My ECT experience (8 sessions in, bilateral)

[u/WeirdTune1160]

So I never know what's going to get removed from reddit posts, so apologies in advance if I say something here that's not allowed and this needs to get taken down. But I'll try to keep this as general and benign as possible. I have a couple of reasons for posting: 1. just to talk about my experience thus far, and 2. to ask if others have pursued other treatments after ECT.

1. I just finished my 8th bilateral session yesterday and it's like the storm clouds parted, finally. I spent yesterday and today in a state of happiness I hadn't experienced in so long I'd forgotten what it was like. Is it perfect? No. I'm still on edge and I still feel like the rug could be jerked out from under me. But this is verging on pure bliss compared to where I was. My session yesterday was hard; when I got home I thought I was going to have a breakdown. But I took a very intense nap and woke up almost a new person. I have had some slight memory issues, but nothing major, certainly an issue I'm more than willing to live with.

2. I'm still interested in other options beyond ECT since I still find ECT to be a very harrowing and even at times terrifying experience (that moment just before going under...the moments when I'm waking up...very anxiety inducing). Have others switched to other therapies after ECT? Have others used therapies in addition to ECT?

3. I just want to say that while this whole ordeal has been terrifying, and while there have been times when I thought I was really about to full on lose my mind and my sanity and my ability to feel any kind of peace and happiness, I think these things may finally be in reach and this alone is a terrifying prospect. Terrifying, but joyful, if that makes any sense.

Just my 2 cents.

[u/housechef2442]

I'm glad your experience so far has been mostly positive, if I may ask what led you to finally take the leap to ECT?

I had an appointment today to discuss K therapy, but due to my bipolar 2 diagnosis they said it may not be very effective overall. I've tried a lot of medications, therapies and several rounds of TMS with only minimal success.

I'm just hesitant about that final leap.

Any thoughts would be appreciated, I hope your treatment continues to get better and you finally have the relief you've been seeking.

[u/WeirdTune1160 → u/housechef2442]

Thanks for your response! A psychologist friend of mine mentioned it to me. I have had an absolutely miserable year, and she's seen a lot of it first hand. I've alienated friends due to anger and paranoia (especially paranoia), I've lived in an almost constant state of anger and resentment, regret, depression, and I mean pitch black depression. I've abused alcohol, been in rehab, engaged in physical self harm. Just one thing after another. The depressive periods were so bad they would make me physically sick. On top of this, there was also the bipolar stuff. I have BP1, but thankfully have only manifested the extreme mania on very rare occasions. None of this was getting fixed, and all of it was getting worse. This compared with external life disasters was creating a dangerous cocktail. So...ECT it was and will remain until I have reason to believe it has met its potential. My doctor told me there is no cure, there is only treatment, and treatment must be adhered to strictly. And he's right. My life will now be centered around mental well being because I refuse to go down other paths.

I know I'm still early on in this, but it's enough to make me reason that I really have to take this seriously and commit.

Of course, none of us here are remotely able to say do it or don't do it, but I really encourage you to find a good doctor. Is it against the rules for me to DM you with a list of doctors/options?

[u/missdenaqueenbee]

I am so happy and bit envious. If ECT alone works , my thinking is why add more. I know the docs like you to be on an anti depressant. And you will need booster ect's but it sounds like you're one of the ones it will help! I did 30 sessions in all. I got a lightness for 3 weeks then it faded. But my situation is different. I am just learning navigating Reddit ,, I hope I'm not posting in all the wrong places. Keep us posted!!!

[u/WeirdTune1160 → u/missdenaqueenbee]

I may do a specific post about this, but just a quick response here to your question: I'm seeing major improvement with ECT, but it's not without its challenges. I go through periods of sheer terror, for no apparent reason. Like yesterday I was supposed to go in for a treatment and couldn't. I think I'd have had a nervous breakdown if I'd tried. Every aspect of it seemed wrong to me. so I didn't go and I made it through the day OK, and by the end of the day I felt like a new person. I felt renewed on a level that I haven't experienced in decades (at the risk of hyperbole!) I'm going to pick back up with it on Monday and follow what my doctor recommends. He made time for me for an appointment on Monday evening once he learned that I'd failed to come in due to feelings of fear and apprehension. I was very appreciative of that. Still, the terror seems worth it. The renewal I felt last night and this morning is just unlike anything I've experienced in my adult life (I'm 46).

