Jenny

Age at interview: 56

Brief Outline:

Jenny had a difficult childhood and lost her father when she was four. Latterly she had a very stressful working life and was admitted to hospital to have ECT following a suicide attempt. She felt ECT had a ‘buffering effect, but - like antidepressants – made no significant impact upon the depression she experienced.

Background:

Jenny is a retired consultant and is married with four children. She describes her ethnic background as Anglo-Irish.

More about me...

Jenny thinks that her experience of mental distress as an adult, has its roots in her experiences of a difficult childhood growing up in Ireland. Jenny’s father died when she was young, and her mother struggled to cope as a single mother looking after four children - one of whom had cerebral palsy. The village priest assaulted Jenny on a regular basis from a young age. As a teenager she describes a number of ‘trivial suicide attempts’ and was at one time a “missing person”. She was admitted to a psychiatric hospital for a short while. 

Despite these difficulties, she was the first person in her school to get a place at a top university, where she went to read Medicine. She says that ages 19-40 could be described as her ‘golden years’. Jenny met her husband, got married and had four children. Jenny trained to be a palliative care doctor and moved to the South West where she got a job as a Consultant.

Some time later, Jenny collapsed and hit her head on the corner of a bath. She suffered a right parietal infarct (a brain injury) as a result and lost the ability of speak for a while. The injury had a significant impact on her life as she was not able to drive or look after her children for a while. At work, she had a significant disagreement with her colleague, where she was assaulted and subsequently not believed. She was moved into another job and for several years she did not have a single day off and worked in an isolated environment. It was during these years that Jenny felt her depression started in a ‘recognisable way’. Her husband suffered a series of health problems, which she felt were caused - at least in part - by the stress caused by her colleague. Jenny felt highly angry about this. Jenny went to see her GP, was prescribed antidepressant medication and was later referred to a psychiatrist. She continued to work during this time. 

She later was retired on mental health grounds from her job at a hospice. In 2009, Jenny was admitted to hospital because she was suicidal. It was during this admission that she was given ECT, age 53. Before having ECT, she had a “One Flew Over the Cuckoo’s Nest” feeling about it and didn’t have any experience of people being helped by ECT. Jenny’s consultant explained ECT to her without looking her in the eye but she trusted what he had to say. She had already been on various different antidepressants and it was suggested to her that she would get better more quickly if she agreed to ECT. She found that the standard of the built environment in the inpatient ward was very poor. She was sharing a room with a woman who suffered with severe anxiety, and although she had sympathy with her, she found it very difficult. Jenny wanted to have ECT in part, so she could get out of hospital more quickly. Her eldest daughter, who was a medical student at the time, was very against ECT so Jenny omitted to tell her she was having ECT. Jenny’s husband supported the decision to have ECT as she felt he was a man who always wanted to do “something” rather than nothing. Jenny actually looked forward to having ECT as the nurses she met were very warm and it was an opportunity to leave the inpatient ward for a while. She was sometimes able to remember the journey back from the unit where she had ECT, but sometimes could only remember events later on that day. 

Jenny felt that nothing – apart from the most recent version of psychotherapy she has received– has actually made any substantial difference to how depressed she was. She felt ECT wrapped her up in layers of cotton wool and that she felt ‘buffered’. She felt she lost small bits of memory, and that days seemed rather fragmented and disjointed. 

Over the years Jenny has had many different diagnoses, including reactive and endogenous depression and personality disorder. However she thought what she suffered from can best be described as grief – for a lost childhood and for a lost career. In the subsequent two admissions to hospital, ECT was never suggested again as a potential treatment option. She has had continuing memory problems but doesn’t know whether this was the the effect of ECT or a number of other issues such as her brain injury, early signs of Alzheimers, or the effect of the medication she takes. Jenny now takes a melatonin based antidepressant as she felt there was a seasonal element to her depression. 

She found that her ECT was delivered ‘thoughtfully, professionally and with care’ and that people approached the treatment with a lot of rigour. Jenny thinks that the most useful information source about the experience of ECT is personal experience.

Jenny’s dad died when she was 4 and she said the household she grew up in was difficult, violent and lonely. She describes being assaulted by the village priest “on a regular basis”.

