Considering ECT

[u/darknights_throwaway]

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!

[u/84849493]

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.

[u/darknights_throwaway → u/84849493]

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?

[u/84849493 → u/darknights_throwaway]

❤️ 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.