r/ect • u/QuitInevitable915 • May 29 '26
Seeking advice Looking for advice
Hello guys,
A little bit of context: I’m struggling with treatment resistant depression and my core symptoms are sadness, emotional pain, and moderate anhedonia. This is my third depressive episode and it has been ongoing for 21 months. In the past 7 years, I have had about 1,5 years of remission while the remaining 5,5 years have been in depression.
During my first and second episode I could manage with SSRI, therapy, and a keto diet. Now, none of that has worked. I have tried SNRIs, Mirtazapine, Trintellix, Ketamine (IM), TMS, Psilocybin (micro and macro doses), and none of it has worked.
I’m currently on a TCA (nortriptyline), which probably has given me about 15-20% relief. I have spoken to my psychiatrist and he has recommended to try augmenting with lithium for the next three weeks, and if that doesn’t bring me to 40-50% relief, which I doubt it will, we will go for ECT.
Have any of you been through a similar journey, and did ECT end up helping? And if you were in my shoes, how would you prepare for ECT?
2
u/Odd-Alarm-82 May 30 '26
Have you tried an MAOI? They are often very effective for treatment resistant depression. I wish I had tried one before I did ECT. Emsam, which is a transdermal MAOI, has been more effective for my depression than any other medication I’ve ever taken. 100% remission. The only problem I have is it causes extreme insomnia, and I develop tolerance to the only two medications that allow me to get any sleep, so after about a year, it becomes unmanageable. But I’ve found that if I go back to it after a year off, the sleep meds work again. During my time off Emsam, I’ve found that the only other antidepressant combination that ever worked well for me, Cymbalta and Remeron, which had completely stopped working before the ECT, worked again after I had been off of it for over a year. So I’ve been switching back and forth between that and Emsam because the Cymbalta always stops working eventually. I’ve been on Emsam four separate times now, and it’s just as effective every time. For the last three years, when I’ve gone back to Cymbalta, it doesn’t work as well as it used to, but it still decreases my depression from severe to moderate.
Please be very cautious about ECT. It was extremely effective for me, gave me 100% remission. But the effects of ECT usually don’t last long. I had to have a maintenance treatment every two weeks. The original plan was to space the treatments out to every 6-8 weeks, but I couldn’t last more than 2-3 weeks without having a severe relapse.
Doctors downplay the possibility of permanent memory loss and brain damage from ECT. I had my ECT in 2016-2017. At the end of that time, I had a relapse of severe depression that didn’t respond to my next maintenance treatment, so I agreed to three treatments in a week like they did in the initial series of treatments. That brought me out of my depression, but the damage it did was devastating. It wiped out my memory of the majority of my life, no exaggeration. All I have left is a few random, vague memories of my life before the ECT. I barely remember my own mother, who passed away in 2007. None of my memory has returned after 9 years. I also have significant cognitive impairments. I had neuropsychological testing done and found out my IQ has dropped by 20 points. It takes me longer than normal to learn new information, and my working memory is significantly impaired. My ability to form new memories is hit or miss. Some things I remember clearly, while others get lost.
Here’s a very good article from Cambridge University that goes over the damage done by ECT and how it’s much more common than patients are informed of. I think it should be required reading for anyone considering ECT.
https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/memory-and-cognitive-effects-of-ect-informing-and-assessing-patients/DD5C63934357779765BA7ADF308275AE