A Brief History of ECT

Yesterday morning, I found myself waiting on my third electroconvulsive therapy treatment.  The procedure center was backed up, so I waited for a while, and the longer I waited, the more I kept wondering, "What the hell am I doing here?"

I looked around at the other people waiting (though most of the people in the waiting room were family members who were there to transport their loved ones to and from their shock treatment), and tried to take comfort in the fact that if all these other people were having ECT, it can't be that crazy.  But then I started thinking about people who have lined up through the years for other treatments that promise to make them thinner, younger, happier, healthier, stronger.  And how most of those treatments didn't have nearly the negative stigma that "shock therapy" has ("shock therapy," as a name, is passe -- ECT is the politically correct name of choice).

It's no wonder that ECT has such a negative connotation and stigma, based on its origins.  According to Andy Behrman, aka "Electroboy," an advocate for people with depression and bipolar disorder, most doctors know that ECT was dreamed up in the early thirties by an Italian physician named Ugo Cerletti while watching pigs being electrocuted into unconsciousness before being led to slaughter to make them easier to work with.  Cerletti figured the same technique could be applied to mental patients to make them more malleable for their doctors (from electroboy.com).

The practice was introduced into the US the next year (1935) and was used to treat a whole host of mental "illnesses" -- from schizophrenia to homosexuality, from mania to truancy (truancy is a mental illness?  Sometimes I thank God I live in the era I do).  So, obviously, as most new, fabulous medical treatments are, it was grossly overused -- and grossly under-regulated.

According to the doctor administration my treatments, ECT began to be refined and specialized in the 1950s and 1960s, not incidentally along with the growth of the specialty field of anesthesiology (from SUNY Downstate Medical Center).  Concurrently with the improvement of ECT treatments, though, public opinion of the treatment began to plummet.  With the book One Flew Over the Cuckoo's Nest by Ken Kesey (released in 1962) depicting the treatment as barbaric and punishing, and the movie (released 1975) further solidifying that image, ECT all but faded into the background as a treatment of last resort for catatonic or extremely suicidal patients.  Sylvia Plath, the poet, didn't help much, either, with her poem "The Hanging Man":

By the roots of my hair some god got hold of me.   

I sizzled in his blue volts like a desert prophet.

The nights snapped out of sight like a lizard’s eyelid:   

A world of bald white days in a shadeless socket.

A vulturous boredom pinned me in this tree.   

If he were I, he would do what I did.

Written shortly before her death by suicide, Plath described what her ECT treatmenents were like to her.  And it didn't sound like anything anyone else really wanted to repeat.

With all the bad press and negative images in the media of ECT, it's not surprising that most people just assume that ECT is no longer practiced on a larger scale.  But since conditions in which the treatment is administered are more humane and streamlined now than it was 40 years ago, it is again becoming a legitiamite treatment.  According to the University Hospital in University, New Jersey, upwards of 100,000 adults receive ECT a year in the US alone.  

Even though the popularity of the treatment is increasing, there is still a fair amount of argument about whether ECT is more helpful than harmful.  I plan to look in to personal and doctors' accounts of the treatment and write more about that later.  The fact that doctors still don't really understand how it work -- though they can cite different brain imaging technicques to show that it does work -- is also a cause for concern.

But for now, I'm three treatments down and three to go.  Usually, the doctor prescribes 6-12 treatments upfront over a 2-4 week period.  I have to say, they're not really fun.  If nothing else, they're nerve-wracking and wearing on my psyche.  Buy physically, they take their toll as well -- muscle aches (especially the backs of my legs and my back and shoulders), jaw and facial pain, brutal headaches, and a general feeling of being "blunted."  Though maybe the "blunting" is the treatment working, I don't know.

Part of me wants to fight that "blunting."  Is it worth feeling dumber, duller, at the price of feeling less sucicidal and self-injuring?  I have to remind myself that it's not exactly like I'm Van Gogh, or Mozart, or even Plath - the world isn't losing anything if my intellect falls off a few notches.  But if I can spare my kids a mom who is in an out of the hospital, who cries less and plays more, who takes more of an interest in their doings, I guess it's worth it.