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A Note on Electro-Convulsive Therapy

July 26, 2015

by

Minna vander Pfaltz & James L. Secor

Let us be real here and not PC. What I am talking about is electrical currents being cast over your brain under cover of therapeutic treatment of depression, suicidal ideation, mania and “other mental illnesses.” This is what ECT is. It is mild electrocution. It is blasting a brain with more volts and amps than you can get by sticking your fingers into an electrical socket in your home. And it is called medicine.

This voltage greater than that used to power your house is touted on the high bandwagon of snake oil salesmen as the Gold Standard of treatment for depression, suicidal ideation, mania and “other mental illnesses.” How are we to believe these insurance industry-laden non-medical men who have enlisted Dr. Oz to sell this horror as good and right? Dr. Oz has been found to be a snake oil salesman, in down home terminology, by a Senate Committee. Dr. Oz will sell whatever it is he’s paid to peddle. Ever notice how everything, absolutely everything Dr. Oz sells is the best? The answer to whatever ails you? Even if “yesterday” he said the same about a different product?

Dr. Oz, and the health industry, are marketing things that are enhancements rather than treatments that will improve functioning, individual and social functioning. As such, it can be said the health industry is marketing disease, since it isn’t curing anything, in this instance. (Cf. David Healy in Mania: A short history of bipolar disorder. Balto.: Johns Hopkins University Press, 2008, pp. 22-23. Though he speaks eloquently to this aspect of the pharmaceutical industry throughout, noting that it began much earlier, perhaps in the middle of the last century.)

From the 1930s to the 1970s electro-convulsive therapy was the Gold Standard for depression and schizophrenia and, cynically, whatever behavior that the status quo did not accept or wish to tolerate. And it got a bad name. A well-deserved bad name. People lost their memories. They lost the ability to find words. They became disoriented and depressed and they committed suicide. Everything electro-convulsive therapy is supposed to cure. The manner of administration was horrid. Medieval, some said. And it fell out of favor.

And then, suddenly, in the early 21st century electro-convulsive therapy was again hailed as the Gold Standard for the cure of depression, suicidal ideation, mania and “other mental illnesses.” Without a study to back up the PR. Without a trial to support the PR. Without any case reports or empirical data or evidence-based medicine. After a 30-year hiatus, enough for people to forget and a new set of medical personnel with no historical knowledge or experience to rise up and take big PHRMA and the health industry PR at face value and follow scientifically wanting randomized control trials (RCT) parading as truth and proof (Cf. Healy, pp. 128-35, 217 and 231-33). It is true that the administration of the shock therapy is very much more humane than before; but you are still strapped down and the side-effects are still the same. I think the new bandwagon selling of mild electrocution might be akin to The Emperor’s New Clothes.

In all those 30 years, there have been no further studies. None. And, in truth, there have been none since only continued RCTs and no gathering together of the findings—bo0th negative and positive—to prove a cure. With the multifarious illnesses electro-convulsive shock therapy is supposed to cure, the variables to be dealt with and overcome must be near to uncountable. That is to say, not all mental disorders are of the same etiology and also do not present with the same neuro-electro-chemical signature. Instead, there have been rehashed versions of past numbers (findings) that enhance marketing—and considerable rhetorical shenanigans.

In fact, there have been no studies at all as to electro-convulsive therapy’s efficacy past the hawked “quick and temporary fix.” That is, no publicly produced long term studies of the efficacy of mild electrocution on depression. Why? The bandwagon leaders and their bought and paid for medical salesmen say right up front that electrifying your brain is a “quick and temporary fix” for depression. And then go on to say that electro-convulsive therapy is the Gold Standard for curing depression, suicidal ideation, mania and “other mental illnesses.” Without the proof. Just because they say so. And it’s both?

Cure, cure, cure! Have I got a cure for you!

Unfortunately, these bandwagon slyboots do not have horses hitched to their wagons so we can stampede the beasts of burden and rid ourselves of the electric neon rhetoric that colors the truth.

The truth? Fully 50% of electrocuted depressives regress after six months or more. For people with Bipolar I this rises significantly. And this is a positive result? So positive that the electric cure is a Gold Standard? There is no doubt as to why this is not a commonly known outcome.

