ect.org

MSNBC.com
‘I Feel Good, I Feel Alive’
In a new book, Kitty Dukakis credits electroconvulsive therapy for relieving her famously disabling depression.
By Kitty Dukakis
Newsweek

Sept. 18, 2006 issue - As many as 100,000 people in the United States each year receive electroconvulsive therapy, a treatment that has improved dramatically since it was first used in the 1930s. On the advice of her doctors, Kitty Dukakis started ECT treatment in 2001 after suffering for decades from severe depression, substance-abuse problems and hospitalizations. Here, Dukakis’s firsthand account.

Next thing I know I am waking up. I am on an upper floor of Massachusetts General Hospital, in the unit where I slept last night. I feel lightheaded, groggy, the way you do when anesthesia is wearing off and you are floating between sleep and wakefulness. I vaguely recall the anesthesiologist having had me count to 10, but I never got beyond three or four. I am not sure I got the treatment. One clue is a slight headache. Another is the goo in my hair, where they must have attached the electrodes.

There is one more sign that I did in fact have my first session of seizure therapy: I feel good—I feel alive.

Michael is standing there next to the nurse as I struggle to keep my eyes open, and I give him a big grin. That surprises him right away. As we head home to Brookline, I remember that it is our anniversary. Our 38th. I turn to Michael and say, “Let’s go out for dinner tonight!” He asks, “What?” I say, “I’m serious. Let’s do it!”

Michael and I did eat out at a restaurant that night, making an anniversary I wanted to forget into one I will remember always. I was back at the hospital on an outpatient basis the next two weeks for four more treatments. After the second one I went to the hairdresser, then a dinner party and watched the Red Sox on TV.

I have had eight sets of ECT since 2001. It is not an exaggeration to say that electroconvulsive therapy has opened a new reality for me. I used to deny when a depressive episode was coming on, to myself and to others. Now I call my doctor, Charlie Welch, as soon as I spot the gathering clouds. As important, ECT has gotten me off antidepressants. I withdrew slowly, with help from my doctors. Since I have been off I know the full range of my feelings. I get into the car now and put on music, the classical station. I sometimes cry because it conjures up feelings of my dad, who died on March 29, 2003, and was a conductor of the Boston Pops. Once I went off antidepressants, I finally could grieve.

ECT has even helped with talk therapy, strange as that may sound. I had been with Roger Weiss, my therapist, for five or six years. After ECT, I was able to work on issues that I couldn’t before, with him and on my own. I stopped smoking 15 months ago and feel terrific about that. I am working on my road rage, which is especially challenging every winter when we head to L.A. and start driving those confounding freeways. I am even addressing what my kids call my sense of entitlement. They kid me for behaving like the “queen bee.” It is not ECT per se that is curing me of those bad habits. It is staying well enough for long enough that I can start looking at behaviors I want to change. Why, for instance, do I always introduce myself by my last name as well as my first? Kara, Andrea and John say I am seeking the recognition that comes with the name Dukakis. Whether they are right or not, it was impossible to acknowledge they might be when I was depressed.

Memory loss is ECT’s most feared side effect. It is what the public hears about most often and what critics complain about most loudly. I believe anyone who says her ability to remember has been permanently damaged, and that big chunks of her life were lost. Who would make up something like that? On the other hand, most ECT patients I know have had milder memory problems, and some have had none. As for the situation I know best, mine, the memory issues are real but manageable.

Things I lose generally come back. Other memories I prefer to lose, including those about the depression I was suffering. But there are some memories—of meetings I have attended, people’s homes I have visited—that I don’t want to lose but I can’t help it. They generally involve things I did two weeks before and two weeks after ECT. Often they are just wiped out.

I forget telephone numbers, including ones I dial all the time. I sometimes don’t know where I am supposed to go or at what time. What embarrasses me most is forgetting people’s names. I live in a political world. My remembering someone may only be mildly important to them, but it is really important to me. After ECT I still go to receptions, dinners and other public events, with Michael or on my own, but I generally am not on my game. I sometimes forget commitments I make to help people. I tell a refugee from Cambodia that I will call the State Department on his behalf. I tell a friend of a friend that I know just the surgeon for her, or a lawyer, or a psychiatrist. Then I don’t make the call or get back to them with the name. Promising it, then not doing it because I don’t remember, is terrible. They must think I’m a ditz, or maybe insincere.

