they advised her to sell her home in the country and move to an apartment in Dublin where she could be close to two of them. It did not work out. " I felt enclosed and trapped, I missed the open spaces, my garden and the familiar surroundings. It was like living in a coffin with the lid off". She became anxious and fearful and disliked going to the shops. She dreaded answering the phone. Everything now seemed pointless. Her admission to a private psychiatric hospital with depression was a speedy one.
After three months of hospitalisation and eight sessions of electroconvulsive therapy, she was discharged on three different kinds of medication; an antidepressant, an anti-psychotic and lithium, all of which she still takes. Mary now wants to come off this medication. "I feel numb, and my emotions are frozen. I can no longer feel joy or sadness, instead I feel nothing. If I stop the pills and can start feeling again, maybe it will compensate for my confusion and memory loss." Mary's story is not unusual for many survivors of ECT.
But what exactly is ECT? In many respects, it resembles a surgical procedure. An electrical current of between 70 and 400 volts is passed through the brain of the patient with the intention of producing a grand mal or major epileptic seizure. The voltage is typically as great as that found in the wall sockets in your home. If the current were not limited to the head, it could kill patients by inducing a cardiac arrest, the cause of death in electrocution.
Electrodes are placed over both temples. The electric shock is administered for as little as a fraction of a second to as long as several seconds. The electricity in ECT is so powerful it would burn the skin on the head where the electrodes are placed unless conductive electrode jelly was used. Because a shock-induced seizure is typically far more severe than those suffered during spontaneous epilepsy, in earlier times, unless the patient's body was paralysed by pharmacological agents, it would undergo muscle spasms sufficiently violent at times to crack vertebrae, break limb bones, and damage teeth. To avoid this, current practice involves sedation with a short-acting intravenous barbiturate, followed by muscle paralysis with a curare derivative, and artificial respiration with oxygen to compensate for the paralysis of the patient's breathing musculature.
The shocks create an electrical storm that obliterates the normal electrical patterns in the brain. They are administered in a series over a few weeks, in an average of six to ten sessions, to ensure the procedure ‘takes', that is, alters the electrical activity of the brain in such a way that the individual will not remember, at least for several months, the depression that they were experiencing before the shocks. I have seen a number of patients who have been administered over100 ECT sessions, and are no better as a result.
In essence, ECT is an electrical brain injury, typically producing a global mental dysfunction. Following it the individual is dazed, confused, and disoriented, and cannot remember or appreciate current problems. The changes one sees are consistent with any acute brain injury — a concussion, such as from a blow to the head from a hammer.
If a woman like Mary came to a hospital emergency room displaying the same symptoms as those produced by ECT, perhaps from an electrical accident in her kitchen, she would be treated as an acute medical emergency and might be placed on anticonvulsants. If she developed a headache, stiff neck, and nausea — a triad of symptoms typical of post-ECT patients — she would probably be admitted for observation to the intensive care unit.
The greater the brain damage, the more likely that certain memories and intellectual abilities will never return. Memory deficits, retrograde and anterograde (before and after the event), are among the most common early signs of traumatic brain damage, and are seen in virtually all cases of ECT. Events which follow an ECT session are forgotten completely, such as visitors calling, phone calls received, speaking with their psychiatrist, etc. Memories are foggy about details of personal history such as family weddings, graduations, and jobs. Since the mind is the place the memory calls home, such deficits are extremely anxiety-provoking and disorienting since one's very identity has been altered. Autopsy studies of animals and some of humans show that ECT causes severe cellular damage, including cell death.
Arguments put forward as to the benefits of ECT have to be examined with extreme caution, for several reasons.
