Electroconvulsive Therapy: what I wish I’d known

Not this bad.

So. When I was in the psych ward last year and my doctors approached me with the idea of electric shock treatment (aka ECT: electroconvulsive therapy), my first reaction was, “that still exists?!” It turns out it’s not the torture treatment it used to be. It’s safe, quick, easy, and very effective. But my hospital wasn’t very good at giving me the full picture, so here’s what I’d like you to know if you’re considering ECT. (Please note, these explanations are in my own words. I’m don’t know if they are 100% accurate, and I’m sure they’re not technically correct. Double-check with a good doctor!)

1. It’s an option for people who are already using the conventional means of therapy and/or medication, and aren’t getting better; and for people who need to get better in a hurry. As a postpartum mother of 4 with suicidal depression, who’d already been on medication and therapy for years, I needed something to change, quick.
2. It re-sets your brain. My husband did a lot of research and found out that ECT kind of erases some of the thought patterns that have built up in your head. If you head back home after your treatments into a situation that hasn’t changed, with all the same stressors and problems, your mind will fall back into its old patterns again. You need to take advantage of the time after ECT to work hard and establish good new patterns for your brain: coping strategies, positive thinking, relaxation techniques, etc. I found Cognitive Behavioral Therapy extremely helpful for this.
3. That means that you’re going to have a long recovery period. You’ll probably need to take time off work, or lessen your other responsibilities. You’ll need people nearby to cover for you and help you out. You’ll need someone to drive you to your treatments and stay in the hospital the whole time, and you’ll need someone to check in on you while you’re recovering. Obviously this is a tall order. But apparently, unless you take these precautions, your ECT may not have much effect and you may end up back where you started.
4. My side effects were short-lived irritability and confusion, and some fairly significant memory loss. I was told that I would lose the memory of the morning before the treatment, and that was it; but in my case, that wasn’t true. I’ve lost memories from the last few years of my life, mostly the last year. I can’t remember places we went, things the kids did, books I’ve read, people I visited. I can’t remember what my friends’ youngest kids are named, or what they’ve told me about recent developments in their lives. It hasn’t really affected my life that much, but it makes me sad. I feel like I’ve lost part of my identity. I think it was worth it, though. I’m not sure how much of my recovery was due to the ECT, and how much was due to medication, therapy, and changes in my situation; but I’ve talked to people for whom ECT was an unequivocal success, even a life-saver.
5. Get somebody you trust to help you research and make the decision, especially if you’re in the hospital or in the middle of a crisis. I was scared, uninformed, panicky, and generally not in any state to make important decisions. I was so lucky to have my persevering husband to depend on. This is something you shouldn’t do alone.

Please write to me if you’d like to talk about it! My email is preverized@aol.com

The Hidden Cross of ADHD

Quick post before I go to work.  I work at a supermarket deli with a boy I’ll call Steve.  He’s extremely hard to work with–rushes around all the time, making funny faces and talking constantly and singing at the top of his lungs, making unfortunate jokes, telling everyone what to do.  The hardest part is that he never gets anything done himself.  He’s extremely obnoxious and slows everyone down, and he can’t understand why nobody likes him.  He’ll charge in and order everyone around, start doing some simple task, then immediately get distracted by three other things.  He’ll stop what he’s doing to answer the phone call you were about to pick up.  At the end of the day, he’s complaining how exhausted he is from working so hard, and he certainly has been running around all day–he’s not lazy–but somehow he’s gotten nothing done, and everyone else has to pick up his slack.

Even the nice people can hardly deal with Steve.  I’m one of the ones who’s nicest to him, and I’ve still lost my temper with him many, many times.  Until the other day, when it suddenly occurred to me: Steve has ADHD.  He’s not stupid, and he’s not lazy; he just can’t keep his mouth quiet and his mind and body still enough to complete a single thing.  And here I am, treating him like a jerk, when it’s not really his fault.

I work with a lot of people with various disabilities, and with most of them it’s easy enough to tell, from their slow speech or their facial structure, that they have mental problems.  But when a person has a disability like ADHD, it’s easy to mistake his symptoms for character flaws.  These people have a hidden cross: they have an excuse for being hard to live with, but it’s not very evident, so they get judged unfairly.  I’m ashamed of myself for not seeing it sooner, since I have a close friend with ADHD and I should have seen the signs earlier.  I’m resolving to be more aware, in the future, that many more of my co-workers may have hidden crosses like this.

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One last note, about ADHD: the friend I mentioned above was diagnosed with ADHD as an adult, and it was literally life-changing.  I was reluctant to accept the diagnosis, because I grew up in an era when classroom diagnosis of ADHD was rampant and lots of kids were medicated unnecessarily.  But I learned that ADHD is not just some trendy diagnosis-du-jour, but something that can really drag down an otherwise intelligent, creative, and hard-working person.  It makes you look like an unaccomplished person who can never see things through, when in reality you’re working as hard as you can.  It makes you doubt your self-worth, and blame yourself for your failures instead of blaming your disability.  And it can be very hard for other people to recognize, because it doesn’t always fit the stereotype of the hyperactive little boy; often it is characterized as the “innattentive” type, which doesn’t involve hyperactivity at all.  I’d encourage everyone to read a book that opened my eyes to the reality of ADHD: Driven to Distraction by Edward Hallowell and John Ratey.  There’s also an extremely helpful book by Melissa Orlov, The ADHD Effect on Marriage, which despite the title can be a good guide for friends and relatives, not just spouses.