We don’t hear of these results because the used car salesmen’s voices are louder and the proponents of electro-convulsive therapy are more powerful, rejecting every finding but their RCT, even if the RCT does not disprove the null hypothesis. (Null hypotheses are never disproven; they are falsified in a particular given situation.) And dialectical materialism can be made to prove whatever is wanted. For instance, if 50 of the patients receiving electro-convulsive therapy improve and 40 of those receiving a placebo improve, the bandwagon salesmen, who have alot to lose, maintain electro-convulsive therapy works. But does it? A 10 person difference is not significant because chance occurrence is not ruled out. Chance must be ruled out for validity. Plus, the sameness (or differentness) of the two samples is not known. In fact, there are so many unknown variables that no conclusion can truly be drawn proving electro-convulsive therapy is more effective than nothing. But the snake oil salesmen don’t care. As long as they outshout their detractors they are right, even though they are not.

And herein, in study populations, lies a major problem: these bandwagon salesmen plunk all depressions into the same basket. As if to say depression is depression. In fact, depressions differ. Bipolar I depression is of a different sort than major depression. Bipolar I and major depression are two different diseases. Bipolar I is closer, chemically, biologically to schizophrenia than it is to major depression. Bipolar I depression can be psychotic depression; not so Major Depressions’ depression. But when your provender is money and prestige, who the hell cares about such differences?

Again, artists and non-creatives are lumped together when it is known, for a fact, the character, the personality and the brain electro-chemistry are different.

How successful is early intervention compared to late intervention? If both are intermingled, there can be no valid findings.

Males and females? White, black, oriental? Young and old and middle aged? First timers versus repeaters?

If none of these variables are taken into consideration, then nothing of any worth can be said about electro-convulsive therapy. And if they are ignored, the peddled findings are scientifically invalid.

I know a writer who was considered a good candidate for electro-convulsive therapy because he had not written for two and a half years. The presumption was that he was depressed. He was not. He ran through a three-month long mixed type episode followed by two months of depression, two months of anxiety determined to be a manic episode, Lithium that became toxic causing transitory encephalopathic symptoms. He then had a TIA of indeterminate origin followed by major surgery. Anaesthesia made him depressed, he was being weaned from another medication for control of depression that was not working, and the pain medication created havoc with his moods. When he gave up this medication, his mood improved to a mild mixed type expression and his rehabilitation progress improved dramatically. Three months later, after a lamictal-induced mania and overdose of lorazapam in an attempt to quieten the manic fury, he began writing again and has continued to write, even through a mild depression (dysthymia?). None of this contextual information was taken into consideration in determining his eligibility for electro-convulsive therapy. Two and a half years of no writing equaled unremitting depression. The only proven characteristic about him, proven by history, was having treatment-resistant depression. But, luckily, he was turned away when he was found to be Bipolar I. The doctors were only interested in major depression. It’s easier to deal with.

Was the lorazapam overdose simply an attempt to ameliorate his pressured mind- frenzy or was it another end-of-it-all endeavor? The happy electro-convulsive therapy doctors didn’t ask. If this was another suicide attempt, as the ER staff suspected, this would be the third attempt. Electro-convulsive therapy does not stop “future” suicide attempts/successes, though the hucksters maintain it cures it while maintaining it is only a “quick and temporary fix.”

These doctors were practicing bad science. But, then, electro-convulsive therapy is bad science.

One of the major players and early supporters of Deep Brain Stimulation for Treatment-Resistant Depression in people with Bipolar I no longer considers DBS. She is now a cheerleader for electro-convulsive therapy. Why? There is more money in it. More grant money. More professional recognition. More academic credentialing. Strutting is apparently more important than relieving the pain and distress of people who have suffered for years. People who have ruined lives. People who are ruining the lives of others. People who have become social problems. People who are more likely to kill themselves than manic depressives, schizophrenics, OCD sufferers, Tourette’s syndrome people, Parkinson’s and other motility dysfunction disorders. Let them eat cake while the electro-convulsive therapy proponents eat caviar and feel good about themselves.

Yet, electro-convulsive therapy is not a cure; it is “a quick and temporary fix.” Nor is DBS a cure. What is most important about DBS is that it increases the personal and social functioning of individuals with a certain disease or syndrome or disorder. Call it what you will. This is what medicine’s various offerings are supposed to do: increase a person’s ability to function. Because a cure is not always available. There is no cure for a genetic mutation—other than death. “A quick and temporary fix” is not even a palliative for these people. For people who have been suffering for years, it is a slap in the face. An insult to one’s intelligence. A snide condescension. After years and years of dysfunction because “nothing” works, increased functionality is wanted. A relief from the pressure and decrease in quality of life. ECT does neither. DBS does

I knew a neurologist who came upon a malfunction with his EMG machine. Several patients in a row showed the same findings though their symptoms predicted differences. In order to appropriately discern the malfunction, he needed to test a “normal” person. So, he did. He had himself hooked up and tested. Same results. What a man! What a doctor! Not only did he prove that his equipment malfunctioned, he now knows just how his patients feel.

