How shock therapy saved my life: an essay

In 2018, I voluntarily received 19 electroconvulsive (shock) treatments at a hospital in Colorado to alleviate my depression. This is the true story of how that decision saved my life. You can read the full text below, or check it out for free on my blog, Miss Misery.

One afternoon late in my twenty-third summer, I found myself sitting on a plastic couch in my psychiatrist’s office, begging him once again to prescribe me something – anything – that might take the edge off my depression. I’d been in and out of offices like these for ten years, always making the same plea: make the pain stop.

Clinical depression began to cast its iron shadow over my brain in 2007, when I was still a child. The change my family witnessed in me that year must have been terrifying. Puberty was not the only force at work: deeply-rooted mental illness transformed me for the much, much worse. Previous to my adolescence, I was a regular kid. I played and made friends and wore bright colors. But despair soon took over, and it warped me. My obsessions spiraled out of hand and I flew into a rage over everything. My decline accelerated with no end in sight, and after two seemingly endless years of psychotic depression and self-harm, I’d had enough. I attempted suicide. I was 14.

That’s when the visits to the psychiatrist began, and with them came the medications. I was prescribed a mood stabilizer. Not long after, my doctor realized I was a tough case and expanded my treatment to include an antidepressant as well. It didn’t make much difference, though, so it was discontinued after a few months. In its wake came trial after trial of new prescriptions, but everything I was given proved to be nearly useless.

(Editorial note: Don’t start or stop taking meds without a prescriber’s approval. Seriously, don’t do it. Also, just because I didn’t have luck with meds doesn’t mean someone else can’t benefit from them. Everyone’s brain chemistry is different, and I do not want to discourage anyone from asking a doctor about treatments that could very likely help them.)

So, ten years after the onset of my symptoms, I found myself back on my doctor’s plastic couch, hoping he would pull a magic bullet out of a hat. My hopes weren’t high that any drug would help (or that there were even any drugs left to try), but he said that didn’t spell doom, because there was another option. It was one that I had considered in the past, but I had never been desperate enough to take the leap.

I was desperate enough now, though, so after talking it through, my doctor and I decided that I was a good candidate for electroconvulsive therapy (ECT). First, I had taken so many different pills over the years that I officially qualified as medication-resistant. I was also physically healthy, with no known heart problems or allergies to anesthesia. And depression had left me without any commitments to work, school, or other people, so I could stay at home for a few months while I was in treatment.

I was confident right away that I had made the right decision. I didn’t know if ECT would work for me, but I was certain that I would suffer for the rest of my life if I didn’t do something about my self-strangling mind.

After the appointment, I did more research into ECT. I learned that not only was it a low-risk and painless treatment, it was also always voluntary. What’s more, its success rate in depressed people like me was impressive. It was conveniently done on an outpatient basis, though someone reliable had to be my chauffeur, since I would be in no state to drive after waking up from general anesthetic after every treatment.

The research made me feel more confident about going down the road I’d chosen, but I did run into one big complaint about ECT: its effect on memory. I could expect to forget most of the months I was in treatment, and those memories would never come back. However, my brain’s ability to retain new memories would probably restore itself shortly after the last procedure. Overall, ECT was a low-risk gamble for a high probability of reward.

My parents reacted well to my choice. I think they saw it coming. They were scared, of course, but the literature on ECT reassured them like it reassured me. They agreed to drive me to and from every treatment and make sure I remembered to follow all of the doctor’s advice when I was home.

Not too long after that life-changing appointment with my psychiatrist, my parents and I met with my new ECT specialist for the first time. He was an affable man in a Polo shirt, sort of Santa Claus-esque, and nothing like the Nurse Ratched stereotype that haunts doctors in his profession. We talked over my psychiatric history, and after reviewing my regular doctor’s recommendation, he agreed that I was a good candidate. We made my first ECT appointment for September, just a few weeks later.

