Tag Archives: ECT

Personal Progress (well, maybe not exactly) on the ECT Front

After a series of uncomfortable phone calls and leaving voicemails for everyone in Seattle capable of administering ECT, bits of useful information started to trickle in. The information was useful because it let me know that my options are extremely limited (many hospitals here that provide ECT have apparently moved away from treating patients with medicaid) but I was able to set up a consultation with one of the leading psychiatrists at Northwest Hospital’s ECT unit.

While I’ve been interested in ECT for a while now, previously my mood swings were not in a position (predominantly depressive or manic, more ultradian cycling and mixed) to lend themselves to the immediate requirement of electroconvulsive therapy. Having my symptoms take a much more noticeable downward turn into depression lately made this seem like the perfect time to look into it again.

Beyond that, though, I wasn’t sure if I would be a good candidate for ECT right now. After all, I have just undergone some pretty significant physical health problems and two surgeries, one being relatively major. Ultimately, the consultation was to learn if I could even undergo the treatment right now in addition to finding out if it might help me.

I tried my best to explain this to the receptionist who tried to schedule me for ECT the following week before my consultation had even began.

The consultation itself was… uneventful. I’d already gone through one of these before at another hospital, but I wasn’t really expecting this psychiatrist to have a significantly less optimistic view on how ECT would probably go for me. While he said he wouldn’t tell me absolutely not to try it, it seemed unlikely the treatment would help my symptoms (based on the point I have reached trying almost every medication available with no improvement). He said that each medication I have tried and been resistant to has made the next subsequent medication more likely to fail. I don’t know if that is true or not, but that is the word on the street.

He also told me that he would suggest I (here’s the baton) seek treatment through DBT (and the handoff) first before trying ECT. Unfortunately this proves to be a program even more difficult to get into than ECT in Seattle as it requires a lengthy wait on a waitlist (I’ve actually already been on the waitlist for two months before last weeks consultation) or about $5000 and a somewhat shorter wait on a waitlist.

I left the facility feeling surprisingly optimistic despite the news. I guess it was just nice to have someone tell me that even if they don’t know if what they have to offer will help me they could suggest something else. Normally people just tell me I’m screwed and do I “have any questions?”

For a while now I’ve kind of felt like “all roads lead to DBT” -at least, given my symptoms and everyday problems with human interaction, working, mood swings, etc. This time I am hoping that seeking out a case manager might be a better option than trying to do all the footwork myself. People don’t respond well to my… aggressive tone on the phone, and I don’t respond well to dickheads on the phone either.

At any rate, I will be shifting focus to moving toward DBT. The hospital said they would keep my file open and get all the necessary paperwork ready in case I changed my mind about doing ECT in the next month or two if I can’t get in to DBT.

When There’s No Room at the Inn… Chill in the Barn?

Sometimes I imagine the Virgin Mary showing up at the inn, hours before giving birth to Jesus, and the inn keeper simply telling her, “err, well, sorry but we just aren’t a provider in your insurance’s network. Off you go!”

I basically just had the same conversation with one of the only TMS/ECT treatment facilities in Seattle. The woman on the phone was able to make it quite clear that people like me (on Medicaid) were not accepted at their facility. In fact, she wouldn’t even give me a figure of how much the treatment would cost without insurance. I felt like I had been marked in some way, as soon as she knew my socioeconomic status I was officially cut off from the prospect of hope.

This is an example of a relatively common conversation for me, and normally I wouldn’t complain, except that this woman had the audacity to go on and tell me that none of the other facilities I had listed to her would be interested in me either and I should just give up now. I told her that was excellent advice for someone currently going through a severely suicidal period and found myself missing the days of owning a phone I could bang on the receiver to signal my frustration upon hanging up on her.

While I am still making calls to other less convenient facilities (including the one I visited in this post and another that would require inpatient hospitalization during the full course of ECT treatment (yuck)), things are looking pretty grim on my treatment front.

To get you up to speed, my depressive shift after that manic/psychotic period a few weeks ago has gone from a walk down a hill to a rapid luge course at the Olympics. The speed and ferocity at which I am encountering extremely disturbing depressive symptoms is almost kind of impressive to me. Of course, I’d be more impressed if I wasn’t also watching it crack (not just strain) my personal relationships, my ability to communicate with friends and strangers alike, and all sense of self.

