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Dr. Bob is Robert Hsiung, MD,
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Posted by Sigismund on June 29, 2009, at 2:02:45
In reply to Re: ECT - Zeba (My Take)... » Meltingpot, posted by Ant-Rock on June 28, 2009, at 21:37:52
>What I'm getting at, is these possible ECT side effects are no worse than the current state a lot of us are in anyway.
Well, you won't know until you try it, but I'm very doubtful.
Posted by alchemy on June 29, 2009, at 11:15:52
In reply to Re: ECT - Zeba (My Take)..., posted by Sigismund on June 29, 2009, at 2:02:45
a side note: ECT has a much higher success rate than rTMS or antidepressants. The main issues of course are the memory, and will the results last? But there is the option of maintenance ECT.
Posted by Ant-Rock on June 29, 2009, at 12:58:12
In reply to Re: ECT - Zeba (My Take)... » Ant-Rock, posted by Zeba on June 28, 2009, at 23:19:27
> Why not try rTMS rather than go for the extreme??
Thank you for the suggestion Zeba.I was actually one of the first to try rTMS in a depression study at Beth Isreal back in 2000.
I recieved the real treatment, not the sham. There were no major side effects, but it also did nothing for my depression, not even a little.That was a while ago, and it is possible the parameters of the treatment have changed, but my shrink doesn't seem to think it's very effective.
Anthony
Posted by Rdragon on June 30, 2009, at 8:29:35
In reply to Re: ECT - Zeba (My Take)... » Meltingpot, posted by Ant-Rock on June 28, 2009, at 21:37:52
> > Hi Zeba (xxxxx),
> >
> > Well maybe you just had an "episode" of depression that went away on it's own or which responded to therapy (lucky you).
> >
> > A lot of people on this board have suffered from unremitting depression for years and haven't responded to meds or therapy and don't have issues in life that they need to resolve. I guess to them (myself included) ECT might seem like a viable option and as it can be useful tool It shouldn't be removed from the list of things to try.
> >
> > Denise
>
>
> My new take on ECT...
>
> I'm on 90mg parnate, and my depression still isn't abolished. Somewhat better, but still suffer from morning exhaustion/brain fog and fatigue.
> I exersize 3x week on top of working a pretty physical job 6days/week.
> Word retrieval and not having the mental energy to focus properly are very prevalent.
>
> What I'm getting at, is these possible ECT side effects are no worse than the current state alot of us are in anyway.
>
> I have an extremely experienced/compassionate psychiatrist I've been seeing on and off for most of my adult life. He's run out of medication/therapy choices for me years ago, and has always left the door open to ECT, which I have resisted so far.
> He's told me several stories of young professionals in college and doing well after ECT.
>
> I'm seriously starting to think I've blown the best years of my life by resisting ECT out of fear.
>
> Just my 2cents,
> Anthony
>
>
>
>I agree with this post, and I don't want to end up like you. I've decided to wait about another 10 or so months before I go ahead and get the ECT done. I'll have to afford it on my own however, since my parents don't want me getting it. I'm praying that this goes away with time and medication however, and I plan on being on Lexapro, Geodon (or Zprexa), and Lithium. Life is too short to spend it being miserable and I will DO WHATEVER it takes to be normal again (namely ECT).
Posted by SLS on June 30, 2009, at 21:37:11
In reply to Re: ECT - Zeba (My Take)... » Meltingpot, posted by Ant-Rock on June 28, 2009, at 21:37:52
> I'm seriously starting to think I've blown the best years of my life by resisting ECT out of fear.
You have done the best you could on a moment by moment basis with what little you have had to work with. That includes the decision making processes that have thusfar had you avoid trying ECT. My best guess is that if you were to respond to ECT, you wouldn't spend too much time lamenting lost years. I think the wondrous feelings and ease of function that life can bring in the absense of depression will fill you with such gratitude, the grieving process won't be so protracted. You might come to terms with the loss fairly quickly.
Good luck with whatever you choose to do.
- Scott
Posted by Zeba on June 30, 2009, at 23:41:30
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by Rdragon on June 30, 2009, at 8:29:35
Be careful thinking ECT will allow you to feel normal. I lost 26 IQ points, can't find my way places anymore, have word fluency and word retrieval problems, slowed processing of information, poor concentration and attention, and short term memory deficits to name a few.
