A professional engineer working at a major employer in the Kansas City area was struggling with severe anxiety and depression. He was contemplating suicide.
"I specifically remember saying, ‘Well, you know, if I screw up enough at work, I can get fired and then that's my excuse...then it will all be over,’" he said, as he referenced ending his life.
Having been through several years of debilitating ups and downs, the man’s doctor brought up electroconvulsive therapy, or ECT.
He and his wife decided he should go forward with it. He was scared, and he didn't sleep the night before.
Then it was time for his first treatment. He was in a hospital room, on a bed, when anesthesia would soon be administered.
"The doctor comes in and does his checklist. He's very compassionate...he grabs my hand and he holds my hand," the man said, choking back tears, "And that was the comfort I needed to begin the treatment."
Statistics show one out of every four people reading this story will suffer from some form of major depression or anxiety in their lifetime.
Many will not seek treatment.
Others will try medication, sometimes multiple medications, and maybe therapy.
For some, those things will work.
For others, they will not.
When doctors consider ECT
Doctors say ECT is generally not considered until medications and therapy don't work, mostly because of the threat of side effects and the misconceptions about treatment.
ECT was once called electroshock therapy. It is still being done today, but it’s very different from what it was like decades ago.
"It was done very barbarically. Patients had no assistance with anesthesia or muscle relaxants to prevent the actual seizure. The reality is we do not need the actual seizure. We need a reset of the emotional part of the brain. It's like rebooting your computer," said Dr. Lolitta Aznaurova with Shawnee Mission Health.
Dr. Aznaurova has had more than 20 years of ECT experience.
"I want to emphasize one thing. ECT is the safest treatment we have with this - medication and therapy included. ECT is the safest treatment," said Dr. Aznaurova.
According to Dr. Aznaurova, ECT patients could be in our neighborhoods or at work and we might not ever know.
"Depression, bipolar disorder, psychotic illnesses, these are all organic illnesses. They don't spare anybody. We have patients who are very highly educated. We have patients who are very poorly educated. We have patients who have supportive families and some with no families. It doesn't matter," she said.
Women make up the biggest group receiving ECT, but doctors say that's because more women suffer from depression.
Dr. Sherman Cole at Research Psychiatric Center said it's not just women, but moms.
"I'll give you one example. We have known a young lady who has children. One of the things she said is she lost the ability to emotionally connect with her children. Very upsetting for her, and very upsetting for her husband. Very upsetting for her family. She had multiple trials and different medications and she did not respond to medication. She works in a professional health care setting and was not able to work. So she heard about ECT and thought of us. We evaluated her and started a course of ECT," recalled Dr. Cole.
For her, it worked.
"She can again emotionally connect with her kids," said Dr. Cole.
And it's working for a number of patients.
"ECT recovery rates are generally 70, 80, 90 percent, depending...," said Dr. Cole.
Dr. Cole said the types of people he's seen include housewives, stay-at-home moms, engineers, and attorneys.
"Including some politicians," said Dr. Cole, pointing out many people struggle with severe depression and anxiety and you would never know, including if they've had ECT.
There are known side effects.
Doctors say when the patient first wakes up, he or she can experience confusion, headache, stomachache, muscle stiffness, increased heart rate, and fatigue.
Short-term memory loss is common. Doctors say it usually is for events right before and after treatment, and that many memories come back over time. Some patients describe more pronounced memory loss.
Doctors monitor heart rate during the procedure and are prepared with medication should the heart be affected by the electroconvulsive therapy.
No one can say for sure how any one person will respond. Many patients say this is what makes ECT so scary.
ECT in Kansas City
There are two more prominent programs in the Kansas City area for ECT treatments. Research Psychiatric Center on the campus of Research Medical Center and Shawnee Mission Health both offer treatments.
Both hospitals provided us with recent ECT treatment numbers.
Shawnee Mission Health
2016 - 1,732 treatments
2015 - 1,833 treatments
Shawnee Mission Health does not have a dedicated space for ECT treatments, but schedules them around other surgeries when rooms are available.
Research Psychiatric Center
2016 - 1,417 treatments
2015 - 1,443 treatments
Research has a department dedicated to ECT treatments and a room specifically for ECT.
Everyone involved with ECT, whether they're patients or doctors, will tell you there is one thing standing in the way of people who could benefit from ECT. The movies.
Specifically, scenes like the one so many remember from "One Flew Over the Cuckoo's Nest."
ECT treatments today
Research Psychiatric Center, along with a willing patient, allowed 41 Action News inside the ECT department to record a treatment to show what ECT is like today.
Start to finish, an electroconvulsive therapy treatment lasts about 10 to 15 minutes.
A patient is hooked up to monitors to watch their heart and brain activity.
An IV is started.
The patient is given anesthesia so they are asleep for the procedure.
Once asleep, a blood pressure cuff is put on an ankle to keep the next drug from affecting the foot.
A muscle relaxant is given. The body tenses briefly then fully relaxes.
The patient is now asleep and will not move during the treatment, except for the foot.
After waiting a few minutes for all medications to take full affect, the doctor picks up the two electrodes and moves closer to the patient.
The doctor places the electrodes on the patient's temple or temples, depending on the kind of ECT treatment they are receiving.
When the doctor is ready to administer the electricity, there are three warning beeps.
Then a longer tone - no more than 8 seconds - which means the stimulus is being administered. The stimulus is the electricity.
The patient's face tightens during the stimulus - eyes squeeze shut. After the stimulus shuts off, the face again relaxes.
A few moments later, the foot starts to twitch, indicating the seizure is happening.
The ECT machine is monitoring brain activity and spitting out a long strip of paper showing the activity.
The seizure is happening. However, the only visual indication is the twitching foot.
Eighty-one seconds since the button was pushed to administer the stimulus, the seizure is over.
The patient will slowly start to wake up, and they will not remember the procedure.
For most patients, six to 12 procedures is considered a round of ECT treatment.
For more information contact:
816-235-8138
913-789-3218
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Christa Dubill can be reached at Christa.Dubill@kshb.com.
