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Please answer a question about ECT

(16 Posts)
ECTquery Wed 28-Nov-12 13:09:54

Thank you everyone for your advice and thoughts. I know that 70 isn't old but my mum looks and acts a lot older than her years. I have family members old enough to be her mum but you would think it is the other way around. Although, they haven't had to live with a mental illness half their life and taken such strong medication. That is one of the reasons she cannot go back on lithium, because it has damaged her kidneys so much.

I feel a little better about her getting this treatment but my mum is refusing, so far. I know if she refuses they will probably apply the mental health act.

I will see how it goes and let you know what happens. Thanks once again everyone.

mumtoaandj Sun 25-Nov-12 20:13:20

i was in hospital in 2001 and saw quite a few patients come back from ect, all ages too. the main thing i noticed was that people really did have memory problems, they could remember things that happened yers ago but recent just happened things had been totally wiped from their minds. After a few days it was obvious that people responded fro ect, they became more animated and not as depressed- it was obvious. I spoke to a few of the patients some had had ect regularly and repeated it every so many years- it made them tick. I myself suffer from depression which only seems to be properly treated when i take lithium plus an antidepressant (i am in my 30;s) i would consider ect if i still have this condition in my later years- currently i have a young family so would be too scared to undergo it. good luck to your mother- very silly question but a few women in hospital at the time were in their late 60's i always wondered if it was some sort of hormonal problem- could it be?

4aminsomniac Sun 25-Nov-12 18:29:00

I am bipolar and had ect 15 years ago, whilst on a psychiatric ward with severe depression.

It does seem barbaric, but for some people it works when nothing else does, fact. It is used much less readily now than 40 years ago, so if they are thinking of it she may well have no other options. Memory problems are the most common side effects, but nearly always get better over time.

It is always done under GA, in the past that wasn't always the case.

Funny, we consider it barbaric, but cutting someone open with a scalpel and rummaging through their insides we regard as quite normal; perhaps this is part of the bias against mental illness?

NanaNina Sun 25-Nov-12 16:49:12

So sorry ECTQ for you and your mom. I suffered a severe depressive episode Easter 2010 and was on a psych ward for 3 months. I was in the "Older people's Ward" as I was 66. I began to hear people talking about ECT and I was shocked and thought this belonged in the past, having seen all those pictures of people violently shaking etc. However I began to realise that several women on the ward were having ECT. My psychiatrist (who wasn't approachable) had a Junior Dr doing a placement with him for 3 months and he spent loads of time withme. I brought up the issue of ECT and how surprised I was it was still a treatment. He told me that it was a very effective treatment for severe depression with psychotic episode (which maybe your mom has I don't know) or drug resistant depression.

I saw women coming back from ECT and I didn't get the impression they had had a GA - in fact I think the Jr Dr told me that they are given a sedative and don't feel any pain. They certainly seemed ok when they came back to the ward and just maybe a bit sleepy but as some of the patients were quite elderly this wasn't uncommon. I talked about it to the Ward Manager as well and she said if she became mentally ill and nothing else worked she would not hesitate in having ECT and she talked about how people remember all the horrid stuff in the 70s and how things had changed so much now.

You mentioned that your mom was much worse after being taken off lithium which I think is the usual drug for bi-polar? why was she taken off it - do you know. I think it can sometimes affect the kidneys, but not sure. You say your mom is "very insane" and she doesn't realise she is ill, so surely she is psychotic, as in out of touch with reality. I am realy surprised that she is being treated at home, by CPNs presumably. Thing is these awful cuts have put such pressure on the NHS (and other public services) that people like your mom who need admission can't get it. I think (though am not sure) that if you do have ECT you need to be an inpatient. If you can talk more to your mom about the modern ECT and maybe help her to feel less afraid (though if she is psychotic she won't be thinking clearly) she may be more accepting.

You say the psychiatrist has given you all the pros and cons. I think that your mom is only going to get worse isn't she, so maybe ECT is a better option than getting worse. You mention the psychiatrist is going to give her a mental health act if she doesn't agree to ECT. I assume you mean a Section under the MH Act, as has happened before, and in my view the safets place for a person with psychosis is in hospital. I think that treatments can be given without the patient's permission under a section but am not sure, and don't know if this applies to ECT.

My advice would be to harden your heart and try and get your mom to accept ECT (called tough love) and if this means that she gets admitted allthe better. Your psychiatrist sounds like he/she is helpful, so maybe ask the CPNs to refer your mom to the psychiatrist again, although this probably isn't necessary as she is already one of his patients.

I know from first hand the torment of mental illness and the way people don't understand and the stigma attached to it - it all makes everything so much worse than physicall illnesses.

Hope your mom gets the help and support she deserves. 70 is not old these days.

