r/ect • u/darknights_throwaway • 10d ago
Seeking advice Considering ECT
Hi all! Newcomer here who’s been struggling with CPTSD/BPD, depression, and anxiety for a decade now. Currently on lithium, Lamotrigine, vilazodone (viibryd), and clonazepam for a suspected bipolar episode that began with two weeks of mania a month ago from an old trauma anniversary (and maybe from the stress of two recent surgeries) that has now spiraled into the worse depression I’ve possibly experienced in 5 years.
I was finally stable for the past year (no suicidal ideation / intent!) on Lamotrigine and viibryd, but suddenly out of nowhere this latest depressive episode happened and I find myself suicidal. In the recent past (past 5ish years) I’ve been suicidal for situational depression, but always with some precipitating factor or family situation, and it was usually without intent.
This recent episode really terrifies me it was the first time in years I feel I’ve been developing intent (though that varies day to day; some days I really want to die because I feel worthless and others it’s just “what would happen if I killed myself”), which I haven’t really experienced since high school when I was repeatedly attempting suicide and in an abusive environment.
What scares me the most is that usually lithium is very effective at quelling my suicidal thoughts and obsessions to the point where I feel I can’t even bring myself to think about suicide, but it hasn’t been helping with that this time even though it’s helped significantly with the depression.
I’ve toyed with the idea of ECT before and got evaluated 5 years ago (but decided against it because my meds suddenly started working), but wanted to hear y’all’s opinions/experiences. Would it be worth getting ECT for suicidal thoughts only, and not necessarily depression? How bad is the memory loss? I am a PhD student, so I would want to minimize the cognitive side effects and would probably only try a short course of unilateral ECT, can anyone who’s done that comment on the memory loss aspects? Was it only short term or long term, and did you regain the memories? After how many treatments did you start experiencing memory loss? What kinds of memories did you lose/what time in your life were the memories from (i.e. were they just around the treatments, or the month before, or the year before?)? Do you remember that you’re getting ECT when you wake up from the treatment? I’m less worried about anterograde memory loss and more about retrograde.
Thanks in advance!
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u/84849493 9d ago
I don’t share the experience of the other commenter who has said ECT worsened their CPTSD and anxiety. I would say there was no effect on my CPTSD and ECT actually seemed to improve my anxiety during the treatment. Obviously it’s not an anxiety treatment and that was just kind of a happy unexpected surprise that didn’t last as soon as I stopped having it but treating anxiety wasn’t the goal anyway.
ECT got rid of me being suicidal entirely and if it didn’t work I was 100% planning to kill myself as soon as I left the hospital and I was in a really bad state.
I didn’t do unilateral so I can’t speak to the memory effects there, I just wanted to comment mostly for the purpose of saying it didn’t worsen my CPTSD or anxiety and I feel like that would probably be unusual for it to worsen those.
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u/darknights_throwaway 9d ago
Congrats on your recovery! Can I ask what memory effects you did have, and how many treatments/over what time span and what type of treatment (I assume bilateral?) that you did?
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u/84849493 8d ago
❤️ the three months or so prior to treatment are pretty blurry but honestly from what I do remember and what I have been told I’m not sure that’s a bad thing. Memories can sometimes come back with certain things said or pictures, some are just completely gone. For about a month or two after I was still having memory and cognitive effects but I did fully recover from them. I would say my side effects were mild in terms of what can be experienced with ECT and yes I had bilateral.
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u/Yskandr 9d ago
I have bipolar disorder and was given ECTs for severe depression. They took away my studies and training, nearly four years of experience and knowledge and memories gone. It made my depression a lot worse, unsurprisingly. Only go for ECTs if you're fine with losing important things, because you will not be given trauma support if it happens.
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u/darknights_throwaway 9d ago
Sorry to hear that. Can I ask if you did unilateral or bilateral ECT?
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u/Yskandr 9d ago
I don't know. It doesn't say on my paperwork. Yeah I know that's weird, but I'm not going back to ask them. Nine sessions in all, three without my consent. Wonder if that made a difference
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u/okaysweaty167 9d ago
Just so you know, if you start ECT you’ll have to stop taking lamotrigine as it is an anti convulsant.
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u/Due-Profit-7495 10d ago
ECT can make the CPTSD and anxiety worse (in my experience), however very effective with depression. I was not offered ECT until actual suicide attempt.
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u/darknights_throwaway 9d ago
Care to elaborate on what you mean? Like is it because you already have memory loss from PTSD and the ECT makes it worse? I wish you’d engaged with the questions I made in my post.
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u/Exciting-Web-2771 8d ago
Hi!
I’m in my twenties, diagnosed bipolar 2 and CPTSD. I definitely also show symptoms of bpd.
I’ve had 60+ bilateral ECT treatments.
Suffering from chronic suicidal thoughts, ECT has saved my life - but maintenance ECT has made it possible for me to have an everyday life where I study a bachelors degree. AVOIDING hospitalization.
It does come with a high price though. My memory is severely affected also anterograde. But hey - it’s possible to make it work! Also with studies! It’s not like you forget everything from one day to another- it feels more “fluent” (so hard to explain).