I guess partly because I’m currently and have been for the last little while seeing a wonderful psychotherapist, I think it would be true to say that probably whatever happened to me in adult life had its roots in a fairly difficult time in childhood. So I didn’t have the greatest of childhoods because I, because my dad, who, who I was very fond of, died just after my fourth birthday and my mum was six months pregnant at the time. And my younger brother, I’m one of four, I have an older brother and a younger brother and then [name] my youngest brother, and my younger brother had severe cerebral palsy. So, and my mother didn’t cope at all well without my dad. So I grew up in quite a violent, difficult, lonely household. And I also was part of a devout Catholic community and started being assaulted on a regular basis by my village priest from when I started school, which was almost as soon as my dad had died. That was one of the things that happened, I started school early, I got sent to school and the priest was waiting for me every day for a very long period of time after that. And I, this was in quite a rural place and those sorts of things happened to people of course. And I, my mum was much more difficult person. My brothers all got sent away, including my disabled brother, because that was what people thought should happen to children without fathers, they should be sent to strict boarding schools to replace the fathers they had lost. So they went on scholarships to free places.

Jenny found it hard being given a label of ‘Personality disorder’. She sees psychiatry as inconsistent because the treatments she received don’t relate to that diagnosis.

And in my experience actually trying to understand someone’s story and to not pathologise them is much more constructive than giving them a label and then treating the label. And I have had several different psychiatric diagnoses over, over the years. But was, amongst the other things that went wrong during 2006 and 2007 was being told that my psychiatric label was of Personality Disorder and that that should make me feel better. Because one of the problems with losing my job was that I was considered just to be a dysfunctional oddball, and so for psychiatry to label me as a dysfunctional oddball was very hard and still is very hard, for that still is my working diagnosis. And it, and it seems to me that the practice of psychiatry is riven with inconsistencies, because actually neither ECT nor antidepressants are good treatments for personality disorder and yet those have been the mainstays of an approach to my care. 

Jenny had tried to kill herself and was admitted to hospital. She was distressed and confused in a way that she had never been before or since.

There wasn’t, I didn’t, I, my last working day led, I was a missing person, I tried to kill myself. I left work, I drove from work and tried to, to kill myself, and then was admitted. So my last working day ended with me, with a suicide attempt. So that was my last experience, and as far as I know my office has still got my books and paperwork in it. So, and I haven’t been back since.

And what can you remember of being admitted to hospital?

I can remember, I mostly try and be quite a clear-thinking sort of a person but I remember being almost childlike really, very pathetically, “I don’t give a toss what happens to me. Just do whatever you feel like doing.” And, and therefore because I was childlike, people did things to me, people told me what they thought was best for me, “Well, Jenny, you’re a risk to yourself and, you know, if you’ve disappeared once and tried to die.” In a rather bizarre way, indeed, but it’s, that was how it was. I didn’t want to die quickly so I, I wanted to die in the cold in the middle of [name of area] overnight. Which I didn’t do unfortunately. But it, it, so when people said, you know, “If we leave you at home, Jenny, this might happen again. Will you agree to being admitted?” I said in a rather feeble way, “Yes, I don’t care what happens to me. I’d rather be dead. But you can do what you, the hell you like really.” So it, it was in that confusion. And then I remember being very, very, very upset, and I’m not usually obviously upset. You’d have to know me quite well to know if I was upset by anything. So I don’t cry very often or get emotional about things really. I try and keep myself very, very clipped emotionally. But I remember being absolutely distraught on, on, what, since I was a teenager this was the first time I had been into a psychiatric ward, and what was upsetting was, “Have I come to this? Has it come to this? Has it unravelled so much, my life, that all that’s left is this heap of humanity crying in a shared room in some grotty hospital ward?” So I found it a very difficult place to have any even atom of self-belief or self-respect. And that was probably pretty well my lowest time. Because although I’ve been in hospital since then, always for the same reason because I say consistently, “I’d rather be dead” and then people get worried about that from time to time, I’ve not in a similar way not had my wits about me.

Jenny was positively “overwhelmed” by the way in which ECT was performed, and the kindness of the staff, even though she didn’t find ECT effective for her depression.

And I, in terms of just the practicalities of it, I was overwhelmed by kindness. And I grew, I really missed it when it stopped because the two nurses who ran, effectively ran, the ECT department were both in their different ways the warmest and kindest and most lovely nurses you could ever hope to find. Which contrasted with a bit like being in prison atmosphere of the acute inpatient ward. And because those two people were so lovely, it almost became a treat, just thinking, “I can get out of this madhouse for a bit.” And one of them was called [name] and the other one was called [name], will just be so lovely to me. They’ll say, “Hello, Jenny” and, “Do you want a cup of tea?” and, and make a fuss of me. And that wasn’t what was happening in the ward. There was an awful lot of effing and blinding, and rules and regulations, and spitting and horrible things went on in the ward. 

