[Redway]

Twosugars recommended one time making a long-running thread re. mental illness (Vicky could make this sticky) and I thought in here can go general questions about mental illness and especially controversial shades.

Thought I’d kick-start by mentioning one controversial mental treatment (electroconvulsive therapy/ECT) and challenging the myths about that practice (wholly undeserved) but like I say this is the thread for any questions you’ve got about these things.

Hope you’re alright with me mentioning your name TS.

Edit - link to the ECT post http://www.thisisbigbrother.com/foru...=344393&page=4 (comment 87)

[Twosugars]

Thank you, Redway, for starting this thread. It should give me a kick to get on with it too.
Look forward to see what we can make of it.

I remember almost begging for ECT a couple of years ago, when none of antidepressants seemed to work. They told me no chance.
Why is it so little used now? Why the stigma? I've heard it is quite a shock (no pun intended) but some psych meds can have some debilitating side-effects too.

[Redway]

Originally Posted by Twosugars

Thank you, Redway, for starting this thread. It should give me a kick to get on with it too.
Look forward to see what we can make of it.

I remember almost begging for ECT a couple of years ago, when none of antidepressants seemed to work. They told me no chance.
Why is it so little used now? Why the stigma? I've heard it is quite a shock (no pun intended) but some psych meds can have some debilitating side-effects too.

It’s the best treatment for melancholia (severe depression) but it’s alwats seen as a last resort for emergencies or when three or more treatments have failed partly because several rounds of it are needed in a hospital stay and partly because of the ignorance of the general public. Note I always use melancholia for high-grade psychotic depressions.

I know it’s used for schizophrenia and bipolar mania too. It’s good for pregnant bipolar women who can’t take lithium during the first trimester at least if they have an episode.

What do you want to know re. technique/preparation specifics? Want me to tackle the amnesia situation?

[Twosugars]

Originally Posted by Redway

It’s the best treatment for melancholia (severe depression) but it’s alwats seen as a last resort for emergencies or when three or more treatments have failed partly because several rounds of it are needed in a hospital stay and partly because of the ignorance of the general public. Note I always use melancholia for high-grade psychotic depressions.

I know it’s used for schizophrenia and bipolar mania too. It’s good for pregnant bipolar women who can’t take lithium during the first trimester at least if they have an episode.

What do you want to know re. technique/preparation specifics? Want me to tackle the amnesia situation?

Will it not confuse anybody if melancholia stands for severe psychotic depressions?

Give us a good intro, Redway: technique/preparation, uses, side-effects plus anything extra you consider useful.

[Redway]

Originally Posted by Twosugars

Will it not confuse anybody if melancholia stands for severe psychotic depressions?

Give us a good intro, Redway: technique/preparation, uses, side-effects plus anything extra you consider useful.

Spoiler:

• Indications: psychotic depression (especially bipolar), acute episodes of schizophrenia, autism (apparently) and Parkinson’s disease. As a side they reckon that ECT isn’t used nearly enough with end-stage Parkinson’s patients.
  
• There’s some evidence it works for people with the DTs.
  
• No one knows exactly how it works but there’s got to be an electrical seizure going on upstairs for it to work. The bad motor reactions can be averted by a med called succinylcholine with the same therapeutic effect.
  
• Every candidate for ECT is given: an electrocardiogram, chem survey and CBC. Medications which make the post-ECT confusion worse (lithium and the tricyclics) are put on hold at this point.

Technique:

• Scalp gets cleaned at night where electrodes (main ECT ingredient) will be placed the next morning
  
• Dentures are taken out
  
• ECT can be either uni-or-bilateral. The charges according to seizure threshold for the patient vary from 50% over (light) to 500% over (deep). It’s always parallel to how severe/life-threatening the case is. Most docs opt for unilateral at moderate charge.
  
• Usual surgery stuff’s done after that point – ECG machines/heart monitor, all that.
  
• The patient’s always oxygenated with 100% oxygen (administered through a few mask).
  
• The seizures aren’t meant to last more than 30 seconds to one minute.

• Treatments given x3 per week—most people need 6 to 12 treatments (in other words up to a month of ECT) for it to work in full. First response usually seen after the third treatment.
  
• Since muscle relaxants were introduced fractures are super rare. ECT’s no more risky than any other major surgery.
  
• The amnesia people mention only happens to some people and doesn’t usually extend to the events a week before ECT until after the last treatment.
  
• Outside the treatment timeframe memory’s perfectly clear.
  
• ECT’s been known to cause mania in bipolar depressed people.
  
