Tagcloud

abortion, accupuncture, ACE inhibitors, acne, ADHD, alcohol, allergies, Alzheimer's, anaemia, anaethesia, anorexia, antibiotics, antidepressants, antihistamine, anxiety, appetite control, arthritis, ASCOT, aspirin, asthma, atherosclerosis, autism, autoantibodies, back pain, beta carotene, beta-blockers, bipolar disorder, birth, bleeding, blindness, blood pressure, body dysmorphic disorder, body mass, breast cancer, breast feeding, bronchitis, Caesarean section, calcium, cancer, carcinogens, carcinoma, cardiac syncope, cardiolgy, cataracts, cervical cancer, chemotherapy, child psychiatry, children, cholesterol, clinical trial, clopidogrel, Clostridium difficile, cognitive behavioural therapy, colectomy, colic, colorectal cancer, complementary and alternative therapies, contraception, COPD, coronary care, coronary stents, Crohn's, cystic fibrosis, defibrillator, dementia, depression, dermatology, diabetes management, diet, disability, DNA, Down's syndrome, eating disorders, echinacea, ECT, eczema, elderly people, endoscopy, epilepsy, erectile dysfunction, euthanasia, exercise, fat, fertility, fitness, flu pandemic, fluoxetine, folic acid, food labelling, fracture, fragile X syndrome, general surgery, genetics, gerontology, GIK infusion therapy, GORD, gout, haemodialysis, hearing, heart attack, heart disease, heart failure, heart health, hepatitis, HIV, hospital care, HPV, HRT, hyperglycaemia, hypertension, hypoglycaemia, IBD, ICU, incontinence, infant, infant mortality, infection, inflammatory bowel disease, influenza, invasive candidiasis, IQ, Irish Heart Foundation, irritable bowel syndrome, keyhole surgery, kidney disease, laser, learning difficulties, leukaemia, liver disease, lumbar disk herniation, lung cancer, lung disease, lymph nodes, macular degeneration, macular oedema, magnetic resonance imaging (MRI), malaria, malnutrition, Marfan syndrome, media, medical ethics, medical research, medication, meningitis, mental illness, metabolic syndrome, migraine, miscarriage, mortality rate, MRSA, multiple sclerosis (MS), NCHDs, nephrology, neurology, OAB, obesity, obstetrics, occupational health, ocular medicine, omega-3, opthalmology, oral cancer, organ transplantation, orthopaedics, osteoporosis, otolaryngology, ovarian cancer, paediatrics, pain management, pancreatic cancer, panic, Parkinson’s disease, patient safety, patient-physician communication, personality disorders, physiotherapy, plastic surgery, polio, practice, pre-eclampsia, pregnancy, preventative health care, probiotics, prostate cancer, psoriasis, psychiatric admission, psychiatry, psychotherapy, PTSD, public health, quality of life, radiology, radiotherapy, rectal cancer, reproductive health, research, resuscitation, rheumatoid arthritis, rheumatology, rhinitis, salt, SARS, schizophrenia, screening, seizures, self harm, sexual abuse, sexual health, sexually transmitted infections, SGA, sinusitis, skin cancer, sleep disorders, smoking, smoking ban, spinal injury, sports medicine, statins, stress, stroke, substance abuse, suicide, supplement, surgery, syncope, technology, teenagers, testosterone, thoracic surgery, thrombosis, thyroid cancer, tonsillectomy, tonsillitis, Tourette's syndrome, toxicology, travel medicine, tuberculosis, tumour angiogenesis, type 1 diabetes, type 2 diabetes, ulcer, ulcerative colitis, urinary incontinence, vaccine, vitamins, weight, WHO, women's health, World Health Assembly

«Previous article | Next article»

Is there a place for ECT in today's psychiatry?

Dr Michael Corry believes that electro-convulsive therapy should now be abolished from modern psychiatric practice.

Electro-convulsive therapy (ECT) is the deliberate administration of electric shocks to the brain. As described by the UK Department of Health in 2007: “Electro-convulsive therapy is carried out under general anaesthetic, and a strong muscle relaxant is administered to patients to prevent the violent muscle spasms that the treatment would otherwise cause. The patient is strapped on their back to a flat table which, in the event of a patient vomiting, can be spun upside down.

“In the presence of an anaesthetist and psychiatrist, electrodes are attached to the patient’s head and the electrical voltage is administered until the psychiatrist observes the patient’s toe twitch. This is a sign that the patient, despite the relaxant drugs, is convulsing. Up to 400 volts are used.”