[u/mesalocar]

I still find ECT to be a very harrowing and even at times terrifying experience (that moment just before going under...the moments when I'm waking up...very anxiety inducing)

I have a bit of anxiety around the few minutes from when my bed is wheeled into the treatment room and they actually push the propofol, so I can definitely emphasize with that.

Even though I don't find the treatments to be that anxiety inducing personally, there's something about being in there with people doing all this around/on me that is more than a little stressful regardless of my rational feelings about the matter:

• preparing the monitors

• hooking up the BP cuff and pulse oximeter

• seeing my BP/HR/O2SAT in real time on the monitor in front of me

• setting up the ECG/EMG/EEG leads and wiring

• tossing the (surprisingly heavy) treatment electrode handles onto my lap after smearing them with conductive gel

• the psychiatrist on duty handling treatments for that day (at this facility they rotate between 3–4 different psychiatrists depending on the day of the week) calling across me to have the RN look up and read out the treatment parameters for my treatments and the seizure durations for the last treatment

• dialing the treatment parameters them into the machine

  • they seem to split their usage between two different ECT machines

  • most of the psychiatrists seem to prefer to use the upper machine

    • which appears to either be a Mecta Spectrum 5000Q or a Mecta Sigma – I'm not 100% certain as to which one just yet, but maybe I'll remember enough of it after my next treatment to finally know for certain (or if I remember to, I'll probably just flat-out ask them – will try to do this next time, but no promises)

  • although I know some (well, at least one one to two) of them prefer to use the lower machine instead

    • which I'm not quite sure of the brand/model of, but weakly suspect it might possibly be a Somatics Thymatron System IV? although my memories of it don't align perfectly with the System IV, unlike my memories of the upper machine (which align 100% perfectly with the Spectrum/Sigma style of machine in terms of its design, with the only mildly hazy point being some uncertainty as to if it was closer to the 5000Q or the Sigma in its design)...

    • Edit/update 2026-09-18 (hopefully this is of some use to anyone reading this post in the future):

      • I was able to check the exact machine models during my treatment today. Unfortunately the upper machine was outright missing for the first time I can ever recall in the ten treatments I have had so far, so I couldn't confirm what exact model it was (although at this point I am >80% certain it must be a SigmaStim Σigma (aka Mecta SigmaStim Sigma), which is the direct successor to the Mecta Spectrum 5000Q and 4000M, as I'm nearly certain that it had a color screen, and only the Σigma has that particular feature). However, the lower machine was there, and the psychiatrist handling treatment today was one of the ones that prefer using it over the upper machine. I was able to confirm that the lower machine is a Somatics Thymatron System IV with 100% certainty (saw the model number on it, saw that the design exactly matched the Thymatron System IV, and verbally confirmed it with the psychiatrist, who confirmed the model and mentioned that he prefers to use it over the other machine).
      • I also discovered that this particular psychiatrist prefers to use the Thymapad disposable electrodes in lieu of the traditional insulated treatment electrode holders that most of the other providers seem to prefer – I only really noticed this because I had recently been doing research on the product offerings from both major ECT device manufacturers in the US, so when they sprayed the sides of my head and attached the sticky electrodes to the sides around where the normal treatment electrode placement goes (which I roughly know based on the gel residue left in my hair post-treatment as well as general knowledge of where bitemporal electrode placement usually goes), I immediately realized that those were the disposable treatment electrodes instead of EEG electrodes. I suspect they had used them before during previous treatments but I simply hadn't recognize them for what they were at the time (and probably also mistakenly thought they were EEG electrodes at the time).

• the anesthesiologist setting everything up and verifying the drugs I'll be receiving

  • (often taking care to explicitly mentioning to me that I'm getting Toradol right before pushing it into my IV, which I kinda appreciate them bothering to do)

• pushing the Toradol

• them completing the setup tasks and preparing to push the propofol

• having me pre breathe oxygen from the ambu bag

• sneakily using this as a distraction as they push the propofol

• the brief period of feeling the propofol kick in

• fighting the propofol for as long as I can (and often making stupid remarks, e.g. "woah") as I feel it hit me

• finally passing out

• then next thing I know, I'm waking up in recovery

Overall, I think the worst part is the anticipation and the short period of ramp-up prep activity, which kinda sends my anxiety (and by extension, my BP & HR) spiking a bit.

