Posted by utopizen on October 22, 2008, at 19:17:52
The quotes from this article by clinicians are the most poetic I have yet to ever read. Enjoy. =)
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Note: article posted here because it discusses meds, ECT. Of interest to anyone interested in pathology of disorder as well.--------------------------
TIME Magazine Monday, Aug. 07, 1972
http://www.time.com/time/magazine/article/0,9171,879142,00.html
DEPRESSION is such a commonly used term and such a frequently experienced mood that there probably would have been no great national concern if it had been learned that Thomas Eagleton had merely sought medical help to shake such a state of mind. But the revelation that his condition had been considered by some doctors clinically serious enough to require electric-shock treatments twice sounded alarming. To many people, that smacks of a radical, frightening assault on the brain that would only be used in desperate circumstances. In fact, both the illness and the remedy are surprisingly commonplace. A panel of experts convened by the American Psychiatric Association to help handle press queries after Eagleton's medical history was revealed calls depression "the most common form of mental disorder." Every year doctors treat some 4,000,000 to 8,000,000 Americans for it; about 250,000 of the cases require hospitalization. No one knows how many undergo shock therapy, which, like the illness, remains in some ways mysterious. Explains Dr. Lothar Kalinowsky, a New York City psychiatrist who was one of the pioneers of electroconvulsive therapy in the U.S.: "We must admit that we are very successfully treating conditions of an unknown cause with treatments of an equally unknown mode of action."There is no clear-cut medical definition of depression (which used to be known as melancholia). No consensus exists on whether it is merely an aggravated degree of the sadness or "blues" that everyone feels at times, whether it stems from some deeply rooted inner psychological condition, or whether it has a biochemical origin in the body. Pragmatically, it tends to be defined by its symptoms: feelings of worthlessness, guilt and anxiety; an inability to find pleasure in normal activities; early-morning sleeplessness; fatigue and change of weight; and occasionally, serious consideration of suicide. When a person's feelings do not seem to be justified by his actual circumstances, and when they interfere with his functioning, he is considered ill.
Shock treatment is not a new technique in treating depression. Modern electroconvulsive therapy was developed by Italian psychiatrists in the late 1930s. They acted on others' observations that patients who developed spontaneous convulsions, as in high fevers, seemed to become less melancholic. Shock therapy in effect artificially throws the body into a brief convulsion.
As practiced today, shock treatments are administered through electrodes attached to the patient's temples. A device the size of a file-card box is used to send an alternating current of about 400 milliamperes through the brain at roughly 100 volts for seven seconds (electric chairs employ a seven-ampere current at 50,000 volts). The resulting convulsion lasts less than a minute. The patient is protected by both muscle-relaxant drugs and anesthesia against one of shock treatment's early hazards: the possibility of arm or leg fractures. The patient experiences loss of recent memory when he regains consciousness, but memory returns quickly to all but elderly patients.
No one knows why the treatment helps, but it usually does. Boston Psychiatrist Robert Arnot theorizes that "when an intense, hard-driving person overdrives himself, the nervous system just won't turn off; shock turns off the mind and stops the patient from thinking about whatever it is that he is preoccupied with." Other experts suggest that the shock somehow shakes up the brain so that "things fall back into their normal places." It is largely because of the lack of scientific understanding about its workings that many psychiatrists distrust the treatment.
There has been a general decline in the use of shock therapy since the 1950s, when various antidepressant drugs such as Marplan and Thorazine came into wide use. Although their effect generally takes place more slowly, they do not present the doctor with the problem of first having to combat his patient's fear of the treatment, as in the case of shock. In treating depression, psychotherapy is always used by psychiatrists, sometimes in combination with shock or drugs. Prevailing medical sentiment seems to have shifted to the idea that shock therapy ought to be only an emergency measure or one of last resort, on the theory that psychotherapy alone can get at the underlying causes of the depression, however elusive they may be. This was not as much the case in 1960, however, when Eagleton first underwent treatment, and it has still not persuaded many doctors and hospitals.
Fast. In medical circles, both St. Louis' Barnes Hospital and Minnesota's Mayo Clinic have a reputation for liberal use of shock therapy; thus the fact that Eagleton was treated by shock at those institutions does not necessarily indicate that his depression was severe. Shock is often preferred by politicians and others in the public eye because it is faster than psychiatric counseling (also cheaper: about $55 a treatment). The American Psychiatric Association claims that electroconvulsive therapy is effective in at least 90% of the depression cases in which it is carefully used, "sometimes in a matter of days and virtually always within a month."
While no psychiatrist can comment intelligently on Eagleton's case without knowing him and without the full disclosure of his records, some say he might well fit a fairly common depression syndrome: the ambitious, energetic and successful person who at moments of achievement envisions even higher goals that seem depressingly out of reach. It is, oddly, an illness of the ablest. Says Washington Psychiatrist Zigmond Lebensohn of Eagleton: "The very fact that he reached out for help is healthy." While recurrence of depression cannot be ruled out, the fact that Eagleton has gone six years without treatment and has performed effectively in office makes it less likely. Lebensohn says he treated high political figures as long as 20 years ago without noting any later ineffectiveness among them. Some psychiatrists even say that Eagleton may be less likely to break under pressure than those who have never undergone such therapy. A period of depression, the A.P.A. panel insists, does not permanently impair a person's judgment.
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thread:858812
URL: http://www.dr-bob.org/babble/20081016/msgs/858812.html