The last recorded figures reveal that in 2003, 859 individuals were treated with a series of electric shock treatments in Ireland. Yet alarmingly, ECT is experiencing a revival, with articles in national and international psychiatric journals approving its rising use.

Guantanamo Bay

If we were to hear that there was a group of people, somewhere in the world, who were being given electric shocks to their brains, in an effort to change their thoughts or feelings, we would immediately think of torture, death camps, the horrors of concentration camps, and perhaps Guantanamo Bay.

ECT causes an electric brainstorm of such magnitude that its exponential energy is released in a series of spasmodic outbursts involving the entire nervous system. The muscles go into a rhythmic series of violent contractions, breathing is interrupted, stress hormones are released and blood pressure rises.

Before the use of muscle relaxants and general anaesthesia, evidence abounds that bones were broken, teeth cracked and damage was rendered to muscles and ligaments due to the ferocity and the length of the convulsions. If the heart’s independent electrical system is overwhelmed by the electric storm nearby, abnormal rhythms are caused leading to cardiac arrest and death, particularly in the elderly. Brain autopsies have revealed micro haemorrhages and the rupturing of the protective blood-brain barrier.

Electric shocks to the brain artificially induce epileptic fits that are much more violent than those experienced as a result of that medical disorder. In this way, a double impact is administered to the brain — the destructive force of electric shock itself and the secondary ‘grand mal’ seizure it produces. It has also been demonstrated that successive electric shocks create an excitability in the brain which increases the potential for future ‘grand mal’ seizures to occur in the aftermath of ECT treatments.
Within whichever medical speciality they occur, it is universally agreed that the occurrence of seizures in a patient is always harmful to their brain. Within neurology as a speciality, every effort is made to prevent seizures. It must be understood that the ‘grand mal’ seizure in the brain is believed by psychiatrists to be the mechanism which brings about the cure. There is no known scientific evidence of any benefit to an individual experiencing epileptic seizures from any other cause.

Psychiatry

Incredibly, psychiatry stands out as the only branch of medicine which specialises in deliberately causing seizures. Psychiatry seems blind to the possibility that after an electric shock to the brain, it is the befuddled state of confusion, sometimes tinged with a mild euphoria (regularly encountered in the aftermath of some types of head injuries), which obscures the individual’s original symptoms. This temporary obscuring of original symptoms is then classified by psychiatrists as an ‘improvement’.

In this way, a powerful physical intervention is used to jolt dysfunctional metaphysical thoughts and feelings into alignment, as if they were cogs in a machine requiring a kickstart. Such interventions are counter-intuitive and lack scientific rigour.
Mental distress does not emanate from a malfunctioning, diseased brain but rather results from problems of living: family breakdown, school and work pressure, bullying, financial difficulties, relationship dilemmas, fear, loss, a broken heart, grief, sexual abuse, violence, traumas, drug abuse, physical illness, loneliness, abandonment, lack of meaning, ageing and the titanic sense of being overwhelmed that sensitive children and teenagers experience.

Using ECT is the equivalent of sending the TV or computer for repair if the programmes are not to one’s liking. The problem really is not in the hardware but rather in the software.

The most difficult thing to accept about ECT is that it has the potential to cause irreversible brain damage, and to bring about intellectual impairment and emotional disruption. Memory is the first obvious casualty, which is the place the mind calls home.

When we awake each morning, we are completely reliant on our memory to tell us who we are, and ‘re-mind’ us of our roles and responsibilities as it places us correctly in our respective worlds. These specifications of our autobiographical history, held by our memory, are fired at us point blank the moment we become conscious each day. They help us to re-create anew our sense of identity, which encapsulates the essence of our being. Our past memories form the platform to create our future: to time travel.

Fear and vulnerability

The individual who experiences memory loss in the aftermath of ECT, now lacking their traditional map for working the world, can find themselves plunged into a state of confusion, fear and vulnerability.

Other areas of intellectual functioning that are also compromised include the ability to solve problems, process new information, prioritise, concentrate, plan, make decisions and engage fully in the acts of self-awareness, imagination, creativity, abstraction and reflection.

Damage to the limbic brain from ECT can cause an emotional shallowness and hinder the ability to experience the full range of feelings. This can create an inability to emotionally connect with others.

