ECT etc

Friday afternoon I finished week one of a projected 4–5 weeks (to start) of ECT. It’s taken a long time to get to this point. Thirty-five years fighting chronic depression that’s eaten away at, and routinely threatened, my life. A parade of therapies and medications, therapists and psychiatrists, emergency rooms and hospital wards. One slippery
diagnosis after another to explain why my desire for self-erasure—a desire that seems exceedingly logical and warranted to me—is a mistake, a misperception, an illusion.

Although some people see a change in the first few sessions, my doctor advised me that it’s more usual for effects to become clear by the end of the second week and that not only will the duration and strength of the electrical current used be modified, but we can also consider using bilateral placement of the electrodes (so far they are using right unilateral placement).

The procedure itself is straightforward and I am under general anesthesia during the actual stimulation of the convulsions. The commute from Tacoma to Ballard, without coffee due to not being able to eat or drink, is more trying than the actual event…and I’m not even driving (not allowed to)!

So far the memory loss has been minor and (as far as I can tell, and setting aside the existential questions of time and memory and how I would even know) all involved formation of short term memory after the procedure is over, such as forgetting that we’d had food and coffee after, or doing things around the house that afternoon and not remembering.

More troublesome is handling my own expectations. ECT treatment feels like the end of the road, treatment-wise. It’s the gold-standard for treatment-resistant depression, one of the reasons I opted for it over the less involved TMS and the less effective (and under researched) Ketamine options.

But that leads to the question: what if it doesn’t work? I just don’t know if I have the wherewithal and the energy to keep experimenting on myself.

And then there’s the question: how will I even know if it works? It could be that whatever I am, this is it. Or it could be that I’ve never actually experienced not being depressed. Or maybe I’m just a weak, slothful, “normal” person just as I’ve been and…this is it.

And the final, related query: what if whatever is revealed by the clouds parting isn’t a happy, verdant green dale but what I’ve suspected all along, a sere place of blackened, withered stalks?