Shock treatment's return to Niagara provokes range of intense emotions
Joanna Frape
The St. Catharines Standard
4/30/99
Jean Johnson does not remember shock therapy. Like so many other large sections of her life the memories have been erased. The 52-year-old St. Catharines artist only remembers snapshots of the terrifying moments before and after the treatment she describes as "absolutely devastating." Walking down a long hallway beside a doctor in an Ottawa hospital. Fear of the volts of electricity that would soon race through her head. Electrodes being placed on her temple and forehead. Darkness. And then struggling to remember her own name. "My mind was racing and I felt like I had run into a brick wall," she said. "When I woke up, I couldn't lift my head and I didn't know who or where I was."Electroconvulsive therapy, a highly controversial treatment for patients with mental illness, is coming to Niagara this summer under the same cloud of suspicion and doubt that hovered over it at the height of its use in the 1960s and 1970s.
St. Catharines General Hospital has agreed to be the regional provider of shock therapy, sparking raging debate among mental health professionals over whether the technique helps or harms.
"It's pretty frightening," said Sheila Bristo, executive director of the St. Catharines and District Canadian Mental Health Association. "There are people who say it saved them. And for those people it's good to have it here. But we have concerns about how it will be used. It's a very drastic form of treatment and we want to make sure they've tried everything else."
While some patients swear shock therapy saved them from crippling depression or even suicide, Johnson is horrified by its sudden reappearance in Niagara.
She was a 23-year-old suffering from severe depression when she went to have shock therapy for the first time and 30 years old when she went for the second time. The mother of a young daughter, she agreed to the treatment after being told it was the only way to escape the haunting memories of a childhood filled with physical, emotional and sexual abuse.
But instead of finding relief in electroconvulsive therapy, Johnson said she was "stripped of everything." Her memory is fragmented with large chunks of her life missing and she has trouble retaining information. "I lost myself," she said. "The treatment I got was extremely inhumane. When you put electrodes to a person's brain it changes the molecular property and that never goes back to where it was again."
Hospital officials argue shock therapy is different now from the days when Johnson received her treatment. Dr. Robert Kraus, the doctor heading up the therapy in St. Catharines, calls it "90 per cent effective and almost 100 per cent safe." Kraus was not available Thursday to comment on the strides shock therapy has taken in recent years. But in a 1997 Canadian Medical Association Journal article that was distributed this week to hospital board members, Kraus along with another physician wrote electroconvulsive therapy needs to be better understood and accepted by the medical community.
"It should be the first choice for patients who cannot tolerate pharmacotherapy (drug therapy) and for those, such as actively suicidal patients, in whom a rapid response is needed," stated the article. Patients now receive anesthetic and muscle relaxants before the 90 to 110 volts are passed into their brains stimulating a seizure. The electricity is thought to release neurotransmitters such as dopamine and noradrenaline to relieve depression. Unlike 30 years ago when the therapy was used mostly for schizophrenics, shock therapy is usually done on an outpatient basis now for people with depression. It is rarely given to people in long-term institutions with complex mental disorders.
"We recognize there are mixed opinions about the therapy," said Freddie Schmitt, vice-president of St. Catharines General. "But I think we are talking very much about a different technology these days. What fills us with anxiety is the old movies and the old mental pictures." "It has been used in inappropriate circumstances in the past," added Dr. Heime Geffen, chief of staff at St. Catharines General. "But, while we stood still, the teaching hospitals have gone on and improved the technology."
Although memory loss and cognitive impairment are still potential side effects, they are less common now and last for shorter periods of time. Despite the hospital's reassurances, many remain unconvinced the therapy should come to Niagara.
"It's obtrusive," said Donna Wowk, a board member at the General. "It has serious side effects and it remains controversial."