2 book One Flew O ver The
Cuckoo’s Nest, and the 1975
movie, depicted ECT as a form
of beh av iou r a l cont rol for
psychiatric patients, perhaps
an accurate portrayal of certain
hospitals back in the 1950s. And
in the 1980s, ECT was used as a
‘treatment’ for homosexuality.
This practice didn’t last, but it
still remains etched in cultural
memory.
The use of ECT is declining in the UK, according to the latest
report by the ECT Accreditation Service. “Its portrayal in movies
has been profoundly stigmatising, and has misrepresented current
practice,” says McShane. He argues that a lack of knowledge
around severe depression means the costs and benefits of the
treatment cannot be accurately weighed up. “That discussion
often omits the severity of the illness. ECT causes side effects,
but so does chemotherapy.” He says that if the public were
more aware of the reality of being severely mentally unwell,
they might be more accepting of the treatment – “but those
patients often don’t want to talk”.
Stigma can affect doctors as well as patients. According to
Kirov, most psychiatrists who object to ECT haven’t actually
seen it used. To counter misinformation, he encourages every
medical student to observe ECT. But he isn’t sure what to do
for the public. “It’s hard to change public opinion. People have
heard too many bad stories,” he says.
To m a k e m a t t e r s wo r s e, E C T h a s b e c om e a pr o x y f o r a lon g-
argued question: is depression a medical problem, or a social
one? Read, who’s critical of ECT, argues the social side, saying
that ECT is the most extreme example of the over-medicalisation
of human distress: “It’s not an appropriate response to a social
problem.” He calls for more work on population-wide wellness,
and improved access to a range of psychological therapies and
social support. McShane insists that ECT patients “are generally
either too ill to make use of psychotherapy, or have already
tried it without success”.BRIGHT FUTURE
In the end, Karen needed both ECT and psychotherapy. Her
return to health was difficult. She relapsed a few months after
her first course of ECT, falling back into severe depression. “I
was reliving [the trauma] all the time. I started hearing him
constantly talking to me, and I could feel him touching me.”
By February 2012 she was back in a psychiatric unit, sectioned
after another suicide attempt. She spent a year and a half trying
various other therapies, before starting her second round of
ECT in August 2013. At that time, Karen was too unwell to
give consent herself, but her family fought for her to receive it.byHELENGLEN N Y
Helenis a freelancescienceandtraveljournalist,
witha backgroundinneuroscienceandphysiology.DISCOVERMORE
If you have been a ected by any issues raised in this
article, there is help and advice available here:
bit.ly/mental_health_support If you are concerned
about the mental health of you or a loved one,
please visit your GP.Watch short films and read articles
about mental health from the BBC
Three series Minds Ma er.
bit.ly/bbc_mind_ma ersAf ter t h ree sessions, Ka ren beca me
calmer. “I had lots of input f rom t hen
on,” she says. Karen was assigned a new
psychologist, who guided her through
psyc hot her apy du r i ng her ECT. She
continued with the ECT, gradually reducing
its frequency, until she was having just one
session every three weeks. In September
2014, she was discharged, and in 2015
decided to stop ECT completely. “I’d
got to a point with therapy where I was
processing what had happened to me,” she
says. In 2016, after three years of therapy,
Karen decided to stop that too. She doesn’t
regularly see doctors any more, and says
that life is finally back to normal for her.
What wou ld have happened if ECT
wasn’t an option? “I don’t think I’d be
here,” she says. She cautions that while
ECT certainly isn’t for everyone, “there
is a role for it. Banning it would be like
removing a lifeline.”“THERE IS A ROLE FOR ECT.
BANNING IT WOULD BE LIKE
REMOVING A LIFELINE”
ELECTROCONVULSIVE THERAPY FEATUREILLUSTRATION: EMMANUEL POLANCO