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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by denise1966 on August 12, 2005, at 15:13:44
Hi,
Had my first ECT session this morning and really don't know what to do next and feel so indecisive about everything.
Around Christmas time I felt the good effects of Seroxat starting to wane so I went to see a psychiatrist privately and told her I wanted to try two things, plan A) was take Nardil (which I don't particularly like) for a month stop it and then take Seroxat, as the seroxat seemed to work better after doing that before for some inexplicable reason. Plan B) was ECT.
On June 22nd I was told I was being made redundant so I decided that being off work was as good as time as any to start having the ECT. I sent a note to my psychiatrist telling her that was what I wanted to do and she went along with it.
She has been off this week and everything was arranged by email.
Now I'm not sure what to do about the ECT, I feel so crap today, not crap because of the memory problems I'm having but because I feel so depressed. I know ECT can take 13 sessions to work but I feel so impatient and indecisive probably part of the depression I know.
So not sure whether to actually go back to plan A, I know if I suggest this to the psychiatrist when she gets back on Monday, if I actually do get to speak to her on the phone, she'll probably be pissed off and she has every right to be. And then I know what I'm like, if she does agree to let me go back to plan A, and I wouldn't blame her if she does put her foot down this time, I'll end up wishing I'd continued with the ECT as soon as I start the Nardil.
I'm constantly worrying about what treatment to try next because I just can't get the impetus to do anything else and then when I get a new medication I start worrying about what to do if that doesn't work.
Help!
Denise
Posted by med_empowered on August 12, 2005, at 16:21:27
In reply to Had my first ECT and don't know what to do next, posted by denise1966 on August 12, 2005, at 15:13:44
hey! First off, let me be entirely honest and say I'm not a big fan of ECT; I have family members and friends who have done it, and I'm just not impressed...the results don't seem too impressive, especially given the potenital for adverse reactions (which seem to be VERY under-reported) and the enormous expense in terms of time and money that are involved. Now...with that...I think if you're unsure about continuing with ECT, and you think a less aggressive approach (therapy, medications, etc.) *could* be helpful, you owe it to yourself to pursue that option--Option A is what I think you call it. Your shrink might be irritated, that's understandable, but remember: it is YOUR life. Your decision to stop ECT and go back to medication-based therapy might be a hassle for your shrink, but hey--she gets paid to make YOU and her other patients better. If she seems terribly irritated, I'd recommend finding someone else...this is YOUR treatment; she's just there to help you get better. Resuming medication-based treatment will involve waiting for the meds to work, and some meds may not work well for you or may not work at all...unfortunately, that's the way it works. But, if you hang in there, and you have a doctor who is also willing to aggressively treat your condition, which may involve adjusting and changing meds for a while, the odds of finding a useful, effective treatment program should be very good. Again, if your doctor seems impatient with you, or irritated or is otherwise unhelpful in helping you make the progress you want and need to make, please get a different doctor *as soon as possible*. This is YOUR life--there is no sense in spending energy on dealing with unprofessional, callous doctors when that same energy can be (and should be) directed towards building a better life for yourself. You don't owe your shrink ANYTHING. As for being indecisive about what to do...that's completely understandable. Depression is tough, especially when you're not seeing enough progress. Try to accept that you don't know for sure what will work, what won't work, what's best--face it: even shrinks can't predict what will or won't work for any given patient, so why SHOULDN'T you be indecisive? Here's what I do when it comes to tricky situations, both those dealing with my treatment (I have an odd form of Bipolar Disorder, along with some secondary "issues") and any other situations that might arise...try to formulate a very clear goal of how you want to feel, how you want your life to be. Then, try to dig up information on how you can get there--the potential methods of moving from Point "A" to Point "B". Try to get the most in-depth, objective information you can find. Then, try to evaluate each method on its merits--potential side effects, costs, how effective it is--and compare to other available methods. With something as major as ECT, its also important to think *long-term*. In 20 years, where would you like to be? Are the potential reactions to a given treatment acceptable to you, or are they simply not something you could live with? Also, I've found that "thinking outside the box" has helped me a *whole* lot. For example...one thing that has helped my bipolar "issues," more than any medication or therapy, is finding something meaningful and fulfilling to do with my time and energy--for me, its writing and volunteering. I'm schedule to consult with a doc who does a lot of "alternative" (herbs, vitamins, and innovative counselling/therapy methods) work with psychiatric issues. It may or may not work, and I accept that, but I also came to the conclusion that since this is *my* life and *my* problem, I'm going to search for the best treatment for *me*, regardless of whether or not they are "conventional" or "accepted". With problems like bipolar disorder, schizophrenia, and severe, treatment resistant depression, it makes sense to be very, very thorough in your search for help; what benefit do you get, really, from allowing your quest for happiness to be confined to the "usual" program? Anyway, whatever you decide to do, I wish you well. Please post to let everybody know how you're doing.
