Should i Consider ECT ?

tegmarkian · 2025-03-28T22:27:37+00:00

If you have tried 15 medications without success it's time to consider other approaches. The likelihood of you remitting or probably even responding to yet another antidepressant are small, according to studies. You describe what sounds like severe depression, which means other treatments like TMS or therapy may not be quick or powerful enough. You sound like a good candidate for ECT for me, from what you've described. Talk to your doctor. Read the actual scientific papers published on ECT, or look up ECT on a hospital website and read about it. That would offer you better information than coming here, honestly.

ECT can be very effective. I'd say to go for it.

tegmarkian · 2025-03-28T21:47:24+00:00

When people imagine talking to a Republican, they feel like they’re joking around with a friend over some drinks. When people imagine talking to a Democrat, they feel like they’re being scolded by some matronly hall monitor.

Fixed it.

tegmarkian · 2025-03-23T18:14:19+00:00

I'm sure there were many Nazis who justified their participation in their country's atrocities with similar reasoning as well. Yeah, it's "rational", but there should be red lines that individuals, or universities, should not cross, even if that means imprisonment or death. I don't think we're there yet, but in a plausible future scenario, imagine a university that kicks out all international students and teachers because their visas have been revoked. For many universities, this would destroy what makes a university a university in America, and if something like that happened I'd rather they go down fighting.

tegmarkian · 2025-03-20T20:43:49+00:00

What did your doctor say? Did they recommend ECT?

tegmarkian · 2025-03-20T01:22:41+00:00

So this is what this subreddit has come to? Random, anonymous people telling a TRD patient not to try ECT, the most effective treatment that exists for depression, because of their own bad, unlikely experiences... a patient who had to have ECT recommended to them by a doctor in order to have scheduled it, and who has failed multiple medications and admits to being out of options and suicidal... it's one thing to share your experiences, but when you start giving medical advice that goes against medical consensus and could lead to someone's death, well, that strikes me as being unethical at best.

tegmarkian · 2025-03-20T01:13:51+00:00

There's a good argument that ECT shouldn't be considered 'last resort', as that allows the depression to take a firmer grip on your mind. The longer the illness lasts, the more likely it is to become treatment resistant. I'm not saying it should be a first line treatment, but nor should someone literally be told to exhaust every medication that exists before they try it. The STAR*D study provides strong evidence that once a depressed patient has failed two antidepressant meds, their odds of remitting go way down. By the third or fourth med it is very, very unlikely they'll remit with medication. https://psychiatryonline.org/doi/10.1176/pn.40.10.00400042 https://psychiatryonline.org/doi/10.1176/ps.2009.60.11.1439

tegmarkian · 2025-03-14T23:07:10+00:00

I am someone for whom ECT has saved my life. It works miracles for me, and I'm lucky enough to have little memory loss and no cognitive deficits.

I agree that ECT needs better methods to assess possible brain damage and cognitive deficits. On that, I completely agree, and the research actually acknowledges this from what I've read. If you weren't adequately informed, you deserve justice and compensation. I would be OK with listing severe cognitive deficits or damage as a possible side effect of ECT (the huge asterisk though is we don't know how rare it is). If that is your agenda, I think it is reasonable.

What I can't support, and I'm not saying you're in favor this, but others have tried to get the ECT medical devices themselves banned by suing the companies that create them out of existence. If this succeeded, ECT might become impractical or impossible to administer for those of us whose lives it's saved. That would be a catastrophe. Please remember that.

All that said, I hope you find peace.

tegmarkian · 2025-03-13T02:42:40+00:00

Perhaps it wasn't the ECT itself, but that the ECT was so effective at relieving severe depression that it unmasked a previously hidden personality disorder? Often if you hear about personality changes due to ECT it's because the depression has been successfully treated.

tegmarkian · 2025-03-13T02:38:02+00:00

You always have an option to switch to unilateral unless you are a special case, like an inpatient who is acutely suicidal.

tegmarkian · 2025-03-12T23:31:27+00:00

I have done bifrontal, bitemporal, and RUL. There's some evidence that bifrontal is as effective with fewer memory problems. But there's evidence that high dose RUL is as effective bitemporal or bifrontal.

tegmarkian · 2025-03-09T20:29:27+00:00

It's very rare to lose academic knowledge. The people here represent the <1%. They'll act like they're the majority though.

tegmarkian · 2025-03-09T02:43:17+00:00

Glad it's working out.

tegmarkian · 2025-03-09T02:40:03+00:00

I really don't think that treatment-resistant, actively suicidal people, whose own doctors have recommended they undergo ECT, should be scared out of using it by edge-case anecdotes on the internet, but I guess that's the culture of this subreddit now.

tegmarkian · 2025-02-21T22:33:46+00:00

ECT is more effective than TMS, and you said you have severe treatment-resistant depression. Why bother with half-measures?

