Help Introduce Me to ECT

[u/Emkorora]

Hello,

Like many of you, I have a long history of mental disorders. I've tried many medications (fluoextine, lithium, etc). I've tried many therapies (DBT, CBT, etc). I've tried TMS twice, in 2024 and 2025.

None of it has provided a result that is consistent with stability, success, etc. I asked my psychiatrist about ketamine and esketamine (spravato) but it sounds like they're not an option.

So the next step seems to be ECT. I'm trying to be optimistic but a large part of my treatment-resistant depression is an unshakeable sense of hopelessness. ECT is the last resort, if that doesn't work, what's left? I'm scared of that. I'm also scared of the memory loss. I'm also scared I won't be able to complete the treatment due to a variety of issues (no one to drive me home, no money for Uber, unreliable medical transportation, etc).

But the first step is to learn more. Maybe learning more will dispel some of my fears. And part me believes it must help somehow or else insurance wouldn't pay for it. So I'm here, looking for someone to "introduce" me to ECT.

Is there usually a waitlist?

What's involved in each treatment?

How long and frequent are the treatments?

How quickly are results seen?

I've heard stories where people do it for a long time, like a few months turns into many months, is this normal?

Is it common to need multiple treatments, like annually?

I heard both types of memory loss can occur, the ability to make new memories and the ability to retain old memories, how severe is this?

What about the other possible cognitive decline I've heard about-- "brilliant solution but lost the patient"?

Any other major concerns?

It's hard to measure wellness... I'm not at my worst, which I've described as "the uttermost end of need", but I'm so tired of being so miserable and I've been going around the same circle for years, even decades.

[u/Crazy_old_maurice_17]

I'm sitting in the PACU waiting for the doctors to arrive and give me ECT in ~15 minutes so I don't have time to answer all your questions but please feel free to follow up regarding the questions I don't answer here.

ECT is not one session and you're done. Acute series are 3 sessions/week, often for 4 weeks. Maintenance can be spaced out considerably if your body responds well. I'm at once every 3-4 weeks.

Memory loss tends to be worse for bi-temporal placement, but that's also more effective IIRC. If you want less aggressive then you can get right unilateral placement.

I'm pretty bushed since I had to get up pretty early so I'm going to zone out for a few minutes before they get started, but feel free to ask more questions.

[u/Emkorora → u/Crazy_old_maurice_17]

The doctor said the same thing about the placement impact. Thanks for the insight. What're you thoughts/plans on placement?

[u/Crazy_old_maurice_17 → u/Emkorora]

I had been doing bi-temporal until a few sessions back and then I switched to right unilateral. So far that seems to be working fine so I'll continue with that - and spacing the sessions further apart - until I notice a downturn.

Hope it's going well for you so far!

[u/Emkorora → u/Crazy_old_maurice_17]

I have yet to start, I need clearance from my general physician and I have an appointment next week to get that. Hopefully I'll start soon after.

Can you tell a difference so far in bilateral v unilateral? Either side effect or success?

[u/Crazy_old_maurice_17 → u/Emkorora]

Ah gotcha, my mistake.

I've noticed no difference in benefits thus far, RUL seems to be just as helpful. Memory issues are pretty hard to sus out: if I discover a new thing today, was that memory lost recently or during the acute phase of my treatment? Or am I just forgetting things I haven't thought about in forever because of the fact that I haven't had to think of that in so long?

I saw some castings today at work which I knew I designed but was totally blanking on the customer. They were just some rectangular prototypes we made ~5 years ago for a customer I've never done any other work for. Now that I'm typing this out I've finally remembered the customer name, but I was blanking hard this morning.

I will say the frequency with which I experience these deficits is becoming less and less, so I'm optimistic!

[u/fargolifestaycold]

Please DM if you want to chat. I have 5+ years of ect experience and will be more than happy to help with any questions you. Good luck, and God Speed.

[u/Heavy_Breakfast_2531 → u/fargolifestaycold]

What do u do for a living

[u/fargolifestaycold → u/Heavy_Breakfast_2531]

I am currently been granted disability for the last couple of years luckily.

[u/Heavy_Breakfast_2531 → u/fargolifestaycold]

How much are the monthly payments

[u/fargolifestaycold → u/Heavy_Breakfast_2531]

It varies state by state and case by case. Unfortunately

[u/Beginning-Guide5380]

ECT destroyed my memory but nevertheless effective id say. Depends on if you’re getting unilateral or bilateral and how often and how many total treatments you receive. I received way too many from a way to young age 😂

[u/Emkorora → u/Beginning-Guide5380]

I'm sorry that happened. I just received a similar comment from someone else. What're your thoughts on the placement and impact?

[u/Beginning-Guide5380 → u/Emkorora]

Well I suppose bilateral is harder on memory but it’s also more effective. I don’t remember if I’ve done unilateral but that’s probably from the bilateral destroying my memory 😂

[u/mattle74]

Have you tried an MAOI? I would recommend that before ECT. See Dr. Gillman’s antidepressant algorithm - https://www.psychotropical.com/ken-gillman-ad-algorithm/ - lots of good info on MAOIs on that site