• Someone closer the top of this thread said that ECT doesn’t alter the natural course of the illness and that it just suppress symptoms. That’s true but there’s people that depressed that the ECT saved them in the same way that Lazarus resurrected from the dead. It brings people out of the danger zone.
  
• Maintenance ECT is sometimes given to people who relapse—about one treatment a week for 2 months and then tapered down.

Summarised as much as I could. Holla if you've still got questions though.

[Redway]

Listen, who wants information on other mental health surgeries (like DBS for high-grade OCD)?

[Maru]

Originally Posted by Redway

Indications: psychotic depression (especially bipolar), acute episodes of schizophrenia, autism (apparently) and Parkinson’s disease. As a side they reckon that ECT isn’t used nearly enough with end-stage Parkinson’s patients.

That's very interesting about ECT & Parkinsons... my mother has Dystonia (very similar) and they did an experimental surgery where they inserted a metal probe into the top of her skull, connected it to a wire that goes through her neck to a battery that's put in her heart... it regularly sends impulses to the probe... anyway, it's been a miracle for her. She's never had a resting posture or what we could call a "stance" in her life... she's now walking upright where before she used to lean at a dramatic angle when walking and she can manipulate things in her hands now where she used to drop them and shake uncontrollably... I forget what the surgery is called, but they've asked our family for years to participate in that program...

Edit: I said skull, I meant brain -_- (but yeah that too)

[Toy Soldier]

Most places still have strict regulations on when ECT can be used, it can only be used "freely" in certain in-patient clinical settings (e.g. If you've been held involuntarily on the grounds of the Mental Health Act). Of course even then it's a voluntary treatment.

It is apparently very effective, it can completely alleviate some forms of clinical depression for some people for a short period of time (sometimes weeks) and offer respite in that way. Also providing that glimpse of the "light at the end of the tunnel" can help people overall, if they've lost sight of what feeling OK actually feels like.

The main issue with it is that the effect is temporary... It wears off after a while and has to be repeated. Also, every time its repeated it becomes less effective (doesn't last as long) so eventually it becomes impractical as an ongoing treatment...

It also varies massively from person to person with some people having massive relief, and others it not doing anything at all.

The procedure itself, apparently, can be distressing for observers but not for the patient themself these days as its done under heavy sedation. But it basically triggers seizures so for anyone watching, it seems pretty barbaric... And obviously was pretty barbaric in the past when it was a less refined procedure and sedation wasn't always used.

[Twosugars]

Originally Posted by Toy Soldier

Most places still have strict regulations on when ECT can be used, it can only be used "freely" in certain in-patient clinical settings (e.g. If you've been held involuntarily on the grounds of the Mental Health Act). Of course even then it's a voluntary treatment.

That's more or less what I was told.

[glibberglobber]

Why is this in SD&N when mental health is about health

If I was looking for an answer to a mental health I wouldn't go to SD&N

Yea , discuss controversial treatments etc etc but make individual threads for that too

[Nicky91]

Originally Posted by glibberglobber

Why is this in SD&N when mental health is about health

If I was looking for an answer to a mental health I wouldn't go to SD&N

Yea , discuss controversial treatments etc etc but make individual threads for that too

you do have a point somehow, there is a health subforum on here

[glibberglobber]

Originally Posted by Nicky91

you do have a point somehow, there is a health subforum on here

Thanks

[JoshBB]

afaik, the therapy helps relieve the symptoms but doesn't really target the 'cause'. so, it's short-term.

i might be wrong ofc

[Maru]

ECT often makes me think of what my doctor suggested to me in the past for something else. They have something that is done for painful bladder where they put you under and pack your bladder full with water, i.e. essentially expanding it... it sounds awful when you think about it, if something is already inflamed and ulcerated, why would you want to expand it?? You'd think expanding something like that would cause significant pain. And it is literally hell at first supposedly, but then it can cause periods of relief for several months after as it does something to "spread" the nerves. I was never quite bad enough to need it done, but it was fascinating...

Sometimes with restless leg, punching it can help things to calm down. Though hard to sleep when I have to sit up to punch myself... but nerves really respond to the weirdest things... We're still learning about chronic pain, but I wouldn't be surprised if depression and physical pain are linked in such a way through the nerves somehow that when there is the ability to treat one, we could probably accommodate the other. Maybe "retrain" the nerves somehow. Like one example, some people have their bladders removed if the symptoms are severe enough (and untreatable)... but sometimes the pain remains as a sort of "phantom pain"... and this is unusually common... I guess it is possible for something to build up overtime overtime that it leaves a physical "mark" on us. Pain is a weird thing... There is a strong link between depression and pain in general, so maybe there are associations made over-time that make it possible to continue to feel symptoms despite "relief"... in the physical sense... and I guess ECT "disrupts" and similar trauma to this effect causes a "numbing" effect?

