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Electroconvulsive Therapy Changed My Life

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I miss the voices.

I never thought in a million years that I would be writing that I miss having psychosis. But I do.

The silence is eerie. I had gotten used to the constant commentary on my life, the brutal words, and sometimes the kindness that they had shown me. It was a mixture of different emotions, words, and experiences that led me to seek electroconvulsive therapy or ECT.

But the fear that it will slowly creep back into my life is evident. There is this hypervigilance, being on guard to see if I slip at all. Intrusive thoughts are questioned, anxiety is increased because there is this lingering effect of “what if it comes back?”

I miss the voices because it filled my life with company, noise, but also this sense of loneliness. Loneliness in the fact that no one understood what I was going through and it brought a profound sense of “otherness” that kept me bound to the house. My hallucinations and delusions became so severe that it was impossible to work. When I first started hearing voices, it was maybe one or two. For about a year it grew into a whole family of people, all ages, genders, and some were mean or kind. Reality became distorted.

According to the American Psychiatric Association, “ECT is a medical treatment most commonly used in patients with major depression or bipolar disorder that has not responded to other treatments.” It goes on to explain the procedure, as it involves a brief electrical stimulation of the brain while the patient is under anesthesia. It has been found to be highly effective, about 80% of patients find relief. Typically, patients that receive ECT treatment go two-three times a week for a total of 6-12 treatments, depending on the severity and how the patient responds.

If it is so effective, why is it not commonly used?

The risks and benefits can be hard to cope with, mainly because ECT treatments are associated with temporary memory loss and difficulty learning. Usually, these symptoms improve within a couple weeks or months. There are other common side effects of the day of treatment, nausea, headache, fatigue, and confusion. But these risks were worth it in treating my psychosis.

Something that isn’t mentioned are the side effects of general anesthesia. Awareness during general anesthesia is common, but its after-effects are really what I want to highlight. According to the Archives of Physical Medicine and Rehabilitation, sleep disturbances, nightmares, and flashbacks have been reported by about 70% of patients following general anesthesia.

I have sleep disturbances every night because of the procedure. While I am grateful that the voices and my mood has improved, the fact remains that I want to give you a clear picture of what to expect.

In order to explain why I received electroconvulsive therapy, I need to explain how my condition affected me and why I was a viable candidate. I’ve been diagnosed with bipolar disorder for the last five years and nothing seemed to have worked. I’ve tried medicine after medicine with no luck but unfortunate side effects. Anti-psychotics, mood stabilizers, anxiety meds, and still nothing seemed to have worked. It caused rifts in my relationships, in my marriage, losing my job, and in my own self-esteem.

Psychosis was the main issue that caused strife in my personal life. Hallucinations and paranoid delusions ran through my life. According to the National Institutes of Health, over half of patients with bipolar disorder develop psychotic symptoms during their lifetimes. I had experienced the unfortunate ups and downs that characterize bipolar disorder, but the psychotic symptoms caused me so much pain. The despair of never getting better because of being treatment resistant caused me a significant amount of stress.

I was lucky enough that my psychiatrist gave me a referral and when I made an appointment with the doctor that practiced ECT, he recommended that I check myself into a psych ward and he’d continue treatment from there.

It was the best experience that I could be given. Within the first few sessions, my suicidal ideation decreased, the voices were all but banished, and I was thriving like I had never before.

The side effects were bearable — some slight memory loss, confusion, and issues concentrating. I did have terrible nightmares from the anesthesia, some slight memory of the actual procedure that caused me significant distress. But I would trade all of that for the ability to manage voices.

I miss the noise, but I do not miss the problems they caused for me.

Getty image by Uwe Krejci

Originally published: October 18, 2023
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