Perhaps the doctors advocating electro-convulsive therapy as a cure-all for mental diseases (which it is not) should undergo the treatment. Heal thyself, doctor. Don’t say you know, don’t say you understand what people experience, for you show not only your ignorance but your total disregard of your patient’s experience. Not just one shock, either. The entire multiple shock regimen that is the full treatment. And then write a paper and deliver a public lecture and teach and treat patients. I think you will find your functionality has decreased. . .and that has wrought a less acceptable life; that is, a life of less quality.

The trigger point for Bipolar I depression is scientifically and medically known. It is very local. The subcallosal cingulate. Area 25. So, why would anyone want to deny facts of focal locality in favor of a global non-local, non-focal treatment? There is no focus in electro-convulsive therapy. It is global disorganization of the general brain mechanism, the over-all everyday constant electrochemical neurological running of the organ called the brain. This background noise, if you will, is always present. It is what makes character and personality and, for lack of a better word, spirit. And electro-convulsive therapy disrupts this in the name of a cure. Electro-convulsive therapy institutes an unknown disease in its victims, though only for a short time, in the name of curing that victim of a known but totally unrelated disease. That the seizure lasts a short time does not speak to the long term negative effects and, in the case of artists, downright ruination of personhood of the treatment.

Again, proponents of electro-convulsive therapy—they prefer ECT because it’s nicer—while selling electro-convulsive therapy as a cure for depression, also maintain that it is no more than quick, temporary relief. Is dialectical materialism at work here? Are we being told that we can have and not have green hair at the same time?

The fact that it is almost impossible to discover the negative side of electro-convulsive therapy in the modern day is illustrative of the old, very old adage that if you only hear one side of an assertion, you are being lied to. The truth is being hidden. And it behooves you to look further. For there are two sides to everything, as they say.

You can also be sure that if someone is trying to control you, make you think and believe in a certain way, they are lying to you. This is most obvious in politics. It is also what is going on with the recent push for electro-convulsive therapy as the Gold Standard for cure of depression, suicidal ideation, mania and “other mental illnesses.” Since it doesn’t differentiate in diseases, one has to wonder about its claims. In fact, it is not so very far removed from the application of electric eels in the Middle Ages for the cure of frenzy.

Frankenstein applied electrical energy and created a monster.

There is a cure—more precisely, there is a method of control and stabilization of depression for both Major Depression and Bipolar I depression. Treatment-resistant depression. It works. It is effective. It is life-enhancing. But it is only allowed by the FDA for Major Depression. Bipolar I people must continue to suffer. When people suffer with treatment-resistant depressive Bipolar I, so do all around them. Their disease worsens. The risk of suicide increases the longer treatment is withheld. Major Depressives don’t commit suicide, they just more or less waste away if they don’t recover. Manic depression, easier to treat, is more worthy than the more erratic and dangerous Bipolar I TRD. Could it be because Bipolar I is a more complicated, more multi-faceted disease and therefore requires more energy but is not such a money-maker?

How much is a life worth?

So. . .you say you approve of and want electro-convulsive therapy? Go commit first degree murder and you will be assured of a cure. Otherwise, you have, at best, a 50% chance of a quality life after electro-convulsive therapy. For me, that is not enough. I was told that and better with drugs: not true. Not true at all. One hundred percent failure. When you open Schroedinger’s box, you want a greater probability of life than 50%, which is all you have to begin with. And now? Now you’re told you cannot get the treatment that is guaranteed to settle you. Deep Brain Stimulation for Treatment-Resistant Depression in Bipolar I is not approved by the FDA. The FDA wants you to have the sure failure of electro-convulsive therapy, by which time you may be too old, chronologically, to qualify for DBS. The FDA and the bandwagon proponents of electro-convulsive therapy prefer you to suffer, and allow you to become obsessed with getting even with the people who will not allow you a life of quality and maybe commit suicide. In the name of. . .what?

