Barbaric? No, electric shocks can SAVE lives

DEPRESSION kills. Suicide is the single biggest killer of young men after road traffic accidents and the leading cause of maternal mortality in the UK.

Depression also destroys lives insidiously, dismantling them piece by piece until little remains. With around a quarter of us experiencing depression in our lifetimes, it represents a significant public health issue.

But depression is treatable. The development of talking and drug therapies has transformed the lives of millions of people.

However there remains a small group of people for whom standard treatment does not work. How do we help them? The answer is controversial, but it shouldn’t be.

This week figures were published showing that the number of patients being referred for Electro-Convulsive Therapy (ECT) is on the rise — up 10 per cent in the past four years alone.

i hope it’s because ECT’s bad press — thanks mainly to One Flew Over The Cuckoo’s nest — is being reversed by evidence that shows how effective it can be.

i used to think ECT was barbaric, but i’ve been converted, particularly to its use for depression in older people and women with post-natal depression where other therapies haven’t worked.

ECT involves passing an electrical current through the brain via two paddles on the head until the person has a fit. it was used widely for untreatable depression in the Fifties and Sixties.

There’s no doubt this early form was crude and in popular culture it came to be seen as institutional barbarism. This legacy is difficult to erase and for a long time i refused to participate in ECT.

But then i asked myself if my repulsion was rational and so i tried to approach the subject scientifically, reading up on the research.

i was amazed to learn how safe and effective ECT was: my image of a screaming patient, tied down, being electrocuted until they were gibbering wrecks in some grotty back room in a Fifties asylum, couldn’t have been further from reality.

ECT takes place in an operating theatre with doctors and nurses. The patient is anaesthetised and given a muscle relaxant to stop them jerking, so they don’t shake wildly or scream. There are no bolts of electricity flying around — the electrical current lasts for no more than a few seconds.

indeed, when i eventually agreed to participate in ECT treatment, i was almost disappointed at how uneventful it was.

ECT still has its critics, but i wonder how many of them have seen the practice in its modern context? it’s like condemning leg amputations carried out by orthopaedic surgeons because of images of sailors having their limbs hacked off in the napoleonic Wars.

in fact, ECT has far fewer side- effects than many of the drugs i happily prescribe. What’s interesting is that it’s popular in the private sector, where people would rather have it than endure drug side-effects.

THAT doesn’t mean it’s risk-free — while ECT is among the safest medical treatments given under general anaesthetic, side- effects include headache, dizziness and memory problems.

Memory issues receive the most attention, but they tend to affect memories formed in the time directly after treatment and this usually improves within a few hours or weeks, if it occurs at all.

it’s also true that the science behind how it works is not fully understood, but this is the same for many treatments doctors use.

The point is that ECT helps and patients crippled with depression readily ask for it. More than the science, the thing that convinced me was seeing how it transformed lives.

i remember one elderly patient who was so depressed that she’d become psychotic, believing she was already dead and her body was rotting away. She’d been in hospital for more than a year and had made only a slight improvement, having battled suicidal depression all her life.

Her daughter cried as she admitted she’d sometimes wished her mother would kill herself because it was unbearable watching her in such mental pain. Then the patient had ECT. After a few sessions, i was astonished to see her in the ward lounge drinking tea.

She continued to make such a dramatic improvement that after a few more weeks she was discharged. Her daughter wrote a touching letter thanking the ward for giving her mother’s life back.

ECT is an invaluable weapon in the arsenal to fight depression. Depression kills. ECT can save.