Many survivors of ECT, in particular the elderly, reveal brain wave recordings showing a predominance of delta wave activity, usually associated with sleep. Notably absent are the normal levels of beta brainwaves seen during states of alertness and concentration during the waking state.

ECT has to be seen as a psychosurgical intervention with serious side-effects. It is self- evident that ECT is unsustainable, since if it were seeking a licence today, it would be rejected on grounds of safety. No independent scientific body would consider it as a viable intervention for human beings. The ratio of risks to benefits would just be considered too great.

Mental distress

Abolishing ECT would draw a line in the sand. It would allow a psychosocial, humanistic understanding of mental distress to emerge, and pave the way for prevention and healing. It would facilitate an approach that is person-centred: based on the science of individuality, individual hearts and souls. And in so doing, it would deconstruct the Procrustean bed of outdated psychiatric models and practices. Lofty ideas fill our airwaves about dignity, freedom, human rights and the inalienable rights of each individual as enshrined in the Constitution. Yet there is a deafening silence when it comes to the treatment of the mentally distressed. ECT is frequently given involuntarily, forced against patients’ wills and repeatedly so. Those receiving it are emotionally vulnerable individuals who may have already suffered bullying, coercion and violence. ECT re-traumatises them, with the additional burden of brain damage.

No branch of medicine except psychiatry has created such terror, stress and condemnation from those at the receiving end. The literature and the internet tell story after story of lost personal histories and ruined lives. Anti-psychiatry movements abound, populated by survivors who want their opinions respected and who are motivated to protect those who may come after them. Psychiatry refuses to listen.

The abolition of ECT has now become a human rights issue and it took its first bold step into the political arena on 25 June, when a Private Members Bill was debated for two hours in Seanad Eireann.

It was proposed by Green Party senators Deirdre de Burca and Dan Boyle and the Independent, David Norris. The Bill deals with two provisions of the Mental Health Act 2001. One is Section 58, which refers to lobotomy.

The other is Section 59, dealing with ECT. The Bill would ban the use of ECT without the consent of the patient concerned.

We, in order to see ourselves as a humane society, require urgent legislation to protect the dignity and rights of those with special needs.

• For further information on the campaign to abolish ECT, visit
  www.wellbeingfoundation.com

Posted in Mental Health & CNS on 16 July 2008
Tags: ECT

Tagcloud

abortion, accupuncture, ACE inhibitors, acne, ADHD, alcohol, allergies, Alzheimer's, anaemia, anaethesia, anorexia, antibiotics, antidepressants, antihistamine, anxiety, appetite control, arthritis, ASCOT, aspirin, asthma, atherosclerosis, autism, autoantibodies, back pain, beta carotene, beta-blockers, bipolar disorder, birth, bleeding, blindness, blood pressure, body dysmorphic disorder, body mass, breast cancer, breast feeding, bronchitis, Caesarean section, calcium, cancer, carcinogens, carcinoma, cardiac syncope, cardiolgy, cataracts, cervical cancer, chemotherapy, child psychiatry, children, cholesterol, clinical trial, clopidogrel, Clostridium difficile, cognitive behavioural therapy, colectomy, colic, colorectal cancer, complementary and alternative therapies, contraception, COPD, coronary care, coronary stents, Crohn's, cystic fibrosis, defibrillator, dementia, depression, dermatology, diabetes management, diet, disability, DNA, Down's syndrome, eating disorders, echinacea, ECT, eczema, elderly people, endoscopy, epilepsy, erectile dysfunction, euthanasia, exercise, fat, fertility, fitness, flu pandemic, fluoxetine, folic acid, food labelling, fracture, fragile X syndrome, general surgery, genetics, gerontology, GIK infusion therapy, GORD, gout, haemodialysis, hearing, heart attack, heart disease, heart failure, heart health, hepatitis, HIV, hospital care, HPV, HRT, hyperglycaemia, hypertension, hypoglycaemia, IBD, ICU, incontinence, infant, infant mortality, infection, inflammatory bowel disease, influenza, invasive candidiasis, IQ, Irish Heart Foundation, irritable bowel syndrome, keyhole surgery, kidney disease, laser, learning difficulties, leukaemia, liver disease, lumbar disk herniation, lung cancer, lung disease, lymph nodes, macular degeneration, macular oedema, magnetic resonance imaging (MRI), malaria, malnutrition, Marfan syndrome, media, medical ethics, medical research, medication, meningitis, mental illness, metabolic syndrome, migraine, miscarriage, mortality rate, MRSA, multiple sclerosis (MS), NCHDs, nephrology, neurology, OAB, obesity, obstetrics, occupational health, ocular medicine, omega-3, opthalmology, oral cancer, organ transplantation, orthopaedics, osteoporosis, otolaryngology, ovarian cancer, paediatrics, pain management, pancreatic cancer, panic, Parkinson’s disease, patient safety, patient-physician communication, personality disorders, physiotherapy, plastic surgery, polio, practice, pre-eclampsia, pregnancy, preventative health care, probiotics, prostate cancer, psoriasis, psychiatric admission, psychiatry, psychotherapy, PTSD, public health, quality of life, radiology, radiotherapy, rectal cancer, reproductive health, research, resuscitation, rheumatoid arthritis, rheumatology, rhinitis, salt, SARS, schizophrenia, screening, seizures, self harm, sexual abuse, sexual health, sexually transmitted infections, SGA, sinusitis, skin cancer, sleep disorders, smoking, smoking ban, spinal injury, sports medicine, statins, stress, stroke, substance abuse, suicide, supplement, surgery, syncope, technology, teenagers, testosterone, thoracic surgery, thrombosis, thyroid cancer, tonsillectomy, tonsillitis, Tourette's syndrome, toxicology, travel medicine, tuberculosis, tumour angiogenesis, type 1 diabetes, type 2 diabetes, ulcer, ulcerative colitis, urinary incontinence, vaccine, vitamins, weight, WHO, women's health, World Health Assembly

