ECT – Benefits Are Short-lived

Last Monday (August 26), Lauren Spiro published a post on Mad in America.  The post is titled The Today Show and ECT: The Full Story & Informed Consent.  Here’s the gist of Lauren’s article.

On August 20, the Today Show ran a segment on ECT (electric shock “treatment”).  Lauren contends that the coverage was not balanced, but was pitched heavily in favor of shock “treatment.”  Lauren provides a link to the segment, and also a transcript.  I have watched the video, and read the transcript, and I agree that the coverage was very much pro-ECT, and that side effects were trivialized.

Lauren is the Director of the National Coalition for Mental Health Recovery, and she includes in her post a copy of a letter that the Coalition sent to the Today Show, taking them to task for the one-sidedness of their presentation.

Lauren’s primary concern is that the Coalition had provided NBC with the names of five shock survivors who were willing to be interviewed, and were standing by their phones.  The show producers called only one of these people, and later called him back to tell him that they probably wouldn’t need the material he had provided.

NBC did, however, use material from people who had made positive statements about their experience with shock “treatment.”  They also aired a clip from an interview with Jeffrey Lieberman, MD (President of the APA), in which he described ECT as “…an effective treatment…”  He also claimed that ” Seventy to 80 percent of people will respond favorably, in some cases will have a complete remission of symptoms.”

NBC’s chief medical editor, Nancy Snyderman, MD, spoke enthusiastically about shock treatment.  She acknowledged that sometimes there could be memory problems, but that they were minor:  “…you don’t lose the memory of who you are or what you’ve done in life.”  This is in marked contrast to Linda Andre’s story.  In her book, Doctors of Deception, she reports that she has no memory of her college days, and in fact only knows that she went to college because she can see her diploma hanging on the wall.

Lauren Spiro’s general point is that a television segment about shock “treatment” should include the comments of people who were harmed by it.  And who could argue with that?

The negative aspects of shock treatment that Lauren feels should be included in a balanced account include:

  • Risk of brain damage
  • Risk of memory loss (sometimes years of life)
  • The theory that the so-called positive effects of shock treatment are actually side effects of brain injury (numbness and euphoria)
  • Evidence of substantial relapse following treatment
  • High hospital re-admission rates
  • Lack of solid scientific data as to why/how the treatment works at all

Here again, what reasonable person would quibble with this list, to which, incidentally, I would add:

  • The fact that sham ECT (in which the individual is prepared and anesthetized, but not actually shocked) is just as effective as real ECT!  (Northwick Park ECT Therapy Trial)

For decades, psychiatry has been peddling the fiction that ECT is a safe and effective treatment for severe depression.   Side effects, we were told, were minimal and transient.  The complaints of individuals who were damaged by the shocks, including those who had lost all memory of large chunks of their lives, were dismissed, in true psychiatric fashion, as the incoherent ramblings of the “mentally ill.”

But, as in other areas of psychiatry, the tide is turning.  The facile psychiatric fables are receiving serious challenge.  On Mad in America, Lauren was able to find a large audience.  Linda Andre’s book, Doctors of Deception, (which I discussed in an earlier post) has been published and is being widely read.  And thousands of victims of this “treatment” are speaking out in survivors’ groups and elsewhere.

It is now six years since Harold Sackeim, PhD, previously one of America’s most enthusiastic proponents of ECT, published his six-month follow-up study of 250 “patients” and concluded that ECT does indeed cause “…permanent amnesia and permanent deficits in cognitive abilities, which affect individuals’ ability to function.”

I don’t ever recall reading, or even hearing about, a well-designed study with adequate follow-up time that found ECT to be effective and safe.

So the question is:  why are the psychiatrists still using this brain-damaging “treatment”?  Why is it that, with very few exceptions, psychiatrists are not drawing attention to the lack of efficacy and the dangers?  Why does it fall to the survivors and to websites like Mad in America to draw attention to this destructive “treatment” that is inflicted on 100,000 people in America every year?  Is psychiatry as a profession so self-enamored that it is incapable of exercising even this minimal amount of self-scrutiny?

I imagine that psychiatry considers the Today Show segment a victory of sorts.  They see their elected president, Dr. Lieberman, basking in the limelight, delivering the same old unsubstantiated and self-serving assertions.  NBC certainly treated their flagship treatment kindly.

Or did they?  During Dr. Snyderman’s interview, a text overlay came on the screen, with Dr. Snyderman’s audio in the background still responding to the interviewer.  The text overlay was not related to what Dr. Snyderman was saying.  The overlay was a kind of summary statement.  Here’s what it said:

HOW DOES ECT WORK?

  • Session Usually Lasts One Hour
  • Typically Two or Three Times a Week
  • Improves Depression in 70%-90% of Patients
  • Benefits are Short-Lived

This overlay was on screen for 6 seconds.  Note the last item:  “Benefits are short-lived.”

This is what we “mental illness deniers” have been saying for years.  People often come out of ECT with a kind of brain-damage-induced euphoria, but this fades fairly quickly and within a few weeks, they are no better off then people who did not receive shock.  (In fact, they’re a good deal worse off, because of the neurological damage.)

So what’s going on?  Apart from this one line on the overlay, there was no mention on the show of the fact that benefits are short-lived.  One of the interviewers did in fact try to engage Dr. Snyderman on this matter, but she evaded the question.

So how did the line “Benefits are short-lived” get onto a segment that in every other respect was little more than an advertisement for shock treatment?  It’s food for thought, because BENEFITS ARE INDEED SHORT-LIVED.  Somebody on the Today Show got that part right.