I feel like Hemingway did before he committed suicide after undergoing ECT at Mayo. He said some famous quote about how the cure made it impossible for him to write again and so no career. He wasn't so depressed, but he could no longer write. He felt his life had been destroyed, and so he just could not go on.
As they say, be careful what you wish for.
Zeba
Posted by SLS on July 1, 2009, at 4:26:43
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock » Rdragon, posted by Zeba on June 30, 2009, at 23:41:30
> Be careful thinking ECT will allow you to feel normal.
I underwent a series of 15 ECT treatments. I would neither endorse them nor condemn them at this point. Just as the application parameters of rTMS have been refined over the last decaded, so, too have those of ECT. However, I just don't trust that ECT will be a benign treatment for everyone. What seems to slip by peoples's attention, is that being very treatment resistent to antidepressant medication makes for a reduced prognosis that ECT will work. Still, if you have reached the end of the line pharmacologically, the choices are few:
1. ECT
2. VNS
3. rTMS
4. DBS
5. PsychotherapyI can't think of any more at the moment. Please add to this list, as I feel that I have reached the end of the line myself.
- Scott
Posted by linkadge on July 1, 2009, at 15:52:25
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by Rdragon on June 30, 2009, at 8:29:35
>will DO WHATEVER it takes to be normal again (namely ECT).
Well, that is if you think ECT will make you "noraml" again. Even if it does induce some sort of improvement, it will be (from a statistics standpoint) only temporary.
Linkadge
Posted by linkadge on July 1, 2009, at 15:56:35
In reply to Re: ECT - Zeba (My Take)... » Ant-Rock, posted by SLS on June 30, 2009, at 21:37:11
>if you were to respond to ECT, you wouldn't >spend too much time lamenting lost years.
And if you don't respond? What happens when you relapse? Many people regret having ECT and do infact spend much time lamenting the decision and lamenting the fact that they don't have the memory or cognative capacity to do many of the things they used to. Plus, there is the depression on top of that to deal with.
>You might come to terms with the loss fairly >quickly.
Some might, some don't. Thats ECT for you. A crap shoot.
Linkadge
Posted by linkadge on July 1, 2009, at 16:00:14
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock » Rdragon, posted by Zeba on June 30, 2009, at 23:41:30
Thats the problem with the whole ECT thing. People justify their fears about having it with some sort of grandiose belif that ECT is the "big gun". "This is my answer". They've generated this little place in their brain in which ECT sits upon this big pedistal. This association is flawed. The efficacy of ECT is overblown, and new statistics suggest that between nonresponse and relasepe 80% will be back to where they started within about 6 to 8 months.
Linakdge
Posted by linkadge on July 1, 2009, at 16:03:54
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by SLS on July 1, 2009, at 4:26:43
>What seems to slip by peoples's attention, is >that being very treatment resistent to >antidepressant medication makes for a reduced >prognosis that ECT will work.
Bingo.
Thanks for bringing this point up. Nonresponse to pharmalogical antidepressants is a strongish predictor of failure for ECT. So if you have failed many chemical AD's and think that ECT is your ticket, you may want to think again. This is, of course, contrary to what many people consider the prime application of ECT.
Linkadge
Posted by Phillipa on July 1, 2009, at 19:47:18
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock » SLS, posted by linkadge on July 1, 2009, at 16:03:54
So after reading Scott's list is there a real answer? Phillipa
Posted by Ant-Rock on July 1, 2009, at 20:28:49
In reply to Re: ECT - Zeba (My Take)...))Ant-Rock, posted by linkadge on July 1, 2009, at 16:00:14
Linakdge
"80% will be back to where they started within about 6 to 8 months."
In 6 to 8 months, 100% Who get no help from meds/therapy will get progressively worse and wish they were dead, or worse, act on their wish.
Look, I always respect your posts on this board, and I'm not trying to start a war here.