«Previous article | Next article»

Is there a place for ECT in today's psychiatry?

Dr Michael Corry believes that electro-convulsive therapy should now be abolished from modern psychiatric practice.

Electro-convulsive therapy (ECT) is the deliberate administration of electric shocks to the brain. As described by the UK Department of Health in 2007: “Electro-convulsive therapy is carried out under general anaesthetic, and a strong muscle relaxant is administered to patients to prevent the violent muscle spasms that the treatment would otherwise cause. The patient is strapped on their back to a flat table which, in the event of a patient vomiting, can be spun upside down.

“In the presence of an anaesthetist and psychiatrist, electrodes are attached to the patient’s head and the electrical voltage is administered until the psychiatrist observes the patient’s toe twitch. This is a sign that the patient, despite the relaxant drugs, is convulsing. Up to 400 volts are used.”

The last recorded figures reveal that in 2003, 859 individuals were treated with a series of electric shock treatments in Ireland. Yet alarmingly, ECT is experiencing a revival, with articles in national and international psychiatric journals approving its rising use.

Guantanamo Bay

If we were to hear that there was a group of people, somewhere in the world, who were being given electric shocks to their brains, in an effort to change their thoughts or feelings, we would immediately think of torture, death camps, the horrors of concentration camps, and perhaps Guantanamo Bay.

ECT causes an electric brainstorm of such magnitude that its exponential energy is released in a series of spasmodic outbursts involving the entire nervous system. The muscles go into a rhythmic series of violent contractions, breathing is interrupted, stress hormones are released and blood pressure rises.

Before the use of muscle relaxants and general anaesthesia, evidence abounds that bones were broken, teeth cracked and damage was rendered to muscles and ligaments due to the ferocity and the length of the convulsions. If the heart’s independent electrical system is overwhelmed by the electric storm nearby, abnormal rhythms are caused leading to cardiac arrest and death, particularly in the elderly. Brain autopsies have revealed micro haemorrhages and the rupturing of the protective blood-brain barrier.

Electric shocks to the brain artificially induce epileptic fits that are much more violent than those experienced as a result of that medical disorder. In this way, a double impact is administered to the brain — the destructive force of electric shock itself and the secondary ‘grand mal’ seizure it produces. It has also been demonstrated that successive electric shocks create an excitability in the brain which increases the potential for future ‘grand mal’ seizures to occur in the aftermath of ECT treatments.
Within whichever medical speciality they occur, it is universally agreed that the occurrence of seizures in a patient is always harmful to their brain. Within neurology as a speciality, every effort is made to prevent seizures. It must be understood that the ‘grand mal’ seizure in the brain is believed by psychiatrists to be the mechanism which brings about the cure. There is no known scientific evidence of any benefit to an individual experiencing epileptic seizures from any other cause.

