Electroconvulsive Treatment (ECT)
First thoughts about ECT and finding out more
Many people we spoke to said that when they or their loved ones were first offered ECT, they were surprised the treatment was still offered by psychiatrists. Some had negative ideas of ECT from TV shows and movies, like the 1975 film “One Flew over the Cuckoo’s Nest.” They said the media often portrayed ECT as a frightening procedure. A few people mentioned that they had noticed the ECT suite when walking around hospital, and were taken aback to see it or thought “they’re going to take me to the extremes and I’m going to end up there”.
When his wife was offered ECT Matt was surprised that it was still used as a treatment and felt scared, so he researched ECT on the internet.
When his wife was offered ECT Matt was surprised that it was still used as a treatment and felt scared, so he researched ECT on the internet.
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But on the other hand by then, we knew nothing else was working. And I was very open to any suggestions. …And also quite scared, because I knew that [name of wife] would react very strongly against the idea of, you know, she’s been reacting very strongly against the very idea of being ill, so I knew that this would be really, something really extreme that she wouldn’t want to get involved in.
So the first thing that I did. As soon as it was mentioned was I went off and looked it up on the internet. And I was really, I was really aware that sort of looking on the internet is problematic because you’re never quite sure where you’re getting your information from and you can quite quickly get into people with kind of maybe agendas and fixed ideas.
But I came across some quite helpful stuff. There was one information sheet from the Royal College of Psychiatrists and one or two other things that seemed quite kind of level headed and quite kind of, you know, this is the evidence, these are the studies that have been done. This is, you know, this is what it is, for starters because I think I still had my kind of mental pictures from films. And actually to be told right, this is something that happens under general anaesthetic. This is the procedure, to how long it lasts, this is the after effects. That was really helpful. …And then you know, the actual statistics about its effectiveness seemed really surprising. Do you what I mean. I can’t remember what it was, but it was something really significant, like… oh I’m going to guess, but you know, like 60 or 70% of treatments are successful as opposed to 20 or 30% of medication courses.
And it was kind of puzzling that nobody really seemed to have a clear answer about the process by which ECT might be effective, but then also nobody seemed to have much idea of the way in which medications are effective. And, you know, like I said, by then I just thought, you know, we’ll in a real mess, we’ll try anything that isn’t actually dangerous. It’s got to be worth a go.
Others we talked to had had medical training themselves and had seen ECT take place, or worked in an ECT suite. Some recalled stories of ECT helping people improve, and this gave them confidence in the treatment. Others recounted unpleasant stories or didn’t remember much about it. Some stories were mixed: Tracy had helped with ECT as part of her training as a nurse, and she remembered one particular lady making a good recovery, but then getting worse when the treatment stopped.
Sheila worked in an ECT suite twenty years ago and didn’t want any of her relatives to have it. When her husband was offered ECT recently she thought treatment might have improved and read up about it.
Sheila worked in an ECT suite twenty years ago and didn’t want any of her relatives to have it. When her husband was offered ECT recently she thought treatment might have improved and read up about it.
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20 years down the line my husband has been offered ECT and I thought back to my words. Oh is this really what we want? Obviously things have changed over the 20 years but it’s still the same initial ECT. So I spoke to the staff who recommended it, I spoke to the consultant who recommended that my husband had ECT.
I was given literature to read up about it. I also looked on the internet at things, so I sort of really thought I needed to go into it in depth.
Although Enid had worked as a nurse, she didn’t know much about ECT but thought it was for extreme cases. When she was offered it she was so ill she didn’t care what happened.
Although Enid had worked as a nurse, she didn’t know much about ECT but thought it was for extreme cases. When she was offered it she was so ill she didn’t care what happened.
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And obviously, you know, from your medical background you’ve seen ECT and so on. Can you remember what you thought about ECT before you…?
Well I thought it was probably for extreme cases [laughs]. And that… you know, kind of, it wouldn’t be for most ordinary people you know. I suppose really because I didn’t do psychiatry it was just a little part of the training. You king of go in one day and you see it, but you don’t know anything much about psychiatric problems and diagnoses and so on. So you don’t have a very sensible idea of what it’s used for. You know, you learn very little in one day’s visit really. It’s surprising how little you do learn.
When she was an inpatient, Sue thought ECT was a Victorian era treatment. She felt there was a lack of information about medical treatments and that most people don’t question their treatments.
When she was an inpatient, Sue thought ECT was a Victorian era treatment. She felt there was a lack of information about medical treatments and that most people don’t question their treatments.
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And I thought how are doctors using something and they don’t know how it works? Would you really do it in any other sort of like, life situation? Wouldn’t you really want to know? And I suppose its individuals that don’t. I’m just very curious. I think that’s why I said, initially before you started sort of recording this, I find it very difficult to understand when people had got a medical problem and they don’t know what, you know, how to describe it, what it really is. They’re just given a name. And you ask them what mediation they’re on and they say I’m on tablets. But they don’t what it is, how it sort of reacts with its contraindications and I just feel generally, not just with ECT today there’s still lack of information. I think there’s such a lack of information. I think there’s the assumption that everyone’s on the internet and they’ll go find this information out for themselves, and a lot of human beings aren’t, you know, in that sort of state of mind or they don’t really want to know. They just want to take the tablets and hope it all goes away.
People who could access the Internet read online information about ECT and found that “quite helpful”, but they also found “horror stories” about ECT. Others visited the hospital and spoke to health workers to get more information, or spoke to people who had had ECT (see for more ‘Getting information about ECT’). Doing research helped some people decide to opt for medication instead.
Mandie was prepared to have ECT 9 years ago after doing some research, but visited the hospital and found it scary. Even now when she drives past the hospital she is relieved that she didn’t go there.
Mandie was prepared to have ECT 9 years ago after doing some research, but visited the hospital and found it scary. Even now when she drives past the hospital she is relieved that she didn’t go there.
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And then, obviously, it wasn’t so, it wasn’t so much the treatment that put you off as the surroundings…
The environment.
…and the aftercare that was offered?
Very, very scary environment, yes. I mean, I have to drive past the hospital quite often, and I have this sense of relief, you know, nine years later, that I didn’t go in that place. Yes. I just remember going in there, and it just was not inviting, at all. It just instantly was, and the people in there weren’t particularly, I was expect-, I suppose I was expecting someone to be very ‘hold your hand’ kind of attitude, “Come on now. I know you’re in a bad place. Let’s, let’s sit down and talk about your options here, and why we’re considering this option for you, and why we feel it could be the right move forward.” But it wasn’t. It was very, “Well, you know, this is what’s on the table. If you take it, you take it. If you don’t, you don’t. And if you don’t, there’s nothing we can offer you.” “Oh, thanks very much” you know. I, as I said, I’ve said before, I was actually told by, one of the mental health team, that as far as they were concerned. And my father had come to this appointment with me, and it was just before I was going to go for the ECT, because they were desperate for me not to do it too, so I was going against the whole family, I’m part of a close family. And he said to the doctor, “There must be something you can do.” And she said, “You must remember as far as the NHS is concerned, it’s classed, the British NHS is a sinking ship, and even the rats are leaving.” And that’s what they told a mentally ill person. Which is nice [laugh]. “Thanks for that,” [laugh]. “What country do you suggest then?”
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.
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.
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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.
Last reviewed January 2018.
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