Take away my life. Take away my art. Take away my children. Take away my grandchildren. And take me away from all this. All in the name of electro-convulsive therapy, a false sinecure. These people and the FDA are making sure that when Schroedinger’s box is opened, you (the cat) are dead.

Gosh! But, y’know? How sad.

The cure—no, the stabilization and control that results in increased functionality is known and shown to be effective for the long term. You don’t need trial after trial after trial after trial ad infinitum if the therapy works. But this good therapy, DBS, is sold out for electro-convulsive therapy. . .and money. Florian Engert of Harvard blasts such a “cure.” For years he tried to change behavior by giving animals shocks (and rewarding them) to no avail. Electro-convulsive therapy doctors don’t give rewards, just shocks. They have too narrow an idea and understanding of the brain and how it works because the more cells you try to track at one time, the higher the risk of killing some of them, of disrupting the general electro-chemical functioning of the brain (Cf. Ariel Sabar’s article on Florian Engert, “Flashes of Genius” in The Smithsonian, July/August, Vol. 46, No. 4. 2015). As attested to by the long term nasty side-effects reported by patients carefully omitted from bandwagon snake oil salesmen’s pitches.

How much is a life worth? Dr. Wu. . .how much is a life worth? How much is an artist, an artist’s life worth? And. . .who the hell are you to make a judgment call on my quality of life? That’s your idea of quality of life, not mine. You and all the other snake oil salesmen who throw everyone into the same boiling cauldron. Double bubble, toil and trouble. (Perverted Shakespeare for a perverted cure.)

Electro-convulsive therapy was a lie earlier in the 20th century. It was a lie during Medieval times. It is a lie today.

How many people have committed suicide post-electro-convulsive therapy, deaths that are not included in the yellow journaled reportage? How many artists have gone on to commit suicide post-electro-convulsive therapy? How easy it is to write them off, forgetting the cure that was, in fact, no cure at all but only a quick and temporary fix. How can you have and not have green hair at the same time?

But electro-convulsive therapy is easy and remunerative. It takes no thought at all (and sometimes leaves none). It is no more than beating a dead horse. . .and then maintaining that the horse was the fucking problem to begin with. As in this story:

Of Nails and Heads

Gao Wenping 膏紊平 was a successful salesman, a garrulous merchant with a knack for making a good deal out of nothing. He dealt in whole cloth. His loud voice and boisterous laughter could be heard throughout the marketplace. Everyone wished to set up their stalls near Gao Wenping’s in order to wreak profit from the fallout from his dealings, for he drove a hard bargain and when customers left his stall, they were fair game for a soft sell.

After a rather immoderately long stay in one particular town, he decided to take his newfound fortune and return home. If he started early enough in the morning, he could be home by supper time. So, he packed up his bags, mounted his horse and was off, immensely satisfied with himself.

Around mid-morning, Gao Wenping decided he’d stop for some tea and put up at a tree-shaded roadside teahouse. While he was drinking his tea and snacking on some delicacy or other, he harangued the innkeeper with delightful tales of his exploits. The other guests were listening in as well, which only served to swell Gao Wenping’s story telling the more.

A leather-clad man filled the doorway and shouted in a rich, booming voice, “Who’s grey mare is that outside?”

“She is mine,” answered Gao Wenping.

“She’s a loose nail in her left hind shoe should be seen to.”

“It is of no consequence. I’ve only a few hours more on the road.”

“I’m a blacksmith on my way to Anxing town. I’ll fix it for you.”

“No bother. No bother,” said Gao Wenping, who then got up, paid his bill and went on his way. Gao Wenping was a thrifty man.

Around noon, Gao Wenping stopped for a bite to eat and his mid-day rest. The inn was very crowded but being bellicose and free with his money, he managed a comfortable table and room. Before he went inside, while he was tying up his horse, a farmer noted, indicating with his chin, “Your old mare has lost a shoe. Better take her to the smithy.”

“No problem. I’ve only a short way to go,” replied Gao Wenping. “There’s no reason to do anything.”

So it was that, after his nap, Gao Wenping loaded up his horse and went on his way with nary a thought to the horse’s hoof. There were no other towns or villages or inns on this stretch of road, so when the old grey mare took lame and then stumbled to the ground, Gao Wenping found himself in the middle of nowhere. He cursed and kicked the beast but to no avail–she’d broken her leg. Slandering her under his breath, he hoisted his bags onto his back and walked the rest of the way home.

He was late for dinner, expostulating all the while, “That damned nail has caused all this inconvenience!”

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