All I'm saying is that my shrink is an experienced and compassionate person, who actually is jaded with the big pharma mentality.He has offered me ECT for years, and I resisted. Actually I have no immediate plans to try it yet,\
but if he tells me he has several succesful professionals who have benefitted greatly from it, why woudn't I believe him. He's also had zero ect patients with permanent memory problems.Anthony
Posted by SLS on July 1, 2009, at 23:08:54
In reply to Re: ECT - Linakdge, posted by Ant-Rock on July 1, 2009, at 20:28:49
I know you have been working and working and working to get well. It sounds like your doctor has your best interests in mind.
Have you discussed with your doctor:
1. Unilateral vs. bilateral vs. bitemporal?
2. High dosage vs. low dosage?
2. Unilateral left or unilateral right?
I don't know what to think about ECT anymore. I do think that *some* people come to blame ECT for memory difficulties that are, in fact, symptoms of the depressive illness itself. I know one person that I believe fits in this scenario. However, it is hard to ignore the horror stories that are present on the Internet. I would like to believe that ECT is safe. I do not know anyone personally who has had ECT and reported a horror story.There is one person who posts here who was excited to have ECT performed on him. He reporting having a bad experience with it. I don't know if there are any residual memory or cognitive issues with him, but he is quite vocal about his bad experience with ECT. Yet, I have met people who do well on ECT. Many of these folks do go for maintenance treatments. In this regard, it is really no different than treatment with medication. If you don't take them every day for maintenance, you relapse.
Without researching the latest and greatest protocols in ECT, I guess I would go for high-dosage unilateral right and try to avoid bilateral.
Like I said, I can neither endorse nor condemn ECT as a treatment. I am very ambivalent regarding this.
My only recommendation to you is that you research the recent advances in ECT protocols and discuss what you find with your doctor. At least you will feel more confident in whatever decisions you reach. If you have already reached a decision, then forgive my butting in.
Good luck to you.
- Scott
Posted by Zeba on July 2, 2009, at 0:26:16
In reply to Re: ECT » Ant-Rock, posted by SLS on July 1, 2009, at 23:08:54
I had a compasionate Pdoc and ECT doc too. They said they were actibg in my best interests. I had 7 right unilateral treatments at 5 imes the seizure threshold level. I had 2 treatments per week instead of the typical 3 per week, and still I ended up with documented damage per neuropsychological testing. I am just now starting rehab. I was diagnosed with ECT coghnitive decline. Parnate worked for me in the past but the pdoc wanted me to do ECT.
The behavioral neurologist said I was vulnerable to damage given my history of two concussions in my youth plus one later, Also, I have a family history of Parkinson's on both sides of the family. Any history of head trauma puts you at greater risk.
ECT is a crap shoot. Be very careful I have had depression on and off for 30 some years. It is hell to end up depressed and brain damaged. I have short period of no depression, but it always seems to come back. The answer is to perervere and keep on going.
Other things to try I guess would be herbal treatments, exercise, and acupuncture.
Posted by SLS on July 2, 2009, at 2:07:05
In reply to Re: ECT » SLS, posted by Zeba on July 2, 2009, at 0:26:16
Wow. It's stories like yours that have convinced me to no longer endorse ECT as a treatment.
Thanks for adding the additional predisposing factors that might have increased your risks for ECT cognitive damage.
I'm sorry that this had to happen to you.
- Scott> I had a compasionate Pdoc and ECT doc too. They said they were actibg in my best interests. I had 7 right unilateral treatments at 5 imes the seizure threshold level. I had 2 treatments per week instead of the typical 3 per week, and still I ended up with documented damage per neuropsychological testing. I am just now starting rehab. I was diagnosed with ECT coghnitive decline. Parnate worked for me in the past but the pdoc wanted me to do ECT.
>
> The behavioral neurologist said I was vulnerable to damage given my history of two concussions in my youth plus one later, Also, I have a family history of Parkinson's on both sides of the family. Any history of head trauma puts you at greater risk.
>
> ECT is a crap shoot. Be very careful I have had depression on and off for 30 some years. It is hell to end up depressed and brain damaged. I have short period of no depression, but it always seems to come back. The answer is to perervere and keep on going.
>
> Other things to try I guess would be herbal treatments, exercise, and acupuncture.