Part of me is hoping that the sudden intensity of this shift will also mean a rapid rise out of the pit once things have cooled off, but I already know that my mood-swing-predictor isn’t very accurate and in the situation where that doesn’t happen… this very well may be the biggest depressive punch I will have seen in a couple years.

I have unveiled all arsenal; special happy-feeling foods (donuts, cheese), sleeping when I’d rather not be conscious during the day, cuddling with my dog probably more than is healthy, The Muppets… but the depressive symptoms are progressing so quickly that they are almost near the point where none of my usual helpful coping skills are working.

Needless to say, a very bad time to be going separate ways from my psychiatrist of 5 years and my appointment with my new psychiatrist, although not condescending or bossy, did not go as well as I had hoped. She made it clear she didn’t really want to touch me with a ten foot pole and said that if she can help keep my symptoms from getting worse it was the best I could hope for.

If there was any time that seemed like revisiting the idea of ECT was a good one, this seemed like it was it. Unfortunately, now that I finally feel like I am at a point in my life where I welcome the idea of ECT (my mood swings being in the proper spot to warrant it), I have researched it thoroughly (including doing so while I was more rational and stable-ish) and the verdict in the psychiatry world is that I have pretty much exhausted all typical medication options… I’m having a hard time getting in.

I know that I can ride this the way that I always do. Hold on. Let my sense of self be stripped away completely. Check myself into the ER when things get too sketchy. Get agitated in the hospital enough for me to want to leave. Come home and continue to ride it out. Eventually it will get better. Eventually patch things up with my friends and family who haven’t heard from me in months. Hopefully the people around me can withstand it.

At any rate, if there’s no room for me I’ll just stay in the barn. Maybe if I close my eyes and breathe deeply the sweet smell of the hay will make me forget why I’m there.

Investigating ECT

Yesterday I had a consultation with a local ECT specialist.

ECT (electroconvulsive therapy) is generally considered a last resort treatment for people in severe manic or depressive states whose symptoms have not responded to medication. The procedure works by producing a controlled seizure in an anesthetized patient by means of a low controlled electric current passed through the brain.

I can probably guess what you’re thinking at this point, and yes… it is a serious procedure. Though this form of treatment has undergone significant improvements since its early usage it is still highly stigmatized, even by many of those within the mental health community. At the same time, it is one of the few “proven” (i.e. studied) treatment options for people who experience severe symptoms that do not respond to medications (like mine).

I also feel inclined to note that I have not made any solid decisions regarding this form of treatment yet and I still consider myself to be in the investigative phase.

Thus the consultation.

Frankly, I am not sure why I was so nervous heading into my appointment. I knew I wasn’t headed toward receiving ECT yesterday and I have generally reached the point in my  life where I don’t let doctors boss me around anymore. Still… I guess I was worried that, like most doctors, this one might try to shove his agenda down my throat without letting me make an important decision like this on my own.

Turns out I was completely off base, and the man I met with (a psychiatrist who I believe I may have encountered while hospitalized in 2011, though it is hard to remember) was extremely straightforward with me and seemed genuinely empathetic to my situation. Those two qualities are ones that I look for in particular from my healthcare providers, and after talking with him for 45 minutes to an hour I was convinced that if I were to receive ECT treatment he is someone who would genuinely do his best to help me. That was a breath of fresh air, let me tell you!

He told me the treatments would be 2-3 times a week for 6-12 treatments (depending on how I responded) and though the procedure only takes 20-30 minutes, the anesthesia would require me to spend about three and a half hours at the hospital. He performs the procedure in an outpatient setting, which is what I would prefer. My regular psychiatrist gave me the option of speaking to someone at a hospital much closer to where I live but they would require me to be inpatient during the entire course of the treatment which sounds, frankly, like a huge bummer to me.

I was surprised when he told me flat out;

“There will be nausea. There will be headaches. There will be body aches… but those are all things we can treat when they happen.”

No “might-be”s or “possibility of” side effects talk from him, which I also really appreciated. He has been doing this work for a long time, so he knows the routine and had no need to beat around the bush.

