Revenged Posted July 24, 2007 Posted July 24, 2007 I have now met two people who have had their brain's electrically shocked by psychiatrists at psychiatric hospitals... One of them had it done two years ago and so I think it's still going strong in the UK... They weren't psychotic or anything - they both just had long going depression... They were treated at a private psychiatric hospital (not going to say which one) but both were paying for the treatment and willingly had ECT done on them... I was very shocked by it all... It reminded me of that film 'one fell over the cucco's nest'... It didn't do any good for either of them... I read their medical notes and their history wasn't abnormal except for suicide attempts... but even so suicide attempts aren't uncommon in depressed people - especially those that have had it for over 30 years... It just seems like absolute madness to me that you would electricute the brain of someone with severe depression as a last resort... Anywayz, what i was wondering was... 1) what good is it supposed to do anyway (i did a wikipaedia and it didn't tell me much) and 2) how can such a thing be legal?...
Glider Posted July 25, 2007 Posted July 25, 2007 I have now met two people who have had their brain's electrically shocked by psychiatrists at psychiatric hospitals... One of them had it done two years ago and so I think it's still going strong in the UK... They weren't psychotic or anythingSo? Why would you give ECT to a person with psychosis? ECT is not for psychosis and it's not supposed to be a punishment or anything. - they both just had long going depression... 'Just' had long term depression? What do you think clinical depression is like? Hayfever? Anyway, that's what ECT is for; severe depression and bipolar conditions involving mania. They were treated at a private psychiatric hospital (not going to say which one) but both were paying for the treatment and willingly had ECT done on them... I was very shocked by it all... Why were you shocked? Surely that fact that they were prepared to pay for it and were willing participants in the treatment must tell you something? It reminded me of that film 'one fell over the cucco's nest'... It didn't do any good for either of them Are you sure? ... I read their medical notes and their history wasn't abnormal except for suicide attempts... ..wasn't abnormal except for repeated attemps to kill themselves? but even so suicide attempts aren't uncommon in depressed people - especially those that have had it for over 30 years... Oh, well, that's ok then. Have you ever wondered what a person must feel like to want to kill themselves? It just seems like absolute madness to me that you would electricute the brain of someone with severe depression as a last resort... It must have seemed like madness the first time someone suggested passing 200 - 360 Joules of electricity through the chest of someone with ventricular fibrilation as a last resort. However, this often has a visible effect (i.e. not dying) and so people tend to accept it now. ECT doesn't have such a visible effect, and it's to do with scary stuff like 'mental illness', and so it's considered barbaric and akin to witchcraft (except by the patients). Anywayz, what i was wondering was... 1) what good is it supposed to do anyway (i did a wikipaedia and it didn't tell me much) It basically 're-sets' the brain (like a computer hard-boot). It is effective in bipolar disorders and severe depression. In bipolar disoprders, if given at the appropriate time, it can prevent a person from swinging from hypermania into the pits of despair (or visa versa) and in severe depression it can provide a relatively long term alleviation of the worst of the symptoms (like the urge to throw yourself under a train, for example). and 2) how can such a thing be legal?... Well, I'm glad to see you approached the topic with an open mind and no preconceptions . ECT is legal because it's an effective therapy. It can't cure bipolar disorders or severe depression, but it is very effective at heading off the worst of the symptoms. If you are so easily mislead by the apparent 'brutality' of a theraputic procedure, you should check out some surgical procedures, especially some of the more extreme abdominal/gastrointestinal stuff. They're just peachy! I wonder why nobody complains about them? Could it be because they're medical (i.e. physical) and so they're 1) good, by definition, however brutal they might be, and 2) not to do with 'mental' stuff which is all a bit scary and clearly the fault of the person, who should just jolly well pull themselves together anyway! .
