Psychiatric nurse Anita Hagin presented to the U.S. Food and Drug Administration Neurological Devices Panel examining the reclassification of electroconvulsive therapy (ECT) devices on January 27, 2011. These are her remarks as published in the public record of the meeting.
Thank you for this opportunity to speak to the Panel. I’m a psychiatric nurse at Sheppard Pratt Health System, and I came on my day off to express my concern about this issue.
For over 20 years, I have been a registered nurse working with patients receiving ECT. It has been a career of helping people. I can say that I look forward to going to work each day and having the privilege of helping someone battling depression get relief from their symptoms when medications have proven ineffective.
ECT is a treatment that has been proven effective in treating depression. To see a patient who was mute, despondent, suicidal, or psychotic come into the room with a smile and say, “I’m doing better,” there’s professional and personal satisfaction in being part of that. Patients have said to me that ECT has given them their life back.
I come here to speak as an advocate for the patient receiving ECT. Patients receiving ECT have treatment-resistant depression and are often suicidal. The decision to receive ECT comes after much deliberation and thought, to say nothing of the many medication trials they have undergone. The decision by the psychiatrists to refer their patient also comes after prescribing multiple medications in varying doses only to find that their patient continues to suffer and are suicidal. So you see, the decision to receive ECT or prescribe ECT is a seriously considered treatment choice. Ultimately, the decision to receive ECT is made by the patient and the family alone. 71
There are many cases where ECT has been the only treatment that has worked for patients and improved their quality of life. I have two examples.
Mr. S, an inpatient on the geriatric unit, was suffering from a severe depression. He had stopped eating and was being fed by a gastrostomy tube. His family sought help for treatment for Mr. S. He is someone’s husband, father, and grandfather. Medications were not working. He received a course of ECT, and within weeks, he was eating again. We see him now, and he works alongside his son on the family farm. ECT saved his life. What would have happened to Mr. S. if ECT was not available to him?
I have seen many patients with similar stories. I see dramatic improvement in moods that are just short of miraculous.
There’s a mother with two children who was suffering from psychotic depression. I see the fear in her eyes and the tears in the eyes of her husband as she struggles with depression and paranoia that makes it impossible for her to be a wife and mother. Within three treatments, she is smiling, greeting the staff, the paranoia is gone, and the depression is lifting. Only ECT can bring about this type of change. I believe that I save lives every day.
Therefore, it is important to classify the ECT equipment so that it would not interfere with the opportunity for patients who need this lifesaving treatment to receive it. I ask you to be an advocate along with me for the depressed patients, those patients who need this treatment and without it would continue to suffer with severe and debilitating depression.
I also brought a little card from one of our patients that she sent at Christmastime. “I would like to thank everyone in the ECT Suite who helped me get back to being Sarah again. Everyone in my family always talks about how great it is to have me back. I will never get tired of hearing this. My mom says it’s a miracle, and sometimes it brings tears to her eyes. These tears are no longer of worry or sadness but of joy. I finally see how great I am and how great I can be. With all your encouragement and care, I’ve gotten back to work, I’ve gotten back to doing the things I love, and most importantly I’ve gotten back to me. Yesterday was great. I look forward to tomorrow, and my future will be even better.” Thank you.