The first morning of my first treatment, I awoke hungry from the mandatory fast, had my nurse-approved cup of black coffee, double checked that I hadn’t taken my lithium the night before (it interferes with treatment), and climbed sleepily into the backseat of my parents’ car to embark on the half hour journey to the hospital.

The medical campus where I received treatments happened to be in the late stages of relocation, so almost every service had moved out of the building. The ECT center was the only remaining practice, so the place was a ghost town. As my parents and I walked somewhat meekly into the elevator, hopeful but apprehensive, I chuckled inwardly and tried not to let the eerie setting get to me.

We stepped onto the third floor and found the waiting room. There were no padded walls or harsh restraints: just a picture window at the end of the room, a puzzle in the corner, and some psychology magazines on a low table between the seats.

An older lady greeted me from the reception window and I offered her a quiet hello. She asked me to sign in and fill out a few straightforward forms. I glanced through them: there was a standard depression evaluation, a consent form for the treatment I was about to receive, and written verification that I hadn’t eaten or taken any interfering medication in the past 12 hours. I went through the papers carefully and returned them to the lady without a word.

I sat. Time passed.

A nurse poked her head into the room and called my name.

As I stood up, I glanced at my parents. They were clearly as nervous as they were excited for me to start my journey toward long-awaited mental health. I had a flashback to the way they looked at me before every play, speech, and song I had performed since I was a kid. It was a lot like the anxious hopefulness that was on their faces as they sent me off to my first treatment.

I followed the nurse across the hall to a long, sunny room. There were spaces for three or four patient beds along the far wall, each separated by a beige curtain that could enclose the bed in a small, private area. Cupboards lined the near wall. To my right was a door to a supply cupboard marked Medical Personnel Only; on my left was a closed door that could only lead to the treatment room.

The nurse assigned to me that day was a small, kind, competent woman in her middle age who spared no time in welcoming me to the ECT clinic. At her request, I took off my shoes and my belt, which she placed into a large bag already labeled with my name. She invited me onto one of the beds and told me the doctor would be ready for me in a few minutes. As she spoke, she pulled a small cup of strange liquid out of a drawer, peeled back the seal, and asked if I wanted any added drops of artificial flavoring. She explained that the concoction would neutralize my stomach acid, but it tasted pretty rank unless it was mixed with something like grape or mint. I opted for vanilla. Grape sounded gross.

The serum was biting and unpleasant, but far from unbearable. The nurse brought me a heated blanket and explained I would stay in the bed for the duration of the treatment, as well as the post-procedure, which mostly consisted of nurses huddling over me to make sure my recovery went well. She easily inserted an IV picc line into the crook of my arm, then bustled away importantly.

A few minutes passed. I stared at my Halloween socks. Being shoeless felt oddly cathartic, like the ward was someone’s living room and not a hospital.

Suddenly, the treatment room door opened and a nurse wheeled a bed just like mine to a curtain-enclosed space on the other side of the room. The person in the bed was almost comically anesthetized – like they were asleep, but even more limp than that. There was some sort of goop in their hair, which I later found out was a gel used to conduct electrictricity. Looking at that patient in such a vulnerable state felt disrespectful, so I examined my socks some more.

My nurse returned: I was next. “Okay, here we go,” she said with a reassuring smile. I was glad for her relaxed demeanor. She pulled the bed’s blue railings up on either side of me, unlocked the wheels, and pushed the whole unit through the open door

The treatment room was very small. It had one window, which was high enough that no one could look in from the outside. In one corner, behind a tangle of wires and tubes, a young woman gave her undivided attention to something she was holding. In the other corner sat the jolly ECT specialist I had met with a few weeks before. I reasoned that the black box in front of him was the electroconvulsive machine itself. Its simplicity surprised me: I had seen music mixing hardware with more dials and knobs.