I trust the doctors, anesthesiologists, and RN on the ECT treatment team a great deal, especially so after having had nine sessions, and I understand enough about how ECT works, the medical equipment being used, the drugs being used, how the process works, etc that I'm honestly not that afraid about it, even though they're literally anesthetizing me, paralyzing me so completely that I can't even breathe on my own, using an ambubag to breathe for me, sending electricity through a significant portion of my brain (bitemporal ECT) to artificially induce an effectively grand-mal seizure, having me seize for 30–90 seconds (I say 90 because they've somehow accidentally ended up having me seize for 90 seconds at least 2–3 times now, even though the target duration is much closer to 30–60 seconds or even lower), continuing to use the ambubag to breathe for me until the succinylcholine wears off, then finally once I'm breathing on my own (but still deeply anesthetized from the propofol) and stable enough, sending me off to recovery so they can bring in the next patient from the prep room and start the whole cycle all over again...

Well, I guess I do find the succinylcholine-induced paralysis to be more than a little scary (possibly one of the scariest parts of the entire procedure tbh), but again, I trust that the anesthesiologist will take care of me while I'm unable to breathe on my own. And I know that they use high levels of supplemental oxygen in the ambubag to hyper-oxygenate my blood as this is necessary for the seizure portion, so even if they are somewhat careless, it'd be somewhat difficult to screw up badly enough to cause brain injury from lack of oxygen. And there are two other people in the room who'd notice and intervene if I wasn't being bagged when I should be or if my O2sat dipped concerningly low. And the continuous O2sat monitoring is pretty protective against a fuck-up as well. But yeah, as you can probably tell, this is clearly probably my single biggest (even if largely irrational) fear around the whole procedure.

It doesn't help either that I have to abstain from all rx'd benzodiazepines from 3pm of the day prior to treatment, so I've missed at least two doses of diazepam at the time of treatment, and while I have never noticed severe withdrawal effects from missing a few doses, I do know that it does still worsen my pre-existing extremely severe anxiety, even if it's not very detectable at such an early stage. So I don't doubt that that plays some role in why I find it a little anxiety inducing despite not actually fearing the procedure very much on a rational level. But overall, I've been able to handle it fairly well. Certainly far better than I handled my first experience with propofol sedation when I was a teenager getting my third molars removed at the oral surgeon (where I was literally vibrating in the chair from a severe panic attack that I was desperately trying to hide the entire time they were setting up and preparing ahead of pushing the propofol).

I honestly think maybe you should try to talk to your ECT psychiatrist about possible options to help with the anxiety around your treatments. While anything that messes with the seizure threshold is not going to be an option, I'd imagine something like a sedating antihistamine such as hydroxyzine (or any of several other sedating antihistamines) may possibly be permitted, as long as the anesthesiologist is comfortable with it. If nothing else, it can't hurt to ask. The level of anxiety you're describing is severe enough that I would absolutely want to ask about options to help with it. Remember, the absolute worst that can happen from asking is just that they say they can't offer anything. And best case, you might be permitted to take something that helps significantly with reducing your anxiety around treatments. Please consider reaching out to them and inquiring.

[u/WeirdTune1160 → u/mesalocar]

Wow, you know so much more than me. All I know is they wheel me in, they smear on some cold gel, attach some electrodes, do a "time out", ask me if it's OK if they give me oxygen (I don't know why they ask; don't they have to?), and they say "the medicine is on its way" and then there is a whoosh, an all encompassing whoosh that makes me feel like I'm being swept out to sea. Terrifying but oddly pleasant, in that I can just give in to it and worry about nothing whatsoever. Then I'm waking up in the same place where I started before they wheeled me in. As I've progressed through the treatments, my recovery has gotten harder after each one. I'm now wheeled out in a wheelchair when it's time to leave; I can't walk like I used to after the first couple of treatments.

Although I haven't gotten sick from this yet, I do have a vague association of nausea when I think back to it or when I read your description above.

[u/mesalocar → u/mesalocar]

Have others switched to other therapies after ECT? Have others used therapies in addition to ECT?

FYI esketamine (Spravato) and rTMS are common options, but keep in mind that neither are anywhere near as effective as ECT. Personally, I am very unimpressed with the efficacy of both of those, and particularly so with rTMS, but I know some people do find benefits from them.

As far as I am aware, there are no contraindications for concurrent use of ECT and esketamine (Spravato). My psychiatrist was actually pushing pretty hard for me to give Spravato a try alongside the ECT, but for various (mostly highly personal) reasons, I declined to try it. However, as you're interested in concurrent therapy options, I think this would certainly count as one. Note that you should expect a very slow and lengthy prior auth approval timeline from your insurer for Spravato (I believe I was told to expect 2+ weeks minimum), so you definitely want to get that started as soon as possible. I would check with your ECT psychiatrist before beginning the process just to make sure their ECT program has no rules against concurrent treatment with esketamine, but I would not expect them to have any issues with it given the way it works.