ECTquery Sun 25-Nov-12 14:49:18

No, it's worse that she doesn't think she is ill. She doesn't want to take her medication so she has to have carer's come in twice a day to make sure she takes it. Also, she ruminates her 'problems' and about the reason she is like she is. She has had tests over the past few years for dementia. She doesn't have that and she isn't an old girl sat in the corner with bats in the belfry. She can hold a conversation and knows who people are - it's just her skewered view and perspective that is the problem.

thornbirds Sun 25-Nov-12 14:41:43

Sounds difficult situation but maybe it is a blessing that she does not think she is ill. Has she been checked for dementia or other diseases that can cause confusion and axiety?

ECTquery Sun 25-Nov-12 14:25:43

Thanks everyone for your advice.

My mum is not young (70) and she has bi-polar with treatment resistant depression. Unfortunately, she should be in hospital but where she lives there have been massive cuts and they are only putting people in hospital who are a danger to themselves or the public. She is neither. Although, she has been in and out of hospital, sometimes under a section. The psychiatrist said, if he could, he would admit her because she is so ill. It is awful. She is having 'care in the community' which is a complete shambles. She is just existing. She is extremely ill. Very anxious - very insane, I'm afraid and I do not say that lightly or flippantly. I mean it. She is in a terrible place right now, mentally. She doesn't even think she is ill. But isn't that the thing? People who say they are sane, aren't and vice versa???

PrincessSymbian Sun 25-Nov-12 13:00:08

As far as I am aware the procedure they use nowadays is very different to the one they used in the seventies.
Like all medical interventions for depression it can be very hit and miss as to if it works/ what the side effects might be.
I know if my depression had not responded to anti-d's, then it is probably something I would have considered undergoing.
Also perhaps do some research on 'ketamine infusion therapy'. It is still in early days of usage but there has been some evidence that it is quite effective for treatment resistive depression.

thornbirds Sun 25-Nov-12 12:50:42

Is your mum psychotic/manic or just depressed and sane? In the previous case they could get your mum sectioned quite easy, I assume.

I had treatment resistant depression but managed avoid ect as one medicine worked a little bit. I was very ill for several years but got better without any meds. It was a long process but worth. Your mum does not sound that young (if she had treatment at 70's) so why can't they just let her be?

TheLightPassenger Sun 25-Nov-12 09:57:15

There is more than one doctor involved IIRC with the decision making/sectioning/ECT procedure, so possibly that might help a little with your concerns re:second opinion. It is a horrible position you are in, you are trying to do your best for your mum's health. I completely understand why the whole concept/procedure seem barbaric to you and your mum.

ECTquery Sun 25-Nov-12 09:33:57

The psychiatrist said that it is the last resort - as nothing else is working and giving the severity of her illness. The psychiatrist also pointed out that there are both positive and negative reactions to this treatment. He cannot advise either way but has given all the facts. My 'gut' is saying no, but what kind of informed decision is that??? It's not! My mum is also saying no. Although, I also understand that if nothing else is working, then perhaps we should try it. I think it is barbaric and hate the idea of my mum being given GA (she is also getting older - and there are the risks attached to that) along with electric volts going through her brain to make her convulse/fit and then to 'see' if 'perhaps' it might work. We cannot afford to take her privately for a second opinion. Also, the psychiatrist is probably going to give her a mental assessment act, if she refuses. So it seems like it is going to happen, regardless. Oh horrible, horrible.

TheLightPassenger Sun 25-Nov-12 09:12:03

I think you need to ask the psych a lot of questions about this, about whether there is absolutely nothing else that can be tried, given your mum didn't feel she benefited from earlier ECT. On the face of it, if it's a choice of ECT or nothing, then it leaves very little choice. I really do sympathise with the position you are in, feeling like you may be involved with arranging a treatment for your mum that she really doesn't want sad.

ECTquery Sun 25-Nov-12 09:04:27

My mum says it didn't work for her and she claims it affected her memory. She hated it and understandably doesn't want it again. But she is very ill right now. I don't like the idea of the whole thing. Also, it has to be administered under GA. Tbh, I don't think there is anything that will work for her any more. I don't want to sound so negative but she is so terribly ill and this time it has lasted years. Before, she managed it but since coming off lithium her life has not been a life. No drugs are working any more. It is awful to see my mum so ill. I feel helpless.

TheLightPassenger Sun 25-Nov-12 08:50:17

I also know someone who had it who it was v effective for, without any apparent longer term issues with memory etc. So if nothing else is working and/or situation is urgent, I would think about it very seriously. Did your mum, despite hating it, improve as a result of the previous ECT?

ohmeohmy Sun 25-Nov-12 08:46:45

Gut reaction is against it but do a search on PubMed and you see some positive results. I know someone who had it and it worked well for her. Ask lots of questions if you can see th drs. Is there an advocacy service that can be involved?

ECTquery Sun 25-Nov-12 08:30:56

Can anyone give me advice/their views on ECT. My mum's body is resisting all treatment and the psychiatrist is suggesting ECT as a last resort. Which I suspect will become a mental health act assessment if she refuses. My mum had ECT in the 70s (when she was first diagnosed) and she hated everything about it. I know technology has changed and that it must be different so many years on, but please, if anyone can tell me what they think, I would be so grateful. I don't feel like I would be making an informed decision either way, in support of it, or not. Thanks.

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