When the topic of memory loss came up, he said, somewhat forlorn, that that is not something that can be treated when it occurs and short term memory loss (being able to remember things from years ago but not what happened twenty minutes go) is pretty prevalent for people who have received ECT, but the memory loss he has seen has improved and dissipated within one month to six weeks after the treatment.

Obviously that is the big-scary when it comes to ECT (for me anyway) but again, I appreciated that he was up front about it.

One thing he told me that I didn’t know about previously was that ECT performed on bipolar patients for a depressive state can (rarely) trigger mania.

He said that for his depressed bipolar patients the procedure had a 70% success rate of reducing depression, however there is also a 40% relapse rate within 2-6 months after the procedure (which may require patients to undergo “maintenance” ECT sessions once a month or every few weeks).

Walking away from the appointment, my biggest concern was that he told me I could not be taking Lithium while having ECT (something I never heard before), and though the 1200 mg of lithium I am on is having no positive effects for me anyway, I am a little nervous about coming off of it because I had a hell of a time reaching my current dosage. With the prevalent side effects I experience, it isn’t uncommon for me to experience side effects when reducing or coming off a medication (in addition to going up or starting one).

After looking into the lithium/ECT issues when I got home it seems that research about mixing the two has not been completely straightforward (some studies have shown it works out fine, others have had big problems) but it appears that if lithium is something that even could cause a problem I certainly wouldn’t want to risk it.

Basically, my goal with this consultation was to speak with an ECT specialist and see if this is something he would recommend for me. Honestly when he heard I had already tried 14 medications with no luck (and some doctors refer for ECT after only 3 medications not working) he told me that while he considers me to be a good candidate for the procedure he wants to give me plenty of time and resources to help me think about it.

I told him flat out that even though I have been experiencing several months of worsening depression at this point, I consider ECT to be something of a last resort. It is important to me to learn what I can about it now, because if my depressive symptoms start getting worse (and trust me, they aren’t particularly hunky-dory now) I know I can enter into a place where I would trade my soul to the devil for one small moment of relief. There are definitely situations I can foresee where ECT will be on the table as an option, but I don’t want to leave that decision to a moment where my only deciding factors are based on desperation and not reason.

His response was not what I expected.

“Well, I really hope your depression lifts before then.”

As it stands now, he is scheduling three weeks out, which is a significantly shorter wait time than I expected honestly. That might increase once winter comes on, but knowing that I have ECT as an option with a relatively short wait time (at least, for mental health services in the Pacific Northwest) gives me a bit of solace.

Of course, I got home and had more questions… but he gave me his phone number and said I can (and should) call and ask him any more questions I can think of.

Despite the terror I felt walking in, I left the appointment feeling slightly optimistic. I am in no rush to make any decisions, and I am proud of myself for exploring this before the depression turns my brain into oatmeal.

Or, at least, overcooked oatmeal.

Feeling Worse Before Feeling Better

During my last two visits with my psychiatrist we concluded to move forward with the idea of pursuing electroconvulsive therapy (ECT) as the next treatment option for my treatment-resistant bipolar symptoms.

While saying, “let’s do it!” has set a series of actions in motion (mostly on his side), I have yet to see any of the fruits of that action. At this point he is trying to get me a consultation with the staff at one of the two hospitals in the area that perform ECT, but the situation is tricky. Of the two hospitals, the closest one severely gives me the creeps, and the other involves a commute through a busy area (and we don’t have a car). Naturally I’m assuming that after urging my brain into a state of convulsion, I probably shouldn’t be riding the bus, so figuring out a system to even get to the hospital for these treatments is another thing to work on.

Having said that, after some research it appears that there will probably be a significant wait time (no surprise there) to even see these leading doctors to have a consultation. I am not expecting any of this to happen any time soon, but I am a little thankful to have some time to allow my head to wrap itself around the idea of taking such a step in such a (scary?) direction. I know my fear probably isn’t overwhelmingly warranted, seeing as I was just as nervous about the idea of taking lithium and now, even after having overdosed on it, I find it no more terrifying (and possibly even less so) than any other drug I’ve tried thus far.

In the meantime my depression is significant. In the month of June I experienced eight days of “stability”, and in July I experienced three. Keep in mind, “stability” is simply a word here that means the majority of the day was spent feeling well, which can mean an entire day -but more often for me means something like experiencing 8 hours of feeling well and 5 hours of total chaos. Even when it doesn’t account for the entire day, a significant mood swing lasting even 1/4 of the day is enough to cause major issues with my plans and ability to get things done.

The most frustrating part of seeing these numbers is knowing that it is summer, and that this is the time of year I typically the best. That means even though I am feeling my “best”, I am still experiencing episodes lasting between 3/4 of the month to the entire month.

For that reason my psychiatrist has opted to allow me to try an antidepressant again while we wait for a word on the ECT situation. Wellbutrin/Bupropion has been the only medication that has ever (presumably) had a positive effect on me, however I took it over ten years ago and the psychiatrist I was seeing was definitely… sub-par. At this point I can’t say if it truly did anything for me, but it appears that in conjunction with whatever else I was taking, it didn’t cause psychotic mania (the way other antidepressants have for me).

In order to even allow me to try wellbutrin/bupropion again, my doctor is requiring me to go up to 50 mg of seroquel/quetiapine. I increased my dosage from 37.5 mg to 50 mg on Sunday night, and the last 52 hours I have been a mess. I’ve had hot flashes and profuse sweating, overwhelming nausea, constant upset stomach and stomach pain, lethargy, lack of appetite, etc. Not a fun time, but this morning I can already tell is a slight leg up after yesterday, so hopefully I can get over this hump soon to test out wellbutrin again.

So there’s an update, this is really the best I can muster in my given state. What I can say is that I am actively doing everything in my power to try to guide (or wrench, whatever works) myself into a better place… even if that means feeling significantly worse because of side effects before I can feel better.

A Bittersweet Return to Psychiatry

As you may remember, the healthcare reform required that I find a new psychiatrist… only to have that one present itself as unreliable. After a few desperate phone calls and a miracle (the fact that my old psychiatrst is now taking my new insurance) I made an appointment with him a few weeks ago.

The appointment was yesterday, and though I’ve only been without a psychiatrist for three months it has felt like forever. While I waltzed into his office feeling quite chipper and very glad to see him, the appointment was rather bittersweet.

At this point it seems like my mood swings have developed something of a pattern, something that hasn’t happened in the three years I’ve been mood charting and tracking my symptoms. I could be jumping to conclusions here, after all the pattern might have been spurred by the pain and/or medication from when my ovarian cysts have been rupturing (now two for two, two months, two cysts). While I would be thrilled to be able to expect some level of predictability with what I’m dealing with, I’m not holding my breath for at least another month so I can see what happens next.

So far, the pattern looks a little something like this:

16 days hypomanic level euphoria dominant mixed episode
6 days with multiple depressive mood swings per day
5 days of stable mood
6 days with multiple depressive mood swings per day
17 days hypomanic-manic level dysphoria dominant mixed episode
6 days severe depression

I realize this is like… barely a pattern, but it is more like a pattern than anything I’ve experienced before.

Anyway, bittersweet. Great to see my old psychiatrist, but somewhat alarming to realize he has given me every medication (save the newest one, Saphris) that is available or reasonable for me to try. Three months ago I knew this, so why did it feel like such a shock to hear again yesterday?

It seems like I’ve exhausted nearly every possibility when it comes to psychiatric medications without any luck. I say nearly because, again, I can try Saphris (though I want to make sure I can get it for free before consenting to that, it currently has no generic and is terribly expensive) and I’ve agreed to try Seroquel. Again.

The thing is, I was first given Seroquel (quetiapine) while hospitalized, and they gave me a massive dosage first thing in the morning. Within an hour I couldn’t stand or walk because I was so dizzy, and because of that I told them I wouldn’t take it again. 

I think things might be different if I can take a little bit at a time at bedtime and get my body used to the effects (as long as they aren’t as horrible as they were taking a massive dose). You see, I have a very sensitive body chemistry and I tend to feel side effects somewhat exponentially, in conjunction with most medications having little positive effect for me (treatment resistant symptoms!). I’m more than willing to try this again, because frankly I have few (two?) options left in this realm of medicine.

By 2 pm yesterday I was feeling completely despondent and suicidal. I mean, nobody likes to hear that they feel like shit but there are no medications left to treat me. Talk about hopelessness!

That is, until I started thinking about the other options out there. I know there are still many other types of treatments I can try, it just gets my goat how often people (patients, doctors, pharmaceutical companies) promise guaranteed relief from pharmaceuticals when that hasn’t been my experience at all.

At this point, though I’ve tried acupuncture, there are other alternative treatments out there I can try. The trouble is that the ones my insurance covers are the ones I can afford at this point. I went into a terrible amount of credit card debt when I was trying acupuncture as a treatment method and unfortunately it didn’t do much to help me at the time.

My mind circled back to the idea of ECT. I don’t think my psychiatrist has brought it up lately because I really freaked out on him the first time he did. My reaction was the same as the first time I was suggested lithium, namely;

“Seriously? My symptoms can’t be THAT bad, right?”

Here, three years later, I can’t hold down a job. I’ve given up doing most of the things I love to do. I’ve tried every medication available to me (well, nearly) with no improvement. I yell at people in public uncontrollably while manic, I deconstruct my relationships while depressed, and I can’t tell the difference between reality and delusions while in mixed episodes. Are my symptoms bad enough to warrant ECT? Yes, I dare say I think so.

So… there. That’s an option. And just feeling like I have an option (albeit a bit of a scary one) makes me feel slightly better. After my last hospitalization I’ve always said that if it came to being hospitalized vs. trying ECT, I would rather try ECT.

I’ll try the Seroquel thing first and see how that goes, and I’ve got Saphris to try as well. Having said that, I’m planning on putting the option of ECT back on the table next month when I see my psychiatrist and see what he says.

I know I’m not the only one out there who has had trouble finding treatment options that work for them. I know it is simply the sickly, syrupy voice of depression when I feel singled out of a group that has already been singled out. The truth is not that I’m an “outcast’s outcast”… but so much of our lives involves comparing ourselves to the people around us that the things that make us unique often feel like pitfalls. I have to (and I will) find a way to make life work for me… and given my tenacity I can’t imagine anyone better suited for the job.

One Flew Over the Cuckoo’s Nest – Demystified

Warning, this post may contain triggering content or themes.

Having been sick the last (zillion) several days, I’ve been laying around watching a lot of TV and movies. When the idea of watching One Flew Over the Cuckoo’s Nest came up, I don’t know if it was a feverish stupor or the fact that I’d never seen it before, but watching it seemed like a grand idea.

Instead, when I reached the end of the film I was mortified and had a terrible time trying to sleep the night after.

One Flew Over the Cuckoo’s Nest is considered to be one of the 20 Greatest Films by the American Film Institute. It won Best Picture at the Oscars and is one of only three films to have swept all of the top 5 categories.

For those that are unfamiliar with this movie, Jack Nicholson plays R.P. McMurphy, a man who has been sent from a prison work program to a mental hospital to be evaluated for his outlandish behavior. He is crass, energetic, and attempts to liven things up around the hospital, failing to succumb to the monotonous and stifling ways of the hospital.

Louise Fletcher plays Nurse Ratched, head nurse of the facility who is perpetually manipulating and crushing the spirits of the patients. Having heard this description before, I expected her to be brutish and forceful, but instead the character in the movie appears largely patient and softspoken, using these attributes as a shield to hide the power she is holding over the patients.

As you’d expect, a power struggle ensues between the two.

The book, by Ken Kesey, was published in 1962. The movie, directed by Milos Forman, was released in 1975.

There are a lot of themes around stifling individuality, sexuality, and a whole gamut of other things. There are aspects of counterculture playing a role in the story, racism, and the list goes on and on. What concerns me about this movie, though, is this:

the story takes place in a mental hospital. 

This is a fact that is ever-present throughout the movie, so how could people not walk away from this with a long list of stereotypes about the things that happen in mental institutions?

I think there are a lot of things that people don’t understand about this film, and that is something that has been coloring people’s perceptions of what mental hospitals are like [in real life] for the last 30 some odd years.

I realize that most people have not been inside of a mental hospital, they have no way to discern what is real from what is fiction in this film. Luckily I have had the pleasure of spending time in no less than 3 psychiatric facilities, so though I don’t consider myself an expert per se, I have quite a bit more experience in this realm than the average joe.

That said, there are a few points I’d like to address.

1. The time period in this film is supposed to be in the early 60’s. Now, what I don’t think people are taking into account when seeing this film is that a) this is a hollywood depiction of the goings on in a mental hospital (in other words, this isn’t a true story), and b) mental facilities have changed dramatically since the 1960’s.

Yes, there are a few elements of truth (as far as how many current facilities function), and I can’t personally compare the setting with hospitals in the 1960’s (though the depiction of the hospital in Girl, Interrupted takes place in 1967 and had some common themes), but knowledge alone that Kesey (who wrote the book) got a lot of information for his setting from his job (he was working as an orderly in a mental hospital) would hold more weight for me if he hadn’t admittedly been taking LSD at the time while working there.

What I’m trying to say is that this film is in almost no way representational of current mental facilities (based on the time period alone), but the setting is largely swaying the beliefs of what people believe to be real, in regard to mental hospitals today. I think if people can get a grasp that this is a fictional period piece, we’d all be much better off.

2. The patients were portrayed in such a way in this film that I was left feeling a little annoyed. Physical oddities (with no apparent nod at any sort of actual mental condition) abounded. I don’t know what the criteria was for being admitted to a mental hospital was in the 1950’s and 60’s, but I am pretty certain this was a device used by the creators of the film to make the group of patients look collectively “odd”.

From my experience, the most bizarre thing about the patients that I’ve seen in any situation of hospitalization has been that they all look deceptively normal. That said, don’t expect to find an abundance of people who others are ashamed of the way they look hanging out in a mental hospital today. You certainly can expect a broad spectrum of ages and races -depending on the population of your locality, of course.

3. The security of hospitals today, unlike the film, is considerably more intense. Of course, that will vary depending on the hospital (and who is sent there, there are hospitals specifically for patients who are considered more dangerous), but at any facility you can expect to be thoroughly searched before entry (something that doesn’t quite happen in the movie) and it is not unheard of to have personal items withheld if they can be considered potentially dangerous in any way.

In the film, orderlies are somewhat easily bribed, and that is something I would not count on in present day hospitals. In some, furniture is bolted to the floor (so it can’t be thrown through windows) and in others, windows only lead to courtyards in the center of the hospital (not outside) so trying to flee from them would be entirely fruitless. What I’m trying to say, is don’t expect to escape from one of these facilities unless you have gained enough trust to be walking around on your own or are willing to escape through conventional (convincing them to let you out) means.

4. “Not Crazy, Just Dangerous” – this is McMurphy’s final diagnosis by the psychiatrist in the film, but somehow they don’t let him go.

I talked with a friend of mine about this recently, not this situation in particular, but the idea that you’re more likely to be held longer in a mental health facility if you claim to be fine and that there is nothing wrong. People who are willing to embrace getting help in these facilities and be open about their issues have a much higher chance of being released than people (even sane ones, statistics show) who claim they are fine and would like to leave. This leads me to:

5. Voluntary vs. Involuntary is a funny thing. Being held involuntarily means you do not have any voice in when you get to leave. In the film, McMurphy is astounded nobody told him that he had just spent weeks pissing off the only person who had the power to free him. He asks all of the voluntary patients if they could just get up and walk right out the door, and though they say yes, they are too timid to do so.

Now I want to clarify something important, because there are two types of voluntary treatment. One involves being able to check out whenever you desire, and the other involves only being able to check out when your treatment team decides you may leave. For anyone who has an emergency facility on file for where to go for big episodes, you may want to know ahead of time which method your hospital of choice takes with its voluntary patients. Personally, I have been in both types of facility and there is certainly a trade-off that happens with both.

6. The shock treatment scenes in this film have been the number one complaint I’ve heard from psychiatrists in regard to the portrayal of mental health treatment in any movie ever. Most doctors complain that the use of ECT (electroconvulsive therapy) is not more widely used today because of this film, but after seeing these scenes I thought they were the least of my worries in regard to the entire film.

So a quick reminder, the film takes place in 1963. This is a hollywood, dramatized version of a fictitious story. Now, what you see in the film is in no way representative of how ECT works today. There isn’t any convulsing that happens, they don’t use the giant metal prongs on your head, there aren’t 8 people holding you down… that’s just movie “magic”.