Psychiatry

Incredibly, psychiatry stands out as the only branch of medicine which specialises in deliberately causing seizures. Psychiatry seems blind to the possibility that after an electric shock to the brain, it is the befuddled state of confusion, sometimes tinged with a mild euphoria (regularly encountered in the aftermath of some types of head injuries), which obscures the individual’s original symptoms. This temporary obscuring of original symptoms is then classified by psychiatrists as an ‘improvement’.

In this way, a powerful physical intervention is used to jolt dysfunctional metaphysical thoughts and feelings into alignment, as if they were cogs in a machine requiring a kickstart. Such interventions are counter-intuitive and lack scientific rigour.
Mental distress does not emanate from a malfunctioning, diseased brain but rather results from problems of living: family breakdown, school and work pressure, bullying, financial difficulties, relationship dilemmas, fear, loss, a broken heart, grief, sexual abuse, violence, traumas, drug abuse, physical illness, loneliness, abandonment, lack of meaning, ageing and the titanic sense of being overwhelmed that sensitive children and teenagers experience.

Using ECT is the equivalent of sending the TV or computer for repair if the programmes are not to one’s liking. The problem really is not in the hardware but rather in the software.

The most difficult thing to accept about ECT is that it has the potential to cause irreversible brain damage, and to bring about intellectual impairment and emotional disruption. Memory is the first obvious casualty, which is the place the mind calls home.

When we awake each morning, we are completely reliant on our memory to tell us who we are, and ‘re-mind’ us of our roles and responsibilities as it places us correctly in our respective worlds. These specifications of our autobiographical history, held by our memory, are fired at us point blank the moment we become conscious each day. They help us to re-create anew our sense of identity, which encapsulates the essence of our being. Our past memories form the platform to create our future: to time travel.

Fear and vulnerability

The individual who experiences memory loss in the aftermath of ECT, now lacking their traditional map for working the world, can find themselves plunged into a state of confusion, fear and vulnerability.

Other areas of intellectual functioning that are also compromised include the ability to solve problems, process new information, prioritise, concentrate, plan, make decisions and engage fully in the acts of self-awareness, imagination, creativity, abstraction and reflection.

Damage to the limbic brain from ECT can cause an emotional shallowness and hinder the ability to experience the full range of feelings. This can create an inability to emotionally connect with others.

Many survivors of ECT, in particular the elderly, reveal brain wave recordings showing a predominance of delta wave activity, usually associated with sleep. Notably absent are the normal levels of beta brainwaves seen during states of alertness and concentration during the waking state.

ECT has to be seen as a psychosurgical intervention with serious side-effects. It is self- evident that ECT is unsustainable, since if it were seeking a licence today, it would be rejected on grounds of safety. No independent scientific body would consider it as a viable intervention for human beings. The ratio of risks to benefits would just be considered too great.

Mental distress

Abolishing ECT would draw a line in the sand. It would allow a psychosocial, humanistic understanding of mental distress to emerge, and pave the way for prevention and healing. It would facilitate an approach that is person-centred: based on the science of individuality, individual hearts and souls. And in so doing, it would deconstruct the Procrustean bed of outdated psychiatric models and practices. Lofty ideas fill our airwaves about dignity, freedom, human rights and the inalienable rights of each individual as enshrined in the Constitution. Yet there is a deafening silence when it comes to the treatment of the mentally distressed. ECT is frequently given involuntarily, forced against patients’ wills and repeatedly so. Those receiving it are emotionally vulnerable individuals who may have already suffered bullying, coercion and violence. ECT re-traumatises them, with the additional burden of brain damage.

No branch of medicine except psychiatry has created such terror, stress and condemnation from those at the receiving end. The literature and the internet tell story after story of lost personal histories and ruined lives. Anti-psychiatry movements abound, populated by survivors who want their opinions respected and who are motivated to protect those who may come after them. Psychiatry refuses to listen.

The abolition of ECT has now become a human rights issue and it took its first bold step into the political arena on 25 June, when a Private Members Bill was debated for two hours in Seanad Eireann.

It was proposed by Green Party senators Deirdre de Burca and Dan Boyle and the Independent, David Norris. The Bill deals with two provisions of the Mental Health Act 2001. One is Section 58, which refers to lobotomy.

The other is Section 59, dealing with ECT. The Bill would ban the use of ECT without the consent of the patient concerned.

We, in order to see ourselves as a humane society, require urgent legislation to protect the dignity and rights of those with special needs.

• For further information on the campaign to abolish ECT, visit
  www.wellbeingfoundation.com

Posted in Mental Health & CNS on 16 July 2008
Tags: ECT