Electroconvulsive therapy or ECT therapy involves administration of electric currents to brain to trigger brief seizures that are therapeutic for certain neurological and mental conditions.
Unlike common understanding of the therapy, it is not painful or traumatic. The misconceptions have been promoted by many movies, for instance, in Ken Kesey’s One Flew over the Cuckoo’s Nest, Jack Nicholson’s character is portrayed to be in pain while receiving the treatment. Beverley Callard, a British actress popularized by her part inCoronation Street, acknowledges that ECT has helped her recover from severe depression.
A case study of ECT and personalitychange
The given case study was conducted by Ronald Pies, a professor of Psychiatry at Tufts University School of Medicine, Boston and Upstate Medical University,Syracuse,NY. He has published several books on the subject. The study shows the positive side of ECT in treating patients with depressive conditions by altering their personality.
Patrice, the subject of the study, suffered from depression. She presented with little interest for life, was lethargic and couldn’t concentrate. Patrice led a moderately good life. Apart from a few physical limitations and modest means, she lived in a comfortable home and had a good marriage. Unlike most depressive patients, she had no story that accounted for the origin and progress of her condition.
It was just depression that arose from within without any apparent cause. Apart from the usual symptoms, Patrice had one more layer to her depression. This aspect is called importuning, known to laymen as being demanding, needy and clingy. Her complaints exhibited needy characteristics. Initially, Patrice was put on a regime of strong antidepressants to treat the condition. Not only that it did not prove very useful, the patient wasn’t at all comfortable with psychoanalytical or exploratory therapy as well.
As an alternative, Dr Pies tried supportive psychotherapy, which helps patients acquire effective problem-solving skills and coping mechanisms. After months of treatments coming to no positive results, doctors concluded that Patrice not only suffered from depression, but also had a personality disorder known as passive-dependent personality disorder (now called dependant personality disorder or DPD).
People suffering from this presentation exhibit an over reliance and have an intense need to be taken care of. They also suffer from the fear of abandonment and require excessive reassurance while making everyday decisions. The disorder took a serious toll on Patrice’s normal life and moods for about a decade before she consulted Dr Pies. He realized the need for some quick and effective treatment when she overdosed on her prescribed medications. After a series of discussions with seniors, a decision was made to give electroconvulsive therapy to Patrice, which has often been the bud of myths and controversies.
The fact is that the rate of remission in ECT is between 60% and 90% compared to anti depression treatments that exhibit a 25% remission rate. ECT is also known to considerably reduce suicidal tendencies in patients. Evidence suggests that ECT treatment increases nerve growth factors that improve connections between the cells in brain. The results last for long periods of time but may require occasional treatments to help maintain good mental health.
Memory loss, a big concern with ECT, is transient and mild with the latest advancements in ECT technology. Muscle relaxants are given that make the treatment pain free. According to a majority of studies done on the subject, memory loss is negligible six months after the treatment is administered.
The benefits seem to greatly outweigh the risks of ECT, including a 4% mortality rate due to suicidal tendencies among patients. However, patients should always be well informed of the risks and benefits of the treatment before-hand.
Patrice agreed to undergo ECT and about a month later the results were dramatically positive. She underwent a course of ECT on the non-dominant part of her brain to minimize any side effects on her cognition. Her depression completely turned around and she was in remission.
There was a significant improvement in her energy level, mood and enthusiasm for life. She has no memory loss complaints. The biggest improvement was a profound transformation in personality.
Editor’s note: This piece is written for information purposes only. ECT is a treatment that should be carefully considered with your mental health team or professionals.