I have learned ways to partly compensate for whatever loss I still experience. I call my sister Jinny, Michael and my kids, asking what my niece Betsy’s phone number is, what we did yesterday and what we are planning to do tomorrow. I apologize prior to asking. I wonder when they are going to run out of patience with “Kitty being Kitty.” I hate losing memories, which means losing control over my past and my mind, but the control ECT gives me over my disabling depression is worth this relatively minor cost. It just is.

From “Shock” by Kitty Dukakis and Larry Tye. To be published by Avery, a division of Penguin Group (USA). © 2006 by Kitty Dukakis and Larry Tye.

3 Responses »

Update: The spam has gotten out of hand and I can no longer keep up. Fortunately the Akismet system has worked well, but I’m averaging over 1,000 spam attempts a day. I can no longer scroll through the caught spam and try to find comments that may have accidentally been caught in the trap. Therefore, if you try to post a comment and it doesn’t show up, assume it’s been Spaminated for reasons known only to Akismet. You can try to post the comment again, or if it’s important to you to have your comment posted, you can email me (contact info in left sidebar) and I can override the spaminator and post the comment for you. Until spammers realize nothing is getting through (not likely since they’re using bots and never know the results of their bombardments) and go elsewhere, it’s the best I can do. Without Akismet, you would be seeing many thousands of long ads for penis extenders in the comments section of every page.

I know the frustration of unfairly being lumped with the baddies. As a woman with blond hair, very fair skin and blue eyes, I am always the subject of foot wipes and full body searches at airports in the politically-correct effort to prove they aren’t profiling against anyone who might actually fit into a terrorist category. It’s a sign of the times, it sucks, but if I couldn’t be subjected to a rub down by a creepy airport guy once a week, then the terrorists would win. We can’t have that.

/end update

I get an extraordinary amount of comments posted to the site that are blatantly spam: online casinos, porn, virtual viagra, and so on. I have a spam catcher that does a very nice job of catching them and either flagging them, or putting them in a que for me to review. Generally, I delete them all, but a couple caught my eye and I decided to make a separate page for those that actually have something to do with depression and other related topics. Those will be rescued from the spam trap and placed here. Note that ect.org makes no endorsement of any of these, but felt they might be of interest to some.

For those who post something that ends up saying it’s in the moderation que, that means it’s been caught by the Akismet spam trap for review. (It’s a program, and sometimes genuine stuff gets caught there…sorry, but it’s something I must use or this place would be overflowing with porn ads.) Note that I always review them before deleting, though 99 percent are true spam.

I would prefer that advertisements be posted here in the comments section, rather than on unrelated pages. If they aren’t, they will be moved here. Do understand NO ads for casinos and other junk will be permitted. If you’ve got a genuine link that would fit on the links page, email me with the info. That’s the best way to get linked! (But I don’t add all links…only if they’ve got something to do with ECT, mental health issues, or my own personal favorite links which are generally dissidents, music and animal rescue.)
One foul comment from VNSdepression has been moved here:

VNSdepression comment

Moved comments:

Nida Ali Khowaja - ehealthguide
Health Care News, Disease, Diagnose, Physicians, Residents, Medical Officers, Nursing Care, Technical Staff, Health Policies, Organizations, Certification, Standards, Alerts, AKUH and All about Worlds Health. Step to Facilitate the Health Care Professionals and Patients.
http://ehealthguide.info/rss.xml

Posted on 04 Oct 2006 at 10:59 am

David Schmidt
You might be interested in SAME and other supplements for depression. I had severe depression for years and tried antidepressants, electroconvulsive therapy and psychotherapy. Nothing worked until I began to use a regimen of natural products including SAME. This site has good prices:

www.doctorstrust.com

Posted on 23 Aug 2006 at 10:59 pm

—————————

Albert Ellis
A prominent psychologist specializing in depression offers readers step-by-step, clinically proven cognitive behavioral therapy (CBT) techniques to recognize and change depressive thinking.

