It was still dark as Barb and I pulled into the near empty parking lot. I was feeling groggy since I hadn’t my much-needed morning coffee. In fact I hadn’t had anything to eat or drink for the last 12 hours. Paying the outrageous parking fee we crunched across the icy parking lot and up the salt saturated stairs. We went through the very heavy doors, followed the signs to the room we would be spending the morning. This part of the hospital was quiet and dark, dark except for a room at the end of a corridor. We walked towards the light. It was the ECT clinic.
When I think back, I think I always had a depressive personality. I always felt like an outsider, isolated, melancholy and unloved. Knowing what I know now about depression. I must have had my first major depressive episode in my early 20s. I muscled through it and it eventually lifted, however I believe it never left me completely. I did learn to manage it though with alcohol and being a workaholic. These things could only mask the depression for so long, eventually it crept up and escalated to a point where I couldn’t function any longer.
By the time I reached my late 40s I was barely able to concentrate any longer, hardly sleeping, and had a constant feeling of dread and impending doom, I could barely get out of bed. I had reached a crisis and needed more medical help.
The psychiatrist I had just started seeing urged me to go to the emergency ward at North York General, which I did and that began the long difficult process of finding effective treatment for a mental illness.
Treatment for depression as with most mental illnesses is not an exact science; it’s very hit and miss. One needs to try different medications to find one that shows benefit. If there are any benefits from that specific medication, it will only show it self after several weeks. If not, you must start again, and try something new, repeating the process. In can be very frustrating. It is very frustrating. One can start to feel like a lab rat.
After about a year and more of trying different medications and group therapy sessions I was only having minimal improvement. I was labelled as having refractory depression, or treatment resistant depression. While things were improving, I still could hardly function. I eventually asked if he thought ECT would be a viable option. I had heard an interview with Carrie Fisher, Princess Leia, where she stated she was having ECT once a month and it had saved her life. He did think it was a good idea, and I was referred to CAMH to pursue this form of treatment.
ECT stands for Electro Convulsive Therapy, a frightening scenario to think about. A doctor sends a low and brief electrical current through the brain, which triggers a seizure. During the seizure the brain is flooded with different chemicals, like adrenaline, dopamine, and a bunch of others I don’t know the name of. It has been shown that these chemicals can open pathways in the brain that will lift the patient out of depression or kick-start the medication to work. The history of the treatment is interesting to look into if you are interested.
So there I was, with my wife, on a frigid February morning, cold, scared, frightened and craving a coffee, heading to the lit room at the end of the hallway. The room was a classic cinder block construction, inspired by Soviet era designed by people who hate people. Painted a drab yellow with florescent lights overhead. Much to my surprise the waiting room was already full. There was room for me to sit but not Barb.
Scanning the room I noticed an adjacent room where the nursing staff was preparing what seemed to over twenty gurneys with sheets and small pillows. They were lined up side by side, for some reason this really disturbed me. It reminded me of pictures and videos I have seen of war hospitals where the dead and dying all lined up, waiting to be treated. I was also shocked at how many people would be receiving treatments that morning.
There was nothing to do but sit down and wait. Eventually a nurse came around, took my temperature, blood pressure and confirmed I had not eaten or drank anything over the past 12 hours, and that I had a ride home. The information was added to my chart and placed at the bottom of a pile. The small room continued to fill with people and was spilling into the hallway. The first light of morning was beginning show itself.
After what seemed like forever, a man carrying a brief case hurriedly walked in. He headed towards a second door without looking at the room full of patients. Who was that? Ten minutes later a second man arrived and went through the same door the same way.
Things were about to get real. The gurney room door was closed, the pile of charts was grabbed, I guess its show time. The first name was called and an older woman went through the mysterious door the two men had gone through. After about five minutes I heard a beep, beep beeeeep, then silence. Fifteen minutes later the next name was called, then the next, until eventually my name was called. I was so nervous, I had only small idea what to expect.
Weak kneed I entered the treatment room where I was instructed to remove my shoes and lie down on the gurney. The nurses came at me from all directions, tearing the backs off adhesive tabs that were used to stick monitor leads to both my ankles and chest. A cool gel was applied to top and side my head. The man who had arrived first was sitting next to me and painfully inserted a needle into the back of my hand that a was attached to an IV bag.
I could now hear my heart being monitored on a smaller beeping machine. The second man who had his back to me the whole time while he read my chart finally turned around, said something to the staff then told me about some drug he wanted me to start taking, and how often and how long I would be receiving the treatments. Like I’d remember any of that, I was very frightened.
I was told to take some deep breaths, and the head nurse told me to relax that they will take good care of me while I was asleep. I felt the anesthetic enter my arm. Before I knew it I was losing consciousness, listening to the beeping fade with a swooshing sound, staring at the fire sprinkler attached to the drop ceiling.
When I awoke, I was lying on my side on one of those gurneys lined up in the room I saw earlier. There were people, knocked out on either side of me. My head was killing and I was disoriented. I called out about my head and a staff member calmed me down. After lying there awake for several minutes, I was helped up offered a Dads cookie and a juice, which I took.
I was escorted back into the waiting room where I was required to sit and wait for another hour, just to make sure it was safe for me to go home. Besides the headache I noticed I felt like I had to bounce my left leg and that I was clenching my jaw.
After that hour I was allowed home, I had a coffee and light breakfast and went back to bed as if in a dream.
I continued with two courses of treatment. Which meant 3 weeks twice a week then a gradual tapering off maintenance treatments. They got easier to endure as I got more acquainted with the procedure. I did experience some memory loss, which was disconcerting; although handy when watching a movie I had supposedly already seen. Eventually I got to know the nursing staff and got to know my fellow patients. People, who had been not three weeks earlier almost catatonic, zombies now had a spark of life in their eyes and were able to have conversations and show emotions.
The procedure seems archaic, barbaric, torture: mainly because of “One Flew Over the Cuckoo’s Nest”. While it is quite unpleasant, every effort was made to make it as painless as possible by the staff. I don’t think medicine fully understands why ECT works, but it does. It helped me. I hope I never need it again.
I still have depressive episodes; they are not as long or as intense as they once were. Suicide doesn’t seem like a treatment option any longer, and because of the illness I have become more active in the mental illness artist community. I have met some of the most genuine, caring people amongst the mentally ill, than I have in the so-called well population. It has helped me be accepting of the things that are out of my control and I think it has help me be a more compassionate and empathetic person. And I guess that’s all right.
Steve In Toronto stevenlewisart.com