Revenged Posted July 25, 2007 Author Posted July 25, 2007 Well, I'm glad to see you approached the topic with an open mind and no preconceptions that's a little ironic considering with how much sarcasm you answered my post... you have put me off posting... and since you seem to disregard everything i say i'll give you some evidence... http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000076/frame.html http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003593/frame.html http://www.mrw.interscience.wiley.com/cochrane/cldare/articles/DARE-20020063/frame.html http://www.mrw.interscience.wiley.com/cochrane/cldare/articles/DARE-970633/frame.html http://www.ncbi.nlm.nih.gov/sites/entrez where is there signficant evidence supporting the effectiveness of ECT?... it is controversial... there is a reason it only happens to desperate people who have been admitted to psychiatric inpatients... there certainly isn't like any prove of effectiveness for depression like there is for CBT or anti-depressants... and ECT certainly does have a tainted past for being giving it's use to psychotic and 'mentally retarded' patients who being 'non-competent' cannot consent to medical conditions and so doctors can treat against their will... the film 'one flew over the cuccko's' nest wasn't to inaccurate... ECT occured in that film and lastly the inpatient had a frontal lobe lobotomy, which was a psychiatric treatment which still took place in the eighties despite making people go into a complete vegetative state... lobotomies were certainly done against people's wills... and ECT can still be done without consent and even in some countries without anasthesia - so of course it is barbaric... http://en.wikipedia.org/wiki/Lobotomy it is shocking that they don't even give people anasthetic for the treatment in some places... it has already been banned from quite a few countries already but yet the UK and USA it's still going strong... the psychriatric profession is very slow to admit they are wrong and change their ways (look at the lobotomy stuff - it was still occuring only twenty years ago!)... btw, the idea that there is informed consent in such cases is madness... when people are admitted to a psychiatric hospital they aren't really in a position to say no to a doctor...
Glider Posted July 25, 2007 Posted July 25, 2007 that's a little ironic considering with how much sarcasm you answered my post... It begged for it. You did not originate this thread from a neutral perspective in order to enquire. Your original post can be accurately summed up thus: “Oh my God, look at what they are doing to these poor people! And they’re not even mad, they only have depression (for 30 years). How do they get away with it?”. That post (and your subsequent one) shows you have already prejudged ECT as a therapy, and moreover, the dismissive way you treat both depression and attempted suicide shows you have no understanding of the condition(s) for which it is used. I hear it too much and it pisses me off. you have put me off posting...Oh no and since you seem to disregard everything i say i'll give you some evidence... What do you think this evidence is in support of? You would do well to read it yourself: http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000076/frame.html Plain language summary The induction of a seizure (fit) for therapeutic purposes by the administration of an electrical stimulus (electroconvulsive therapy or ECT) remains a common treatment option for people with schizophrenia. This review pools data from 26 studies that included over 798 participants in receipt of this treatment. The evidence suggests that courses of ECT can, in the short term, result in an increase in global improvement for some people with schizophrenia.. http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003593/frame.html Plain language summary The reviewers examined the effectiveness and safety of electroconvulsive therapy (ECT) in elderly people with depression. The reviewers performed this review because antidepressant drugs often cause side-effects in elderly people which may limit the effectiveness of treatment . ECT therefore can be an important alternative to drug treatment for depressed elderly people. The reviewers searched the literature for well-conducted (randomised) studies, both comparing real ECT to simulated ECT and to antidepressants. Only three studies were found, which all had serious problems in their methods. At present, no firm conclusions can be drawn about whether ECT is more effective than antidepressants. Also, we cannot draw clear conclusions on the safety or side effects of ECT in elderly people with depression. http://www.mrw.interscience.wiley.com/cochrane/cldare/articles/DARE-20020063/frame.html Author's conclusions The case studies suggested that ECT may be of value in treating severe psychiatric disorders in mentally retarded patients, with similar indications as in general psychiatry. However, the lack of strong scientific evidence, besides complicated psychiatric assessment as well as ethical and legal issues, probably causes an unnecessarily limited use of ECT in these patients. http://www.mrw.interscience.wiley.com/cochrane/cldare/articles/DARE-970633/frame.html Author's conclusions Our knowledge about ECT in adolescents and children is deficient, and randomised controlled trials are needed. ECT should be used with caution in this age group because of the lack of knowledge. However, bearing in mind the severity and complexity of illness of the patients treated, and the mild nature of most adverse events, the rate of improvement across disorders of 67% is heartening. . where is there