Electroconvulsive Treatment (ECT)
Depression, psychosis and anxiety
People we spoke to talked about what it was like to experience severe mental health problems such as hearing unpleasant voices that were not there, or feeling extremely anxious. There were also physical experiences, such as extreme tiredness, bodily pains and lack of appetite. For some it was only in remembering their experiences that people recognised that they were so mentally unwell at the time. However, for many, their mental distress was familiar. Having experienced it throughout their lives they, or a loved one, could “read the signs”.
Some people, like Sunil, had clear periods of their lives when they were unwell but also had many years without experiencing any symptoms. Other people, like David Z, spent most of their lives dealing with mental distress of one form or another. You can read more about people’s experiences in ‘First becoming unwell’ and ‘Diagnosis of a mental health condition’.
Steve describes how his wife’s depression looked ‘from the outside’. There were peaks and troughs, but when it got bad she usually had ECT and felt a lot better within a week of being home.
Steve describes how his wife’s depression looked ‘from the outside’. There were peaks and troughs, but when it got bad she usually had ECT and felt a lot better within a week of being home.
While the types of distress varied, people who were depressed often experienced anxiety as well. No two people’s experiences were exactly the same, however, there were some things most people experienced:
• not being yourself, acting “out of character”, being more quiet, “everything [seeming] unreal’, being detached, feeling isolated, being fearful, hyper sensitive to others’ behaviour, loss of self-esteem
• physical symptoms: physical illness, immune system being low, sweats, weight loss, dizziness, exhaustion, feeling lethargic, not looking after yourself, poor hygiene, hypersensitivity, lack of/disrupted sleep, loss of appetite, loss of sex drive
• emotional aspects: no interest in things, shutting down, being uncommunicative, fear, anxiety, panic attacks
• psychotic symptoms: auditory and visual hallucinations (“the people were really, really, really there”), ‘voices’, feeling paranoid, hearing religious themed voices, not moving or being ‘catatonic’, ‘despondent’, being high (mania).
Most people were so distressed at certain times that they talked about being suicidal and or wanting to harm themselves (see ‘Suicide and self-harm’).
Although people talked about very distressing experiences, equally they found ways of understanding these experiences in time, and this helped them cope. Many people talked about working out how to better manage their mental illness (see ‘Managing mental illness and recovery’). Yvonne had the usual worries, like how would she be able to pay for her mortgage, but she came to understand her mental health issues as the “added wee bits on top”. She said as long as she could find a way to cope she was fine and “quite happy”. But most people found it difficult to cope and they needed help from others to learn how to do so.
Helen describes her schizophrenia as like having a different personality every other day. At the beginning it was “just dark horrors” but now she works through it.
Helen describes her schizophrenia as like having a different personality every other day. At the beginning it was “just dark horrors” but now she works through it.
Being high meant Tania had “vast amounts of energy”, but at other times she was also “mentally suicidal”. She fought the voices in her head, but believed she was going to kill herself and eventually had ECT.
Being high meant Tania had “vast amounts of energy”, but at other times she was also “mentally suicidal”. She fought the voices in her head, but believed she was going to kill herself and eventually had ECT.
The next one, I got really, I’d come off the drugs by then because the side effects, they weren’t helping, the side effects were, it was unliveable and I became, I became very I became very manic. It was once again, it was one of these mixed episodes but you know, manic in a really, really bad way. I was incredibly high out in terms of you know, being up all night and having vast amounts of energy and being mental productive but I was also at the same time mentally suicidal, and I was desperately trying to stop myself killing myself. I mean everything in my head was telling me to do it, but I knew because of the effect it would have on my family that I, you know, I was fighting so hard as I had always done against these kind of voices in my head that were telling me to do it. But I also knew it was just a matter of time because it was so intense, I really believed that I was going to die and I believed that I was going kill myself and I believed it was inevitable and that there was nothing that could stop this, you know, this kind of power from subsiding because up to them we hadn’t to the we hadn’t found anything and I did in the end, I, I made another attempt and once again, I was, fortunately unsuccessful and I tried throwing myself off a bridge, but I was caught again. So, and you know, I went back to hospital and, and we didn’t know what to do really, we were all stuck and in the end my consultant said to me, “Look, you know, will you try ECT again because nothing else is working?”
Depression is different from sadness. The people we spoke to described depression as feeling cut off from the rest of the world, feeling worthless, not wanting to carry on living, wanting to self-harm and feeling the pleasure that they normally experienced “slip away”. Jane wrote a poem in her teens called ‘Shrink back’ describing her “inability to have physical contact with people.” Enid described not being able to stop crying for long periods of time, and many people talked about life having no meaning.