Read The Cognitive Behavioral Workbook for Depression: A Step-by-step Program now out in paperback!

Posted on 10 Sep 2006 at 10:59 pm

—————————

Charles Donovan
Patients considering ECT may also want to investigate a newly FDA approved procedure for chronic depression called vagus nerve stimulation(VNS). It is the only FDA approved long term treatment option for chronic depression. It has not related to ECT or brain surgery.

The ninety-minute out patient procedure does not have any cognitive impairment( i.e. memory loss), the response is sustained and the therapy does not interfere with any drugs.

The treatment completely changed my life and inspired me to write the book:
“Out of the Black Hole: The Patient’s Guide to Vagus Nerve Stimulation Therapy and Depression”

For more information about VNS Therapy, I would visit www.OutoftheBlackHole.com

on 12 Sep 2006 at 11:17 am
—————————

3 Responses »

ect.org will close at midnight ET on September 11, 2006, in remembrance of those who died five years ago. I will keep a link to the old site for those who need information about ECT. The site will reopen 24 hours later. Thank you for your understanding.

I ask that no matter where you are in the world, that you take time to remember those who died. Forget the terrorists and politics for one day. Remember 2,996 individuals.

And remember Philip Thomas Hayes. I hope you will return Monday and get to know him. He was one of many who died that day, but to many, he was special and so very loved.

Read about Philip Hayes

2 Responses »

The Scotsman
Sept 6, 2006
STUART NICOLSON

SELF-HELP books are being made available on prescription in an attempt to tackle depression, eating disorders and other mental-health issues.

The scheme allows patients to borrow the books anonymously from local libraries for up to six weeks. The initiative has been introduced in Fife and Glasgow, and if successful it is likely to be extended to other health authorities across Scotland.
Click to learn more…

Depression is the most common condition recorded by family doctors in Scotland.

Statistics show that more than 300,000 Scots visit their doctor each year because of stress or depression.

But it is estimated that 75 per cent of people with depression do not seek treatment.

Experts believe part of the problem is that many people - especially young men - are too embarrassed to ask for help.

They hope prescribing the books will allow many people with mental-health problems to treat themselves in privacy, without the need for attending therapy sessions.

The books offer complete step-by-step treatment programmes, including exercises, self-assessments and diary sheets.

Alan Freeburn, a psychologist with NHS Fife, said that similar schemes running in Wales had been very successful in treating comparatively minor mental-health problems.

He added: “Libraries are already well stocked with self-help books, but many people are unaware of the range that is available, or which one would be right for them.

“It can be very embarrassing for people to go into a library or bookshop and pick a self-help book off the shelf, or ask for a particular book.

“With a prescription they will be able to get books from the library very discreetly.

“The books will also allow people to begin overcoming their condition in the privacy of their own home. That, in itself, is often a major factor in helping people overcome mental-health problems.”

Funding for the project is split between local health boards and council-run libraries.

The scheme is confidential, with libraries barred from disclosing who is borrowing the book or what it is about.

The book loan can be renewed for a further six weeks if the patient requires.

Mr Freeburn said: “People feel empowered by treating themselves, rather than simply relying on a psychologist.

“The books can also often help people avoid lengthy waiting lists for therapy sessions, and will hopefully nip problems in the bud quickly before they become more serious.

“When we were setting it up here in Fife we canvassed opinion among GPs, and the vast majority were in favour of it and said they would use it,” Mr Freeburn said.

“The books cover everything from eating disorders, anger management, low self-esteem and depression, to helping a child cope with bereavement.

“The first scheme of this kind was set up in Cardiff a couple of years ago, and all the indications are that it has been very successful down there.

“We are confident that success will be replicated here.”

Doctors in Fife are also able to prescribe exercise classes in local leisure centres to patients.

Jim Brennan, Fife Council’s community services spokesman, said that only titles included on an approved list of self-help books could be prescribed by doctors.

He added: “We are hopeful that allowing doctors to prescribe these books will help overcome some of the stigma that is attached to mental-health issues.