signficant evidence supporting the effectiveness of ECT?... Well, you just provided a whole bunch in your links. However, here’s some more: Depression Studies of ECT in depression have used various control conditions for comparison, including "sham" ECT (e.g., all of the elements of the ECT procedure except the electric stimulus), tricyclic antidepressants (TCA), monoamine oxidase inhibitors (MAOI), combinations of antidepressants and neuroleptics, and placebos. The efficacy of ECT has been established most convincingly in the treatment of delusional and severe endogenous depressions, which make up a clinically important minority of depressive disorders. Some studies find ECT to be of at least equal efficacy to medication treatments, and others find ECT to be superior to medication. Not a single controlled study has shown another form of treatment to be superior to ECT in the short-term management of severe depressions. It must be noted, however, that those studies that found ECT to be superior to medication were not designed to study the persistence of this advantage of ECT beyond the short term. Moreover, the available evidence suggests that relapse rates in the year following ECT are likely to be high unless maintenance antidepressant medications are subsequently prescribed. Several studies suggest that ECT reduces symptoms in severely depressed patients who previously have not responded to adequate trials of antidepressant medication. The literature also indicates that ECT, when compared with antidepressants, has a more rapid onset of action. Delusional Depression ECT is highly effective in the treatment of delusional depression. It is superior to either antidepressants or neuroleptics used alone and is at least as effective as the combination of antidepressants and neuroleptics. ECT is often effective in patients who have previously failed to respond to medication. The duration of therapeutic effect beyond the initial acute episode is not clear. Endogenous/Melancholic Depression The severe endogenous/melancholic depressions are characterized by early morning awakening, marked weight loss, psychomotor retardation and/or agitation, diurnal variation, and lack of reactivity. ECT is at least as effective as TCA and more effective than sham ECT in the short-term treatment of these severe endogenous/melancholic depressions. ECT appears to be more effective than MAOI in the treatment of severe depressions, but available studies have generally used relatively low MAO doses. There is evidence for the efficacy of ECT in those endogenous depressives who have not responded to an adequate trial of antidepressants. The long-term efficacy of ECT with endogenously depressed patients is not known. Other Depression The majority of depressed persons encountered in medical and psychiatric settings do not have the severe endogenous/melancholic or delusional depressions described above. ECT is not effective for patients with milder depressions, i.e., dysthymic disorder (neurotic depression) and adjustment disorder with depressed mood. Patients with major depression that is nonendogenous/nonmelancholic have not yet been extensively studied. Because of this, it is unclear whether their response to ECT would be more like those with dysthymic disorders or those with endogenous/melancholic features. Acute Manic Episode ECT and lithium appear to be equally effective for acute mania, and either is superior to hospitalization without somatic therapy. A treatment regimen in which ECT is used for the acute episode, followed by lithium maintenance, does not appear to be associated with an increased risk of early relapse compared with lithium treatment alone. Schizophrenia Neuroleptics are the first line of treatment for schizophrenia. The evidence for the efficacy of ECT in schizophrenia is not compelling but is strongest for those schizophrenic patients with a shorter duration of illness, a more acute onset, and more intense affective symptoms. ECT has not been useful in chronically ill schizophrenic patients. Although ECT is frequently advocated for treatment of patients with schizophreniform psychoses, schizoaffective disorders, and catatonia, there are no adequate controlled studies to document its usefulness for these disorders. Other Disorders There are no controlled studies supporting the efficacy of ECT for any conditions other than those designated above (i.e., delusional and severe endogenous depression, acute mania, and certain schizophrenic syndromes). (National Institutes of Health Consensus Development Conference Statement. June 10-12, 1985). Also: “This systematic review has identified a substantial body of evidence concerning the effectiveness and safety of electroconvulsive therapy (ECT). The evidence consistently shows that, in the short-term, ECT is an effective treatment for depression. ECT also leads to short term impairment of memory although it remains unclear for how long this persists. There is no evidence of structural brain damage due to ECT, nor is there any evidence of a negative short-term effect on all-cause or cause-specific mortality. Different doses and modes of application of ECT appear to show differences in efficacy and adverse acute effects. In general high efficacy is often obtained only at the cost of some increased risk of acute adverse effects in the short term. The subjective effects of ECT tend to be less severe and less easy to demonstrate than objective evidence of short-term impairment of memory.” (Geddes, J. 2002. Systematic review on effectiveness and adverse effects of ECT. The Research Findings Register. Summary number 820. Retrieved 25 July 2007, from