What’s the rush here?

F.D.A. is Studying the Risk of Electroshock Devices

Extract below from the New York Times

“It’s a treatment for the most severe form of depression,” Dr. Kellner said. “It can really be life-saving.” … The treatment costs $1,000 to $2,500 a session, and typically involves three sessions a week for two to four weeks, Dr. Kellner said. The fee includes the services of a psychiatrist and anesthesiologist. The equipment itself costs about $15,000 and may last years.

Hmm. When doctors like Dr. Kellner say electroshock treats the most severe form of depression, this raises questions with me and it should raise questions with others. When I think of someone suffering from “the most severe form of depression” it brings to mind someone who has a long history of depression who is perhaps suicidal. This person has exhausted all other forms of treatment and has discussed the pros and cons of electroshock at length with their doctor.

Here’s a more likely scenario for administering electroshock, based on what happened to us. A young man (e.g. Chris) is admitted to hospital for first episode psychosis. He does not have a history of depression. He is put on respirdal or some other antipychotic along with a tranquillizer. He, at some point within a short time of being admitted, falls into a psychic slump and begins to ask existential questions. Maybe he is told, like Chris was, that he can resume his classes while checking in at night to the hospital. He quickly figures out he can’t cope with classes, leading to feeling, well, depressed. Perhaps his family is an ocean away (as we were) and suddenly, life begins to really look black. He refuses to eat. The doctors call the parents and say that they will administer electroshock if things don’t improve. Being clueless about electroshock, they readily agree. Nobody informs the parents that electroshock is still considered controversial.

All of this happened within a month of Chris entering the hospital with no history of depression. One month! Not a lifetime of struggling to cope with the worst of depression. Situational depression I would call Chris’s case. As it happened, somebody spoke to him and he perked up enough to avoid electroshock. What was also avoided was the insurance bill, which, according to this article, would have run anywhere between $6,000 and $20,000. For what? For something that human concern could have cleared up for free?

7 thoughts on “What’s the rush here?”

  1. I have some indirect experience with shock therapy (ECT) too. An elderly relative received it last year, and the bill came to over $100,000, but hey! there’s Medicare. Thanks Medicare! I would not have “authorized” this, if given the chance, but in my family I was in the minority. It’s done now. He was zapped, there’s no question about it. There’s some …. loss there, but at the same time, he is to some extent “better.” I’m pretty sure his depression was not caused by the meds (pretty sure, I say) because for several weeks prior, he had been refusing to take them because he said they would get stuck in various parts of his body. These meds included heart and BP medications. He does not have Alzheimer’s.

    It’s good your son did not have this done. I know there are people who swear by it (Dick Cavett). But that they are thinking of downgrading the machine to the level of syringes is bad and should be fought. Breggin blogged about it.

    My relative is surviving in spite of the ECT, I think. He is a difficult person but has a strong life force. Had I been on all the psych meds he’s been on and received ECT, I think I’d have been kaput by now.

    Here’s a link I came across this a.m. about the prevalence of Celiac disease among those who’ve received a diagnosis of schizophrenia.

    http://www.ncbi.nlm.nih.gov/pubmed/19494248

    -B’

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  2. Thanks very much for your comment. My son has been treated for gluten sensitivity as well, not before his diagnosis, but after. I’m a little skeptical of the popularity of the theory that gluten sensitivity may be the cause of schizophrenia. He was treated for two years, at great expense in terms of the vitamins he was taking and the doctors fees, and yet he still relapsed. This led me to believe that “schizophrenia” is more complicated than just being sensitive to gluten. Perhaps gluten sensitivity is the end result of a nervous state. Clear up the psychological underpinning of what is causing you to relapse and the physical symptoms clear up as well.

