The Washington PostDemocracy Dies in Darkness

My depression was consuming me. My doctor’s prescription? Shock therapy. It worked.

(Alla Dreyvitser/The Washington Post)

Unless absolutely necessary, I did not get out of bed. It took colossal effort just to take my daughter to the bus stop. It was only a short walk from home, but I preferred driving. I could not only stay in my pajamas but also get back under my white duvet as fast as possible.

When explaining depression to people, I described feeling my body was a strong magnet and my bed was the magnet of the opposing pole. This was not my first bout with depression. I have bipolar disorder and experience both sides of that disease — the manic and the depressive — but this depressive episode was long and unyielding.

I was exhausted. I felt worthless. I was certain my family would be better off without me. But any time I was close to downing all of my prescription psychotropic medicines at once, I would repeat a mantra: A mommy in bed beats a mommy who’s dead.

Honestly, even when I was stable, being bipolar meant there were things I just would not or could not do. I would not host a holiday gathering of any kind. I would not travel. Every Easter and summer, I drove three hours to Harrisburg, Pa., to meet my mom halfway, and hand over my daughter so that she could spend time with her grandparents.

My overriding emotion wasn’t sadness or guilt that I wouldn’t be there with her, but relief. I could get into bed and stay there until she came home.

Even in the best of times, I never felt I truly fulfilled my obligations as a mom or wife, but this huge chunk of depression had gone on for six months without any improvement.

My psychiatrist kept changing my meds to no avail. So after 13 years with the same doctor, I switched to a new one. She quickly diagnosed me as having medication resistant depression and said I should have electroconvulsive therapy (ECT). She explained ECT is a series of treatments where, under anesthesia, electric currents are passed through the brain to trigger a seizure, and that it can provide relief to some people for whom other therapies haven’t worked.

I was flabbergasted. Shock therapy?

I knew I was sick, but was I so sick I needed induced convulsions to get better? Like Jack Nicholson’s character in “One Flew Over the Cuckoo’s Nest”? How could this doctor be so quick to recommend this? I would need to be put under for this procedure, for God’s sake. I was so overwhelmed I started to cry, but my doctor reassured me. The treatment would not only get me out of depression but also increase my quality of life even when not depressed.

As I drove away, sad and scared, I got annoyed. Why didn’t my previous doctor recommend ECT? If this was such a miracle cure, why had I been mired in depression for a half-year without even the suggestion of this treatment?

“Many psychiatrists are unaware of these techniques, or at least don’t think to recommend them for their patients,” said Daniel Press, a Harvard neurology associate professor who is chief of the Cognitive Neurology Unit at Beth Israel Deaconess Medical Center, in a Harvard report about a 2019 study on the effectiveness of ECT.

Yet the American Psychiatric Association says that “ECT’s effectiveness in treating severe mental illnesses is recognized by the American Psychiatric Association, the American Medical Association, the National Institute of Mental Health, and similar organizations in Canada, Great Britain and many other countries.”

Irving Michael Reti, director of Electroconvulsive Therapy Service at the Johns Hopkins Hospital and an assistant professor in psychiatry and behavioral sciences at Johns Hopkins University School of Medicine, wrote in a report on ECT that the therapy “is hands-down the most controversial treatment in modern psychiatry,” but that “modern-day ECT is a far cry from the old methods that earned ECT its sinister reputation. . . . The treatment has evolved into a relatively painless procedure with proven effectiveness in the fight against depression. It has survived its critics because it is safe and because it works.”

He estimated that 100,000 people in the United States get ECT each year. (The percentage of people experiencing relief from their symptoms has varied in studies, but is generally thought to be from 50 to 80 percent or more.)

A week after talking to the doctor, my husband, Jay, accompanied me to the ECT department at Morristown Medical Center near our house in New Jersey. The doctor explained what to expect.

I would need 12 treatments, each lasting less than a minute, but the time in the hospital for each treatment would be about four hours. The most common side effect was memory loss. When I asked what that might look like, the doctor said, “Well, you might have lunch with a friend and later forget that you did.”

I put my head in my hands and shook it in disbelief.

“Also,” he said, “you could forget the locations of places, even ones you’ve driven to your whole life.” This would be most pronounced in the time right after treatment and could lessen with time, though how much time was not known. He also mentioned that while rare, patients could lose control of their bladder or bowels during the treatment.

Jay and I were stunned but desperate. We scheduled the first three treatments and left in a daze.

A couple of weeks later, we drove back to the hospital, so early that the sun hadn’t even come up. In the dark car we each thought the worst of what might happen. Jay was afraid I might totally forget him, an idea planted by his father. Stomach issues were often on my mind — in addition to bipolar disorder, I have Crohn’s disease, which causes inflammation of the digestive tract. I was petrified I’d have an accident so I was wearing disposable underwear.

We also may have been thinking subconsciously about ECT as it used to be. As a report by the Mayo Clinic put it, “Much of the stigma attached to ECT is based on early treatments in which high doses of electricity were administered without anesthesia, leading to . . . fractured bones and other serious side effects.”

I undressed, put on a hospital gown and got into a bed at the ECT unit. Nurses came in and hooked me up to an IV and a blood pressure cuff and stuck electrodes to my chest. Once I was prepped for the treatment, I had to wait.

There were at least 12 patients there for ECT. I listened as the doctor went from bay to bay, inducing seizures in my compatriots. When it was my turn to receive the treatment, an anesthesiologist, a nurse and the doctor filled up my bay. Cold, gooey gel was squirted on the left side of my head and electrode pads went on top. As the anesthesia was administered, a bite block was put in my mouth to prevent tongue laceration or dental injury. I was told to mentally count backward from 10. I think I got to seven before I was out. The next thing I knew, I was alone in the bay. My head hurt and my jaw ached, but otherwise I was fine. No accidents.

After 12 sessions, my depression was gone. Memory issues did occur, and I had to make use of GPS on a few occasions, once getting lost on the way home from my stepson’s house, a route I knew well. I had trouble recalling some words, and would watch shows or movies that I had unknowingly already seen.

Jay would reference things we’d done or places we’d been and I would draw a complete blank. It was toughest on my daughter and she got extremely frustrated by my poor memory. She was in third grade and if she started a sentence with “remember when,” I usually couldn’t.

“Why can’t you remember? It’s not that hard!” But she also recognized that ECT allowed me to mother better than I ever had.

It has been five years since I got ECT. I still get bouts of depression but they are fewer and less intense. Now, I have the energy to spend time with my daughter. We play tennis. I allow her to have friends over. We go to Pennsylvania together. I volunteer at her mountain bike races and work at the school store. I make food for her to take into school instead of always sending store-bought items.

I improved in other ways, as well.

My bed doesn’t constantly call to me. I don’t want to die. I RSVP yes to parties whose invitations previously went in the garbage. I go on trips with my family instead of sending my mom. ECT gave me a life I hadn’t known since before having Kate.

Not everyone benefits as I did from ECT and some people require regular repeat treatment. But my new psychiatrist had been correct: I’ve been shocked back to life.

From pills to psychotherapy, treating depression often lies in a gray zone

Not ‘just depression.’ She seemed trapped in a downward mental health spiral. The real cause was a profound shock.

Exercise seems to help alleviate depression, but not for everybody

The coronavirus pandemic is pushing America into a mental health crisis