What I found much more disturbing was the time leading up to these “shock treatment” scenes, and I would venture to guess that this is where the chief complaint is for many psychiatrists today. Any portrayal of a treatment that involves dragging adults down hallways kicking and screaming in terror just to get there is not one you’d probably have any luck at pitching to patients in real life.

7. Nurse Ratched was very difficult for me to handle in this film, and though I imagine this is one of the few things people would write-off in the grand scheme of how mental hospitals actually operate, the unfortunate truth is that I’ve seen this sort of character in my travels before.

I am not saying you’ll find a Nurse Ratched type character in every mental health facility, I’m sure many have excellent, professional staff. Unfortunately, every so often there can be someone (like in any field) that feels the need to abuse the power that they wield over others, and when you’ve put your faith in the hands of professionals that are supposed to help take care of you, it is easy not to see it coming.

The result in the film with Billy’s death is something I can’t take very lightly. After having a nurse withhold my medication until I was having withdrawals and then, in that point of extreme vulnerability, try to manipulate me into thinking I had an eating disorder, tell me I was a terrible girl, and that she absolutely wouldn’t help me… seeing Nurse Ratched’s final blow on Billy’s psyche hit way too close to home.

Obviously I didn’t commit suicide when this happened, but it turned me into an extremely non-compliant patient for a very, very long time.

8. Lobotomies are something that genuinely terrify me to an overwhelming degree, particularly because I know the fear of having my rights being subject to the whims of a psychiatric institution, but also because if I had been born some 70 years ago this is something that could have happened to me. 

Lobotomies reached a peak of popularity in the 40’s and 50’s and involved damaging portions of the nerves in and around the brain to “change the behavior” of patients. Sometimes patients were able to still function somewhat normally, and other times (like in the film) a lobotomy could render someone to a vegetative state. The procedure was done blind (meaning instruments were inserted without the technician being able to see where the instruments were in the skull) which is what partially accounts for the large range of mixed results. Between 40,000 and 50,000 lobotomies were performed in the U.S. before the first anipsychotic drug (Thorazine) became the new preferred method of treatment.

Today, receiving a lobotomy in a mental health facility would absolutely be considered illegal, so I wouldn’t let the fear of this sort of thing keep you from seeking treatment. Neurosurgery for Mental Disorders (NMD) is used today (though rarely) as a last resort for extreme cases of things like obsessive compulsive disorder and epilepsy, but even in that situation you can expect to sign a stack full of documents before they get anywhere near your head.

Honestly, I understand that it is a film and that it is fiction, but I can’t help but feel like One Flew Over the Cuckoo’s Nest is a harmful representation of mental hospitals in general. If there was more indication that the content is fiction or that it takes place in the 60’s, I think it wouldn’t bother me so much… but I think those are both things that people don’t always walk away realizing.

If you haven’t seen it, I’m not sure I would recommend it, simply because the last 10 minutes of the film pack a big, extremely intense wallop. If you have endured any sort of abuse during a psychiatric hospitalization, I would highly recommend avoiding this film. Otherwise, knowing heading into it that it is fiction and a period piece can help a lot with the potential discomfort you my feel.

Study Finds ECT Works By Dampening Brain Connections

A fellow bipolar cohort sent me a link to this article last week, and it never ceases to amaze me how the things I just believe to be true are later “discovered” by researchers. I do understand the difference between scientific theory (unproven) and scientific fact (proven) but it usually takes the fact portion a considerably  longer to catch up.

SO, that said, researchers believe they’ve finally cracked the 70 year old case as to why ECT (electro-convulsive therapy) works on depression. ECT has been used for quite some time as a treatment for bipolar disorder (among other things), but it tends to get a bad wrap because most people aren’t aware that the technique looks much different than the way it looked when the therapy first began.

Depression was long thought to be brought on by lowered activity in the brain, but research lately (including that recent research about the chemical found in magic mushrooms being used to potentially treat depression) have helped conclude that the trouble with depression is that there is overactivity in the parts of the brain that control mood and concentration. Both ECT and the psilocybin (the active ingredient from the hallucinogenic mushrooms) work by lowering the amount of activity in that overactive portion of the brain.

Interesting, no? I’d recommend reading the full article here…