Posted by bob on February 5, 2002, at 14:58:39
In reply to Re: Discovery Channel - Shock Therapy » bob, posted by IsoM on February 5, 2002, at 0:55:55
For someone who doesn't know anything about it, I definitely think ECT did not come off very well at all in that show. They only really present two successes: a tympani player in an orchestra, and a girl that went completely rigid and catatonic around the age of 9 or 10. In the latter case, there was absolutely no other choice. Luckily, the treatments brought her completely out of whatever happened. They don't mention her being on meds. That leaves only the tympani player as someone who WILLINGLY sought treatment and is satisfied with the results. I don't remember him mentioning being on meds either. Curiously, he gets very little air time. I guess lack of controversy doesn't make for a good tv program.
The others are all "failures". One in particular I feel is quite inappropriate. It's an older man who seems to have received a rash of treatments when he was a child (thus placing him in the medieval era for ECT) and then stopped having them. He dwells on the insensitivies of the staff when he was being treated, and naturally attributes ECT to destroying his life. He may very well be right. I don't understand what this has to do with modern day ECT though. His treatments were probably 50 or more years ago. This, of course, gives another opportunity to show what ECT used to be like, file footage and all. Of course it's even more disturbing because he was a young child. They have a liberal dosing of ancient footage from the earlier part of the 20th century where, of course, no muscle relaxants or anesthia are used, so people are flailing and convulsing wildly. I'm not so sure why these type images always have to be shown with ECT. It seems people are very reluctant to let go of what the treatment used to be.
There is a woman who appears in her thirties who describes having had a psychotic episode of depression in the about 5 or 10 years ago. She underwent ECT treatment and is now on meds. She says if they had the meds then that they have now she wouldn't have had to do it (she apparently is taking a med that wasn't available then, although I wouldn't hazard a guess as to what that would be). I contend that the decision would have been no clearer today than it was then. Besides, ECT often changes how people respond to meds. It seems to me the ECT did do what no med apparently was able to for her. She said she has no "feeling" memory anymore, just factual, and that she wouldn't do it again.
The largest portion of the program is dedicated to a young mother who's depression began with a post-partum espisode and degenerated into chronic unremitting major depression about 5 years ago. She undergoes 6 or 7 treatments in the show, during the course of which, she remits for a short time (about 2 to 3 weeks). Then, she falls right back into depression and requests another treatment. There is no success and she stops. She experiences memory loss, but she says it wasn't major, was short term, and was well worth the chance to feel better for a few weeks. At least here, we get to see what going through an actual course of treatments is like, as they follow her through the procedures.
There is no discussion of maintenance ECT. In every example shown, it is implied or stated that a set number of sessions was given, after which no more were to be administered. I think it's pretty well understood now that ECT is not a cure, except in rare cases. There is also no mention of alternate placement of electrodes. The woman who they follow through treatment is obviously recieving bitemporal. No mention is ever made in the show of RUL, or BF placements. Brevital is used as her anesthetic, so this obviously leads to her confusion upon waking.
They do mention rTMS and show a short stint on that, immediately followed by one of Peter Breggins many appearances ranting about yet another form of "electrical lobotomy".
The show does raise a question for me:
If certain things are found to improve the Electroshock therapy, such as using certain anesthesia, or electrode placements (i.e. Bifrontal), why isn't this information immediately disseminated to all people practicing this therapy? It seems like the place at which the woman was receiving treatment was just blowing through the treatments using Brevital and good old fashioned BT placement. What about Dipravan? What about BF placement?Maybe the show is just revealing ECT treatment for what it is: an absolute last resort treatment for psychotic and/or severe suicidal depression/agitation? Or are there many, many cases out there where ECT is a very successful treatment? They do say that over 100,000 people per year reveive the treatment, and that it is on the rise. Are the vast majority of these 100,000 having their lives irreparably destroyed by these treatments? Breggin states that even the proponents of ECT readily admit that any remission will only be shortlived, and so he asks why we are putting people through this for something that ultimately will not be a solution.
The show raises many more questions than it answers.
poster:bob
thread:92888
URL: http://www.dr-bob.org/babble/20020131/msgs/92975.html