ECT

Here’s an interesting story from Australia, recently back in the spotlight. From 1962 to 1979, psychiatrist Harry Bailey, MD, serving as chief psychiatrist at Chelmsford Private Hospital in New South Wales, practiced “deep sleep therapy”, which involved keeping people in barbiturate-induced comas for days or even weeks. Twenty-four of the individuals who received this “treatment” died while still in the hospital. Many more died or showed permanent brain damage after discharge. ...

On March 4, 2020, the very eminent Allen Frances, MD, published an article in Aeon, which according to its About page is “a digital magazine, publishing some of the most profound and provocative thinking on the web. We ask the big questions and find the freshest, most original answers, provided by leading thinkers on science, philosophy, society and the arts.” The article is called The lure of ‘cool’ brain research is stifling psychotherapy. The central theme is that prior to 1990, the National Institute of Mental Health (NIMH) “appreciated the need for a well-rounded approach [to mental health] and maintained a balanced research budget that covered an extraordinarily wide range of topics and techniques.” However, since 1990, the opening year of the Decade of the Brain, the NIMH has “increasingly narrowed its focus almost exclusively to brain biology – leaving out everything else that makes us human, both in sickness and in health.” ...

 Everyone has their own story, some fortunate, some less so. Mine is a story of abuse, neglect and mental illness, and the long road back. I offer it for whatever hope and guidance it may provide for others currently suffering. Me, A Victim In 1956 when I was thirteen and starting in middle school, my mother had the first of her several operations for intestinal cancer. She told me that she had “tumors,” but that meant one thing to me— cancer. Around the same time, I, too, began having stomach pains along with constipation like hers. I always had problems getting along with other kids, being teased and harassed, and being nervous, and now I was in great distress. ...

"…they're human beings, for God's sake! In the name of everything holy, how can they do that to them?" (p 108) The Other Mrs. Smith, by Bonnie Burstow, 2017   In the March 2017 issue of the Journal of ECT, there was an editorial titled: Electroconvulsive Therapy (ECT) in the News: “Balance” Leads to Bias. The authors are Melissa Choy, BA; Kate Farber, BA; and Charles Kellner, MD. Dr. Kellner is Chief of Geriatric Psychiatry and Director of ECT Services at Mt. Sinai Medical Center, NY, and is clearly the senior author. I was unable to find much information concerning Ms. Choy or Ms. Farber. ...

On March 25 of this year, Psychiatric Times published an article titled Dementia, Agitation, and Aggression: The Role of Electroconvulsive Therapy. The author is Manjola Ujkaj, MD PhD, and the article’s subtitle is “What role might electroconvulsive therapy play for short-term treatment of agitation and aggression in patients with dementia?” According to their website Psychiatric Times is a medical trade publication that covers news, reports, and clinical content related to psychiatry “for psychiatrists and allied mental health professionals who treat mental disorders.” The circulation of the monthly print publication is approximately 40,000. ...

On May 16, 2014, the International Journal of Geriatric Psychiatry published an article by Deepa Archarya, PhD, et al. The article is titled Safety and utility of acute electroconvulsive therapy for agitation and aggression in dementia. Here are the authors’ conclusions: "Electroconvulsive therapy may be a safe treatment option to reduce symptoms of agitation and aggression in patients with dementia whose behaviors are refractory to medication management." In their Introduction section, the authors write: "Despite the high prevalence of these agitated and aggressive behaviors, there are currently no treatment options approved by US Food and Drug Administration for this indication. Nonpharmacological interventions, including environmental and behavioral modification, are difficult to implement in nursing home settings because of low staff-to-resident ratios." ...

There’s an interesting article in the June 2014 issue of the Journal of ECT. It’s written by Max Fink, MD, and is titled Celebrating 80 Years of Inducing Brain Seizures as Psychiatric Treatment. Dr. Fink is a psychiatrist and neurologist, and professor emeritus of psychiatry and neurology at the State University of New York, Stony Brook. The article is short (approximately 400 words), and is essentially a tribute to Ladislas Meduna for his discovery “…that induced seizures alleviated severe psychiatric disorders…”, which Dr. Fink describes as “…a remarkable medical advance…” ...

TMS is a psychiatric treatment that uses a rapidly alternating magnetic field to induce electric currents in the brain. These currents stimulate neurons, causing them to “fire.” When used repetitively, TMS is said to alter the excitability of the brain area that has been stimulated. In the psychiatric field, TMS is being used increasingly as a treatment for depression, particularly with so-called treatment-resistant clients. I Googled the string “TMS + depression” and got 1.35 million hits. So the idea is attracting attention. ...

A couple of months ago I wrote an article concerning ECT which generated some controversy. One of the issues that came up was the relationship between biological explanations of human activity and more global explanations, which, for want of a better term, I’ll call person-centered explanations. Any human activity can be viewed from different levels of abstraction. Suppose, for instance, that I am sitting in my living room reading a book. Then I put the book down, stand up, and go outside. If the question were to be asked: why did he put the book down and go outside? A wide range of perspectives and answers are possible. One could, for instance, focus on the fact that I am a biological organism, and one could develop a detailed and comprehensive flow sheet of every muscle movement, every heartbeat, every sensory input, neural impulse etc., that had occurred from the moment that I put the book down until I was standing outside. Such an account might be more or less detailed. There would, of course, be physical limitations on the amount of information of this sort that is attainable, but from a theoretical point of view, one could compile a detailed, complete, and accurate biological account of the actions in question. And such an account would be a valid response to the question: why did he put the book down and go outside. ...

ECT, or shock treatment as it’s sometimes called, is a controversial topic. Adherents describe it as safe and effective; opponents condemn its use as damaging and ineffective. But it is still widely used in the US and in other countries. The treatment consists essentially of passing sufficient electricity across the brain to cause a seizure. Clients are anesthetized during the process. It is used primarily in cases of severe depression. Typically, shock treatment is administered twice a week until the depression remits or until no further improvement is noted in two successive sessions. Most courses of treatment involve about eight sessions. ...