Tuesday, November 03, 2009

ECT & Media Portrayals of Depression Treatment Options

Dr Shock's blog is a wonderful mix of informative articles, videos and analysis of a variety of things from music, travel and art, to psychiatry and back. Of course, his focus is psychiatry, but the renaissance man in him shines through in his blog.

In one of his recent posts... "Illuminate Depression" he has posted a video about different treatments for depression. It is fascinating and talks about a variety of treatments. A big kudos to it for bothering to mention (unlike most overviews of depression treatments) some people's depression is treatment resistant.

I have pretty much given up hoping that main stream media will explain that depression is not always as "treatable" as they would have us believe. Nothing annoys me more than the statement "Depression is a treatable illness". It's the opening line of so many self help and depression information books...and for many of us it sounds like a lie. For me it creates an intense internal struggle within me about whether or not it is my fault I remain depressed despite trying several different kinds of treatments.

While the video is informative and interesting I found it very curious...and annoying...that the makers of the video included talks about all kinds of different treatments, some common, and some in the early stages of development, including rTMS, (which from what I understand has not been shown to be any better than a placebo***), yet it neglects to even mention Electroconvulsive Therapy (ECT); even though ECT is a well-studied, scientifically proven, highly effective treatment for resistant depression. (***see this recent post in the blog "Clinical Psychology and Psychiatry: A Closer Look" for a scathing look at the FDA's approval of rTMS and you will wonder how it was possibly approved)

It irritates me, (and does not help me explain potential treatments to concerned family members), when the media, either by negative portrayal or by leaving positive and informative information about ECT out of stories about depression treatments, subtly dismisses or devalues an effective and proven helpful treatment for resistant/refractory depression.

I feel confident I have informed myself about ECT as an option. What though of others who have not had access to any information about ECT except what they see, or don't see, portrayed in mainstream media? What about those who only ever hear negative information, or who trust that the books and videos the media are promoting and showing them the best, or the only, options available?

Will some people with resistant depression, some who might be helped with ECT, miss out on the chance to become well because popular media at best has failed to share balanced, scientific information about ECT, or at worst is colluding with naysayers to portray ECT as either a dangerous choice, or a barbaric one?

I worry also that the lack of accessible and scientific information in the media about ECT perpetuates the fears and myths that exist about the treatment. In effect this may (and I am certain does) lead fewer people to see it as an option...even if they have tried many, many other unsuccessful treatments for their mood disorder. I also think the negative media, and lack of media, and especially lack of an unbiased media about ECT affects how willing partners, family members and friends are when it comes to supporting a patient's decision to try ECT.

The media, when they discuss and examine depression treatment options and leave out, dismiss, or malign ECT as a valid and valuable treatment option, is not doing anyone with treatment resistant depression a favour. In doing so the media perpetuates ECT myths, hysteria and misinformation.


Anonymous said...

I tell ya, the ECT treatments I had last year brought me back to life. I can't explain how such a treatment works, I just know that it did for me. Yes, there are some tiresome side effects, but they're nothing in comparison to having my life back. Yes, ECT has taken some memories from me, but what the mind forgets, the heart holds. So when things of importance are mentioned, I can recall a bit. Plus, who's to say that the bit of memory loss I experienced is from ECT only and not the depth of the depression. The media needs to relent on portraying ECT in a negative light. From what I understand, it is still the most effective treatment for treatment resistant depression.

Anyway...I related much to the internal struggle you shared in regards to "Depression being a treatable illness." I share that inward struggle and oftentimes it's without even hearing those words.

Be encouraged...you're not alone. Keep writing...Kara

dr shock said...

ECT is the therapy longest in use in psychiatry and extensively researched and still developing. Nevertheless it's still "mistreated" by some media. Information by those who had ECT , as shared be you both, is of enormous value to other patients facinf decisions on treatment options.
I share your opinion on tms.
Take care Dr Shock

Anonymous said...

I really wish people would wake up and use common sense. ECT causes memory loss - BRAIN DAMAGE. Yes, you may forget for a time that you are depressed, or you may forget what you are deprpessed about, but for most people it eventually comes back. It might be even worse if it doesn't. To some people it can seem worse for the heart to hold what has been brain damaged out of the mind. How then can one make any sense of their depression? How can it be resolved but by more and more brain damage?It has been my experience that most people are depressed for a valid reason. It sometimes goes all the way back to childhood. For someone who is considering incurring brain damage to rid themselves of a problem, I would ask this: What unpleasant truth are you willing to damage yourself in order to hide?

Anonymous said...

ECT is like most therapies. If it works for you it works. Like other psychiatric therapies, there are a large percentage of people it does not help and some percentage of people it does help relapse, unless they supplement the ECT with meds and/or psychotherapy. The only person I ever knew personally who had ECT was not helped by it and found the side effects and memory loss intolerable. She was nauseous for days after her treatments and also suffered very severe headaches. However, I agree that if the treatment does help some people it should be presented as a viable treatment option so that people can make informed decisions. Lord knows the side effects of some of the meds they hand out these days can be pretty awful and they usually don't help either.

I totally agree with your statement about treatment resistant depression. People tell me all the time "depression is a treatable illness" and I have to stop myself from telling them "so is cancer, but sometimes the treatment fails." For some reason, people don't like it when I tell them how it really is for me. Go figure. :)

Aqua said...

Hi Kara, Thanks for the post Cara. I am really glad to hear you are feeling better. I agree that getting your life back is worth a few side effects. Your comment about whether the memory difficulties are depression related or ECT related are dead on. My ongoing difficulties with depression are really effecting my memory and it is getting rapidly worse.

Dr. Shock, thanks for the comment. My ECT experience was really positive. The only thing I was disappointed by was that my depression came back. If my new medicine does not help me I will try ECT again, this time trying maintenance ECT after the initial treatments

Anonymous, Thanks for the comment. I do think it is important that ECT info be balanced, and to your point there are people who report severe side effects, like headaches and memory loss. I know for me I did have headaches for a couple hours after the procedure, but they went away, and my memory loss was only during treatment and it became better after the treatment too.

merope3, thanks for you balanced response. I also agree that ect does not help some and helps others...much like all the other treatments.