h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Entry: Electroconvulsive Therapy (ECT) - A811216
Author: Namaste - U201288

This is from my own experiences of ECT.

Interesting. I had considered this a discontinued, almost medieval, form of treatment until I recently heard of a friend of a friend being booked in for it. I was astonished to learn that it was still being done. What puzzled me then, and still does, is how is it supposed to work?
If you don't mind me saying so, I suggest your entry might be improved by adding a little more of the theory behind this practice. You might also, perhaps, include a little more detail from your own experiences. The entry may well end up being read by someone about to undergo the treatment themselves and I imagine it would help them greatly if you could say whether there was any pain involved, how long the procedure lasts, are you burned where the electrodes are attached, etc. I know I would be apprehensive if it were me. Also, a few words about the results; do you think it helped you, is it generally considered to be successful?

Fascinating stuff - thanks for sharing your knowledge with us, I look forward to seeing this entry evolve.

Sprant

Hello Namaste,

I to though it had been discontinued, although it does seem a bit more humane to what it used to be A friend of mine told me of having similar treatment for a psychaiatric disorder some years ago. Incedently a disorder that is now accepted as just being part of the natural variation in human behavior.

It was used as part of aversion therapy. All it achieved with my friend was to make her violently sick every time she goes into into a hospital.

Best wishes

Stuart

For some reason, ECT can be surprisingly effective, although I don't think anyone is really sure why. It seems to be the medical equivalent of thumping the television when it isn't working - sometimes it produces a beautiful picture; sometimes you put your fist through the screen...

Hi Danny,

Thats one of the reasons I believe it was discontinued, becasue of its unpredictability as described in my earlier post.

Perhaps the technology has improved and now they can get just the right voltage in just the right place at just the right time?

The euivelant of thumping the TV right next to the componant that is causing the problem instead of thumping the whole TV as hard as you can and hoping it effects the faulty componant. To do this you need to know where and which companant is faulty.



Stuart

further information...

some of the problems with ect can be much worse if the operator is poorly trained or is using older equipment.

the general method works by disrupting the brain, in the hope that this random dirsuption will cause which ever process is causing the problem not to be used.

another problem is that once you have signed up to have one treatment of ect, you have given them a blank cheque to keep giving you it until they are satisfied with the results.

a good link for ect is http://www.voicesforum.org.uk/ect-no.htm and another is http://www.voicesforum.org.uk/zspeech.htm

Many thanks for all the comments and feedback. I am in the process of updating the writing based on what you have said. I was not sure about putting my own thoughts into it so tried to keep it factual.

Please keep responding; thanks for the input

Namaste

> Perhaps the technology has improved and now they can get just the
> right voltage in just the right place at just the right time?

That may well be part of it. It's possible that it's also connected to the fact that nowadays patients are carefully chosen for the procedure. That is, only those with a condition that is likely to respond to ECT are given the treatment. This is in contrast to the "he's mad, let's zap him" attitudes that are associated (rightly or wrongly) with the early days of the treatment.

Updated 15.35 on Sunday 25th August (time is GMT).

Comments welcome!

Namaste

You might say something about why it was developed in the first place, after epileptics who also suffered from depression were observed to recover temporarily from the latter after a grand-mal seizure. Hence the idea of simulating such seizures by ECT.

I've been looking into the history of ECT and will update the entry tomorrow. it seems it started back in Roman times with the application of electric eels to the head to cure headaches!

I'm really grateful for paracetemol

Jane

I've been looking into the history of ECT and will update the entry tomorrow. it seems it started back in Roman times with the application of electric eels to the head to cure headaches!

I'm really grateful for paracetemol

Namaste

Look forward to reading it. Its a fascinating subject with a lot of potential for inclusion in the Edited Guide.


Best wishes

Stuart

Hiya!

It's a nice topic for an Entry, and it has the potential for a great Edited Entry.

However, I'm going to cut to the chase. This may seem like a controversial move to my distiguished peers as an insult to your writing, but I think that this should be moved to the Writing-Workshop.

