Treatment Resistant Depression and Electroconvulsive Therapy?

Wild Coyote · Feb 04, 2018, 02:41 PM

I have had a "treatment resistant depression" for most of my life.

I had been diagnosed with Major Depression, Severe Atypical, for most of my life. This diagnosis has recently been changed to a "treatment resistant" Bipolar II depression. Either way, it's "treatment resistant depression." I think very many of us know what chronically stubborn depressions are like? Paralyzing, humiliating, often deadly.

I have exhausted med trials. I cannot tolerate most drugs. The few I could tolerate are now giving me dystonic reactions. I have written more about this here: https://forums.psychcentral.com/bipo...e-therapy.html

My pdoc has asked me to consider ECT. I have had ECT suggested many times in the past, by different pdocs, as my depression has always been so stubborn. In the past, I have immediately said "no" to any suggestion of ECT.
However, now things are changing. If I do not yet have tardive dystonia, I certainly do not want to develop a permanent dystonia.

I am starting my ECT research, a part of which is learning from other having had experience with ECT. I am hoping someone might share their experience with me.

Have you had ECT experience?
Was ECT helpful?
Did you complete a short course of ECT or did you also do longer term maintenance therapy?
Would you recommend ECT to a loved one in need?
Is there anything else you feel is important to share, either experiences, opinions, concerns?

Thank you very much for sharing anything at all. This is a big decision for me. I am going to take some time to make this decision, so please do not see the date on this post and feel it's "out dated." I'll likely still be reading responses.

WC

Feb 05, 2018, 02:40 PM

I have not done ECT myself, so I can't answer your questions. I just wanted to give you a hug and bump your thread.

Wild Coyote · Feb 05, 2018, 04:05 PM

Quote:

Originally Posted by TheSadGirl

I have not done ECT myself, so I can't answer your questions. I just wanted to give you a hug and bump your thread.

Thank you!

WC

tecomsin · Feb 05, 2018, 05:48 PM

I hope you get some replies one day to this thread. I've not had ECT but also have long, deep depressions that don't seem to respond to medication and worry about long term side effects of antipsychotics and other psych meds. Maybe google scholar is a friend here and I also wouldn't want to extrapolate too much from one or two experiences. My impression is there can be big upsides and also big downsides, so it's risky. I have some weird neurological symptoms and take indomethacin for what are called (without exaggeration) "idiopathic stabbing headaches".

We both have serious health issues, on top of the mental illness. That is a double whammy and i do think people like us should be congratulated each day for just living it without complaining too much. haha

But more seriously, it could be that some of the depression is situational too. I am currently a lung cancer survivor. That is a situation. I also live alone and spend inordinate amounts of time alone. My energy is super low. I mean taking a shower, driving to Walmart and cleaning the dishes is a big day.

I just add finally that I really appreciate your presence, WC.

Wild Coyote · Feb 05, 2018, 06:20 PM

Quote:

Originally Posted by tecomsin

I hope you get some replies one day to this thread. I've not had ECT but also have long, deep depressions that don't seem to respond to medication and worry about long term side effects of antipsychotics and other psych meds. Maybe google scholar is a friend here and I also wouldn't want to extrapolate too much from one or two experiences. My impression is there can be big upsides and also big downsides, so it's risky. I have some weird neurological symptoms and take indomethacin for what are called (without exaggeration) "idiopathic stabbing headaches".

We both have serious health issues, on top of the mental illness. That is a double whammy and i do think people like us should be congratulated each day for just living it without complaining too much. haha

But more seriously, it could be that some of the depression is situational too. I am currently a lung cancer survivor. That is a situation. I also live alone and spend inordinate amounts of time alone. My energy is super low. I mean taking a shower, driving to Walmart and cleaning the dishes is a big day.

I just add finally that I really appreciate your presence, WC.

Yes, you are right, there's a lot to consider. It's definitely not straight-forward. I believe its taking a risk. I am also taking risks with the meds, esp with so much dystonia present. I want to avoid tardive dystonia/dyskinesias, if at all possible. It's feeling like there is no truly promising answer. It's all trial-and-error, hoping people don't get hurt by treatments of any type.

I deeply appreciate your input!
I also appreciate your presence here!

Thanks again!

WC

Bird Feeder · Feb 05, 2018, 06:35 PM

Quote:

Originally Posted by Wild Coyote

Yes, you are right, there's a lot to consider. It's definitely not straight-forward. I believe its taking a risk. I am also taking risks with the meds, esp with so much dystonia present. I want to avoid tardive dystonia/dyskinesias, if at all possible. It's feeling like there is no truly promising answer. It's all trial-and-error, hoping people don't get hurt by treatments of any type.

