Adverse Psychological Effects of ECT - ECT Adverse Effects

Written by Lucy Johnstone

'I can remember asking him (the consultant) about what happened about me coming round (from the ECT) crying, and telling him I felt really frightened having it. And he certainly didn't acknowledge the fact it was frightening '.

'I always said I wasn't feeling any better, but they started saying towards the end they thought was feeling better, and I discovered a lot later that on my notes they invented that the ECT had been a successful treatment, and there was no way I was any better.. At the end of the treatment I had a meeting with the consultant who said he thought was biologically cured of depression... The implication was, I suppose, that all the other things were just personal things I'd got to sort out'.

It is perhaps not surprising that the experience of ECT had left some participants with a lasting distrust of mental health professionals and hospitals:

`When I was in hospital last time I was terrified that they were going to give it to me again. They promised they wouldn't, but can I trust them, can I trust them ? I was terrified, I hated walking across the room where they did it'.

`It was a useful lesson really. It's not sensible in this world to tell psychiatrists of your, what they call "delusional systems ", and in fact I never told them another one'.

(This woman was feeling suicidal around the time of the interview, but had deliberately not told her community psychiatric nurse. She had previously had ECT under section.) `They've only got to mention the word hospital to me and I freak out... when I go into hospital, I won't trust nobody in there, because my mind runs away with me. Are they going to force me to have ECT?... I know the staff on the ward, I've been there so many times, but each time I've been and come away, when I have to go back again I try and build that trust up all over again'.

Many participants were very unhappy with other aspects of their psychiatric care, such as the use of medication. However, a number of them made the point that there is something qualitatively different about ECT: the idea of putting electricity through someone's head carries powerful symbolic meanings which still apply no matter how caringly the intervention is delivered. It can be experienced as a brutal assault on your very self: 'I think to tie somebody up and zap them with electricity...it goes back to the days of Frankenstein, doesn't it'.

`Well, it's an assault on your head, isn't it? It's an assault on who you are, you are in your head. And yet you've gone to them expecting them to heal you '.

'I would have thought anyone would be apprehensive about something like that, especially when they are messing about with your brain. That's the centre of your being, isn't it?'

`They make it all nice, they're nice to you when you go into the room, they pamper you a bit...talking to you very personably (sic) and all they want to do is jolt you with a thousand volts...It goes back to the Jews, doesn't it, who went into this room and had a nice shower'.

What other forms of help would have been more appropriate instead of ECT?

Nearly all participants were convinced, looking back, that ECT and all its disadvantages could have been avoided had the right kind of counselling and support been available instead:

`It was so obvious that one of the things I needed help with was grieving for this friend. I needed to be given some way of knowing that I belonged to the human race'.

`You used to say what you thought your troubles was, and she was nice, this doctor I had, and she would talk back and explain everything to me...If I could have carried on with her, on Valium, I would never have had ECT'.

`There was one nurse who was actually a trained counsellor and about three or four years ago I was quite ill and there were things I wasn't disclosing to anybody, not even friends or whatever, and when I was in hospital I managed to talk to her and it all came out, and that was like a step forward'.

`Although at that particular time I was very very psychotic, I needed to be allowed to be mad, but be somewhere with human decency and not be so restricted...I needed someone to talk to more than anything '.

`Somebody sitting down with me in a room on your own, talking to you when you needed it... There were so many people on the ward and only three nurses, so you didn't get a lot of attention'.

Ten of the 20 participants had ultimately been able to take up a variety of occupations including student, caretaker and voluntary or paid worker in the mental health field. Two of the ten felt that they had recovered largely by their own efforts. The other eight had finally found the help they needed through a mixture of counselling/therapy, self-help groups and support from other service users: `I've had private therapy on and off for about 4 or 5 years which I pay for, so that's helped a lot'.

'I ultimately found the answer at a tranquilliser withdrawal group. I work for them and we all help and encourage each other, support each other and it's brilliant. And you have to build back your self-esteem, your self-worth, it doesn't just happen...and it's fantastic '.

'I had so much inspiration from other people who were further on (at a support group), and I really just got involved and started helping out there and becoming a bit more empowered...I just knew that's what I wanted to do, try and help other people in the way that that helped me'.