The reason why is that this Entry, although, and I say it again, has the potential to be a great Entry, needs a great deal of work before it can be considered as really finished and ready for Peer Review.

Spelling issues aside, there are a quite a few important issues which have been misinterpreted in the Entry:

"Once the consent form is signed there is carte blanche to the psychaitrists to continue treatments until there is an improvement."

This is not true. Under UK law, unless the patient has been put under one of the Sections of the Mental Health Act, you can refuse treatment at any time, regardless of whether you consented originally. If you have consented to the treatment, you have only consented to one session of ECT. Subsequent sessions still require individual consent. This means that before you go in for each session of ECT, you have to consent to that session. Even after signing the form, it is checked whether you signed the form under any duress, pressure, or other external forces. This means that the decision that you undergo ECT has to be your own and your own only.

Different issues are raised if the person comes under one of the Sections of the Mental Health Act, but as this Entry is not a discussion of the right to treat/decision to treat/refusal of treatment, it's probably outside the scope of this Entry, and best left as a completely different discussion

--
"4) Electricity is passed through the brain triggering a fit similar to an epileptic fit. Due to the medication given there is no obvious sign of this occuring in the unconscious patient."

There is an obvious sign to the observers, but it may not seem like that to the patients as they are under general anaesthetic. In fact, the tonic-clonic seizure, which is what the epileptic fit is called, has to be timed, and although it is a modified seizure, since a muscle relaxant is given, the time in seconds of the seizure must be noted in the medical records of the patient.

Therefore, some jerking is seen in the clonic phase, however, it is only gentle

--
You're right that ECT is not for everyone, but the same can be said of most psychiatric drugs. After all, the treatments that are used have to be titrated to the patients' needs/requirements, so it comes within a selection of treatments. In fact, a great deal of psychiatrists don't use it because of their opinion of it.

Interestingly, the 'One Flew Over the Cuckoo's Nest' portrayal of ECT is grossly inaccurate (The clinical nurse supervisor told me in no uncertain terms that it was the greatest pile of s**t he had seen in his life. When I had pointed out that Jack Nicholson had won an Oscar for it, he casually replied:

"What he needs is a kick up the arse, not an Oscar.").

--
I see you've put a section of your own experiences at the end. I'm sorry to hear that your experiences of ECT weren't positive, but to balance out the Entry, would it be possible to get a positive view of ECT from someone who's experienced it as well? It would balance out the Entry nicely

--
Also, are we talking about ECT in the UK or somewhere else? It's not clear in the Entry. I think they call it shock therapy in the USA, where it is rapidly returning into favour.

--
Also, as you are still working on the 'History of ECT' section, and there are quite a few bits that need to be clear here and there, IMHO, I think this is better off in the Writing-Workshop rather than in Peer Review. When it is complete, you can re-submit it to PR later

--
Please don't take this as rejection - after all, I'm just another fellow Researcher others may have different opinions on the matter at hand.

I hope you will write some more on this very interesting topic

Stay ,
WD

Dear WD,

Many thanks for the reply and all the information. I'm happy for this to be moved to the writing workshop if people think that would be a good idea. I have to admit, I thought it was finished when I submitted it but researchers have kept coming back with such good ideas the article has grown and grown!

By the way, I CAN spell but I can't type!

If anyone has a positive experience of ECT to include to balance it out I would be grateful.

Here goes - back to work. Thanks again

Namaste

Updated 12.00 GMT Monday. Added history.

Namaste

Excellant. This is getting to be a good candidate for the Edited Guide. I a bit dubious about the opinion bit at the end, but perhaps the Subs will have more to say on that.



Stuart

I'd say the opinion piece is fine for an entry of this type. What I'd do (as a sub) is start it with a line such as "Here is one researcher's experience of ECT" and then put the whole lot in

That should keep everyone happy

Updated - formatted using GUIDEML and links to articles added.

Phew!

Namaste