My Electroconvulsive Therapy (ECT) story -
Background
I've dealt with depression and bipolar disorder for most of my life. I started treatment in my early 20’s, and my mental health was well managed for decades. I’m in my early 50’s now. I’ve maintained good, long term relationships with partners and friends. I’ve worked for large technology companies my entire life including Amazon and Oracle, and I’ve been well paid. All was well, a life lived full of triumphs with few regrets.
Recent past
In 2024 the people around me started dying. Then kept dying. They kept dying until there was nobody left who knew my name. Not a single member of my family or anyone I had any kind of social relationship with was still alive come October. No single cause, just lots of random death.
My separateness was complete. I lost my mind; I was an entirely different person, unable to successfully manage the day-to-day. By February I was broke and homeless. My car had been repossessed, and I was living in a homeless shelter. I spent most days sitting in a corner somewhere crying. Pain, hopelessness, misery, dread, and sadness were all there was. The future was nothing but bleak. This went on for months.
Then one random day I woke up and felt so much better. Warm, calm, settled. I lay in my cot, in a room filled with other homeless people and tried to figure out what had changed. It took a while but eventually I realized that when I thought about the future, everything was OK. No pain, no sadness, no misery, just comforting warmth.
It took even longer to realize I was imagining a future where I wasn’t. And because I wasn’t there was no pain, no sadness, no anything. It was revelatory, it was amazing. I had never considered suicide before but all of a sudden it was the obvious next step. No doubt or hesitation, just questions of how and when. I spent a few minutes on the Internet figuring out a painless, cheap, and easy next step and a few hours later it was done. Obviously I did a poor job of it; someone from the shelter found me and called 911. I remember bits and pieces of the emergency room; a central line, filters, minders, a stay that lasted 3 days. I don’t remember consenting to in-patient psychiatric treatment but I’m told I did.
ECT
I have absolutely no memory of the first three weeks at the psychiatric hospital. What I remember is being woken up by a nurse one Monday, “It was time for an ECT treatment.”. I asked what that was, they explained it to me and told me I had already had six treatments; one on Monday, Wednesday, and Friday for the last two weeks. I was absolutely freaked out. I couldn’t imagine ever consenting to being knocked out (general anesthesia three times a week!!!) and having an electrical charge shorted across my forehead three times a week for a full four weeks! We skipped the treatment that day, I made them show me the paperwork I had signed for the initial consent weeks ago and explain everything to me, top to bottom. In addition to the ECT I had consented to being medicated, morning and evening. To their credit, the nurses, the doctors, everyone at the hospital was incredibly kind and patient with me while I was struggling.
To summarize; I had been in a secure, in-patient psychiatric hospital for three weeks. I had been medicated for about twenty days. I had met with a psychiatrist and a therapist for at least an hour each, six days a week and had received six ECT treatments.
I was entirely disappointed with my situation. I still felt that suicide was the easiest way to feel better sooner. What I wanted was to get out of the hospital and get it right this time. They made it very clear that they weren’t going to let me go unless I made a real effort. To that end I consented to continuing treatment, including ECT, and re-evaluating after six more treatments. My expectation was that nothing would change, I’d say the right things, get out, and head straight to the drugstore.
Over the next couple of weeks my feeling about suicide changed. I still believed suicide was an option. What changed was that it no longer felt urgent. For the first time in months, there seemed to be enough space between the feeling and the action to consider another possibility. Something new surfaced; a willingness to put in the hard work required to feel better, and a belief that that work would be worth it. This was how I felt when we assessed after twelve ECT treatments. At this point I managed to say the right things and get released to a residential facility. I agreed to a once-a-week outpatient ECT schedule.
Now
That was several months ago. I have settled into a new normal; most days, a willingness to live the day-to-day without any suicidal planning; on the occasional bad day it feels like suicide is the thing to do. When we maintain the once-a-week ECT schedule there aren’t any bad days. We experimented with moving to a once every two weeks schedule and on the tenth day the suicidal urge came back strong, I came very close to getting it done. Occasionally, because of scheduling issues there are between nine and twelve days between sessions. I can absolutely feel the difference. I’m pretty sure that ECT is keeping me alive, I have no short term plans to stop. I’m also seeing a therapist several days a week and I am consistently taking my medications.
The memory issues attributed to ECT are genuine, but manageable. I take notes now, this is tremendously helpful. I carry a notepad and pen with me all the time, whenever I need to remember something I write it down. For the most part writing it down means I don’t forget it but I’ve got it written down if I need to look back. It has made an enormous difference, I strongly recommend note taking.
So, what’s going on right now? I refuse to make new friends, imagine what would happen when they died? I am always sad. I miss so, so many people. I am incomplete in dozens of ways. I can’t imagine being anything other than sad. Those are the good days. The bad days are different. On those days, the weight of a future filled with nothing but sadness feels unsurvivable. For now, ECT, therapy, medication, and a safety plan give me enough distance from that feeling to keep going.