Posted by 4WD on August 12, 2005, at 22:29:40
In reply to Had my first ECT and don't know what to do next, posted by denise1966 on August 12, 2005, at 15:13:44
Denise,
Are you having any ill effects from the ECT? Do you feel that further treatments will make you worse?
The idea of ECT really scares me but it also sometimes seems like a good idea -no medication side effects, etc.
If it were me, I think I would give it a least a few tries before I made up my mind to stop it. UNLESS you feel you are being damaged by it! How many sessions are you scheduled for? Have they told you how long before you should feel better?
I know exactly how yo feel about getting on one med and worrying about if it will work and what will you do if it doesn't. I obsess constantly about that sort of thing. The thing is that when you most need your faculties about you (trying to know how to treat your depression) is exactly when you are unable to do it. When you are so depressed, it's impossible to think rationally and logically.
It's so important to have a doctor you trust. Did your doctor think the ECT was a good idea? Did she want to to try plan a first?
You have my most sincere empathy and sympathy. Whatever you decide to do, know that I will be praying for you.
Marsha
Posted by denise1966 on August 13, 2005, at 4:31:23
In reply to Re: Had my first ECT and don't know what to do next, posted by 4WD on August 12, 2005, at 22:29:40
Hi Marsha,
Thanks so much for your response.
My current psychiatrist is fairly new to me, I started seeing her about two months ago and she has gone along with everything I wanted to do which is why I'm feeling so guilty.
First of all she added Mirtazapine to my Seroxat (this was not at my request though) and I came off the mirtazapine after about a week because I felt too strange and disconnected on it. I told her that I wanted to try Nardil and then do a switch back to seroxat and she was willing to let me try this. However, when I found out I was to be made redundant I practically bamboozled her into rushing through the ECT so that I could have it done privately before my medical insurance ran out. She has rushed all this through for me and now I want to go back to plan A, Nardil to Seroxat and I'm know she will be extremely pissed off with me.
Also, one of the reasons but not the main one that I'm thinking about stopping it is:-
a) My medical insurance runs out on 2nd September, which means I'll only get 7 ECT treatments at the most, after that she is going to have to find some way of getting the NHS to pay for it and I'm not sure if she's thought about that.
b) When I went in for the ECT session yesterday I told the ECT Nurse I wanted Unilateral ECT and wouldn't even consider Bilateral ECT, the nurse wasn't happy at all and said having unilateral ECT would cause problems eventually because of having to have so many of them and because of the eventuall affects of the anaesthetic. She was trying to get me to have Bilateral ECT because less treatments are needed.
To answer your question about how I felt after having ECT, it really wasn't that big a deal, I had some confusion afterwards and ache slightly today but that's about it. I was very apprehensive beforehand because of the fear of the unknown but wouldn't be half as concerned next time if I do have it again.
Denise
Posted by denise1966 on August 13, 2005, at 5:06:13
In reply to Re: Had my first ECT and don't know what to do nex, posted by med_empowered on August 12, 2005, at 16:21:27
Med-Empowered,
Thanks for the support, I think I will go back to plan A which was the Nardil for a month and then switch to Seroxat again in the hope it will somehow help the Seroxat to get working again.
I've tried lots of different medications over the last four years and they've never worked half as well as when I first started taking them 15 years ago and I'm always hankering for that affect deep down.
I must admit I'm pretty cynical when it comes to vitamins, minerals and herbs as I believe that we tend to absorb those naturally providing we eat the right foods.
But anyway good luck to you and thanks again for your support.
Denise
Posted by ed_uk on August 13, 2005, at 9:00:39
In reply to Re: Had my first ECT and don't know what to do next, posted by denise1966 on August 13, 2005, at 4:31:23
>the nurse wasn't happy at all and said having unilateral ECT would cause problems eventually because of having to have so many of them and because of the eventuall affects of the anaesthetic.....
That's nonsense! Unless you're severely medically ill, modern anesthesia is safe - the safety of ECT itself is much less certain. The anesthesia used for ECT is 'light' and brief. Seriously problems are very unlikely - an experienced anesthetist is vital.
Kind regards
~Ed
Posted by 4WD on August 13, 2005, at 22:30:17
In reply to Re: Had my first ECT and don't know what to do next, posted by denise1966 on August 13, 2005, at 4:31:23
Denise,
You have to make your decision based on what you feel is right for you and not whether your pdoc might be pissed off by it. It sounds to me like you have pretty much decided you want to try the Nardil/Seroxat plan. If that's the case, then that's what you should do. Don't worry about what she will think. This is your life. I think for most people, ECT is kind of a last resort and maybe you haven't reached that point yet.
