Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The misunderstood consequences of electroconvulsive therapy

lithub.com

Post reply on HN
Print view View original

11–20 of 62 posts

Re: The misunderstood consequences of electroconvulsive therapy

#11

Post by imperio59 »

bellerose wrote: post #9

My opinion is suicide being the better outcome than electroconvulsive therapy. People are so irrational in fearing the unknown "death" that they'll do something barbaric to themselves and where the outcome is creating a disabled version of their former self. Humanity is really disgusting. First, we label people with "depression" a word denoting human expression built upon a pseudo practice named psychiatry and where…

We used to offer support and accept that sadness and sorrow were a part of life and that sometimes people needed to grieve, or people went through rough patches, and eventually got themselves out of it with the help of others.

Now we say sadness and depression are diseases that must be medicated with drugs whose side effects (WRITTEN ON THE LABEL) include suicidal ideation and depression, and we wonder why the suicide rates are up?

The worst thing this country did was vote to allow pharmaceutical companies to advertise drugs on TV and in other media. Once that pandora's box was open, there was no going back. It's sad that we're only now waking up to the fact that things like the opioid crisis were actually fueled and manufactured by pharmaceutical companies to increase their profit margins... :/

Re: The misunderstood consequences of electroconvulsive therapy

#12

Post by rincebrain »

justtopost wrote: post #2

The most dangerous placebo. Please never allow yourself, or your loved ones to be subject to this. You have power within yourself.

I've had (unipolar) ECT done, many times, and it didn't work even marginally for me.

It wasn't a forced option, either - I wasn't in an environment where anyone was compelling me, directly or indirectly, to do it, or threatening to do something if I didn't, it was just another option presented to me.

I still don't think it's just a placebo - there's pretty good evidence that it's effective for a number of people, both in the small population of others I know who have had it done and outside of that, even though it wasn't helpful for me.

It also wasn't obviously deeply destructive for me, either - I don't remember the particular days that this was done well (and didn't even a few days after the fact), but I and others haven't noticed any memory or activity issues outside of that.

Do you have specific documentation of why you have these strong opinions?

Re: The misunderstood consequences of electroconvulsive therapy

#13

Post by bellerose »

imperio59 wrote: post #11
bellerose wrote: post #9

My opinion is suicide being the better outcome than electroconvulsive therapy. People are so irrational in fearing the unknown "death" that they'll do something barbaric to themselves and where the outcome is creating a disabled version of their former self. Humanity is really disgusting. First, we label people with "depression" a word denoting human expression built upon a pseudo practice named psychiatry and where…

We used to offer support and accept that sadness and sorrow were a part of life and that sometimes people needed to grieve, or people went through rough patches, and eventually got themselves out of it with the help of others. Now we say sadness and depression are diseases that must be medicated with drugs whose side effects (WRITTEN ON THE LABEL) include suicidal ideation and depression, and we wonder why the suicid…

The pharmaceutical companies wanted to make money. The US politicians are pushovers when receiving donations for favours. Social conditioning is a real thing and commercials sadly work.

Re: The misunderstood consequences of electroconvulsive therapy

#14

Post by nickbarnwell »

devoply wrote: post #6
Analemma_ wrote: post #3

Earlier quoted context omitted.

Your comment is dangerous and irresponsible. This is not the 40’s, ECT is not used lightly; it is the treatment of last resort for severe depression when lifestyle changes, medication and therapy have all failed. The side effects are well-understood and patients who choose ECT do so because the alternative is unbearable. What you are saying cashes out to the claim that depression can be overcome with sheer positivity…

Not particularly last resort. And apparently there is a large line-up in the system for people to get this therapy. They claim that there is a lot of efficacy... but apparently for many the symptoms return over time. The author of the article concludes: "Despite the discomfort and the temporary memory loss it caused, I would have ECT again without hesitation." Much of psychiatry to me seems like an infant mad science…

It really is the last resort; even if you were able to find a psychiatrist willing to administer a course of it without extensive trials of multiple classes of psychotropic medication as an adjunct to psychotherapy, your insurer is definitely not going to spring for it. The NHS’ NICE guidelines outline what’s to be considered before ECT is even proposed (https://www.nice.org.uk/guidance/cg90/chapter/1-Guidance#seq...), and criteria are at least as stringent in the US.

Re: The misunderstood consequences of electroconvulsive therapy

#15

Post by rincebrain »

devoply wrote: post #6
Analemma_ wrote: post #3

Earlier quoted context omitted.

Your comment is dangerous and irresponsible. This is not the 40’s, ECT is not used lightly; it is the treatment of last resort for severe depression when lifestyle changes, medication and therapy have all failed. The side effects are well-understood and patients who choose ECT do so because the alternative is unbearable. What you are saying cashes out to the claim that depression can be overcome with sheer positivity…

Not particularly last resort. And apparently there is a large line-up in the system for people to get this therapy. They claim that there is a lot of efficacy... but apparently for many the symptoms return over time. The author of the article concludes: "Despite the discomfort and the temporary memory loss it caused, I would have ECT again without hesitation." Much of psychiatry to me seems like an infant mad science…

A lot of medicine is rather more grey than black and white than we'd prefer, since we either find things out through long tails of researching lots of things and seeing what works better than placebo, or by verifying unexpected reported outcomes (several entire classes of medications have come from unexpected side effects - Rogaine and Viagra were blood pressure meds, the entire SS*I class of drugs was found when someone noticed by accident that a type of antihistamine seemed to improve malaise in some patients, ketamine is rather well known at this juncture as an anesthetic and party drug that got signoff as a novel antidepressant...), and observational evidence isn't necessarily predictive of how it happens on its own.

