Shocked Back to Life (ECT)
The nurse gently took my hand and led me to the chair. I had put the gowns on to cover my front and back and as I started to lie down they were twisting around my body. She helped me to straighten them. The chair was in the upright position and I leaned slightly back and made contact with the backrest. The nurse was adjusting my legs and I was aware of the Anethetist to my left taking my arm gently. It was nearly time and I was paralyzed and overwhelmed by a numbing sensation of hopelessness and fear. From my raised position I could make out what seemed to be at least three other persons, all staring intently at me. I could feel their eyes boring into me. What was passing through their minds at this moment? Somewhere deep inside of my tortured soul I pleaded for their understanding. Could they not see that I was a good man at heart, someone who had just gone wrong, someone who could not help it. A broken lifespirit crying out for help. To my left I heard the soft voice of the man getting ready to let me have some rest from this hell. " Relax Alan, it won’t be long now." The nurse appeared at my side again and smeared a strong smelling liquid on my left and right temple. It must have started to run into my eyes and instinctively my hand moved to wipe it. She beat me to it and pulled my hand away and wiped my eyes clean. "How's that?" Unable to speak I nodded and she took this as a yes and stepped back.
Moments later she reappeared holding two leads with what appeared to be stickers attached to the end. These were gently pressed onto my temples and then she stepped back again. Time was now in double slow motion and through my haze of confusion I noticed all the bright flickering lights of the machines around the room. My mouth was so dry that the shock of the salty taste of my own tears brought a new wave of panic. I wanted to scream out for someone in this torture chamber to hold me and say that everything would be all right. I suddenly tried to sit upright and at that very moment my own Psychiatrist was standing at the bottom of the chair. At last somebody who knew and understood me. He stood with his arms folded behind his back. " And how are you this morning Alan?" He pronounced my name with a kind of French accent and as I paused to consider this strange action I leaned back on the chair. I closed my eyes and the only thought that I could muster was who was going to throw the switch? I opened them again and a stillness had settled over the chamber. Peering into the eyes of my Psychiatrist and the nurse I could sense that it was time to rock n’ roll. How I wish that my Mary was standing beside me now. A terrible weight descended on me and I now knew that I was ready. The months of desperation and pain compressed into a single second and I was tired, so very tired. I sensed a movement to my right and before I could respond the blackness overcame me.
And so began my journey back from the suicidal hell of chronic depression and hopelessness. The "Shock" was so powerful that I awoke about 45 minutes later to find myself standing at the reception desk, with my escort nurse at my side and in the middle of a conversation. I felt no pain and only a kind of dreamlike reality surrounded me. I managed to walk slowly back to my ward and thus began my experience of the ‘last resort treatment" of ECT. The trip to the Annexe was to be repeated four more times, every morning at about 6.45am. Once back in my bed I would be given breakfast and I would spend the rest of the day watching T.V. and reading. I could sense that something had happened to me but I could just not put my finger on my feelings. After the months of torment, tears and despair I was sure that somehow or other the lifespirit was returning to my broken soul. I was calm and yet at the same time not quite sure what my feelings were before this latest chapter on my journey. The nurses were continually in and out of my room with my meals, snacks and pills and I slowly started to realise that I was alive and well. I wasn’t perfect but all things considered the glimmer of hope was returning. At night I slept like a baby and every meal was a treat for me. My Psychiatrist regularly came to visit me and said that everything was going well.
After the first "Shock" the whole mission of getting down to the Annexe and walking into the "Shock Chamber" did not seem as horrific and I even found myself admiring the lovely Durban morning. It had became a time to savour the rest and peace. To savour the thrill of the splashing water under the shower and the clean bedding. To recognise my favourite T.V. show and to hold a conversation with one of the nurses without tears and raised voices. To stand on the balcony and marvel at the sight of the Port of Durban. To come to terms with the fact that I was maybe going to make it after all the drama that I had put myself and my loved ones through. By day five I was almost feeling human again. Physically I still felt as though I was not back to 100% and generally I seemed to exist in a slight blur but with no pain. My Doctor came in to say goodbye and give me the drugs that I would need in the weeks ahead. I liked him. He was a quiet and compassionate man and wished me well. He also asked to come and see him in a couple of months time. I dressed and waited for Mary and my parents to arrive. I had my back to the door when they walked in. I turned and almost ran into Mary’s arms. She held me tightly and I murmured quietly in her ear. "I’m back."
And so ended my personal experience with Electro Convulsive Therapy (ECT). That it had been life-saving in my case was beyond doubt. I walked out of hospital with most of my reason and personality returned to me. I had walked in a babbling and confused man, probably close to taking my own life. Chronic and long-term depression had reduced me to a shell of my former self. Self-hate had brought me to the brink of self-anihilation, the last desperate act of depression. The late American President, Abraham Lincoln, himself a sufferer had described it perfectly, "To remain as I am is impossible. I must die, or be better." After months of counselling and numerable drugs my home Doctor confided in me that it was time to try ECT. He later told me that I was one of the worst cases of mania and depression that he had encountered. Even in my confusion and mental pain this advice took me by surprise. As with most laymen my visions of ‘Shock Treatment’ were not inspiring. Movies such as ‘One Flew over the Cukoo’s Nest’ had not helped. I had images in my mind of been dragged into an institution, strapped down on a bed and forced to endure a form of legalised torture which would result in a scene of spine-twisting, tongue-shrieking and bone-breaking torment. However I found myself in such a cold and isolated place, with no immediate hope for a recovery that I was ready to try anything that would relieve me of my misery. I made the right choice.
