David Z

Age at interview: 44

Brief Outline: David had always experienced depression but when he was in his early 40s his depression got much worse and he had a breakdown. He was admitted to hospital and was offered ECT, age 43. David had 20 ECT treatments which lifted the depression in a way that antidepressants never had. He is however still looking for work.

Background: David lives by himself, is currently unemployed and describes his ethnic background as White British.

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David had struggled with mental health problems for a lot of his life. However, in his early 40s he had a breakdown when his depression became ‘very, very deep’ and he felt suicidal. David made a plan to end his life and said it felt ‘very natural and very calm’. At the time he wouldn’t have classified what he experienced as an ‘illness’ but now he says that he does accept it was an illness.

After he was referred to a consultant psychiatrist, it was agreed that he should be admitted to hospital. Although hospital seemed an alien environment at first, David didn’t find it frightening. He felt that the antidepressant medication he had been taking hadn’t really worked and was offered ECT. At the time he didn’t think much about ECT because he wasn’t in a fit state to understand the information he was being given. Before ECT was offered to him, he only had images of ECT from TV and things he had read. David didn’t believe that ECT would work as nothing had worked before (such as psychotherapy or antidepressants). He made the decision to have ECT by himself. 

David said that the first ECT treatment was a ‘bit alien’ because he wasn’t sure what was going on. However he said everyone was nice and the procedure was ‘very calm’. He said that there was a separate suite where the ECT took place and the nurse was very good. The nurse told him what to expect, talked him through the procedure and got his consent before each ECT treatment. David had 20 separate ECT sessions over a period of 10 weeks, and said that by the end of the treatments it became a normal thing to do twice a week. He found that he did lose his memory slightly at the time, and still struggles to recall things. However his long term memory wasn’t affected and he got ‘instant relief’ from the depression after having ECT. David didn’t find out too much detail about how the ECT worked, but he was just happy that it worked. 

When the ECT course finished David, was a bit worried because it had become part of his routine in hospital and worried that the depression would come back. David was given a social worker and a mental health care worker who helped him through the process of being discharged from hospital. David found that for him recovery was a process of ‘getting out and about’ and felt that he needed to work. David said that if ever became that seriously depressed again he would much rather have ECT, as he didn’t have much faith in antidepressants. Although he had had depression for most of his life, the depression got worse with age. David would like to go back to work but to a job that was less pressured than before.

David recommends that people try ECT and that it should give them relief. He found staff involved in ECT treatment highly knowledgeable and the treatment only took five minutes.

David Z had coped with his mental illness from childhood and only sought help much later in life when his depression was “longer and deeper”, “very dark” and he felt “very, very suicidal”.

I guess my story is that I’d suffered from mental health issues most of my life since I was about a teenager, since I was about 12, and I coped quite well with them, most of my teenage and working life. Up until I got to about 38-39, and they started to get progressively worse. My depression would get longer and deeper. And that went on for a couple of years until I got to my early 40s where I got, I really had a bit of a breakdown, I would say, and the depression got very, very deep and very, very dark and very very suicidal. And at that point I’d been referred to a consultant psychiatrist and it was agreed that I would then move into hospital at that point. 

David spent most of his life feeling depressed. When he wasn’t depressed he said things felt “artificial”.

I think in truth I’ve probably been depressed most of my life. It’s been kind of a cyclical depression. You get some relief, then it comes back, and its back for longer and it’s back for deeper the older I got. And, as I say, my 30, late 30s, 40s, it just didn’t seem to go away. So I would be more depressed than I would be normal, as it were.

Yes, yes. And I suppose that you’re kind of almost saying that there’s not a time, can you remember not being depressed?

No, I’ve been, that’s, yes, that’s true. I can’t think of a time, or if I have felt not depressed I’ve felt that’s very artificial. And I’m a bit frightened of when I’m not depressed because it feels a bit alien.

David Z felt very calm when he planned to end his life.

If, do you mind if I ask you about the time when you were suicidal and how that felt?

It felt quite comforting, I guess. Because when you, you want to exit this life and you’ve made plans to do so, it feels very natural and very calm. So it’s very kind of, yes, it, it felt kind of c-, normal for me at that point in my life. It wasn’t frenzied, it wasn’t driven by sheer emotion, it was just very calm and very calculated. And I think that’s what concerned the, the consultant psychiatrist.

When David Z was discharged from hospital he had support from social workers, a mental health care worker and a medical team.

And you said you’re quite an independent person. Did you have any support around you at the time?

I had support, but any decisions that were getting taken I was making on my own. So I wasn’t referring to anybody, “Do you think I should do this or not do this?” I was making my own decisions.

And do you have a kind of wider support network that you could…?

I mean I did, but I wasn’t accessing it at the time in hospital. In fact if anything I was quite content just to be just on my own, to be honest.

Okay. And you said you had twenty?

I had twenty sessions over a ten-week period, yes.

And how did you feel when that was complete?

I was a bit worried actually because a) you get used to it and it becomes part of your routine in hospital. But I was worried about when it ended. What would this mean? Would I slide? Would it maybe come back? What, you know, what would happen? And there was a bit of a slide, to be honest. But then about three or four weeks later I was discharged from hospital, so I was dealing with that as well. So it was hard to say. But I was worried about what would happen if they stopped them, you know.

What kind of support did you get in terms of, you know, moving out of hospital for example is quite significant.

Well, there was good support. I mean it was all new to me. I had a social worker appointed to me and I had a mental health care worker appointed and they kind of took me through the whole process of coming back out. 

So actually I felt the support networks were quite good, I felt quite supported. And the medical teams were very good. So I guess my whole experience from what should have been or could have been quite a negative thing was actually quite positive.

Although David Z didn’t think ECT would work he decided to “go for it and see”. He wasn’t frightened by it, and it was just one more thing to try.

I mean I was offered ECT in my first consultation as an inpatient and at that point a lot of what they were saying to me was very, it was very new. They were trying to get a handle on the diagnosis for myself and give it some labels. And I knew I wasn’t comfortable with that. So when they offered me ECT in the first week it wasn’t I didn’t care about it, but in a sense I didn’t. You know, it was just one more thing they were offering me and I didn’t feel resistant to it or I didn’t feel frightened about it. I guess it felt a little strange because, you know, “What is this?” But I guess there was also part of me, a small part of me was a bit intrigued. So there was probably a little bit of an interest there to see exactly what this was. So I guess I felt quite, quite okay with it. I wasn’t, wasn’t nervous and I wasn’t fearful of it, you know.

That’s a fascinating word to use that you were intrigued by it. So there was a kind of curiosity?

Yes, because you, you’d heard so much about it on the TV and you’d seen it in documentaries and you’d think, “Oh, actually what is this?” And I guess I didn’t believe it would work, to be honest, because nothing else had worked, you know, the psychotherapy, the antidepressant tablets. ECT, it was just like one more thing in a long list of things and, no, I didn’t really think it would work, to be honest.

David Z didn’t get any great relief from antidepressants and found that ECT gave him a lift, which the tablets didn’t. He finds he is able to manage his moods better by himself than with tablets.

I mean I don’t have much faith in antidepressants, rightly or wrongly. To me they don’t work really. They always tell me about what would it be like if I wasn’t on them, which is fair enough, but I don’t feel any great relief with antidepressants, I don’t feel any up. I, I kind of manage my moods better myself rather than from the tablets. But the one thing the ECT did give you that lift. When you came to you did notice a difference. And you don’t get that difference if you’re on tablets.