Electroconvulsive Treatment

Sunil

Male
Age at interview: 56

Brief outline: Sunil first became seriously depressed when he was a medical student and was eventually given ECT. He responded rapidly to treatment. Later he was diagnosed with bipolar affective disorder and has had relapses of his condition. Sunil has found that out of all the treatments offered, only ECT really gets him better.

Background: Sunil is a Consultant, lives with his wife and describes his ethnic background as Indian.

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Sunil was born in Kenya and emigrated to the UK with his family at the age of 18. He had his first inkling that he had a psychiatric problem when he was still in Kenya, when he changed schools and worried he could not understand the lessons. He was taken to a doctor and prescribed sleeping tablets. In the UK, he found moving into self-catered accommodation a struggle and felt ill at ease in his fourth year when he found himself not with his peers after a year doing laboratory work. Sunil found himself in a situation where he worked in obstetrics and gynaecology and was “thrown in at the deep end”. Soon he became clinically depressed and this was recognised quickly by a teacher he had had from psychiatry. He was admitted to a ward away from the medical school he was attending and given antidepressants and responded quite rapidly. He was discharged after 4-5 weeks. The professor of psychiatry arranged for him to have ECT as an outpatient or as a day patient. He can vaguely remember being picked up in an ambulance to have ECT, but has very little recollection of this period. 

Eventually he completed his medical training and qualified as a doctor. He got married but his wife didn’t know about his major episode of illness when he was a student. Sunil moved into research in a laboratory based environment, researching HIV, but found the transition from taught syllabus to research daunting. He was also involved in a long commute between work and his family life. Sunil realised he was having ‘flights of fancy’ during a visit to relatives, and on his return told his wife, he became severely depressed. Sunil thought that it was around this time he was told he had “manic depression” (now referred to as bipolar affective disorder). However, he thinks that his care was grossly mismanaged as he had an under active thyroid and was prescribed thyroxine as a treatment. At the same time he was also prescribed lithium as a mood stabiliser, but one of the side effects of lithium is interference with the thyroid gland. During this time he had “several bouts of ECT” but can’t remember because of the memory loss. He thinks he must have signed a consent form but isn’t sure whether a form was needed that long ago (in the late 1980s).  

After this he qualified as a haematologist and became a Senior Registrar and then, became a consultant. Although his new position as a consultant was quite stressful, he has a period of being illness free for more than 18 years. He then had a prolonged episode and was off work for nearly a year. His wife knew his condition well, knew he didn’t respond well to antidepressants and asked the psychiatrist to give him ECT. After this, he was referred to a specialist bipolar service and attended a course called ‘Mood on track’. 

In 2012 he had the last serious episode. He was changed from his medication. He took carbamazepine during this period, which is an anticonvulsant medication. However, later he developed a very sore mouth. He was then put on Depakote (divalproex sodium) but developed osteoporosis and then olanzapine and lamotrigine. He believes that the change in his medication caused his latest episode. He has had two or three courses of ECT and in total had 39 ECT treatments.

Since New Year he has been on antidepressants and finds that he is very slightly hypomanic. He says that although his wife can cope with him if he is depressed she finds hypomanic periods more difficult. He now takes quiapine, mirtazpine and venlafazine (one mood stabiliser and two antidepressants). 

Sunil talked about the process of receiving ECT. He said he happened early in the morning after fasting before the anaesthetic. He says that the first thing you notice when you come around is being in a room with the other patients and being given some breakfast to eat. He felts a bit dazed and confused and ‘not fully with it’ but then had a sleep afterwards. He has says that the treatment has very little in the way of side effects and that suffering from long periods of recurrent depression, you are more likely to develop dementia and other conditions. 

Sunil sees ECT as treatment for severe depressive episodes, and he has agreed with his psychiatrist that if he gets this depressed in the future she will bypass antidepressants and go directly to ECT. He says that there are very large gaps in his memory, and sometimes he can’t remember the names of people he has known for years. He says that he used to worry much more about people at work knowing about his experiences, but he is no longer embarrassed or ashamed as he says that his illness is not something he invited. He thinks there is a particular stigma attached to ECT. Sunil is now very much looking forward to returning to work.

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