Fortunately for me the advances in modern Psychiatry have resulted in a well-used but controversial form of treatment. The controversy appears to be based mainly on an emotional level rather than medical science. In 1934 Ladislas Meduna, a Hungarian neuropsychiatrist noticed that sufferers of Schizophrenia who developed epilepsy showed a remarkable improvement. He went on to intentionally induce seizures by injecting chemicals. By 1938 Italian psychiatrists took this one step on and induced the seizures by means of electrical shocks to the brain. The idea of ECT had been born and until 1954 and the introduction of alternative drugs, such as Thorazine to replace electrical induced seizures, ECT was an important tool in the fight against Schizophrenia, mania and chronic depression.
However by 1970 the new drugs were proving to be not entirely effective and the modern treatment of ECT evolved. It was in this period up to the 1970’s that ‘ShockTreatment’ achieved it’s dubious reputation. Without the help of anesthetics and muscle relaxants stories were rife of the ‘legalised torture’ inflicted on the mentally ill. There were also claims that the procedure was used to calm many forms of uncontrolable behaviour. The fact is that nearly 100,000 shocks are administrated every year in the U.S. South African figures are harder to come by as the central Department of Health does keep those records but it is widely used in both the public and private sector and unoffical numbers run at around 12,000 annually.
The modern procedure is remarkable safe and according to numerous studies carries no more risk than any minor operation carried out under anesthesia. I returned to my Doctor and asked him to fill in the blanks for me. My initial impression of going to the ‘execution chamber’ is the impression of a very confused and sick man. In reality you are met by a well-oiled and drilled team of professionals well aware of the fear and trepidation that you are feeling at that moment. Ideally they would like you to walk in on your own steam but as is the case with many people you can be sedated beforehand. Once you are on the ‘shockbed’ it is only a matter of minutes until you are under the anesthetic. A rubber bite bloc is inserted in your mouth and straps are positioned on your legs, chest and waist. After getting the go ahead from the Anesthetist and Nurse that your vital signs are O.K. the Psychiatrist administers the electrical shock. This is delivered to your brain via the two electrodes attached to your temples and lasts between 30 and 180 seconds. According to my Doctor there is contortion in your face and legs but nothing like is imagined. After about 30 minutes you are awoken in the recovery room and ready to walk to your ward. In fact in many instances the procedure can be undertaken as an out-patient. In effect the machine-induced brain seizure sends impulses which directly affect the various hormones and master glands which in turn control our moods. It is estimated that 95% of the medical knowledge concerning the human mind has been discovered in the last 10 years so it is comforting to know that people such as Dr. Harold Sackeim of Columbia University U.S.A. considered to be the modern pioneer of ECT, continue their work to improve this very useful tool in the psychiatric fight against mental illness.
There are of course opponents against the continued use of ECT. Their opposition usually stems from some of the side-effects arising from the procedure. Headaches, nausea and memory loss are the most common. In my case I had to completely relearn how to use my computer and on occasions I could not help Mary with her crossword but on the plus side I rediscovered my long lost sex drive! Looking back now it is clear that for about two months I was not the full sixpence! My brother Neil and his wife Irene from Cape Town, whom I had not seen for 5 years came up to see me and Mary and myself went out for lunch with them. To this day I have no recollection of that event.
The World Health Organisation estimate that by the year 2005 depression will be the most serious disease on earth. We live in a fast moving world and stress appears to be part and parcel of modern life. In the April edition of ‘Psychiatric Services’ which is published by the American Psychiatric Association, Curtis E. Hartmann an attorney and writer records his lifelong fight against depression in the most moving way. He has received over 100 shocks over a period of 30 years and it is the only treatment that offers him a chance to live a normal life. His analogy of depression is both accurate and moving at the same time. He akins it to watching your own execution and then been forced to look at the corpse. Like him I use the description of the monster calling on you at any time, without warning. It strips you of your self-worth. It leaves you questioning your very existence. Most importantly over a period of time it strips you of your resolve to fight back.
Depression is a fatal disease. It must be treated as soon as possible and this is where family and loved ones come into the picture. The very people whose life you no doubt made a hell during the worst of your illness are the very ones that can be there when you need it most. As Hartmann says, it is life by strangulation. The great author, Ernest Hemingway booked into the renowned Mayo Clinic for a series of ECT and on coming out wrote, "It was a brilliant cure but the patient is dead." He committed suicide one month later. He had lost his hope.
For me ECT was an astounding success. It has been a year or so since my experience and it has not been an easy road. On occasions I have yearned for peace of mind. The monster comes and goes without warning. This time however I am aware of the great uncharted oceans of the human mind. ECT is now considered to be a ‘continuing’ treatment and for many sufferers regular trips to the ‘chamber’ remain a necessity in an effort to counter the unwelcome visitor that chronic depression can become. Electro Convulsive Therapy gave me back my hope and for that I am eternally grateful. One year ago I had reched the end of the road and through the miracle of ECT I regained the lifespirit within me.
"Hopefully over the last 4 Posts you have got some insight into my struggle with Alcoholism and Depression. Remember there is always hope."
I always like to quote that senior British staesman, Sir Winston Churchill. As the Nazi menace threathened to engulf his little island he declared:
"If you are going through hell, keep going.'"
Better advice was never given.