For some, depression came in episodes, but for others it seemed to be how life was.
David spent most of his life feeling depressed. When he wasn’t depressed he said things felt “artificial”.
David spent most of his life feeling depressed. When he wasn’t depressed he said things felt “artificial”.
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.
People we spoke to had often felt anxious. Severe anxiety can make it difficult to deal with everyday life. People talked about being overwhelmed by feelings of intense fear to the point of terror, feeling that they were going “mad,” or that something awful was about to happen. Annie and Lorraine described their mother constantly worrying that she had something in her throat or that she wasn’t able to breathe. Their mother found it hard to go out when she was unwell.
Julian felt that waves of terror and anxiety made suicide seem an entirely rational choice.
Julian felt that waves of terror and anxiety made suicide seem an entirely rational choice.
And it’s not, it’s not something that’s illogical either. You, you know, I guess I’m quite a rational person actually and, you know, people think, ‘Oh, well, you’re sort of ill and you’re overcome with this kind of nonsense about, about wanting to kill yourself.’ Well, it’s not like that, or at, or at least it wasn’t for me. I mean it was entirely rational that where I was I’d reached the end of the line. I was, it was unbearable to have the anxiety, it was unbearable not to feel human and there really was, you know, it was unbearably painful. And it, you know, it would have been a relief, a release not to have to suffer that. I mean you wouldn’t put a dog through that. So there was nothing, there was nothing un-, you know, it was entirely rational. And it, it wouldn’t have, I know a lot of people say about like the impact it has on people that are left behind. But it really shouldn’t have a negative effect on them. It’s not their choice. It’s nothing they can do anything about. It, it’s their loss if they have to deal with that, you know, it’s them that’s lost something. They shouldn’t feel like they’ve failed in any way.
For years Sheila thought her husband was just ‘anxious’ but later he developed severe obsessive compulsive disorder. He has intrusive thoughts about killing himself to stop himself from killing others.
For years Sheila thought her husband was just ‘anxious’ but later he developed severe obsessive compulsive disorder. He has intrusive thoughts about killing himself to stop himself from killing others.
He’s become very, very anxious about things. He says it never goes away. Even if he feels better, you know, if he’s having a better day. But yes it’s probably over about the last four years that he’s been as bad as he is at the moment, yes.
The referral that’s been made recently for him to see a professor who specialises in OCD which they have said that my husband’s got OCD. As in, it’s not OCD as in hand washing and things like that. The way they described it to me, is because he has very intrusive thoughts about killing me or our grandchildren, and he knows that he would never do that that they are thoughts, but they are so intrusive that they are there. That if he kills himself he then won’t be in this turmoil that he’s in and we will all be safe. So this is where they’ve got the OCD from. Because I always thought it was always being tidy, putting things in place and everything. I couldn’t see to start with where they got the OCD from, but that’s, that’s where they get it from, because as I say rather than him killing me with a knife or our grandchildren he wants to kill himself.
Psychosis describes the situation where you see or explain events and things in ways which others would consider highly unusual. It includes seeing or hearing things others don’t, holding beliefs that others don’t share, or making links between things that only you are making. People who experienced psychosis frequently did not know what was happening to them at the time. Some felt very distressed while others thought nothing was wrong with them (see ‘First becoming unwell’). Julian remembers thinking the CIA were following him and thinking the television was giving him messages. In between psychotic periods, he was completely rational and could remember being psychotic.
A few people talked about what they described as ‘spiritual’ or religious elements to their psychosis. Suzanne had a panic attack because she thought the end of the world was coming and thinks she had a “spiritual God connection type-thing”. Catherine Z remembers pulling her hair back and looking in the mirror and “seeing the devil”. She also thought she knew “the secret of the universe”. But Jane, who was brought up a Christian, felt the anxiety she experienced during her depression about going to hell had a protective quality because it actually stopped her from killing herself.
Beattie felt her psychotic episodes had a spiritual element. When she was high she felt she understood things about life, although she could also insult people or do silly things.
Beattie felt her psychotic episodes had a spiritual element. When she was high she felt she understood things about life, although she could also insult people or do silly things.
That sounds very interesting
Yes.
Can I hear some more about your experience?
Yes, I’m a spiritualist as well and I sort of when I went high I sort of sort of understood things about life etc., about why the world is as it is. And a lot of people who are called schizophrenic, they hear voices which could be spirit voices in some cases.
Can you talk me through some of the things you learned through those experiences?
The trouble is I can’t remember unfortunately. I mean I thought I lived during the French Revolution. That’s all.
And how are you feeling when you are on these “highs” or...?
I’m quite, I’m quite happy but no one else is because I don’t stop talking and I insult people and I do silly things, you know.
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