“Depression is a major problem across Scotland, and anything that helps tackle it should be welcomed.”

New figures released last week showed that Scotland has the highest suicide rate in Britain, with both the male and female rates almost twice that of south of the Border.

The Office for National Statistics report also found that areas of Scotland dominate the list of places in the UK with the highest rates.

Shetland was revealed as having the highest suicide rate for men, while women in Glasgow were the most likely to kill themselves.

Experts said exact causes for the regional differences were unknown.

No Responses »

Details from the report on ECT use in Turkey, from CPT:

Full report:

http://www.cpt.coe.int/documents/tur/2006-30-inf-eng.htm

C.        ECT and other psychiatry-related issues

1.         Preliminary remarks

58.       As already mentioned, one of the issues focussed on during the December 2005 ad hoc visit were the procedures for the administration of electroconvulsive therapy (ECT) in psychiatric establishments. This subject had been addressed in some detail in the report on the 1997 visit to Turkey (cf. CPT/Inf (99) 2, paragraphs 178 to 182). However, information recently received from various sources indicated that certain of the CPT’s recommendations had not yet been implemented, in particular as regards the discontinuance of the practice of unmodified ECT.  For the purpose of examining this question, the CPT’s delegation visited two State hospitals, Bakırköy Mental and Psychological Health Hospital in I˙stanbul (this establishment, the largest psychiatric establishment in Turkey, had previously been visited by the Committee in 1992 and 1997) and Adana Mental Health Hospital.

In addition to the above-mentioned subject, some comments will be made in this report on procedures relating to involuntary civil placement in psychiatric establishments and living conditions for patients at the Adana Hospital.

59.       At the outset, the CPT wishes to emphasise that relations between staff and patients in the two psychiatric hospitals visited were on the whole found to be positive and tension-free, and many patients spoke favourably about the manner in which they were treated by staff. This is all the more commendable in the light of the often low staffing levels and the paucity of the resources at the staff’s disposal.

However, some complaints were heard of the ill-treatment (notably slaps) of patients by orderlies at the Bakırköy Hospital; allegedly, such acts would occur in the event of a failure to take prescribed medication or of disobedience. Under no circumstances can methods of this kind be tolerated. The CPT recommends that the management of Bakırköy Mental and Psychological Health Hospital deliver the clear message to all categories of staff at the establishment that any form of ill-treatment of patients is unacceptable and will be the subject of severe sanctions.

2.         Electroconvulsive therapy

60.       Electroconvulsive therapy is a recognised form of treatment for psychiatric patients suffering from some particular disorders. However, like certain other forms of therapy, its administration must be accompanied by appropriate safeguards.

The CPT is particularly concerned when it encounters the administration of ECT in its unmodified form (i.e. without anaesthetic and muscle relaxants). As was emphasised in the report on the 1997 visit to Turkey, use of this outdated method entails a heightened risk of untoward medical consequences and can lead to situations which could justifiably be described as degrading.

The Committee also pays attention to whether ECT is being used for the proper indications and to the procedure for obtaining consent to this treatment.

61.       In their response to the report on the 1997 visit, the Turkish authorities stated that they were “paying close attention [to] the discontinuation of the practice of unmodified ECT”.[8] However, in spite of that assurance, the delegation which carried out the December 2005 visit observed a widespread use of unmodified ECT in the two psychiatric establishments in Adana and Bakırköy.

At Adana Mental Health Hospital, ECT is only used in its unmodified form. At the Bakırköy Hospital, there is a single ECT unit with a capacity of 10-15 patients per day, where a part-time anaesthesiologist makes modified ECT possible. However, the great majority of patients to whom ECT is administered at this hospital also receive the therapy in its unmodified form; of the total of 15,877 ECT sessions administered at Bakırköy in 2005, only 512 (i.e. some 3.2 per cent) were modified.

62.       Further, the information gathered by the CPT’s delegation at the Bakırköy Hospital indicated that ECT was being used in an even more extensive manner than had been observed during the 1997 visit. In some units, more than 60 per cent of patients had received ECT in 2005, and the therapy had been administered to 26 per cent of all patients admitted to the establishment during that year. In the CPT’s view, these figures indicate excessive resort to ECT.