Do you live in the U.S.? If so, you can continue your medical coverage for up to 18 months if you are able to pay the premium (the same group rate your company was paying). If that's an option for you, you might want to do that for at least a couple of months til you figure out what treatment is going to work for you.
Marsha
Posted by linkadge on August 13, 2005, at 23:36:59
In reply to Re: Had my first ECT and don't know what to do next » denise1966, posted by 4WD on August 13, 2005, at 22:30:17
I'm gonna pray for you.
Linkadge
Posted by Mr.Scott on August 14, 2005, at 1:00:40
In reply to Had my first ECT and don't know what to do next, posted by denise1966 on August 12, 2005, at 15:13:44
Hi,
I have had success with right unilateral ECT. I would continue with it for awhile, as for me it has been miraculous. I mean a total and complete turnaround. I agree with you however on wanting to avoid bilateral ECT. I had that once and it confused the hell out of me for 2 days. If you stick with the unilateral and the doctor knows what he/she is doing it will do its job. Its generally considered WAY more effective than these disgusting pills that made me fat, emotionless, and nearly impotent. No thanks I'd rather shoot myself!
Even If RUL ECT takes longer, so what...It will not disrupt your life as much as bilateral. My advice is to carry on with one plan at a time, otherwise if you don't see it through you won't know if it works or not. Just have a little faith that things will be okay, and you may be very surprised to see your depression evaporate without any major side effects (In fact none for me!).
Never give up hope, and try to be brave. My bet is you'll not regret it in the end.
Scott
Posted by denise1966 on August 14, 2005, at 7:45:13
In reply to Re: Had my first ECT and don't know what to do next » denise1966, posted by Mr.Scott on August 14, 2005, at 1:00:40
Hi Mr Scott,
How many treatments before you noticed any improvement?
Also, the ECT nurse said it might be a problem having to have so many anaesthetics, are you finding that a problem so far?
I'm feeling very flat today, which is making me feel pretty negative about everything.
Denise
Denise
Posted by denise1966 on August 14, 2005, at 8:04:19
In reply to Re: Had my first ECT and don't know what to do next, posted by linkadge on August 13, 2005, at 23:36:59
Thanks Linkadge, although my brain does feel pretty much intact.
It wastn't as scarey as I thought although I made sure they only gave me unilateral. The ECT nurse was trying to get me to have Bilateral! and then she started saying something about some people going gaga after having it which really frightened me.
Fortunately I had a really sweet girl accompanying me to the hospital, we both looked at each other after the ECT nurse said the bit about going gaga and the girl asked the nurse to expand on the gaga bit.
Anyway, don't think I'm gaga, just feel very flat today and still not sure what avenue to pursue next. Whether to carry on with the ECT Treatments or try my Nardil to Seroxat plan.
Sometimes I think (as I'm sure many others on this board do) I'm gonna spend my whole life chasing a feeling I'm not even sure is possible anymore.
Denise
Posted by smith562 on August 14, 2005, at 9:26:54
In reply to Had my first ECT and don't know what to do next, posted by denise1966 on August 12, 2005, at 15:13:44
Dear Denise,
It takes about 6 to 12 treatment for ECT to work. Many, many people have received ECT and it was the only treatment to "reset" the brain and allow medication to work again. Hang in there .... ECT is still the *most* effective treatment for depression (75 to 80% response rate).
The most important step is once ECT works, get on low dose lithium and an antidepressant combo (pamelor if possible). Most people needing ECT are these "soft bipolar" patients who need a combo of mood stablizer and antidepressant to get relief.
Smith
Here is an article by the GodFather of ECT ... tell about many famous people who have got ECT
Posted by Mr.Scott on August 14, 2005, at 14:02:25
In reply to Re: To Mr Scott, posted by denise1966 on August 14, 2005, at 7:45:13
Hi Denise!Maybe I got lucky, but I responded after 6 treatments maybe 7. The first one was bilateral however and I almost would not go back due to the confusion it caused me..so they switched me over to right unilateral but eventually I switched over to a better hospital that has a whole unit for the procedure. I now go in once a month for maintenance. I would not worry about the anesthesia, and I'm not sure why the nurse is saying that. I use 250-300mg of Thiopental, along with whatever dose of succinylcholine. One time I noticed they added 5mg of versed. I goto work by 10am after having a treatment.
The hard part is getting the procedure done when you're depressed, because you are so scared and you see it as such a horrible thing, and it means all kinds of things like your a loser and a true nutjob. Nonsense! If you feel bad, and there's no good reason except bipolar disorder or TR Unipolar depression, and ECT helps, do it up! It aint no big thing. Ask Lou Reed..
