Adverse Psychological Effects of ECT

Although this investigation did not specifically seek to investigate the effects of ECT on memory, nearly all participants spontaneously reported some degree of loss. While acknowledging that medication and depression itself can affect the memory, they nevertheless believed that ECT had also been an important factor, and this caused much concern:

`Sometimes it really affects me, I break out in a cold sweat. Have I really got brain damage?'

`It's not the thought disorder that's disturbing me now, it's the damage done by the ECT... I've probably got another 50 years to go, and I thought, well, I'm going to be damaged for the rest of my life'.

Some participants had lost large pieces of their lives, which was particularly upsetting where the memories involved young children:

`My memory is terrible, absolutely terrible. can't even remember Sarah's first steps, and that's really hurtful...losing the memory of the kids growing up was awful '.

'I can't remember when they started junior school, I can't remember when they left infant school. Now those are things you remember, they're highlights...and I'm quite resentful really to think that my ex-husband has got more memories of my children and did pretty well nothing to help'.

The commonest complaints were inability to follow films, books or TV programmes, and problems with facial recognition. These disabilities were both frustrating and embarrassing. Less tangible was the general loss of sense of self described by a few participants:

'I can be reading a magazine and I get halfway through or nearly to the end and I can't remember what it's about, so I've got to read it all over again. Same with a film or a programme on the telly'.

I can understand the individual sentences but when it comes to taking in the whole story, you don't know what the hell's going on really... like reading and I find it very irritating .

`People would come up to me in the street that knew me and would tell me how they knew me and I had no recollection of them at all...very frightening'.

`It happens all the time. It's tiny little things, which on their own don't really matter, but it's this permanent sense of something that you've lost. '

`It's a void, I can't describe it, and there's also a feeling of something fundamental that I don't even know what it is missing.. just like an intrinsic part of me that If feel isn't there and it was once... Part of it feels like there was a real death of something, something died during that time'.

Did ECT have any beneficial effects?

Nine people said that ECT had given them at least some temporary relief from depression, or in one case from hearing voices, although all but two of these felt that the costs had far outweighed the benefits. Two other participants reported a paradoxical effect: 'I felt I'd reached the absolute rock bottom and I couldn't go any further. Everything had been tried... Perhaps If elt the ECT gave me permission to get better'.

`In a very bizarre sort of way, because the treatment and the abuse was so terrible, it made me come to my senses. I've got to get my act together, I've got to help myself.

Two of the nine believed that ECT had 'worked' by triggering a high mood. A man with a diagnosis of manic-depression described how ECT had several times precipitated a change from suicidal depression to elation:

'I felt fantastic... Basically it puts you high, so you need the help then, that's when you need the help. Not, "aren't you doing well, how are you feeling on a scale of one to ten, " "oh about eight or nine, good I can get a job ", "are you, oh fantastic, go out and do it then ". Because you're sick, still sick'.

A woman who also responded dramatically described it like this:

'I felt as though I had become a completely different person...I felt as if I had just totally gone off my head. I was totally dependent on the ward and everything and all of a sudden I think ECT had blasted me into this other reality. And some positive things did come out of it because I went out and I worked for a year and I was discharged from hospital.. It was at a very high cost, obviously. You feel you've got to adapt to this new person that you are...For a year or two afterwards If elt very mad... felt I'd lost the person I used to be... Too happy, really, too sort of split off from the side that was there before I had ECT, that all disappeared completely'.

Nine years later, this woman felt that she had still not entirely reclaimed her real self.

Did you tell anyone how you felt about ECT?

Most participants had felt unable to tell psychiatrists or other professionals of the strength of their feelings about ECT, for the same reasons that prevented them refusing to have it in the first place. The few who tried to hint at their reluctance and terror felt they had been met with little response:

(LJ) `Did you explain to anyone how traumatic it had been for you?'

`No, I didn't dare. They had complete control over you, they could lock you up. You can't be angry with them. People who are, get a really bad time'.

`Once or twice I've been able to say that I think it's a waste of time.. . and they say you've got to complete the course now, you've got to go through to the end and it's best for you and you're not in any fit state at the moment to know what you want. It's like the power's. taken away from you all the time'.