I deeply appreciate your input!
I also appreciate your presence here!

Thanks again!

WC

I have had ECT for the past 4 years, it is the ONLY thing that has helped my treatment resistant, atypical depression. Although I still take medication I know that the ECT is what is saving my life.

The procedure is very straight forward....you get to the hospital and an IV is started. You are put to sleep for what amounts to 10 mins or so and the treatment is administered. you will wake up somewhat groggy although I don't have the grogginess. You are watched for about one hour and then you go home. I go back to work after my treatments as I have no memory loss or confusion after my treatments. There are people who do, so be prepared for some sort of side effects like memory problems or confusion. If you get them it is usually temporary.

The procedure has literally saved my life time after time. I take treatments every 2 weeks because I have a particularly stubborn depression and the ECT definitely helps me cope.

If you have any questions please feel free to ask.

Good luck to you.

tecomsin · Feb 05, 2018, 07:08 PM

Hey WC, glad that Bird Feeder has jumped into this with personal experience and a good outcome. I'm also one of those people who thinks a lot about long term side effects and quality of life... that many people give psych meds kind of a free pass where if they had to live with the side effects themselves they might not.

Google scholar says that ECT is about %70 effective in bipolar depression. The side effects vary a lot. If I were in your shoes I'd seriously look at figuring out a med cocktail that isn't feeding dystonia. I mean I'd ask myself if I well and truly needed each med and eliminate one at a time. I don't know what you are taking and you may have already done that but in case not it is worth mentioning that meds can be reduced, dropped and switched.

I've got my headaches and weird neurological problems that kind of puts me off the idea of ECT plus my memory is already terrible and wouldn't want it worse and I don't have prominent tardive, dystonia or dyskenia at the moment but if I did I'd be switching meds.

Wild Coyote · Feb 05, 2018, 07:24 PM

Quote:

Originally Posted by tecomsin

Hey WC, glad that Bird Feeder has jumped into this with personal experience and a good outcome. I'm also one of those people who thinks a lot about long term side effects and quality of life... that many people give psych meds kind of a free pass where if they had to live with the side effects themselves they might not.

Google scholar says that ECT is about %70 effective in bipolar depression. The side effects vary a lot. If I were in your shoes I'd seriously look at figuring out a med cocktail that isn't feeding dystonia. I mean I'd ask myself if I well and truly needed each med and eliminate one at a time. I don't know what you are taking and you may have already done that but in case not it is worth mentioning that meds can be reduced, dropped and switched.

I've got my headaches and weird neurological problems that kind of puts me off the idea of ECT plus my memory is already terrible and wouldn't want it worse and I don't have prominent tardive, dystonia or dyskenia at the moment but if I did I'd be switching meds.

I am at a dead-end with meds.
I have tried al kinds of cocktails for over 30 years. This pdoc has been with me for 20 years and we have exhausted everything over and over again. the meds which used to work somewhat now give me dystonia. More than just the AP meds give me dystonia. I've had a lot of exposure to all kinds of meds over the 30 years, trying to treat severe atypical treatment-resistant depression.
I am tapering Abilify in hopes of finding a low dose which does not cause overt dystonia; yet, I get a lot of muscle twitching and myoclonic jerking at 2mg and 4 mg. It does not look like low-dose Abilify is going to be safe for me. We will see, still tapering that med.

Thanks for all of your thoughts/suggestions.

WC

Wild Coyote · Feb 05, 2018, 07:39 PM

Quote:

Originally Posted by Bird Feeder

I have had ECT for the past 4 years, it is the ONLY thing that has helped my treatment resistant, atypical depression. Although I still take medication I know that the ECT is what is saving my life.

The procedure is very straight forward....you get to the hospital and an IV is started. You are put to sleep for what amounts to 10 mins or so and the treatment is administered. you will wake up somewhat groggy although I don't have the grogginess. You are watched for about one hour and then you go home. I go back to work after my treatments as I have no memory loss or confusion after my treatments. There are people who do, so be prepared for some sort of side effects like memory problems or confusion. If you get them it is usually temporary.

The procedure has literally saved my life time after time. I take treatments every 2 weeks because I have a particularly stubborn depression and the ECT definitely helps me cope.

If you have any questions please feel free to ask.

Good luck to you.

Thank you so very much for sharing!
I am very happy for you, in that ECT has been helpful!

I am just getting started with my research. I may have more questions at some point. Thank you for making yourself available for questions.

With Gratitude,

WC