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Shock Therapy
I was impressed with the evenhandedness of "Shock Therapy: It's Back" [Cover, September 24]. I had 12 shock treatments in early 1995 and 17 early this year. The results? I have major memory loss of at least the past two years. I still get somewhat confused when driving, even in familiar areas.
I retired from my job between the two series of treatments, and there were three different retirement parties for me. I have no recollection of any of them. I have kept a daily journal for the past two years. Most of it is so unfamiliar to me that it could have been written by somebody else.
Another result of the treatments is that I am alive to write this; I did not kill myself. I believe that my "cure," if any of us can be cured of our maladies of the mind and of the soul, will come from my continuing talk therapy. Recovering from depression is real work, and neither pill nor machine can substitute for the labor involved.
A fellow human who has been trained can make the work of recovery just bearable, but possible. It is the human touch that makes the difference; the hand that can reach to the bottom of the barrel to find me, that can give a shove from behind or a pull from ahead and that can squeeze my hand in encouragement as we move ahead together.
I have the utmost respect for people in the mental health fields. I intensely hope that researchers will be doing studies that will shed more light on the memory problems connected with ECT [electroconvulsive therapy]. There is research going on into treatments with similarities to ECT and continuing research into many aspects of depressive illness.
With managed care doing its part, perhaps we can look forward to bringing down the true costs of serious depression, which are suffering, broken physical health, broken homes, lost productivity and suicide.
Ann M. Hargrove
Arlington
The superb article raised serious questions not only about the procedure's usefulness but about its safety.
The American Psychiatric Association's model informed consent form, which many ECT facilities use at least in part, makes false claims on two safety issues: that "perhaps 1 in 200" ECT patients report lasting memory problems and that one in 10,000 patients dies as a result of ECT.
The crucial question is not, "Does ECT cause lasting memory problems?" but, "How severe and disabling are they?"
The article reported on a group of more than 2,000 ECT patients in Texas that had a death rate of roughly one in 100. It also cited a 1993 study of 65 hospitalized patients over 80 years of age, 28 of whom were treated with medications and 37 with ECT. Within a year, one in the medicated group and 10 in the ECT group were dead.
In these and other ways, psychiatrists are misleading tens of thousands of patients annually into accepting ECT.
I underwent electroshock involuntarily in 1963.
Leonard Roy Frank
San Francisco
As a psychiatric survivor of more than 50 insulin subcoma shocks, shock critic and anti-psychiatry activist, I congratulate you for publishing a sound and well-researched critique. Electroshock is increasing at an alarming rate as a psychiatric pacification weapon north and south of the (U.S.-Canada) border.
Don Weitz
Toronto
I am a former teacher and registered nurse whose life was forever changed by 13 outpatient ECTs I received in 1983. Shock "therapy" totally and permanently disabled me.
EEGs [electroencephalograms] verify the extensive damage shock did to my brain. Fifteen to 20 years of my life were simply erased; only small bits and pieces have returned. I was also left with short-term memory impairment and serious cognitive deficits.
It is beyond me how the government and the FDA can take issues such as the labeling of orange juice as "concentrated" or "fresh" as important to the American people while disregarding issues such as shock machines. There is no government inspection of ECT devices.
Shock "therapy" took my past, my college education, my musical abilities, even the knowledge that my children were, in fact, my children. I call ECT a rape of the soul.
Barbara C. Cody, BS, RN
Hoffman Estates, Ill.
Your cover story correctly notes that electroconvulsive therapy is broadly considered by organized medicine to be a treatment of proven efficacy against severe depression. However, it is inaccurate in stating that the American Psychiatric Association "has sought to make ECT a first-line therapy for depression and other mental illnesses, rather than a treatment of last resort."
The APA Task Force Report on ECT recommends that the treatment be used only when other forms of therapy, such as medications or psychotherapy, have not been effective or cannot be tolerated, and in life-threatening cases when other treatments will not work quickly enough.
It is significant that the National Alliance for the Mentally Ill and the National Depressive and Manic-Depressive Association, two major organizations representing patients and families, support the appropriate use of ECT.
Melvin Sabshin, MD
Medical director
American Psychiatric Association
Washington
In 1995, Texas State Reps. Dawnna Dukes, Billy Clemmons and I introduced bipartisan legislation in the House of Representatives to outlaw the use in Texas of the barbaric psychiatric treatment known as electroshock therapy. We were aided by advocacy groups like the National Association for the Advancement of Colored People (NAACP), the National Organization for Women (NOW) and the World Association of Electroshock Survivors.
Our legislation died in committee. Fortunately, Texas has a law requiring detailed reporting on the use of shock therapy. As your story pointed out, vulnerable elderly women are the primary targets.
Since introducing my bill, I have met with and heard from scores of human "after-shock" victims who were treated like lab rats and now suffer permanent new afflictions such as memory loss, learning disabilities and seizure disorders. Few people are properly warned of the known dangers of shock treatment.
Senfronia Thompson
State representative
Austin