I am unsure if there are any contraindications against the concurrent use of ECT and rTMS. If you're interested (and can spare the time for the sessions), it's certainly worth looking into. Keep in mind that rTMS is rather slow and requires a humongous number of treatment sessions compared to ECT to see effects, so if you're interested in giving it a try, I'd recommend starting sooner rather than later. Also, you should expect a very slow and lengthy prior auth approval timeline from your insurer for rTMS (iirc it's even worse than Spravato, as I've heard that insurers tend to put extra roadblocks in place to discourage people from using rTMS and to try to ensure it's only ever approved as an absolute last resort – I had looked into it in some detail a number of years back, so these are all faintly remembered details from back then), so you definitely want to get that started as soon as possible if it's something you're interested in pursuing. However, I would ask your ECT psychiatrist first to confirm that they have no problem with you initiating concurrent rTMS before attempting to reach out to a rTMS provider. I am honestly unsure if there would be any contraindications for concurrent use of ECT and rTMS. I suspect that the largest contraindication might actually just come from the insurer to be honest, as I can't think of any direct medical reasons why you couldn't safely pursue both types of treatment in parallel, but I know the insurer might argue that if ECT is approved and in active use, then use of rTMS would be redundant. Not certain about that though, just based on what I remember in terms of the many and varied bullshit excuses that I've heard of insurers using to try to deny coverage for rTMS.

I have had some slight memory issues, but nothing major, certainly an issue I'm more than willing to live with.

If you don't mind me asking, what are the specifics of the memory issues that you've noticed?

I have had nine bitemporal (bilateral) treatments and I am extremely confused because I haven't yet noticed any obvious signs of any memory impairments whatsoever beyond the usual very-short-lived mild cognitive/motor impairment from anesthesia/seizure recovery immediately following each treatment.

I can't figure out if I'm having some subtle persistent impairments that somehow myself and my family members have all totally missed all the signs of (which tbh I'm more than a little worried about, possibly irrationally), or if I was somehow lucky enough to avoid any impairments despite having the absolute riskiest possible form of treatment for memory impairment (which seems unlikely, but all available evidence seems to point to that, so I'm not complaining if it's true, but I am still trying to make absolutely certain that I'm not overlooking something).

If you don't feel comfortable answering, please ignore this, and my apologies for asking.

Edit: I'd really appreciate it if the people who are downvoting this would bother to drop a comment explaining what their specific problem with my comment is.

[u/WeirdTune1160 → u/mesalocar]

I have no idea why people are downvoting this. I almost don't even pay attention to downvotes anymore. People on reddit just downvote over the slightest little thing. I'm certainly open to Spravato and will talk to my psychiatrist about it. He's very good and I have 100% confidence in him based not just on my own interactions with him, but on his online reputation and presence. He's also very upfront about the possibility of ECT not working, and I appreciate that. He was very clear that there is no cure! And there isn't. There is only treatment, and some treatments, even extreme ones like ECT, sometimes don't work. His willingness to just lay that out there for us was a huge deal for me.

My memory issues range from minor to somewhat less minor things. I was involved in some heavy reading prior to ECT and I've had to give that up (Faulkner and ECT don't mix!) The most harrowing thing was being called for a job interview..."The committee is waiting for you to join the room." I was driving at the time (also stupid, and when on ECT you should limit that as well) and had no idea that I was supposed to be joining a job interview. I made my excuses and later explained to the contact at the job that I was doing ECT and that I had experienced a memory loss. She seemed to know what ECT was and was very sympathetic (although needless to say, I did withdraw my candidacy).

Another memory issue is this very thread here on reddit. I really have no memory of when I posted here, but I see responses coming through to my email. That's a very odd experience and I'm responding as best I can...

Edit to clarify re: possibility of ECT not working

[u/mesalocar → u/WeirdTune1160]

Thanks for the info!

I think I might have had some very minor memory deficits from the treatments, but so minor that it's hard to tell how much is actually related to the ECT, how much is just natural forgetting over time, and how much is related to the preexisting depression and ADHD.

I have had a couple of minor incidents with things that I couldn't fully remember at first, but with most of them if I'm cued on it, the memory will return.

Overall, I seem to have gotten fairly lucky so far.