Where I get it done, its very different from what the stigma is. First off I have ZERO memory loss. In fact I'm more on the ball right away! Second, The long-term effects from ssri's, benzos, and all the other crap they gave me are FAR more likely to cause brain damage than the tiny amount of electricity used in RUL ECT today (according to my doctor who I actually trust). I know SSRI's caused me brain damage. They worked for a long time, but then they started to cause side effects indicative of neurologic damage akin to what some experience from antipsychotic drugs.
Because I am on a maintenance schedule I go in there and joke around both before and after with the doctors and nurses. People make such a big to do out of ECT. It's no big thing! Just scarry.
What's been most dramatic and gratifying for me has actually been to watch other people who came in while they were in the throws of HELL! I mean these people were in such bad shape they had to be watched constantly because they were so suicidal and impulsive. One lady who met that description the previous month whom I saw last week was smiling and talking to the nurses and reading People magazine while waiting. Initially she couldn't stop crying and needed someone to constantly hold her hand. She was in SERIOUS emotional pain and drowning in her fear and emptiness. Not anymore! And not because she has been brain damaged into la la land, but because she has gotten better and is now receiving maintenace.
My advice is to stay the course as help is on the way. Unless you really feel something is wrong follow through on this! Don't let fear guide you away from a possible solution before you have given it a thorough shot (same philosophy with meds). You have to do the deal before you know if it works. Try not to jump around from one modality to the next. Patience, and a little faith that everything will be okay is going to be your ticket out of depression! Everything will be okay no matter what. Believe that, and it will come true!
You may only need 6 treatments and then feel totally undepressed for a year! Thats worth it. I hear a new form of deep brain stimulation that does not require anesthesia is on the way. My guess is you'll feel much better like 80% of the people who get it done (some say the % is actually 90).
Keep talking about it, and you'll be okay.
Scott
Posted by linkadge on August 14, 2005, at 18:02:52
In reply to Re: To Linkadge, posted by denise1966 on August 14, 2005, at 8:04:19
Glad you're ok. Hoping you can feel like yourself.
Linkadge
Posted by denise1966 on August 15, 2005, at 5:30:49
In reply to Re: To Mr Scott » denise1966, posted by Mr.Scott on August 14, 2005, at 14:02:25
Scott,
Thanks so much for the encouragement but I'm feeling soooooo negative today about everything. I'm not afraid to go through with the treatments at all just don't have any motivation whatsoever to do anything.
I really need to get back on some kind of medication, my plan before was to go on Nardil for a month and then switch to the Seroxat in the hope that the Seroxat would somehow start to work again even just a bit.
Now I'm taking nothing and am starting to feel more and more desperate.
What I want to do now is get back on medication and then maybe in a years time think about having ECT again when I'm feeling better than I am now hopefully.
It's not the stigma of ECT I mind or even the thought of having it because at least I know now that it's not that bad it's just I have to get on to some medication somehow.
Denise
Posted by denise1966 on August 17, 2005, at 4:28:29
In reply to Re: To Mr Scott, posted by denise1966 on August 15, 2005, at 5:30:49
Well had another ECT yesterday, Before I had it I was feeling really down and negative and anxious and I came round after having the treatment feeling pretty much the same way.
My mum made me take a Zyprexa (thank God for the Zyprexa) but the whole point in my having ECT is so that I won't have to take the Zyprexa.
I'm going to have the treatment one last time on Friday and then discuss with the Psychiatrist the Nardil to Seroxat idea.
Denise
Posted by ed_uk on August 17, 2005, at 9:01:19
In reply to Re: Had another ECT yesterday and felt awful., posted by denise1966 on August 17, 2005, at 4:28:29
Hi Denise,
>thank God for the Zyprexa
Why don't you try a few different antipsychotics? I'd recommend trying Seroquel or Abilify - they can both relieve depression and anxiety.
~ed
Posted by adamCanada on August 17, 2005, at 21:21:26
In reply to Re: Had my first ECT and don't know what to do next » denise1966, posted by 4WD on August 13, 2005, at 22:30:17
I had ECT done a few times at a point of severe desperation and countless meds not working. Big surprise it didnt work well for me eighter.
What did it do to me? Severe life altering memory problems that still effect me to this very day! Before it was more servere with it being better now but still a problem for me!
I would wake up each day never knowing what HAPPENED the day before. I could be talking on the phone and FORGET WHO I am talking to or what we were talking about. It was and still is Severe Brain Damage.
AND I wish to hell I was properly warned about it as I never would have done it. I STILL cant remember most of what happens each day! I am sick of it
Posted by iforgotmypassword on August 20, 2005, at 15:10:11
In reply to ECT will ruin your life!, posted by adamCanada on August 17, 2005, at 21:21:26
This is the end of the thread.
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