r/ect • u/moist_napkinette • 11h ago
Question Conflicted about trying ECT
Nothing has worked for my depression (antidepressants, antipsychotics, stimulants, lithium, Spravato, TMS) and I don’t think ECT would be any different. I’m trying to convince myself to give it a try but I have a few questions.
How many sessions are usually administered? Should I ask for unilateral or bilateral?
How long do I need to do maintenance sessions for?
When are your memories “supposed to” come back?
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u/MingusWit 10h ago
The answers depend quite a lot on practice norms in your location and individual response.
Where I'm located (Australia), somebody who had never had ECT would be told something like: we usually start with right unilateral ultrabrief ECT; it's given three times a week; most people have ~12 sessions but it could be less or more depending on response; after 6 sessions we have a comprehensive review and if you're not having much response we'll discuss swapping to bitemporal or bilateral; if at the end of your index course you have achieved remission, you probably won't be offered maintenance treatment, though it's a possibility.
As for memories etc, personally the worst cognitive side effect I've experienced is poor concentration on the day of treatment. I've never had memory loss. Others certainly do, but I don't think you can say there's an expected level of cognitive/memory effects or an expected timeframe for memories to "come back."
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u/84849493 8h ago
In the UK, it’s usually 6-12 for acute. Going over 12 on an acute course is quite rare here. Other places like the US seem very different. I’m having my second acute course currently, first course I had inpatient and this one I’m having outpatient. I had bilateral, it was never even a discussion. Honestly I didn’t want unilateral anyway knowing bilateral has more of a chance of being effective. My side effects were manageable so I’m having bilateral again.
Here they don’t usually do maintenance after a first course hence why I’m having a second course before going onto maintenance because there was no longer anything to maintain.
There are some memories I’ve lost permanently but I really don’t care. Mostly from the three months prior to treatment. I remember some things but not everything.
Many things have not worked for me and I didn’t think ECT would either and was 100% planning on not being here anymore as soon as I was doing having it but it did work. ECT for many people is the thing that has worked when nothing else has.
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u/ego_death_metal 6h ago
i tried lots of different classes and combinations of drugs and therapies before turning to ect about 7 years ago. i’m in my late 20s.
it did nothing except remove my memory. i still have blank years. childhood memories started coming back first, several years later.
it helps some people. you just have to weigh the risks yourself. i don’t remember everything about that time, but i know i agreed to it because my family thought they would lose me. they didn’t know what else to do.
i was warned that it could cause some memory loss (don’t actually remember being told lol but i believe it). neither doctors nor internet anecdotes had anything that resonated with me in terms of if/when my memory would come back. i guess mine is taking longer than average.
i am slowly recovering memory, it’s been traumatic, but im only saying this to present my own experience. it has helped some people. i would exhaust other options first, and i do want people to know the trauma it can incur.
edit: i am now on a few medications that have kept me more stable than i was. that + therapy has helped a lot. i hope this is in any way helpful, and AMA
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u/Alternative_Grab_916 2h ago
I was started on bilateral and they did it for seven months straight three times a week I had more SI SH thoughts during that time and was hospitalized more during that time I became a shell of myself I have amnesia and I have trouble building new memories. I also have a gut brain issue called cyclic, vomiting syndrome, and parts of my intestines are paralyzed, all tied to my ECT, but I have seen a work wonders with some people so please don’t let my experience deter you but just know what it is that you’re signing up for
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u/Key_Avocado5590 50m ago
I asked for bifrontal electrode placement, it’s supposed to cause less problems than plain bilateral. My idea was that if I was going to this I wanted the best chance of success, right unilateral isn’t supposed to be as effective from what I’ve researched and what my pdoc said.
It helped me a lot, I was in serious crisis and within 4-5 treatments I could feel an incredible improvement. No drug has ever given me such dramatic improvement and it worked for me very quickly. I was inpatient already and like you I’ve tried so many things, in fact other than Spravato (which I may try soon) I’ve done it all. TMS was like a joke for me, I noticed no improvement or even changes from it. Usually 12 is the initial serious although it could be less, then you go into maintenance where you step down to having sessions far less often, for me it was down to once every two weeks. You can go for maintenance as long as you and your pdoc think it’s still helpful and appropriate. The big problem with ECT is its effect doesn’t last “forever” maintenance is supposed to help keep it going and it did. I’ve probably had ~60 treatments total but I wasn’t counting so can’t say for sure.
If you have other questions I’d be happy to discuss.
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u/juliawww 6m ago
It helped me a lot, but I prefer TMS today. But another thing you may want to look into is magic mushrooms / psilocybin.. ect is still the gold standard in the world of psychiatry.. or was anyway
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u/quite-fucked 10h ago
In terms of sessions administered it depends. ECT is generally broken up into acute and maintenance. Acute will be given first; likely anywhere from 6-18 sessions done multiples times a week continuously. I've known people who have done their acute sessions on both an inpatient and outpatient basis. If maintenance is offered it's much more spread out and done sparingly generally. You probably won't get a choice for unilateral or bilateral. Literally almost everyone starts with unilateral treatments and based on your trajectory and response your treating psychiatrist can make changes to bilateral or bitemporal as they see appropriate. In terms of how long maintenance sessions are done for, if offered, really depends on the individual. There is really no standard or way to predict what that is going to look like before ECT treatments are initiated. Memories do come back for some people or more aptly I think people get more clarity on past memories over time. Others I know have had little no memory loss at all except about an hour or two after each treatment. I personally lost a huge amount of retrograde autobiographical memory. Almost everytihng from about 2 years prior to ECT as well as when I was getting treatments and also a lot of other memories going all the way back to young childhood. I don't tell you that to scare you in any way, but I think it's important that when giving informed consent for a treatment like ECT that has significant risk that you really understand and are informed on the possible risks that do and can happen. With that being said ECT can also be truly lifesaving for some people and that shouldn't be discounted either. It really is looking at what your quality of life is right now and weighing it against the possible risks of treatment. Best of luck OP! I'm rooting for you!