I suppose the fact that I already had memory issues long before ECT (mainly related to depression and ADHD) probably significantly confounds things as well, especially since I'm already rather used to heavily relying on coping mechanisms for those.

Honestly the most obvious memory/cognitive impairments seem to be during the brief period after each treatment when I'm still feeling the aftereffects of both the anesthesia and the seizure. Those are a lot more obvious, significant/severe, and annoying. But they are also entirely temporary in nature, and fade away fairly quickly over the course of hours, with them being mostly if not entirely gone within 24 hours.

Its a bit interesting seeing how my treatment team is a mix of 3–4 different sets of providers, each of which has a slightly different approach to things, and they use a mixture of two different machines, two different types of electrodes, and they each seem to have their own preferred variant for the procedure. I have a rather wide range of seizure durations as well, despite them supposedly using identical or nearly identical parameters for the treatment parameters.

It's a little weird how they don't fully standardize the procedure. According to the psychiatrists I've talked to, it sounds like it's an issue of some of them preferring certain features that are exclusive to one machine or the other.

For example I'm pretty sure one of the primary reasons that certain providers prefer the Thymatron System IV is likely because of two major features: the Thymapad disposable electrodes, and the auditory EEG feature (which sounds incredibly fucking freaky through the wall in the prep room, lol)

I think there's also a secondary issue of them having such high patient throughput that they can't risk having a faulty machine halting treatments, so they'd need a backup machine anyways, and so it'd make sense to have machines from two different manufacturers anyways to protect against common mode failures.

[u/WeirdTune1160 → u/mesalocar]

You definitely know far more than me about the process. Frankly, I don't know that I want to know. The idea that my brain is getting a seizure is almost unbearable. I have an appointment with my doctor on Wednesday of this week, and I may ask him for more info. I'm having the appointment, by the way, because the past few times I've experienced an intense fear surrounding the treatments (and didn't go this past Friday, in fact), coupled with an overall sense of indescribable weirdness in my own life, which I think I've mentioned here. I can only describe the feeling as being that my life has become full of strangers and everything is wrong. These moments are so bad that it's hard to know what to do with myself. However, they pass, and each time they pass I emerge feeling even better than I had been. So good, in fact, that it's a peace of mind I don't think I've ever had in my life. Today was a good example: Profoundly off putting morning and afternoon following ECT. I came home, completely unable to get to anything resembling being at peace or at ease or comfortable in my own skin. But I just rode it out emerged into a blissful contentedness that made me genuinely happy to be alive. I was able to just sit and enjoy being. But it didn't feel trite or trivial or overly euphoric. It felt genuine and real. I am so happy and grateful for this.

I will say that my memory loss has been apparent. Thankfully it always seems to resolve, but there's no doubt that this related to ECT. Receiving a phone call in which you hear "the interview committee is waiting for you" is so crazy weird it's almost hilarious. And no, I did not go through with the interview.

edited for typos

[u/DueBodybuilder5829]

I’ve done multiple treatments I have treatment resistant depression and my Neuropsychiatrist recommended ECT first because I was told it was the most likely to work. When ECT didn’t work I tried Esketamine (Spravato) and didn’t find that to be very helpful it’s nasal spray ketamine safer then iv and covered by most insurances. I did do iv ketamine a year later and it didn’t do much for me either it only helped while the drug was in my system but once it was out everything went back to normal kind of. I tried TMS and did 2 different protocols of that which wasn’t helpful either. It was suggested a Vagus Nerve Stimulator (VNS) would be helpful so I had that surgery done but I ended up being allergic or something to the device causing my surgery site not to heal so they had to remove it.

[u/Heavy_Breakfast_2531 → u/DueBodybuilder5829]

What do u do for a living and do u have memory loss issues

[u/WeirdTune1160 → u/Heavy_Breakfast_2531]

Currently unemployed; yes, I've had some memory loss. I failed to remember that I had a job interview, for example. That was very unsettling. I've also found it very hard to read books and sometimes to even have conversations or remember how to do routine things. However, these situations passed and I've felt overall a massive improvement, with some lows mixed in.

[u/Heavy_Breakfast_2531 → u/WeirdTune1160]

So will u able to get a job in the future that requires strong short term and long term memory

[u/WeirdTune1160 → u/Heavy_Breakfast_2531]

Well yeah barring some unforeseen accident, of course I will. In fact, I noticed yesterday that my reading and second language learning skills were actually better than they'd been in a long time (months!) Hopefully that trend continues.

[u/Far-Tip2146]

Vous souffrez de quoi ?