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ECT for major depression in schizoaffective

Hello everyone,

The last 6 months or more has been pretty rough, my depression is as bad as it’s ever been, and I’m feeling increasingly detached from physical reality. I always feel like I may be dreaming, kind of like being muted or wrapped in bubble-wrap. I was already dealing with major depression when two of my pets died in two months. First, my dog suddenly fell gravely ill with an abdominal cancer and stopped eating. She passed after a month, at which time my cat began acting very bizarre, crying constantly, wandering, hiding from us/isolating, and also stopped eating altogether. He also passed within a month. Of a broken heart…

I went from 180lbs to my now 130 since June. I’m getting sick every time I eat, and feeling worse than the hunger pains feel. It’s bad, I’ve got major atrophy on one of my thighs, and never any motivation to do anything. Most days I have a hard time even just laying around all day.

But I didn’t come here tonight to whine or wallow. I’ve been on nearly every class of antidepressants, antipsychotics, alternative supplements, nothing has helped. I take mirtazapine, but this is the only drug that’s ever been in any way effective. I’ve reached the end of my proverbial rope. I’m exhausted and just want to feel what it’s like to smile, or cry, or feel any emotion besides dispair and anger. I feel like I’m nearly out of options, and that the penalty for my failure is my body just fading off into nothing. I did a lot of research and talking with my wife, then asked my doctor about electro convulsive therapy. I was also interested in learning more about ketamine infusion therapy and whether or not sza precludes me from that, but I’m on Medicare and the treatment runs around $5k-$8k. Unfortunately not even something I can consider.

My doctor agreed that ECT could be a good option for my treatment, and I did all the preliminary exams and received my referral. I have the evaluation appointment the day before thanksgiving, and was told I could start treatment immediately after. I’ve also got epilepsy and a bunch of other combat-trauma-related health problems. I feel like the epilepsy (I’ve been seizure free for 4 years) gives me and my wife a unique prospective on the treatment, as we both know what a seizure is like and she’s an expert at dealing with that state of my mind. But who knows.

I’ll be honest and admit to being scared, or at lease sufficiently nervous. I’ve read every paper, study, pdf I could find regarding ECT. I’ve been talking with my family and friend about it. My friend said his mom had it done and that he thought it was a bad idea. I’ve never known anyone with firsthand experience.

Has anyone here had ECT for major depression? I’d love to have a conversation with someone who’s experienced it (or a family member). Like I said, I’m really nervous, but I also understand what’s at stake. I need to be present for my wife and family.

More than anything else I just would really like to talk with someone about it. I don’t exactly have many close, trusted people aside from my wife. Outside input would be really helpful to me. If nothing else, I think I just need to acknowledge my fear and figure out how to proceed from here.

Thanks for reading. Sorry I’m not more clear in what I’m asking for, I guess maybe I don’t really don’t even know…? take care of yourselves. Good night.

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What VA B-HOST or satellite MH clinic do you go to?

I’m asking because although the VA knows more about the physiology and psychology of severe PTSD from direct experience than most p-docs outside the VA, my direct experience with the VA is that some VA facilities and staff are waaaaaaaaaaaaaaay more sophisticated and effective than others.

Are you willing to dig some? If so, I would look into these particular books for clues.

Knowledge is power. With it, I was able to pull myself up out a very deep hole into relative functionality… and literally show and tell my treatment team what to do.

Hi notmoses. Thanks for the reading recommendations. I’ll see what my library has, but to be honest, right now I’m not really reading much. No desire, too much to think about already.

I first went to the VA at the beginning of 2004, I had just got back home from Iraq. I’d sought to talk to my chaplain after starting to cut on myself. Chaplain left and got the JAG, JAG got the CO and corpsman. They determined I was a danger to myself or others and was escorted off base and had base credentials taken away (not allowed on base). The kicker was the legal stipulation that I immediately seek care “within 30 days AT NO COST to the government.” Lost the only job I had, ended up losing my apartment, and was otherwise wayward. Spent the next 5 years trying to get a medical discharge so I could get care, but they just let my contract run itself out. I randomly discovered the VA at American Lake in WA, and they took care of me right away. Saved my life. Maybe 6 months (less) my claim was rated and I began treatment for PTSD. That was over ten years ago, and unfortunately the VA is a different beast now days. I stopped going there because record privacy is not taken seriously. I had an admissions receptionist ask me about my cutting in front of a line of vets, at my primary care clinic. Second it often feels to me like vets are pushed to the breaking point by non-medical staff. Rude, disrespectful, demeaning attitudes that seems to have become a game, a code green lottery.

Sorry, I realize you didn’t ask me any of that. I’ve done inpatient stays at both Seattle and American Lake for the PTSD programs. They helped me with my PTSD, unfortunately there was just more going on. They diagnosed me bipolar I and schizoaffective. I figured the latter precluded the former, but I’m still learning. These days I have a private insurance Medicare plan. They’re not as knowledgeable regarding PTSD, but I’ve got an ok handle on that right now. I have a psychiatrist who values my opinions and understands that I decide what goes into my body. Turns out it’s hard to find a doc who’ll work with that second one. In my experience the VA doctors (especially MH) don’t really like the patient to make recommendations regarding medications, and tend to way overprescribe.

Thanks again for the book suggestions. I’ll look them up, just not in condition to now. Take care friend.

I don’t have 1st hand experience. But when I was doing inpatient at a private hospital the 1st time almost everyone on my unit was getting ect for major depression. I’m a believer now in its use after seeing it. I saw how the people were before, so so depressed, often su/si. Then within hours after the first ect there was… signs of life, smiling, talking, eating. It was really amazing the difference.

I had the same experience during my overwhelms. But as I came out of them, I would take the energy of my anger and anxiety into “detective work.”

Which very often points to PTSD as the upshot of feeling trapped in “impossible circumstances” and “learned helplessness” (see below). (Understanding LH was a god shot for me.) Given your experiences with the VA (very similar to mine and who knows how many tens of thousands of veterans with psych problems), who can blame you?

Have seen this in six different VA anchor hospitals, BUT… one sees a lot less of it in the suburban and ex-urban clinics. The VA has a dire “employee culture” problem in urban settings that is probably insoluable given political realities (and political correctness) at this time. I was detailed for a time to roll out a region-wide culture change project in the VHS. I submitted my resignation after a few weeks along with a letter explaining why. I never got a response to that letter, but upon showing it to a number of veteran mental health professionals outside the VA, I was told every time that my observations were accurate.

This is HUGE, especially after the PTSD-worsening experiences of dealing with supposed “care providers” who are… not.

My experience on both sides of the nursing station counter. Authoritarianism is the cultural norm in a milieu operated by the DOD, after all. But authoritarianism is powerfully correlated to the etiology of learned helplessness. Most veterans with MH problems get sicker or give up (and hopefully find help outside) or… (sigh).

One more excellent and easy-to-read (and use) therapeutic workbook: