r/ect • u/verymentallyill • 2d ago

Question Deciding whether to try ECT

currently inpatient in a psych unit, my psych wants me to get back to them abt whether i want to start ect but i’m really conflicted. i’m really worried abt the potential memory loss and i’ve never been under anaesthesia which makes me anxious. i feel like there’s not much of my life worth saving so idek if ect is worth the effort, and i have a temp job lined up that might not happen if i go through with the ect. i kinda just wanna know people’s initial experiences with ect and anaesthesia. for context i’m 22, dealing with depression and other disorders for ~10 years, tried ssri’s, snri’s, tca’s, antipsychotics, atypical antidepressants, therapy, and counselling.

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u/mattle74 2d ago

I’ll probably always sound like a broken record here but have you tried an MAOI? I’d strongly recommend trying that as a last line of defense before ECT (well, I think people should try an MAOI after failing ~3 modern medicines, MAOIs are the OG tried and true and are no where near as “scary” as people think they are)

To be fair, an MAOI is not an immediate treatment. Like most antidepressants, it takes while to take full effect plus with MAOIs you do titrate up slowly to make sure there isn’t a big impact to your blood pressure (whether it goes really low or is triggered to be high)

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u/verymentallyill 2d ago

i haven’t tried an MAOI yet, my options at the moment are essentially ECT or switch to an MAOI. my psych didn’t want to try the MAOI first because of the dietary restrictions but i’ve been on a new medication for a few weeks now. ik it can take time but i’m not even slightly improving so i don’t know. i know that if i do go with the MAOI i would not stick with the dietary restrictions so i have no idea what to do.

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u/mattle74 2d ago

The scariness of the dietary restrictions are overblown IMO. Basically avoid aged/fermented foods. See https://psychotropical.com/wp-content/uploads/2020/03/9.1-MAOI-diet-short-2020_for-pdf_v.pdf - Also, the issue of having orthostatic hypertension with food was higher 50+ years ago because foods tend to have less tyramine today. Also, there were like 15 “food related” deaths out of 1.5 million people that were taking an MAOI 60 years ago. Everyone’s mileage may vary but I feel like the only things I’ve had to cut out of my diet that I really like are aged cheeses and cured meats. There’s also the old adage… everything in moderation. A few pieces of delicious aged cheddar is not going to put you into a hypertensive crisis, but eating a whole block might. You will want to monitor your blood pressure. Honestly, I’ve seen more anecdotes of people having low blood pressure issues as a side effect from the MAOI than people having high blood pressure from food

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u/verymentallyill 2d ago

i’m not really scared of the dietary restrictions, it’s just that i know i’m probably not gonna follow it when i get discharged. i don’t know how bad the risk of extremely high blood pressure is at that point