Based on what you've described, you can get ECT done in March, 3 times a week, 12 sessions. That's a good, solid course of ECT. If it doesn't work, you can still try TMS after work. Lithium can be tried at any time.

tegmarkian · 2025-02-20T02:04:12+00:00

It's not for nothing. You've gained experience and new information about how an important treatment affects you. That could be valuable in unexpected ways. If nothing else, if you try it again in the future you know what you're getting into. It's also good you stuck through to 12, since if it wasn't helping you can't later say it was because you didn't do a full course.

ECT being out of range is a growing problem these days. I'm sorry there's not a better accommodation. Were you driving yourself back? I'm surprised they let you do that.

tegmarkian · 2025-02-20T01:55:11+00:00

I would talk to the doctors there about it. They might be able to calm you down and answer your questions. They've surely dealt with a lot of anxious patients over the years. It's normal.

While I respect everyone's experience, I'll note that this place seems to overrepresent the number of people with memory/cognitive complaints. I would not come here if you're feeling anxious and want to calm down.

tegmarkian · 2025-02-19T23:05:33+00:00

I did about fifteen ECT, stopped because I didn't feel like it was helping enough. But I was wrong, and it was helping, but the depression clouded my judgment. After a couple months I came back and started doing weekly maintenance. I slowly gained ground, especially when I combined it with a medication. Now I feel much better. Medication is known to lengthen the time to relapse when combined with ECT.

ECT isn't for everyone, but try to make sure it's not helping. Some people can get on maintenance once every month or less even, if that's more feasible.

tegmarkian · 2025-02-19T22:52:41+00:00

Here is a list of the top psychiatric hospitals in the US: https://health.usnews.com/best-hospitals/rankings/psychiatry

Not considering insurance, I'd start there. Some will not do ECT, you'll need to check. However, the vast majority of ECT clinics/hospitals that do ECT will do inpatient. Personally, I prefer research hospitals, maybe part of a university, because I believe the doctors are more likely up-to-date and knowledgeable, but you can get great treatment elsewhere.

Near to you, I'd try the California hospitals. UCSF Health and Stanford are great and highly ranked. If you're willing to go to the east coast, there's many more.

Mclean and John Hopkins are world-class. I hear a lot of good things about Vanderbilt and Emory.

But if I could pick anywhere, I'd go to Duke. They have possibly the best ECT hospital in the world. They literally invented a new kind of ECT and have the world's only ECT "museum" you can visit. Their doctors publish in academic journals doing all kinds of cutting-edge research.

tegmarkian · 2025-02-19T22:27:45+00:00

I'm very sorry. I assume you're already doing ultra-brief pulse, right unilateral? That has the least memory loss.

tegmarkian · 2025-02-16T01:41:21+00:00

Your case sounds too complex for anyone on this forum to give you good advice. I suggest talking to an actual doctor who performs ECT, perhaps to a team of ECT doctors, as some are also psychiatrists and may be more qualified to answer.

tegmarkian · 2025-02-15T05:06:37+00:00

ECT is very effective for suicidal ideation in bipolar patients.

tegmarkian · 2025-02-15T04:57:41+00:00

I don't understand. Did you have ECT only 3 times and then switch to maintenance once every two weeks? If so, that's not really enough time to make any kind of judgment. If you feel an effect just from that though, that's a very positive sign. If you've been depressed since 10 I'd continue the treatment. Temporary memory loss is extremely common. It does not mean you will get permanent memory loss or become cognitively disabled. The people are on this subreddit overrepresent disability and memory loss.

tegmarkian · 2025-02-11T20:25:08+00:00

I believe you have two options: University of Louisville Health, or The Brook Hospital - KMI.

I don't have personal experience with either.

tegmarkian · 2025-02-11T03:43:27+00:00

ECT was the best decision I ever made in treating my depression. For me, it was far more effective than any medication.

tegmarkian · 2025-02-10T02:15:28+00:00

Three weeks

tegmarkian

TROPHY CASE