You're not wrong that a lot of psychiatric medications are "this seems to work, who knows why" and experiments around testing mutations on those things to see if they're more or less effective, because we have so little visibility into the brain and cognition that we can't really gauge these things objectively v. well.

But for people with pathological brain problems, big unpredictable hammers can be a reasonable choice to try if you have an urgent need for mitigation (e.g. acutely self-destructive problems) and/or less invasive things like directed behavioral therapies have not proven sufficiently effective.

Re: The misunderstood consequences of electroconvulsive therapy

#16

Post by kristianp »

This is the most readable webpage I have seen for a while. The combination of background colour, black font, font face and line height make for an extremely readable page. Far better than the popular but varyingly unreadable white background and gray text.

That ECT is still around after all this time, speaks to its effectiveness, despite some of the vehement comments on this page.

Re: The misunderstood consequences of electroconvulsive therapy

#17

Post by rincebrain »

imperio59 wrote: post #10
depressed wrote: post #8

Earlier quoted context omitted.

Have you ever had someone close to you commit suicide? If so, is that truly a better outcome than undergoing ECT? If not, then I want you to understand this: ECT is used to treat a lethal illness.

I'm sorry but that's the equivalent of saying "This person is about to kill themselves, so let's take a bat and hit them over the head with it so they can't do that now. See, now they're doing fine, they're not killing themselves." Would you take someone who is about to kill themselves and take a pair of live electric wires to their head to try to "cure" them? Because that's essentially what ECT is, despite all the s…

Most forms of treatment, in terms of therapy, psychiatric medication, or more invasive options, cease to be effective when they're removed, eventually.

ECT and ketamine, for example, are sometimes found to be effective for O(months) after initial more frequent treatment, while most of the psychiatric meds you run through earlier if you're pursuing that type of treatment take weeks to become effective (or not), weeks to stop, and the beneficial effects often stop much sooner than the side effects after taking them (...if they stop at all, in some cases).

ECT can and often does do lasting damage. It should not be used lightly. But singling out ECT for being a recurring treatment seems unreasonable when the other avenues of treatment, both behavioral and otherwise, have the same caveat.

Re: The misunderstood consequences of electroconvulsive therapy

#18

Post by pdkl95 »

depressed wrote: post #8
imperio59 wrote: post #5

Earlier quoted context omitted.

Sorry but there are dozens of studies and hundreds of reports of people basically losing memories of entire portions of their life and the ability to do simple things like tie their shoelaces or do simple math after just one round of ECT. How this is still not banned by the FDA is beyond me. Not to mention the number of people who get heart complications from it or outright die during the procedure. How can you say t…

Have you ever had someone close to you commit suicide? If so, is that truly a better outcome than undergoing ECT? If not, then I want you to understand this: ECT is used to treat a lethal illness.

> Have you ever had someone close to you commit suicide?

Yes. My girlfriend who lived with me for several years.

> If so, is that truly a better outcome than undergoing ECT?

Yes, absolutely, for the reasons imperio59 and others have already described. You don't solve mental issues by injuring the brain until they the symptoms are no longer obvious to outside observers.

Also, using this type of emotional manipulation that presupposes the false dichotomy of "ECT or suicide" is highly offensive. There are many potential options, and you do not know what someone will do with or without any particular "treatment".

Re: The misunderstood consequences of electroconvulsive therapy

#19

Post by nickbarnwell »

imperio59 wrote: post #10
depressed wrote: post #8

Earlier quoted context omitted.

Have you ever had someone close to you commit suicide? If so, is that truly a better outcome than undergoing ECT? If not, then I want you to understand this: ECT is used to treat a lethal illness.

I'm sorry but that's the equivalent of saying "This person is about to kill themselves, so let's take a bat and hit them over the head with it so they can't do that now. See, now they're doing fine, they're not killing themselves." Would you take someone who is about to kill themselves and take a pair of live electric wires to their head to try to "cure" them? Because that's essentially what ECT is, despite all the s…

There is a both a large and strong evidence base for the usage of ECT in cases of severe, treatment resistant depression. Many aspects of modern medicine can be made to sound barbaric with the right framing; those who disparage ECT are not so quick to characterise chemotherapy as “poison by any other name” or dialysis a “vampiric ball and chain”.

By the time ECT is on the table, every other option is exhausted and the sufferer has been through multiple acute hospitalisations for suicidal ideation, if not unsuccessful attempts.

It is certainly fair to say the effect is not always permanent, that maintenance courses are a burden, and that their long-term efficacy does not justify the risks of the procedure itself or the anaesthesia it requires. Nonetheless, for someone who has been depressed for many years, plagued by crippling ennui and a nihilistic view of existence not even Schopenhauer’s grimmest passages can match, any respite is welcome. To deny them that option, with full knowledge of the risks, is to deny them agency.

Re: The misunderstood consequences of electroconvulsive therapy

#20

Post by [deleted] »

imperio59 wrote: post #11
bellerose wrote: post #9

My opinion is suicide being the better outcome than electroconvulsive therapy. People are so irrational in fearing the unknown "death" that they'll do something barbaric to themselves and where the outcome is creating a disabled version of their former self. Humanity is really disgusting. First, we label people with "depression" a word denoting human expression built upon a pseudo practice named psychiatry and where…

We used to offer support and accept that sadness and sorrow were a part of life and that sometimes people needed to grieve, or people went through rough patches, and eventually got themselves out of it with the help of others. Now we say sadness and depression are diseases that must be medicated with drugs whose side effects (WRITTEN ON THE LABEL) include suicidal ideation and depression, and we wonder why the suicid…

[deleted]
Post reply on HN