Although the management of the Adana Mental Health Hospital was unable to provide the CPT’s delegation with precise statistics on the use of ECT for the whole hospital, it was obvious that ECT was also used extensively there. According to information received from the Director of the hospital, nearly 30 per cent of patients in a female unit had received ECT during the year 2004.

63.       The CPT wishes to make clear that its delegation did not gain the impression in either of the two establishments visited that ECT was being used in a punitive manner or that the patients perceived the treatment as such or had been threatened with ECT. However, the delegation did note that some patients who had received unmodified ECT developed a fear of the treatment, resulting, on occasion, in it being cancelled.

At Bakırköy, the delegation was repeatedly told that the reason for the extensive reliance on ECT was the lack of beds for the high number of patients in need of admission and treatment. From interviews with both patients and staff, it would appear that ECT was sometimes administered only a few times, until the patient was no longer agitated; such a treatment series could commence on the day of arrival of the patient to the hospital. The CPT is very concerned about any possible resort to ECT as a means of quickly subduing agitated patients; this would constitute an improper use of the therapy.

Neither of the two establishments had written policy guidelines regarding the administration of ECT.

64.       In both establishments, ECT was administered out of the sight of other patients, in rooms specifically set aside and equipped for this purpose. However, from interviews with patients at Bakırköy, it would appear that a patient about to be treated may see patients who have already been treated and who are lying unconscious or recovering. This is clearly not desirable.

65.       At the Bakırköy Hospital, recourse to ECT was, as a rule, recorded in both the patient’s medical file and a general ECT book kept on the ward, although at least one of the ECT books only indicated the start of the treatment without mentioning further sessions. At the Adana Hospital, while some wards did have ECT books, in other wards recourse to ECT was only recorded in the patient’s file. Moreover, even in those wards which possessed an ECT book, the registration of ECT sessions was incomplete. A specific (and properly completed) ECT register at ward-level will greatly facilitate supervision by hospital management and discussion with staff about practices followed.

66.       As regards the procedure for obtaining consent to ECT treatment, no written consent was obtained at the Adana Hospital. Special consent forms were used at the Bakırköy Hospital, often signed on admission by the patient, or, in most cases, by his or her guardian or next of kin. However, these forms were often undated, and in a few cases they were signed by the police transporting the patient to the hospital. Further, the examination of patients’ medical files revealed that in several cases no written consent was recorded; the delegation was told by the staff that in certain situations (e.g., in the event of difficulty contacting the patient’s family) the ECT consent form could be signed after the treatment had been started, or even after it had been concluded. It is also noteworthy that some patients did not seem to have been informed about the procedure or the possible benefits and risks involved.

In this connection, it must be stressed that all patients should, as a matter of principle, be placed in a position to give their free and informed consent to treatment, including ECT. The admission of a person to a psychiatric establishment on an involuntary basis should not be construed as automatically authorising treatment without his or her consent. Any derogation from this fundamental principle of consent to treatment should be based upon law and apply only in clearly and strictly defined exceptional circumstances. Of course, consent to treatment can only be qualified as free and informed if it is based on full, accurate and comprehensible information about the patient’s condition and the treatment proposed.

67.       To sum up, the CPT is seriously concerned by the current procedures for the administration of ECT observed in the Adana and Bakırköy Hospitals, and in particular by the continuing frequent recourse to this treatment in its unmodified form.

The Committee’s delegation was informed by the management of the Bakırköy Hospital that two new fully-fledged ECT units would be set up within the establishment in a few months. The Committee takes note of this development. The CPT would like to receive full information concerning these units (in particular, a detailed description of their equipment and staff resources) and to be informed of the planned date of their entry into service.

More generally, the CPT recommends that the Turkish authorities accord a high priority to ensuring that all psychiatric establishments in which ECT is used are provided with the necessary staff, equipment and facilities so that this treatment can be administered in its modified form (i.e. with both anaesthetic and muscle relaxants) and in an effective manner (preferably with the aid of an electroencephalogram).