http://www.ReFeR.nhs.uk/ViewRecord.asp?ID=820) it is controversial... I don’t see much by way of controversy here. there is a reason it only happens to desperate people who have been admitted to psychiatric inpatients...Oh, really? And what would that be? You wouldn’t be suggesting it’s simply a method of torture or control for the psychologically vulnerable, would you? there certainly isn't like any prove of effectiveness for depression like there is for CBT or anti-depressants... See above (and read it this time). and ECT certainly does have a tainted past for being giving it's use to psychotic and 'mentally retarded' patients who being 'non-competent' cannot consent to medical conditions and so doctors can treat against their will... The whole of humanity has a tainted past at some point. Medicine certainly does. That doesn’t mean we should dismiss it now. the film 'one flew over the cuccko's' nest wasn't to inaccurate... ECT occured in that film and lastly the inpatient had a frontal lobe lobotomy, which was a psychiatric treatment which still took place in the eighties despite making people go into a complete vegetative state... It was a FILM FFS! lobotomies were certainly done against people's wills... So was press-ganging into the navy. Let’s disband that too. and ECT can still be done without consent and even in some countries without anasthesia - so of course it is barbaric it is shocking that they don't even give people anasthetic for the treatment in some places... ...Not these days, and informed consent is a legal requirement: see HERE. An interesting extract from that link is as follows: The idea of ECT is frightening to many people, thanks in part to its depiction in the film "One Flew Over the Cuckoo's Nest." Some may not know that muscle relaxants and anesthesia make it a safe, practically painless procedure. Some people who advocate legislative bans against ECT are former psychiatric patients who have undergone the procedure and believe they have been harmed by it and that the treatment is used to punish patients' misbehavior and make them more docile. This is untrue. It is true that many years ago, when psychiatric knowledge was less advanced, ECT was used for a wide range of psychiatric problems, sometimes even to control troublesome patients. The procedure was frightening for patients because it was then administered without anesthesia or muscle relaxants, and the uncontrolled seizures sometimes broke bones. Today, the American Psychiatric Association has very strict guidelines for ECT administration. This organization supports use of ECT only to treat severe, disabling mental disorders; never to control behavior. it has already been banned from quite a few countries already but yet the UK and USA it's still going strong... the psychriatric profession is very slow to admit they are wrong and change their ways (look at the lobotomy stuff - it was still occuring only twenty years ago!)... btw, the idea that there is informed consent in such cases is madness... when people are admitted to a psychiatric hospital they aren't really in a position to say no to a doctor...Spare me your paranoid ramplings and moral rectitude, at least until you can come up with a better treatment for the above conditions. You have yet to provide any evidence that the psychiatric profession is wrong. Just out of interest, what makes you think you are in a position to judge the psychiatric profession anyway?
Reaper Posted July 25, 2007 Posted July 25, 2007 If ECT is voluntary then I don't see the problem with it. Also, there are cases that do warrant involuntary treatment because mental illness can impair rational judgment: http://en.wikipedia.org/wiki/Anosognosia --------------------------------------------------- The main ethical issues with it was abuse of psychiatry. However, this involves "treating" patients that have may not have any mental illness whatsoever and is used with the sole purpose of control. Over medication is also a major concern. This is still happening in various countries including the US and Great Britain. It is also a key argument in the ADHD controversy: http://sitemaker.umich.edu/356.lesser/adhd_controversies Though there are laws that aim to prevent this from happening, that doesn't mean that it doesn't happen. -------------------------------------------------------- From personal experience, I have suffered from severe depression before and it is not fun. I never had to go through ECT though. Some treatments were involuntary during the worst of it. ECT still stands as an effective treatment for depression and schizophrenia. They are also investigating Transcranial Magnetic Stimulation as an alternative because it has less side effects than ECT and it can be focused on certain parts of the brain:http://www.mayoclinic.com/health/transcranial-magnetic-stimulation/MH00115 and http://groups.csail.mit.edu/vision/medical-vision/surgery/tms.html
Revenged Posted July 25, 2007 Author Posted July 25, 2007 From personal experience, I have suffered from severe depression before and it is not fun. I never had to go through ECT though. Some treatments were involuntary during the worst of it. ECT still stands as an effective treatment for depression and schizophrenia. They are also investigating Transcranial Magnetic Stimulation as an alternative because it has less side effects than ECT and it can be focused on certain parts of the brain:http://www.mayoclinic.com/health/transcranial-magnetic-stimulation/MH00115 and http://groups.csail.mit.edu/vision/medical-vision/surgery/tms.html Some interesting links there Lockhead... Thanks...
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