THE BIPOLAR CAGE PART 2: ECT AT SEVENTEEN

An easy referral

You often hear that ECT is only used as a last resort, but that wasn’t the case for me. No one ever looked deep enough into my health, environment, home life, diet, or the effects of medications on my mind and body. If they had, ECT would have been avoided entirely. That’s the goal, right? Treatment of last resort? Contrary to the assumption that shock therapy is only used in emergencies, I got the treatment without being actively suicidal.

THE FIRST ECT SERIES

The first shock treatment series obliterated my memories and mental capacity. Locker combinations, phone numbers, names, places: gone. I began carting a notebook wherever I went to keep track of details I once effortlessly held in mind–basic stuff you wouldn’t expect a teenager to struggle with, like what I’m doing, what I need to say, important dates, when I took my pills last, etc.

But I felt better, so it must be worth it. Right? ECT staff was there to reassure me the treatment was necessary and life-saving and that the side effects were temporary. With an empty head, I started telling myself this too.

I SAY ECT “MADE ME FEEL BETTER” WITH GREAT NUANCE

At first blush, it seemed like the ECT was responsible for the stunning transformation in mental state. However, a closer look reveals several other factors in my seemingly miraculous improvement.

Tegretol

When I was 13, my doctor put me on Tegretol. After a month on this medication, the real side effects kicked in without mercy: I would vomit violently minutes after swallowing the drug unless I sat perfectly still for 2 hours. Repeat twice daily for four years. Why not just quit Tegretol? If only it were that easy!

Drug dependence

No one warned my parents or me that these medications could cause dependence like street drugs. Or that Abruptly stopping them could lead to withdrawal and other life-threatening symptoms.

Taper crisis

Each attempt to take me off Tegretol was met with intense withdrawal symptoms, likely because the dose reductions were too abrupt. Even well-executed tapers can be a nightmare that lasts years. Some cross that finish line only to find many debilitating symptoms remain. I would later learn there was no normal for me after medication.

Like a diabetic takes insulin

Like many, I was told the diabetes analogy of depression; I would need to take antidepressants for the rest of my life like a diabetic takes insulin for diabetes. My childhood was ruled by the chaos of chronic hypoglycemia (low blood sugars caused by too much insulin); this was a concept I knew well.

Hypoglycemia, known by some as “the other sugar disease,” shares low blood sugar symptoms, though the cause and treatment are different. Despite debilitating, sometimes dangerous symptoms, this condition receives less medical and media attention. Many, like me, have their unstable blood sugars misdiagnosed as mental illness. In my case, hypoglycemia contributed to my rapid cycling bipolar diagnosis.

The diabetic analogy reinforced my belief that managing my mental “disease” was no different than my lifelong battle for stable blood sugars. I needed to take psychiatric medications daily for the rest of my life to manage my “chemical imbalance.”   

Withdrawal symptoms are mistaken for mental illness

Constant terror, tremors, restlessness, insomnia, crawling skin, disturbing thoughts, and impulses I’d do anything to escape.

My reaction to tapering, coupled with the words of a trusted authority figure, left me with one conclusion: this was my mental disease unmedicated. I then resolved to take these pills for the rest of my life, like a diabetic takes insulin, no matter the side effects. I became a “depression warrior,” stoically suffering through drug side effects to control my “disease.”

The drug cocktail change-up

Replacing this medication dramatically improved my mood and quality of life. Not having to sit still for 2+ hours a day fighting violent nausea would put a skip in anyone’s step.

The haze of narcotics

The claim ECT is painless is laughable to me. Sure, anesthesia and muscle “relaxants” spared me the pain of a violent seizure (mostly), but the evidence of electrical assault lingered long after. 

I needed round-the-clock Vicodin to manage my skull-splitting headaches. After treatment, I would sleep peacefully for weeks, only waking for meals, meds, and essential self-care.

This was a big change for someone with chronic insomnia. My mental and physical health would improve dramatically after getting so much continuous sleep. Soothing week-long opioid naps made me a new person, rested, calm, and at peace with the world. 

Improved environment

Being away from my problematic home life was transformative in many ways. The daily needs I struggled with were cared for: Eating consistently helped keep my blood sugar levels stable, which helped me maintain a better mood. Custodial staff managed housework I normally struggled with because of fatigue. On sunny days, I would sit outside in the grass after lunch and enjoy nature. I spent more time with people, had group therapy, and hung out with my roommate. Even a favorite aunt I rarely saw came to visit me. I felt seen and cared for.

Validation

It’s hell being depressed in the “pull yourself up by your bootstraps U. S. of A.” American society acts like depressed people could be happy if they tried harder. Electroconvulsive therapy’s extreme nature helped me feel that my pain was real. It matched the severity of my suffering, which had previously been dismissed as a lack of motivation or moral failing.

Everyone I told about having shock therapy was horrified and mostly unsupportive. In contrast, the ECT staff was there for me. These doctors and nurses believed my illness was so severe they were willing to do the extreme to rescue me from it. They cared about me– or so I believed at the time. 

Compassion

My time in this psych unit was seriously the best I’d been treated in years. ECT staff was compassionate and supportive. The young tech who wheeled us to the ECT suite was like a sweet big sister. The anesthesiologist was soft-spoken and gentle. A male nurse lightened the atmosphere with his comedy routine about the dry mouth drugs we’re given beforehand to keep us from choking on our own saliva while we’re paralyzed during treatment.  

Down the K-hole

Another reason for my improved mental state was the medications used to put me to sleep before ECT. Ketamine and propofol are often used in electroconvulsive therapy as anesthetics. These drugs are commonly used as anesthetics during ECT and are known to have antidepressant properties.

At first, I felt like I had a spiritual awakening when exposed to these anesthetics. It made me feel like my experience with ECT was truly profound.

My journal

After a few treatments, my change in mood seemed miraculous. The journal I kept while hospitalized told a different story; I still had mood swings and emotional distress but was high as a kite. All my problems were still there, but I was temporarily oblivious to them. 

Punchdrunk

ECT has been used for over 80 years, yet practitioners say they don’t know how it works. A common sense answer has been around for about as long: electroshock damages the brain, which can cause euphoria. I would learn the happiness I felt from ECT was a sign of “punch drunk” syndrome, also called dementia pugilistica. 

I would also learn that shock treatment alters brain waves. The effects of ECT can cause patients to feel like they are in a sleep or fantasy state for weeks or months. 

When their brain recovers from the trauma, they come crashing back down into depression. It only took a year for my euphoria to fade into relapse. 

Brain damage was the cure

This “improvement” I experienced wasn’t a magical resetting of my neurotransmitters but a symptom of brain injury that briefly masked my underlying distress. Brain damage was the cure. 

Page 3: Relapse and my second ECT Series