I was in a study for the use of an anti-depressant drug that helps with pain. A lot of the newer medications are tweaked from what was learned by doctors experimenting with using anti-depressants "off-label" to treat pain... so I feel like the more we explore that area and learn about it, the more effective we'll probably be at treating things like depression, etc... is my hope.

[Jay28jay2]

Is there any way I can hide this thread, I just find it too triggering for me personally because I see it on the side of the website and I’ve read what is on it and itjust reminds me of my current struggle with anxiety and OCD and depression

[Smithy]

Originally Posted by Jay28jay2

Is there any way I can hide this thread, I just find it too triggering for me personally because I see it on the side of the website and I’ve read what is on it and itjust reminds me of my current struggle with anxiety and OCD and depression

It’s better to face and accept your issues than ignore them

The only way to hide it would be to hide the whole SD subforum

[glibberglobber]

Originally Posted by Smithy

It’s better to face and accept your issues than ignore them

The only way to hide it would be to hide the whole SD subforum

This is in the wrong subforum. Surely it should be in Health, Beauty and Fashion?

[Cherie]

Originally Posted by Smithy

It’s better to face and accept your issues than ignore them

The only way to hide it would be to hide the whole SD subforum

It could be put in private chat then it wouldn't show up

Pm a mod about it Jay

[Niamh.]

Originally Posted by Cherie

It could be put in private chat then it wouldn't show up

Pm a mod about it Jay

I don't know what the other mods think about it but I think it should stay here, while I'm sympathetic to Jay, we can't just hide every thread that could be potentially triggering to someone, where would you draw the line? And I agree with Smithy that Mental health should be spoken about

[Cherie]

Originally Posted by Niamh.

I don't know what the other mods think about it but I think it should stay here, while I'm sympathetic to Jay, we can't just hide every thread that could be potentially triggering to someone, where would you draw the line? And I agree with Smithy that Mental health should be spoken about

I agree it should be spoken about but some people might not want to air it to the the wider community/guests, but of course you are the boss.

[Nicky91]

i guess either private chat would be a good choice cause it is something from someone's private lives and those who don't want to see it, won't see it then

health, beauty, fashion subforum it would fit the health bit then

[Twosugars]

Thank you, Niamh. Your and other mods support for this thread is gratefully appreciated!

Some ideas for future discussion before Redway gives us an overview of ECT:

-noticed there's fair few members on antidepressant medication, so propose creating an anonymous poll in order to identify which meds are taken so that we can then discuss them in more detail; as in any poll thread, there will be an opportunity to post if anybody wishes, but the poll itself would be anonymous
-anxiety as opposed to depression, what is it and its symptoms
-autism
-suicidal ideation (thinking of suicide) - cry for help
-overview of personality disorders - plain introduction listing them and providing symptoms plus when personality traits turn into personality disorders?

Let us know what would you like covered.

[Redway]

Originally Posted by Twosugars

Thank you, Niamh. Your and other mods support for this thread is gratefully appreciated!

Some ideas for future discussion before Redway gives us an overview of ECT:

-noticed there's fair few members on antidepressant medication, so propose creating an anonymous poll in order to identify which meds are taken so that we can then discuss them in more detail; as in any poll thread, there will be an opportunity to post if anybody wishes, but the poll itself would be anonymous
-anxiety as opposed to depression, what is it and its symptoms
-autism
-suicidal ideation (thinking of suicide) - cry for help
-overview of personality disorders - plain introduction listing them and providing symptoms plus when personality traits turn into personality disorders?

Let us know what would you like covered.

BIB 1: I'd have to do that in a separate thread but it's not a bad idea at all.

BIB 2: I take it you've got borderline PD in mind more than others?

[Twosugars]

Originally Posted by Redway

BIB 1: I'd have to do that in a separate thread but it's not a bad idea at all.

BIB 2: I take it you've got borderline PD in mind more than others?

Re.1 Yes, I think so too. A separate poll with discussion.
Re.2 Well, I'd like us to cover all of them, but perhaps most common could be given more prominence (borderline, antisocial, narcissistic etc). So maybe brief intro first and then go into detail

[Redway]

Originally Posted by Twosugars

Re.1 Yes, I think so too. A separate poll with discussion.
Re.2 Well, I'd like us to cover all of them, but perhaps most common could be given more prominence (borderline, antisocial, narcissistic etc). So maybe brief intro first and then go into detail

BIB - yup, makes sense to me. I just know that borderline out of all the PDs has more parallels with things like depression but we can touch on all of them, yh.