People are polarized over ECT, popularly known as electroshock and otherwise electroconvulsive therapy. It’s either a torture device that must be banned, or it’s a lifesaver. Well, my memory is good enough to remember from psychotherapy that things are not black or white. (It’s a cognitive distortion to think they are, and I learned skills to counter and tolerate that distortion). Reality lies in a shadowy wisp of gray.

I’ve had ECT. It helped, and it hurt. It was administered in a skilled, humane way with fully informed consent, and the slight anterograde memory deficits were not as extreme as I’d feared. But I won’t say they aren’t bothersome. Neither will I say I regret having ECT, since it quickly pulled me out of a very severe treatment-resistant depression when nothing else would. Death was the imminent fear, and what I was rescued from. It’s something opponents of ECT tend to overlook. Hospitalized after a suicide attempt, I’d been in and out of the hospital for months. Every day all day I obsessed over and staved off an intense urge to die. Tired of fighting, I had given in to the urges before. ECT was appropriate as an option.

“Normal” people don’t want to deal with depression, they want it gone and for you to behave how you used to. In that sense, you could view ECT as social control, but then all forms of treatment for depression are too. People suggest this herb or that vitamin supplement, which drug they think you should take or which one they think you should quit. They recommend talking to a therapist (instead of them). They tell you to wake up earlier and get over yourself already and at least pretend to be happy, smile, smile. Fit in. Be like us. Just about the only thing they don’t press you to try is ECT.

After having ECT, I wondered why. My experience was nothing like those horrifying movie scenes: screaming women dragged by evil nurses into decaying rooms to flail wildly under straps, with the same sound effects used for electric chair executions. It wasn’t like that at all. My pdoc discussed it with me as an option, with cautions of its risks. I talked to co-patients in the ward who’d done it, and they all said positive things besides some nasty headaches and forgetful moments. I saw the difference in their faces as light crept back in. What was this unfamiliar underground of satisfied consumers? Why hadn’t I heard their voices?

I realized that happy stories don’t make the news.

There was a frustrating fee to be free from that unbearable depression, and a percentage of other consumers have paid similarly. Memory loss is disconcerting. It annoys people (including me) when I forget conversations, or worse, forget to do things I’d said I’d do. The bulk of the memory problems passed within a couple of months but there are lingering deficits. It’s hard to say exactly how much, though, since there are also cognitive problems with bipolar itself.

Can’t we focus on solutions and improvements, instead of rushing to one side of the fence or another and throwing rocks? I feel like I’m balancing atop that fence (am trying to!). I see good points in both arguments, but also see they’re missing the real issue. People need treatments to recover from intractable depression and mania, and non-drug treatments for pregnant women, etc. They need reliable information about options instead of options taken away (to be replaced with what?). It’s confusing out there, with doctors overly defensive and sometimes minimizing drawbacks, while other people are domain-squatting to spread ideologies.

ECT is a storm cloud in the sky. Don’t focus on lightning bolts or silver linings. Instead notice the cloud is mostly an intangible gray, and rain may help those below.

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    Last reviewed: By John M. Grohol, Psy.D. on 16 Jul 2007
    Published on PsychCentral.com. All rights reserved.