Electroconvulsive Treatment

Matt

Male
Age at interview: 36

Brief outline: Matt’s wife experienced severe postnatal depression and was admitted to hospital a couple of times. After she didn’t respond to medication, she was given ECT. He thinks that ECT was eventually effective in treating his wife’s depression.

Background: Matt is a writer, married and has three children. He describes his ethnic background as White British.

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Matt had assumed that ECT was ‘something from the fifties and sixties that didn’t exist anymore’ and he only really knew about it from films. However, when his wife was admitted to hospital with postnatal depression (two years after the birth of their second child), he saw a sign for the ECT suite in the hospital. His wife came home from hospital but wasn’t any better and was admitted again the following spring. It was during this admission that the consultant and the community psychiatric nurse talked to Matt and his wife about ECT. In hindsight, Matt felt that she may have been admitted to hospital so that ECT could be a treatment option. At first Matt found the idea of ECT very frightening, and although he felt used to the idea of inpatient care and medication, ECT seemed very different from this. He looked on the internet for information about it and found lots of information from the Royal College of Psychiatrists website, which he found helpful. This told him about the procedure, how long it lasted and what the success rate was. Matt found that the ‘cultural baggage’ surrounding ECT was considerable, and felt that his wife thought that ECT was somehow embarrassing or shameful.

On the day of his wife’s first treatment, he had pre-arranged with the hospital to see her when she came out of treatment on the ward. When he turned up to see her he was told he couldn’t. Eventually he did see her, and she seemed relaxed and quite comfortable. His wife was later transferred from an assessment unit to another ward and changed consultant in the process. Her new consultant didn’t want her to continue with ECT. Matt felt that his wife’s energy levels had begun to recover ahead of her mood, but when the treatment was stopped, this recovery stopped. He felt frustrated by the whole structure of care and felt his wife’s history and lack of response to medication had not been taken into account by the new consultant. Eventually the consultant agreed to more ECT but there had been a gap in treatment and so they had to start a course of treatment again after some time had passed. Matt didn’t know whether this next series of treatment had worked, but after 12 sessions had been completed they went away for the weekend and he saw his wife laughing and smiling with the children for the first time in a long time. Now he is frustrated that it took so long for ECT to be suggested, particularly as medical staff seemed uncertain about the effectiveness of the different medications his wife was taking.

Matt has had varied experiences of health care staff. The crisis resolution team didn’t greet him when they came into his house and only spoke to his wife. The Early Intervention Team involved him in many aspects of his wife’s care and asked his opinion on her well-being. He suspects this is because that type of team is more used to working with families. When his wife was first admitted to hospital, they were left waiting by staff for three hours in an environment that seemed unfamiliar and chaotic. In the hospital there were facilities, such as a family visiting room, but access to these facilities was not explained to him at first. 

Matt thinks that whether a close relative should have ECT is a very difficult decision to be consulted on. Although research studies evidence the effectiveness of ECT, the fact it takes places under anaesthetic and people have tea and biscuits afterwards, he feels there is no getting away from the fact that it still involves administering an electric shock to the head. Matt has now discussed treatment options for the future with his wife and would now feel comfortable giving his permission for her to have ECT, even if she didn’t want it when she was very unwell. 

Matt went to a weekly support session as part of the team that supported [his wife], but says that the hospital didn’t offer him any form of formal support. Although he has spoken to the children about the time that his wife spent in hospital, he hasn’t spoken to them about ECT as he feels they are too young to understand. Matt would like to know why clinicians and researchers still don’t fully understand the way in which ECT works. In addition he wants to know why, if it is considered to be so effective, ECT is seen as a ‘last resort’ for people who are very distressed. 

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