Further, with a view to ensuring that ECT is only used for the proper indications and is carried out in an appropriate manner, the CPT recommends that a clear written policy on recourse to ECT be elaborated and distributed to each establishment where this treatment is used and that ECT be administered only by staff who have been specifically trained to provide it. As with other psychiatric treatment, recourse to ECT should be part of a written individualised treatment plan, included in the patient’s medical record.

68.       In the light of the other facts found during the visit, the CPT also recommends that:

-           the practical arrangements made for the use of ECT ensure not only that it is administered out of the sight of other patients but also that  patients waiting to be given ECT do not have sight of patients who have just received the treatment;

-           the indications for using ECT, the conditions under which it is administered and the outcome of each treatment session be set out in detail in a special register;

-           the written informed consent of the patient (or of the guardian, if the person concerned is declared incompetent by a court) to the use of ECT, based on full and comprehensible information, be sought and kept in the patient’s file and that, save for exceptional circumstances clearly and strictly defined by law, the treatment not be administered until such time as written consent has been obtained.

C.        ECT and other psychiatry-related issues

            Preliminary remarks

            recommendations

-           the clear message to be delivered to all categories of staff at Bakırköy Mental and Psychological Health Hospital that any form of ill-treatment of patients is unacceptable and will be the subject of severe sanctions (paragraph 59).

Electroconvulsive therapy

            recommendations

-           the Turkish authorities to accord a high priority to ensuring that all psychiatric establishments in which electroconvulsive therapy (ECT) is used are provided with the necessary staff, equipment and facilities so that this treatment can be administered in its modified form (i.e. with both anaesthetic and muscle relaxants) and in an effective manner (preferably with the aid of an electroencephalogram) (paragraph 67);

-           a clear written policy on recourse to ECT to be elaborated and distributed to each establishment where this treatment is used and ECT to be administered only by staff who have been specifically trained to provide it. As with other psychiatric treatment, recourse to ECT should be part of a written individualised treatment plan, included in the patient’s medical record (paragraph 67);

-           the practical arrangements made for the use of ECT to ensure not only that it is administered out of the sight of other patients but also that  patients waiting to be given ECT do not have sight of patients who have just received the treatment (paragraph 68);

-           the indications for using ECT, the conditions under which it is administered and the outcome of each treatment session to be set out in detail in a special register (paragraph 68);

-           the written informed consent of the patient (or of the guardian, if the person concerned is declared incompetent by a court) to the use of ECT, based on full and comprehensible information, to be sought and kept in the patient’s file and that, save for exceptional circumstances clearly and strictly defined by law, the treatment not to be administered until such time as written consent has been obtained (paragraph 68).

            requests for information

-           full information concerning two new ECT units to be set up at the Bakırköy Hospital (in particular, a detailed description of their equipment and staff resources) and the planned date of their entry into service (paragraph 67).

No Responses »

The Council of Europe’s Committee for the prevention of torture and inhuman or degrading treatment or punishment (CPT) has published today the report on its most recent visit to Turkey, in December 2005, together with the response of the Turkish Government. These documents have been made public at the request of the Turkish authorities.

During the December 2005 ad hoc visit, the CPT’s delegation reviewed the situation in practice as regards the treatment of persons held by the law enforcement agencies (police and gendarmerie) and assessed the day-to-day operation of the legal safeguards against ill-treatment currently in force. Attention was also given to developments in F-type (high-security) Prisons, in particular as regards communal activities for inmates and the regime applied to prisoners serving a sentence of aggravated life imprisonment. A third objective of the visit was to examine procedures for the administration of electroconvulsive therapy (ECT) in psychiatric establishments.

Rapor için:

http://www.cpt.coe.int/documents/tur/2006-30-inf-eng.htm

Türkiye’nin cevabı:

http://www.cpt.coe.int/documents/tur/2006-31-inf-eng.htm

Daha fazla bilgi için:

http://www.cpt.coe.int

No Responses »

An epidemic of doc suicides

September 5, 2006

BY JIM RITTER Staff Reporter
Chicago Sun Times

Dr. Harry Reiss’ career appeared to be thriving. The 43-year-old urologist was an assistant professor at New York University, an expert on impotence and author of 13 medical journal articles. Plus, his private practice was taking off.