I can remember these two ladies giving a very warm welcome and just saying, “Well, how have things been?” I remember getting ready on to, clothes off and on to a treatment... mobile bed. I guess it must have been a bed. I remember the anaesthetist talking to me and asking how I was. And then I remember waking up with, sometimes I remember waking up there, being offered a cup of tea afterwards. Some of the time I don’t remember that until I actually found myself back in the psychiatric ward and not really quite sure how I’d gotten there or how, how that had happened, as if I’d, you know, had the most terrible, been on a complete bender, that hasn’t happened to me very often, but just where you have these gaps and think, “Oh, what on earth, how did I get from there to there?” I remember the psychiatrist, who was a lovely and gentle man, consenting me, explaining the procedure before the first time and consenting me for it. And I gave my consent without duress, definitely. And I remembered the conversations, he was called [name] that [name] the very gentle way in which he wanted to reassure you that what you were about to do was completely safe, at least in his opinion, and that the jolts to the brain, the shocks to the brain were minute and nothing to be frightened of.

Jenny says that while she was having ECT she was in a daze. She was less driven to harm herself, but there were things she couldn’t do like baking, as her mind was foggy and it affected her sense of self.

I think it was a, it had some sort of buffering effect. I stumbled through those few months in a complete daze. And I was safer in a daze, I was less driven to do harm to myself, less driven to do impulsive things. But it, it meant probably that the challenge of self-belief and self-esteem was more difficult, because you couldn’t even, you couldn’t even make a cake, let alone do anything else, because everything was just in a bit of a sort of foggy mist really. So I don’t think I felt like a real person. And I would have said that although I felt less anguished, I didn’t shift very much from believing myself to be fairly, fairly convincingly a waste of space because I did nothing useful and I couldn’t function very well at all. But, but I, I think it would be difficult to know really quite how much of a part ECT played in that. I wouldn’t want to look as if I was blaming it for something that may have been a corollary of lots of losses at the time. So, but I think the thing it, it definitely did was made me less clear thinking and less coordinated. So I was less likely to throw myself off a motorway bridge or that sort of thing, because I just wouldn’t have been well enough organised to do those things, I don’t think. 

Jenny’s daughter, who was a medical student, did not want her to have ECT. Jenny didn’t talk about ECT to anyone except her husband.

And she was absolutely terrified, in the way some medical students are, terrified that I’d already had one quite significant head injury and that whatever ECT would do it would damage or worsen memory and cognition. And she knew that actually feeling as if I’d lost a few IQ points and much less able than I had been before I hurt my head had been an upset to me, and she didn’t want that to get worse. So I started ECT in an atmosphere of almost deceit. So [name of daughter] would phone every day and say, “How are you?” And my biggest memory of ECT is of that unhappiness, knowing that I was lying to, or at least not saying anything to her if I wasn’t directly lying. [Name of husband] obviously knew that it was happening. And [name of daughter] indeed came to realise it was happening because I started ECT in hospital and I had twelve treatments, five of which happened once I had gone home. And so she came home around that time, so she indeed took me in for several of those last five treatments, much to her distress because she objected all the time to it, she really hated the idea of it.

I didn’t talk to, my son was travelling, away travelling at the time, my eldest son. I didn’t talk to my two younger children, who were at the time both of them on the at risk register. And one I think remains there, the under-16-year-old remains there. So I, and I don’t tend to talk to people. I don’t, I have very few friends, I don’t make friends easily, and I don’t talk, in fact I don’t think I’ve got any friends I would talk to about something like that. The only person I would talk to and did talk to was [name of husband].

Although ECT wasn’t effective for Jenny, she found the treatment was done professionally and with rigour. She suggests people talk carefully to health professionals about its suitability for them.

I think I would want people not to be scared of the process itself. That it will be done, if my experience is anything to go down, I’m sure it is pretty well typical, it will be done thoughtfully, professionally and with care. So I think that there are, there are good followed standards for its administration. And that because it is seen as un-, invasive in a discipline where invasive things don’t happen anymore, that people approach it with quite a lot of rigour and careful thought. I would want to reassure people that it’s, if my experience is anything to go by with a relatively short number of treatments, that it has had no long-term effects on memory and concentration and intellect as far as I can tell, and I think that’s probably very unlikely to happen. I think it’s more likely to happen for people who have recurrent but separated courses rather than long courses, but recurrent courses of ECT. And that I would want to, to be, people to seek very careful recommendation before they went on to have more for example than 20 treatments, which I would think would be a large number. But I don’t know enough about the technicalities to know that, but I think that would be a lot. I would want to say that you need to talk very carefully to the doctors and nurses looking after you to be sure that this is something they, for your particular illness, believe has a very good chance of making a difference, making you better and safer and happier.