Posted by Meltingpot on July 2, 2009, at 14:51:35
In reply to Re: ECT - Zeba (My Take)... » Zeba, posted by Ant-Rock on June 29, 2009, at 12:58:12
Hi Anthony,
Just wanted to say that I have also tried rTMS to no avail. Actually when I was having it my mood was better than it is now but that was because the Seroxat was having more of an affect.
However, I do know somebody who has had ECT and is now having rTMS and he told me that they have both helped his depression. His depression is more Atypical though so not sure if that has anything to do with it. He is also on Parnate.
Denise
Posted by Meltingpot on July 2, 2009, at 15:26:03
In reply to Re: ECT » SLS, posted by Zeba on July 2, 2009, at 0:26:16
Zeba,
So are you saying that somebody who is suffering from depression with daily, hourly, minute by minute suicidal thoughts might benefit from herbal therapies or accupuncture?
I know a lot of people on this board think herbal therapies and alternative treatments have a place, maybe they help to kill time whilst the person is waiting for the drug to kick in but to even suggest that they might help as a stand alone therapy is, in my view, dangerous condescending. People waste so much time and money on these things and it makes me so angry.
If you think that herbal therapies and accupuncture are helpful as stand alone treatments then to be honest I would not take heed of your opinion on anything. Some people I know who can't get out of bed with their depression would laugh at your suggestion of exercise!
I know that talk therapy has helped you and like I said before you obviously had issues that needed to be talked about but many people with depression do NOT have psychological issues that need to be addressed and for them therapy is useless, it's only helps in the sense that it gives a person a chance (once a week) to vent.
Denise
Denise
Posted by SLS on July 2, 2009, at 17:18:01
In reply to Re: ECT - Zeba, posted by Meltingpot on July 2, 2009, at 15:26:03
Hi Denise.
I'm glad that I wasn't the object of your anger, although I can easily understand your rationales and empathize completely with your desperation.
> So are you saying that somebody who is suffering from depression with daily, hourly, minute by minute suicidal thoughts might benefit from herbal therapies or accupuncture?
Herbs, food supplements, and exercise never did a damned thing for me except to reduce the thickness of my wallet.
What I find frustating and angering is when people assume that their experience with depression is the same as everyone else's. With good intentions, they make suggestions that might work for them, but without taking into account how much different and more severe depression can be in other people.
- Scott
Posted by Ant-Rock on July 2, 2009, at 19:50:08
In reply to Re: ECT - Ant-Rock, posted by Meltingpot on July 2, 2009, at 14:51:35
> Hi Anthony,
>
> Just wanted to say that I have also tried rTMS to no avail. Actually when I was having it my mood was better than it is now but that was because the Seroxat was having more of an affect.
>
> However, I do know somebody who has had ECT and is now having rTMS and he told me that they have both helped his depression. His depression is more Atypical though so not sure if that has anything to do with it. He is also on Parnate.
>
> DeniseThank you Denise,
My depression is also more Atypical.
Maybe there is some hope.Anthony
Posted by Sigismund on July 2, 2009, at 20:36:14
In reply to Re: ECT - Zeba » Meltingpot, posted by SLS on July 2, 2009, at 17:18:01
>What I find frustating and angering is when people assume that their experience with depression is the same as everyone else's. With good intentions, they make suggestions that might work for them, but without taking into account how much different and more severe depression can be in other people.
You are of course right. I have no idea what depression means. Not really. You ask someone and they say 'depressed mood' and you ask 'what's mood?' and they say 'emotional tone...the glass is half empty rather than half full' (which is pretty lame now I see it in front of me). My therapist said (in a not unkind way, I'm sure) that depression was the rag bag of psychiatry, meaning I suppose that it was what was left over after the other diagnoses had been filled.
Posted by morganpmiller on July 2, 2009, at 20:50:34
In reply to Re: ECT - Zeba, posted by Meltingpot on July 2, 2009, at 15:26:03
Umm, I would argue that we all have some kind of psychological issue that contributed to our genetic predisposition developiing into something worse than it may have been minus any psychological issues. Look, we ALL have issues. To say that you do not or that some people with depression do not sounds a whole lot like classic denial to me. Even the majority of psychiatrists most likely adhere to the biopsychosocial dynamic that explains the majority of mental illness.
