Frankenstein op saved me from suicide!!!That's the front page headline on today's News of The World, a popular British Sunday tabloid which would probably be the worst newspaper in most other countries, but which by British standards is only slightly below average.
TV actress Bev Callard tells how she suffered an episode of severe clinical depression, and was given ECT or as the News put it "terrifying electric shock treatment" which "plunged her into a scene of horror beyond anything TV scriptwriters could have imagined." Although it's never made clear what the horror was: according to Callard her twelve sessions of shock therapy was the only thing which worked to help lift her out of her suicidal state and, as the headline says, it may even have saved her life.
She was worried about the possible side effects, including memory problems, and describes experiencing difficulty learning her lines initially, but she says, she always managed to do so successfully.
The print version includes some sensible comments from a doctor who points out that ECT is effective as a last resort in cases of depression that don't respond to drugs alone. He also comments that "Bev is so brave to talk about this".
She is, but she shouldn't have to be: talking about depression shouldn't be a matter of being brave, any more than talking about any other illness. The reason it takes courage is that unlike with other diseases, admitting to suffering from a mental illness is liable to land you on the front page of the papers.
12 comments:
The stigma of depression stems partly from the notion that there is no biological basis for depression. Ironically, if ECT works, this suggests that depression is more than just something you can simply get over by standing up tall and changing your attitude.
However, our understanding of the biology of depression is still poor, and this is probably why all the biological treatments we have (including ECT) don't work for everyone. ECT will continue to be looked at as a "Frankenstein op" until we understand how it actually works.
Biological treatments don't work for everyone because our understanding of the biology of depression is poor? Eh?
If we understood the biology better we'd be able to target biological treatments at the specific biological problem in each patient instead of trying different treatments until one of them works. Hopefully...
Neurokuz says, in effect, that because ECT works, there is a biological basis for depression. Using the same twisted and torturous logic, because psychotherapy works, it means there is a psychological basis to depression. You know, if we put depressed people under the guillotine, and chop off their heads, we can cure their depression too. Does that mean having a head is the basis for depression?
I think we already know how ECT works. It's the biological equivalent of going up to someone and slapping them across the face while shouting, "Snap out of it!"
I hope I didn't leave the impression that psychology and biology are separate.
One of the main criticisms of ECT is the fact that we don't know the mechanism by which it works (when it works). If ECT sometimes works, that isn't absolute proof that depression has a biological basis, but ECT does act on the brain... just as psychotherapy acts on the brain. The goal, as Neuroskeptic pointed out, is to have specific targets and not play a guessing game.
But saying that ECT will work better when we discover how it works is a ridiculous idea.
Yes, ECT acts on the brain. Yes, psychotherapy does too. But EVERYTHING you do or experience or relate to acts on the damn brain. And the brain acts on the environment too! We shape our environments; we choose what niches to inhabit and what to do within such niches! Cure depression? Sure, act on the brain; but also act or re-shape the environment! The only way psychiatry will make true progress is if we get rid of the narrow-minded reductionistic thinking that now permeates this field.
Knowing how ECT works wouldn't in itself make it work better, but it would be a step towards that: we could develop tests to work out who will benefit from it, maybe drugs to boost the effect, ultimately drugs to mimic the effect w/out needing to shock people...
That's as maybe, but you can see why I questioned the original proposition.
Hi Neuroskeptic and dear readers,
I've been thinking about it for a bit but how can doctors prescribe shock treatment to any patient?
I don't know much about biology even less about Neuroscience but from what I've seen in movies and books, is it worth to have a Pyrrhic victory by inflicting shock treatment to anyone and having that person severed of her faculties e.g. intelligence?
I've seen from experiences that it is sometimes better to let people go than having that person half the person she was before the depression.
Just a point of view when reading about shock treatment.
A.
Beside statements like "ECT is the most effective treatment for depression" I heard on lessons on a clinical basis, I am convinced that there are at least some patients (who are not responding to medical treatments) getting cured. Wouldn't it be a good idea to find out _why_ exactly _this_ people react that way? If we could answer this question we could probably find a way to treat them more focused (like some people try by using TMS). However, this would probably not say anything about patients getting better by medication or CBT.
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