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  3. I haven’t studied it in any depth to know if there’s any realistic link or not. I do however have Celiac disease which goes a bit beyond gluten sensitivity. My general anxiety has lessened, or better said, I have become more aware (gotten distance) of it and have made the effort to deal with it. In the end, untreated Celiac disease prevents the absorption of vitamins which can lead to a lymphoma of one kind or another, and so on. That is the primary reason I am concerned. It’s a big pain, no doubt about it. But I have to stick to a GF diet.

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  4. It’s nonsense to say that ECT only is for “the most severe form of depression”, and probably this is meant to make the reader, respectively the NYT journalist believe that there’s no such thing as forced ECT, and that everybody happily and gratefully accepts the offer to escape their “severe depression” through ECT. When you read the files and rulings of the Danish Patients’ Complaint Board that involve forced ECT, most of the complaints are not filed by people labelled with “depression”, but by people labelled with “bipolar disorder” and “schizophrenia”. And it’s not that these complaints are few, while only about 10% of them are accepted by the Patients’ Complaint Board. The usual explanation given by the Patients’ Complaint Board to dismiss a complaint is that “all less invasive treatment options had been tried unsuccessfully before ECT was administered”. In some cases these “less invasive treatment options” are explicitly specified: Zyprexa, Haldol, Risperdal, etc. etc. Did anybody try to actually engage in a conversation with the “patient”? Did anybody at any time try to maybe just be there, with the “patient”? No, of course not. Some time ago I watched a Swedish doc about “mental illness”. There was a clip showing a man lying curled up on a hospital bed, clutching the blanket that covered him with his fist. He was left alone, lying there on the bed in an otherwise bare room lit up by glaring neon light. Next door, the staff were busy discussing what label (and what “treatment”) might be most suitable for him. No one was busy joining the guy, offering him company, and the opportunity to talk about the pain he was experiencing. He’d lost his job, his girlfriend had left him, he’d said at the admission, he just couldn’t take it anymore. What the f**k did he do in this cold, hostile room, left entirely to himself and his pain??? What the f**k were these staff thinking about??? It made my blood boil to watch this. But it also was a very clear illustration of how the system, the way it treats people in distress, reinforces “symptoms”, how it tramples on people, and puts those even further down, who already lie down, and provokes those, who already feel threatened to death, even more. And when then the Zyprexa, Haldol, Risperdal, etc. can’t do the job, we’ve got ECT to break people’s resistance with, after we’ve reinforced it to the extent that justifies ECT.

    A good 3 years ago, I had an email exchange with John M. Friedberg on ECT and “catatonia”. He wrote: “Catatonia whatever else it might mean implies resistance. Can resistance be overcome by torture? Obviously.” There’s an element of resistance to all psychiatric “symptoms”. And whenever the resistance can’t be overcome with drugs, ECT is the “treatment” of choice. No matter what label the person has.

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  5. re “I’m a little skeptical of the popularity of the theory that gluten sensitivity may be the cause of schizophrenia.”
    Not THE cause, just a symptom that can be treated logically with trial and error, to a successful conclusion.
    With bad digestion, the person has no energy (in real science no energy in the blood to do work) as well as feeling pain that can lead to anger-short temper. Outburst of anger can then be perceived as schizophrenia. No sleep from bad digestion/too empty or too full stomach, with no sleep, person gets jumpy and irritable again a symptom of schizophrenia. Feeling bad from the stomach , can make a person unreasonable from the cumulative effects from the pain.
    ECT is murder. No one ever faults psychiatry for making the patients depression worse, before they “need” the brain damage of ECT to be better.

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  6. Very well put.

    “The usual explanation given by the Patients’ Complaint Board to dismiss a complaint is that “all less invasive treatment options had been tried unsuccessfully before ECT was administered”.”

    In my relative’s case, ECT was mentioned at the end of the intake interview. I was not present.

    “In some cases these “less invasive treatment options” are explicitly specified: Zyprexa, Haldol, Risperdal, etc. etc.”

    Check.

    “Did anybody try to actually engage in a conversation with the “patient”?”

    Beyond the intake interview and the perfunctory questions about bedding and meals, of course not.

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