Electroshock no longer taboo in treating mental illness


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By Linda Carroll

Whether it’s “One Flew Over the Cuckoo’s Nest,” “Girl Interrupted,” or “Homeland,” Hollywood’s portrayals of electroconvulsive therapy have never been pretty.

And the images from those movies and TV shows have only added to a stigma that keeps many desperate patients from opting for a therapy that might turn their lives around, experts say.

“We can’t get past the stigma of all the visuals we’ve seen from movies and the fact that it seems so antiquated when you consider modern medicine,” NBC chief medical editor Dr. Nancy Snyderman told TODAY’s Matt Lauer. “But time and time and time again if you look at patients who have severe depression who don’t respond to medications, they will tell you that ECT works.”

That’s certainly true in Denise Stewart’s case.

Stewart, a mother of two, suffers from schizoaffective disorder. Her hallucinations were pushing her closer and closer to suicide each day.

“There would be voices in my head that would sit there and say, ‘Denise, see the knife in the kitchen? Cut your wrists. Denise, see those pills over there? Take all those pills,’” she told TODAY.

After antidepressants made Stewart’s condition worse, her doctors suggested ECT. And the change was dramatic.

“If it hadn’t been for the electroconvulsive therapy, I wouldn’t be alive right now,” Stewart said.

These days an estimated 100,000 Americans undergo ECT each year – and the process is a lot different from what you see in the media, experts say.

“ECT is now being recognized as an effective treatment, as opposed to something that is barbaric, invasive, and potentially has damaging effects to patients,” said Dr. Jeffrey Lieberman, a professor and chairman of psychiatry at Columbia University.

ECT is being used to treat intractable forms of depression and bipolar disorder.

Simon Winchester, author of “The Man with the Electrified Brain” described his experiences with ECT last week on TODAY.

“Electroconvulsive therapy, stigmatized that it may be, actually for some cases – and I’m a classic example – really does work,” Winchester said.

While the ECT of the 50s could be a body and brain wrenching experience, the therapy has come a long way since then.

The ECT of today is a kinder, gentler therapy. It typically involves a series of sessions, lasting a few seconds each. Patients are sedated and don’t feel – or remember – anything from the experience. Doctors say it can be far more effective than antidepressant medications.

“Seventy to 80 percent of people will respond favorably, in some cases will have a complete remission of symptoms,” Lieberman said.

But nothing is perfect. And in the case of ECT, there are some negative side effects, such as memory loss, which Stewart says she has struggled with.

Side effects of ECT include:

  • Headaches
  • Nausea
  • Muscle aches and soreness
  • Disorientation and confusion
  • Memory problems

The most important side effect, Snyderman said “is the short term memory loss. It is real. But you don’t lose the memory of who you are and what you’ve done in life.”

In some patients, memories come back, in others they don’t, Snyderman said, adding that therapies come with side effects.

Stewart was willing to live with the memory loss because the therapy brought her and her family a sense of hope.

“I’m showing my kids the way life should be,” Stewart said. “I’m showing them there is recovery from mental illness. Life is much better. I have life now. I didn’t have life before.”

ECT is supported by the American Psychiatric Association, the American Medical Association, and the Surgeon General.

For some desperately ill patients it can be the difference between institutionalization and a normal life, but it is not a first line therapy, Snyderman said.

“When medications don’t work ... the whole body of medicine has to be stretched,” she said, adding that doctors will always try medication and psychotherapy first. “I’m not pro ECT. I’m pro using things correctly when nothing else works."