But one day after seeing his last patient, Reiss got on the examining table, hooked up an IV and gave himself a fatal dose of the anesthetic thiopental.

Reiss was in despair over the recent deaths of both parents, said his wife, Carla Fine. And like many doctors, Fine said, “He had a very hard time asking for help.”

Between 100 and 150 doctors commit suicide in the United States each year — more than the graduating class of a typical medical school.

Harvard University researchers who compiled the results of 25 suicide studies concluded that male doctors are 1.4 times more likely than the general population to commit suicide, and female doctors are 2.3 times more likely.

Physician suicides occasionally make headlines:

•Dr. Nicholas Bartha died July 15 from injuries he suffered after blowing up his Manhattan town house. The internist apparently wanted to avoid selling the house in a divorce case. Shortly before the explosion, Bartha sent his ex-wife an e-mail that said: “I always told you I will leave the house only if I am dead.”

•On May 27, Dr. Edward Van Dyk, a radiation oncologist from Downstate Godfrey, jumped to his death from a Florida hotel balcony, moments after throwing off his two young sons. Authorities say he suspected his wife of having an affair with their gardener.

•In 2004, an Arkansas Children’s Hospital surgeon world-renowned for repairing infant heart defects killed himself with an overdose of pain-killers and bourbon. “Every day is a living hell!” Dr. Jonathan Drummond-Webb wrote in a five-page suicide note. “These people don’t care. I have a gift to save babies. The world is not ready for me.”

As far back as 1858, doctors in England observed that physicians had high suicide rates. But only recently have suicide experts begun to raise the alarm.

In 2003, an expert panel convened by the American Foundation for Suicide Prevention recommended that medical schools, hospitals and licensing boards educate doctors about physician suicide and stop discriminating against doctors who get mental health treatments.

And at its 2006 annual meeting, the American Medical Association approved a resolution calling for increased awareness of the “preventable endemic catastrophe of physician suicide.”

Nevertheless, the medical community generally still continues to ignore the problem, said University of Chicago psychiatrist Dr. Morton Silverman, a member of the 2003 suicide panel. Physician suicide, Silverman said, “is not a priority.”

Doctors live longer and tend to have healthier lifestyles than the general public. But many neglect their mental health.

No evidence of added stress

“It’s a crazy paradox,” said Dr. Michael Myers, a University of British Columbia specialist in physician health. “We’re in the business of helping people. But we do a terrible job with ourselves.” Myers and Fine are co-authors of a new book, Touched by Suicide: Hope and Healing After Loss.

Doctors often are reluctant to seek treatment for depression or other mental disorders because they fear discrimination in medical licensing, hospital privileges and health and malpractice insurance.

Moreover, doctors who treat fellow physicians for mental disorders often are reluctant to order aggressive treatments such as hospitalization or electro-convulsive (”shock”) therapy. They fear that if the word gets out, it could harm the careers of their physician-patients.

“We are learning that trying to be too ‘nice’ to colleagues is sometimes not nice at all,” suicide experts wrote in a 2003 article in the American Journal of Psychiatry.

Doctors work long hours and are increasingly hassled by paperwork and managed care. Yet there’s no evidence they are more stressed than other professionals.

Rather, the major risk factors for physician suicide are drug and alcohol abuse and psychiatric disorders such as depression. Female doctors have higher alcoholism rates than women in general, and psychiatrists, anesthesiologists and emergency physicians are among the specialists most likely to abuse drugs.

Other possible reasons

In a 2005 article in the New England Journal of Medicine, Harvard researcher Dr. Eva Schernhammer offered several other possible reasons for high physician suicide rates, especially among women:

•Doctors are more likely to blame themselves for their own illnesses.

•Doctors appear more likely to suffer clinical depression brought on by a major setback such as the death of a loved one, divorce or job loss.

•Compared with male doctors, more female physicians are single or childless, which are risk factors for suicide. Moreover, female doctors “may feel more stress than their male counterparts because of the difficulty of succeeding in a male-dominated profession,” Schernhammer wrote. Female doctors also might experience sexual harassment.