I'm sorry, none of us were simply born depressed miserable souls. It blows my mind that there are still people out there that do not think their childhood had anything to do with their depression. If you know anything about psychology and how a child's brain/psyche develops, you know that between the ages of 2 to 4 years old are crucial to how a child develops emotionally. Often we think we had this great childhood and great parents. First, there is no way we can remember what was going on when we were 2, 3, and 4. Second, it is common for us to be protective of our parents and put them on a pedestal, even if they made some mistakes. Third, we just don't realize what it takes to raise an emotionally healthy child. There are things that we may think are no big deal, but in reality, they may have been very detrimental to our emotional development. Fourth, there is this wonderfully powerful coping mechanism called denial.
Zeba,
>
> So are you saying that somebody who is suffering from depression with daily, hourly, minute by minute suicidal thoughts might benefit from herbal therapies or accupuncture?
>
> I know a lot of people on this board think herbal therapies and alternative treatments have a place, maybe they help to kill time whilst the person is waiting for the drug to kick in but to even suggest that they might help as a stand alone therapy is, in my view, dangerous condescending. People waste so much time and money on these things and it makes me so angry.
>
> If you think that herbal therapies and accupuncture are helpful as stand alone treatments then to be honest I would not take heed of your opinion on anything. Some people I know who can't get out of bed with their depression would laugh at your suggestion of exercise!
>
> I know that talk therapy has helped you and like I said before you obviously had issues that needed to be talked about but many people with depression do NOT have psychological issues that need to be addressed and for them therapy is useless, it's only helps in the sense that it gives a person a chance (once a week) to vent.
>
> Denise
>
> Denise
Posted by SLS on July 2, 2009, at 21:38:37
In reply to Re: ECT - Zeba, posted by morganpmiller on July 2, 2009, at 20:50:34
> Umm, I would argue that we all have some kind of psychological issue
Hi. My name is Scott. You don't really know me, but I imagine you would argue that you do.
> that contributed to our genetic predisposition developiing into something worse than it may have been minus any psychological issues.
> Look, we ALL have issues.
Please see above.
You know, depression is not depression is not depression.
I bet your depression is different than my depression. If it were the same, I doubt you would have posted this. I don't think it is valid to generalize one's own depression to that of everyone else on the planet.
While it is my ardent belief that psychosocial stresses often precipitate the onset of some mental illnesses, I don't feel that it is a necessary trigger. This might be particularly true of bipolar depression. I would say that most everyone has stresses in their lives, much of which has more to do with surviving on a day to day basis rather than suffering from some sort of psychological entanglement. I don't believe that one needs to have a pathological psychological "issue" in order to provide the physiological stresses that can precipitate these illnesses.
> I'm sorry, none of us were simply born depressed miserable souls.
And you know this, how? (Leaving the soul out of this)
> It blows my mind that there are still people out there that do not think their childhood had anything to do with their depression.
Please speak for yourself. Indeed, that is who you are really speaking of, isn't it? I am sorry your childhood was such that it brought depression into your life.
*I* would argue that some people have an emotional investment in the idea that "we all have issues" in order to explain their own depressions. It is a form of denial. It is difficult for these people to accept that even healthy minds can become the victims of unhealthy brains. They might be afraid to admit that they might be the only one with a troubled mind.
I'm OK, your OK.
- Scott
Posted by Zeba on July 2, 2009, at 23:22:06
In reply to Re: ECT - Zeba, posted by Meltingpot on July 2, 2009, at 15:26:03
So why does your pdoc think ECT is not for you??
Also, I do not agree that one can have depression and not have psychological issues. We are not a brain with no connection to thoughts, feelings, and perceptions.
I have had depression since childhood, and so it is not a simple matter of some sort of mild depression. I actually hung myself at age eight. I know what it is to be depressed, very depressed, believe me.
Zeba
Posted by Zeba on July 2, 2009, at 23:25:03
In reply to Re: ECT - Zeba » Meltingpot, posted by SLS on July 2, 2009, at 17:18:01
I wasn't saying it would work - herbs, etc. I was only adding to the list of possibility of things people could try. So, I will get the heck out of this babble stuff again. Goodbye and good luck to all. Gees, why did I come back.
Zeba
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