Treating depression with shock therapy

PHILADELPHIA - October 28, 2010

Carol Kivler of Lawrence Township, N.J. was in her forties, was happily married, had three healthy children and a great job when she noticed the first symptoms.

"I was having headaches, I was having sleep disruption, more importantly I was having a lack of concentration," she said.

And it got worse. She says it was paralyzing. "It got to the point I couldn't even cook a dinner, I wasn't there for my kids, I wasn't sleeping at all," Kivler said.

After a handful of misdiagnoses, her doctor referred her to a psychiatrist who told her she had clinical depression. It affects about 10- to 15-percent of people at sometime in their lives and goes beyond everyday sadness. In Carol's case, she had a plan to take her own life.

She was admitted to a psychiatric hospital and when medication failed to help, she was offered electroconvulsive therapy or ECT, commonly known as shock therapy. Her first thought was of the barbaric treatment portrayed in "One Flew Over the Cuckoo's Nest" where ECT is used as a punishment.

But Psychiatrist Dr. Johnny O'Reardon of the Hospital of the University of Pennsylvania said what's in the movies, is not reality.

"In reality, it's a ten-minute painless procedure and all the patient is aware of is having oxygen and getting a medication that send them off to sleep," he said.

In fact, in video taken at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, it shows the standard procedure. Patients are put to sleep and given a muscle relaxer. Two electrodes are placed on the scalp, then Dr. O'Reardon explained, "We pass a very small amount of electricity on the scalp, less than what we pass when we use electricity to stimulate the heart."

That sparks a seizure lasting 30 to 60 seconds. That seizure is said to re-energize circuits in the brain that maintain a healthy mood. Typically patients receive six to 12 treatments over two to four weeks.

For Carol, after her first three treatments she said, "It was like I woke up, like this vail came up and I thought 'I'm not depressed anymore. I was productive again. I was Carol Kivler again."

Still Carol said she was afraid of what people would think so she kept her treatment a secret. Years later she broke her silence and now has written a book about it. In 'Will I Ever Be the Same Again' she hopes to help others by breaking the stigma surrounding depression and de-mystify the therapy that helped her finally come out of the darkness.

"I'm not suggesting it should be the first-line of treatment but if medication is not working at least give it a try," she said, adding no one should have to feel that way.

There is a 60- to 80-percent response rate with ETC. Again it should only be offered when other remedies fail. The risks of ETC include problems due to the anesthesia. And it can affect short-term memory in some cases. However Dr. O'Reardon said there are ways to minimize that effect. ECT is covered under most insurance plans if they cover mental health.

For more on Carol Kivler's story or about her book, visit:

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