•Doctors have ready access to potentially lethal drugs, and their suicide attempts are more likely to succeed. For example, among all women, only one out of every 10 or 15 suicide attempts is successful. But among female doctors, there are more successful suicide attempts than unsuccessful ones.

Reiss knew exactly what he was doing when he hooked himself up to the fatal IV in 1989.

“The medical examiner said he was asleep in seconds and dead in minutes,” Fine said.

Fine described her husband’s suicide in her book, No Time to Say Goodbye: Surviving the Suicide of a Loved One.

“Harry was a wonderful healer,” Fine said. “If his death can help others, at least it won’t seem as senseless.”

No Responses »

A transformation to treasure
Would you agree to electroconvulsive therapy?

September 05, 2006
By Amber Smith
Health & Fitness editor
The Post Standard

It was an average summer weekday, after a routine doctor’s appointment, at an ordinary restaurant on Erie Boulevard. Debbie Ahearn was dining with her 82-year-old mother.

It was a meal, a moment, she will never forget.

Her mother ordered from the menu, then began talking about the weather.

Debbie Ahearn burst into tears.

“When you get a person back to life, you treasure the little things,” she says, recounting that afternoon through tears even weeks later.

Ahearn’s mother, Frances Ahearn, of Baldwinsville, had Parkinson’s disease for six years when, about a year ago, she started becoming anxious and obsessive. Over several months, she spiraled into depression, with hallucinations and paranoia. She was in and out of emergency rooms and psychiatric hospitals. She stopped walking, stopped eating, stopped speaking and stopped recognizing Ahearn. She was near death, doctors agreed, when Ahearn went against her mother’s stated wishes and asked them to try shock therapy.

Today you wouldn’t know it.

“Now she is walking with her walker. She’s laughing. She’s making jokes. She’s eating. She’s gotten back to life,” Ahearn says from her mother’s room at Park Terrace at Radisson, an assisted living center.

The electroconvulsive therapy Frances Ahearn underwent is, technically, the same treatment depicted in “One Flew Over a Cuckoo’s Nest.” Only, patients today must consent to the therapy, and it isn’t used to control behavior. Patients are sedated with anesthesia and muscle relaxants, and they’re provided oxygen during the treatment.

Dr. Roger Levine, who oversees psychiatry for St. Joseph’s Hospital Health Center in Syracuse, says the ensuing seizures are usually mild, with patients only slightly moving hands and feet. “You sort of change the balance of all those neurotransmitters,” he says of what happens in the brain. “It’s actually the most effective treatment there is.”

Shock therapy is used to treat severe depression and other mental illnesses. It was developed in the 1930s but stopped being used so much after antidepressants hit the market. Levine says it helps many people, not by curing their depression but by getting them out of bad episodes.

Frances Ahearn doesn’t remember much of her ordeal.

“I remember the one treatment I got. I remember the doctor putting those (electrodes) on me, but that’s it,” she says.

Ahearn, also of Baldwinsville, remembers doctors proposing shock therapy in April. Her mother was at St. Joseph’s, hallucinating. Sometimes Ahearn would go along with her mother’s hallucinations, and sometimes she would spend hours trying to help her differentiate what was real from the tricks of her mind.

At one point, “she fell limp in my arms,” Ahearn recalls. “She told me she was going to die. It was one of the most scariest moments in my life.”

She stopped eating and curled up in bed. “She was basically, without realizing it, committing suicide. Her refusal of food and medicine was jeopardizing her life.

“She still had that paranoia where she thought people were trying to poison her. She thought cameras were around and people were trying to kill us. She had horrible hallucinations about what would happen to her.

The doctors told Ahearn: “If this continues, you have to realize that her organs will start shutting down.”

She researched shock therapy, then signed consent for her mother to have the treatment. The first of five was done June 13.

Ahearn didn’t notice big changes in her mother after the first couple of treatments. Frances Ahearn recognized her daughter again, and she was able to sit in a chair, but that was all. The big improvements were visible after the subsequent treatments.

“I saw her in her deepest, darkest, basically dying days,” Ahearn says. “The transition is absolutely amazing. It’s a second chance at life, that’s what it is.”

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