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What it's really like to have electroconvulsive therapy (ECT)

When I was first offered a course of electroconvulsive therapy (ECT), formerly known as electroshock therapy, two cinematic scenes sprung to mind. 

‘Take a cigarette, boys – easy’, remarks Randle McMurphy, played by Jack Nicholson in One Flew Over The Cuckoo’s Nest (1975), as he enters a room with a bed fenced in by nurses and doctors. The expression on his face shows that he knows why he’s there. A nurse places some gelatinous conductant on his temples. ‘This won’t hurt, it’ll be over in a moment,’ another nurse says. Randle plays it cool until he gags when a guard is shoved into his mouth. Nevertheless he sings a song through the protector as a crude device that looks like a pair of headphones wrapped up in cottonwool is placed on each of his temples. ‘Here we go,’ a doctor exclaims as he induces the electro shock. Randle’s body twists and contorts. In the next scene, he stumbles back from the treatment into the communal area in a zombie-like state. He winks at his buddy Chief Bromden, turns to the other patients, smiles, and laughs ‘How about it you creeps, lunatics, mental defectives! Let’s hear it for Mongoose Randle, back in action!’

The other scene that comes to mind is the final episode from series one of Homeland (2011), where CIA agent Carrie Matheson, played by Claire Danes, is being treated for an episode of bipolar mania. As Carrie is given a general anaesthetic the viewer is shown romantic snapshots between she and Marine Sergeant Nicholas Brody (Damian Lewis). Just before going completely under, she remembers a piece of information significant to her case and tries to communicate this with those in the room, saying ‘Don’t let me forget’. When her sister asked what Carrie was trying to communicate, a nurse tells her sister ‘Nothing. It’s the anaesthetic – everyone does it’. The hook in the series’ finale is that Carrie may or may not forget this vital information due to the memory loss common to those who receive the treatment. 

There are elements from both of these scenes that will be familiar to someone who has received ECT in the modern day. Just as in Homeland, electrodes to monitor your brain activity and a general anaesthetic are placed on your head. I had no flashes of anything other than the intrusive thoughts and depression of my bipolar/OCD illness. Faces floated round me while I went under and the next thing I experienced was waking up in the recovery room, not knowing where I was. I once asked one of the nurses how I reacted when I received the shocks and she said my arms were dancing. While Randle pretended to be in a zombie-like state, there lies an element of truth in this. Likely a side-effect of the general anaesthetic, which was not given in One Flew, I certainly did not have the energy to joke and run around as Randle did in the post-ECT scene. Yet, in terms of my mood after the first ECT session, it was like ‘night and day’ according to my family. 

As alluded to in Homeland, memory loss was the most significant component of the treatment. I had two sessions of ECT twice a week, adding up to twelve in total, and I could hardly remember what I’d done in the past half hour let alone in the years preceding. I forgot significant events, people and had lost memories from the past several years. It was also hard for me to personally judge whether the treatment was effective as I was forgetting every day. It felt as though I’d freshly arrived in hospital after each treatment, where in fact I was there for over two months. I was also put on various different medicines while receiving the treatment so the ECT’s efficacy was confusing to me. I think this was hard for my family. 

Since finishing my course of ECT, memories have trickled back in. Often I need cues from family and friends, but I’m certainly getting there. It has made me reflect sincerely on the power and mutability of memory. This is only my ECT truth and others undoubtedly have different experiences of the treatment. Yet all are worthy if we are to advance its progression both clinically and personally.

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