My nurse positioned the head of my bed near a single metal IV stand and leaned me back flat. Some wonderful person had installed a single transparent ceiling panel with a pretty garden scene painted vibrantly on it, which glowed from the lightbulb on the other side. I relaxed a little at the small touch of compassion.

“TIME OUT,” my nurse announced, which the doctor acknowledged. As the door closed behind her, my nurse asked me to repeat my name and date of birth, presumably to confirm that I was in the right place at the right time. She patted my pockets to ensure they were empty, then conducted a quick mental acuity test to verify that I was cognizant. At her instruction, I named the current President, spelled the word HOUSE backwards, then consented to being anesthetized and pumped full of electricity.

I felt ready, but that didn’t keep my heart from racing. The woman in the corner attached an IV tube to the picc line in my arm, then expertly administered her anesthesia cocktail into my veins.

Once, when I was in middle school, I received an endoscopy to investigate whatever had been causing me chronic stomach pain. (The camera ended up finding nothing because the culprit was anxiety.) It was the first time I had ever been put under, so the doctor calmed my nerves by playfully challenging me to count all the way down from ten before the anesthesia knocked me out. I remember doing pretty well that day, all those years ago – I might have made it to three.

Whatever drugs they used for that first ECT treatment must have been much stronger. As I gazed into the artificially lit garden scene above me, I was able to count down to eight before everything went fuzzy, then black.

Apparently, the first thing I said when they woke me up was, “When does the treatment start?”, which would have been adorable if I hadn’t been a gel-haired, post-anesthesia mess.

Everything had gone well. Once I was awake and stable, the hospital staff told my parents to bring our car around. A nurse wheeled me in a chair to the designated groggy patient pickup spot in front of the building. I don’t remember being wheeled; I just recall walking into each subsequent appointment feeling weird that I’d soon leave in a chair.

I also don’t remember the car ride home, or the rest of the day, or really anything that happened for the next three months. But I must have been alert and cognizant between appointments, because I recorded and released several original songs in October, in the middle of my course of therapy.

What I do remember is what my parents told the doctor the first time we met with him after I began ECT:

“After two treatments, she started smiling again.”

It was astounding to hear. At that point, I wasn’t even aware of how much I was healing. Without depression, stuff that had hurt for years – waking up, brushing my teeth, talking – just became stuff that I did. It was routine, it was easy. I didn’t have to think about it.

Smiling came so naturally that it took awhile for me to realize I was doing it.

19 treatments later and I was engaging with life again. For the first time in a long time, I was able to feel restless, which was a welcome change from the sulking lethargy that had plagued my days before ECT. My mind felt bigger than my body instead of insignificantly small. I had more ideas than I could put on paper. My aspirations came back, and I doubled down on my goal to finish my degree, which I had all but given up on earlier that year.

In short, I became a person again. I couldn’t remember the last time I felt so sane, so clear.

It’s important to explain that being clear isn’t the same thing as being happy. Happiness is an emotion, and even healthy people don’t feel it all the time. Clarity is better than that because it’s the ability to be happy, ever. For years, joyful things did nothing but throw my depression into sharp relief. That made me more depressed, which made it harder to be joyful, which made me more depressed, ad infinitum. However, after my ECT treatments – if not halfway through them – if something came along that brought me joy, I could finally feel it. The treatments expanded the range of emotion I could experience to heights I hadn’t known since I was ten years old.

Within weeks of finishing treatment, I moved out of my parents’ house and into a friend’s apartment. I stayed there for a year, until wanderlust took over and compelled me to move out of state. I now live on my own in Minneapolis, where I’m finishing my degree, making music, staying on top of my life, and actually really enjoying it.

Instead of limping through my days with depression’s weight on my shoulders, I now feel clean, like a blank slate. I still feel sad at times, of course, when the situation calls for it. But even that feels like a miracle, because it means my emotions know how to respond to the world in a way that makes sense. When problems in my life do arise, I can finally approach them with strength and – get this – hope.

What a word.

Hope.

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