By John David Sutter
The Oklahoman

Oct. 2, 2006

Michele Rodriguez-Ryland thinks about suicide every day - sometimes constantly.

And if not for the 175 times she’s had medically administered electric shocks sent through her brain, she says her unyielding depression would have killed her by now.

“It’s like going outside in the sunlight, you know, colors look brighter, people seem friendlier,” she said of the electroconvulsive therapy, also called ECT or shock therapy, she’s chosen to receive. “I just feel like I wanna go out and do everything. And this is after just a few hours before, feeling like I wanted to kill myself. I mean, that’s quite a radical transition.”

The controversial treatment - mostly used to dull intractable cases of severe and prolonged depression when drugs and therapy fail - appears to be making a comeback from its stigmatized past.

In Oklahoma City, Dr. Shreekumar Vinekar, a professor of psychiatry and behavioral science at the University of Oklahoma College of Medicine, said he now administers the treatment to about twice the number of patients he did 10 years ago - up from about 250 treatments per year to an estimated 500 now.

National and Oklahoma statistics on the treatment are not collected. But Dr. Charles H. Kellner, chairman of the department of psychiatry at the New Jersey Medical School-UMDNJ, a leader in the field, said ECT use is “definitely increasing. It’s going up several percent a year, definitely. I don’t think there’s much question about that.”

Some say the treatment has become destigmatized. Others say patients are simply more aware that it’s an option.

The increase comes in spite of risks, including memory loss.

But for those with depression like Rodriguez-Ryland’s that doesn’t respond to anti-depression medications, or doesn’t respond quickly enough to avoid crisis, psychiatrists have long backed keeping ECT available.

They say modifications have made the treatment a safe and effective option - worth the risks.

How it works
Exactly how ECT works is not understood, but its power is thought to be in the seizures it induces.

Patients are wired to two electrodes placed on their forehead. While under general anesthesia, a series of shocks, lasting usually no more than 6 seconds each, are pumped into the brain. This induces seizures, which are thought to reboot or reset brain chemistry.

Patients are given muscle relaxers before ECT treatments, otherwise they would convulse and maybe get injured.

The procedure takes 10 to 15 minutes.

Rodriguez-Ryland said the first time she underwent ECT she felt terrified, miserable, hopeless. Since then, she has come to know her doctor and anesthesiologists and looks forward to ECT.

She only can receive up to three treatments per week. She goes back for one any time she feels like she can’t go on living otherwise.

Memory loss
Rodriguez-Ryland and others experience memory loss, which they link, at least in part, to their shock treatments.

Rodriguez-Ryland parks in the same, empty section of the Wal-Mart parking lot every time she goes, so she’ll remember where her car is. She uses visual markers to put places she might otherwise forget in a memorable context.

She says doctors have told her severe depression causes her memory loss, not the shocks. But she thinks it may be both. Her memory returns, and it’s a risk she’s willing to take for the benefits.

She said she has tried to kill herself about 30 times. The first attempt was at age 10. She says ECT saved her life.

Tina Boyle says a series of ECT treatments ruined hers.

After shock therapy, she lost almost all recollection of her family. She used stacks of photo albums to refresh her memory but says she will never be the same. “I feel like I’m short-circuiting,” she said.

She and her family members say the memory loss started after her shock therapy. Her children quit their jobs to take care of her for a time. She stays in her south Oklahoma City apartment most all the time, for fear she’ll forget how to get home.

Boyle’s memory loss may not be related to her shock therapy. She has other mental health conditions.

Her psychiatrist declined to comment on her case, despite Boyle’s willingness to sign legal release forms necessary for him to do so. Medical records from 2002 provided by Boyle show she received ECT treatment.

Future
Rodriguez-Ryland hopes more people become aware of shock therapy so that they can discuss the option with their psychiatrists.

She is still very depressed.

But she has enrolled in graduate school at OU, with the hopes of writing a book about her experiences with ECT.

Added: Oct 2, 2006 3:49 pm | Trackback URI |  Email This Post  | Print