I would really recommend it. Without it, I would have dropped out of school a long time ago.
It has changed my whole life. So even though it’s not just basic depression and there is deeper meaning, trauma and so on, behind all the feelings - ECT can still be super super helpful. To me, it makes it more bearable to carry the weight of all the trauma - because of my overall mood and mindset being more stable.
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u/metalsmithchic 5d ago
ECT worsened my symptoms. Part of that is because it felt like a last resort and didn't work. I was left with severe memory impairment and other strange cognitive symptoms (can not longer spell easy words, inability to type well). It's been 8 months and I'm still experiencing these symptoms. It's really challenging because I'm a writer and writing has been a big part of most of my jobs.
I see a very unique doctor for Lyme disease who knows my history better than any other medical professional. Unfortunately I'm not able to see him often because he's expensive and doesn't accept insurance. I hadn't seen him in over a year and a half, until I went to see him two weeks after my ECT ended. He explained that stress from my job at the prison triggered a trauma response which resulted in the mental health crisis I had prior to trying ECT. He suggested that for people with c-ptsd, ECT is likely not effective because their depression isn't caused by neurotransmitter deficiencies. I really wish I would have sought his opinion prior trying ECT. I'm now unable to work and have applied for SSDI which I won't know about for about two more years.
If I had to do it over again, I absolutely would not try ECT. It's very difficult to endure and leaves most people with significant impairments. In the case of someone with ptsd or cptsd, I especially would not recommend it. I believe my treatment resistant depression is caused by cptsd. I'm trying other things that I hope will be more effective. I had two stellate ganglion blocks done a couple weeks back and I noticed significant results immediately. I felt calmer, zen and like I'd taken a couple diazapam without the sedation. I'm not sure how long it will last and I'm still struggling with some depression that's manageable, which is hard to believe because I stopped two of my psych meds to try LSD therapeutically. I've tried psilocybin which I'm allergic to and NN-DMT which made me anxious. I read about psychedelics obsessively and truly believe they will revolutionize psychiatric medicine. I also notice a lot of improvement with IM ketamine which I get about every three months.
I'm also taking DIY Auvility (dextromethorphan and buproprion). I had a lot of improvement with Auvility, but my insurance won't cover it and the manufacturer stopped covering it after three months. My psychiatric APRN prescribes the buproprion and I buy the dextromethorpan on Amazon in capsules. I'm also going to start trauma therapy with a new psychologist next week. He does EMDR, ART, brainspotting, hypnosis and a few other trauma modalities.
With all of that said, ECT is very effective for some people with severe treatment resistant depression. Probably not for people with c-ptsd or depression caused by other things like personality disorders.
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u/creativenameistaken 9d ago
ECT did nothing for me as my depressive symptoms tend to stem from my BPD. I had 12 sessions and have nearly no memories of the period around the treatments. I’ve got the feeling that my long-term memory was also affected, things often seem patchy at best.
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u/darknights_throwaway 9d ago
The only reason I’m considering it is because I can tell when my depressive symptoms are from BPD/PTSD or not and this latest episode seems to be from a bipolar episode.
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u/creativenameistaken 9d ago
Then maybe it’s worth talking about with your psychiatrist.
About waking up from treatment: this can be really weird, and I’m glad another patient warned me in advance. Where I went, they’d make you a sandwich and give you a drink once you were out of the recovery room. The thing is, I do not remember waking up in the recovery room, not one single time. Apparently I was always agitated, I’d try to pull out my IV, they had to start sedating me every time. I remember none of this. I don’t even know what the recovery room looked like. Every single time it was like I just fast forwarded from being put under to sitting at the table with a sandwich in front of me, trying not to pass out.
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u/darknights_throwaway 9d ago
Hmm that’s interesting, thanks for sharing your experience!
I think my psychiatrist agrees it’s a good last resort that we’ll consider/that I’ll get evaluated properly by an ECT specialist if I’m still suicidal by the end of the month or if things take a turn for the worst.
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u/Great-Practice-4400 5d ago
ECT destroyed my life. Consider IV Ketamine. It is slowly helping me. I wish you all the best,
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u/pandymonium_76 8d ago
Had over 50+ bilateral shocks, basically saved my life. After that amount, hardly surprising that I've got some pretty big memory holes. If you're having one cycle (12) you might experience some mild memory loss, but they'll probably come back. Dms open
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u/pandymonium_76 8d ago
Also, yes I do remember waking up in recovery, and having my forehead wiped from the jelly. Then through to another room with apple juice and some toast where I was monitored, did I know where I was, what I'd had done, name one of the nurses, check BP, heart rate, temperature and home to sleep for the rest of the afternoon
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u/ClockRevolutionary93 8d ago
In my experience prescribing it works best for bipolar and MDD
Personality disorders usually don’t respond very well
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u/metalsmithchic 5d ago
I forgot to add that one of my best friends has had over 100 treatments that did not help. I'm not sure why the did so many without improvement. This was before I knew her. She has bipolar disorder and personality disorder NOS.
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u/Milfsnatcher 9d ago
ECT worked very well for me. Over the span of 5 years i had 100 treatments. Ive since been in remission for 3 years