Electroconvulsive Treatment

Tristan

Male
Age at interview: 38

Brief outline: Tristan’s wife had her first major episode of depression after the traumatic birth of their first child. She was admitted to hospital following an overdose and was soon offered ECT, age 33. Although at first she responded dramatically to ECT, she relapsed 6-10 weeks later. Tristan’s wife is now recovered and they have had another child together.

Background: Tristan is a paramedic, and lives with his wife and two small children. He describes his ethnic background as White British.

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Tristan met his wife in university and they married in 2000. His wife had had a history of depressive episodes the first of which was during her ‘A’ Levels. These depressive episodes have been usually associated with particularly stressful times. 

However in 2008 she experienced very acute depression after the birth of their first child. Tristan said that in the lead up to the birth, she seemed happy and that the pregnancy had gone well. His wife had a very long labour and didn’t sleep for two nights. She also lost a lot of blood during her delivery and had to have a blood transfusion. Tristan was left alone with the baby whilst she was resuscitated. When she returned home she looked exhausted, but Tristan expected her to begin her recovery from then on. They got extra help at home and ended having someone look after the baby for quite a lot of the time. His wife, however, still really struggled to sleep. By the end of the month Tristan said that his wife started to develop symptoms of ‘not being normal’. She appeared to have very anxious and delusional thoughts. Tristan said that she never had hallucinations as such, but that the way she saw the world was very negative. 

Tristan said that they saw the GP, and then a psychiatrist, relatively quickly. His wife had developed puerperal psychosis and was significantly delusional and psychotic prior to being given ECT. They tried to manage at home and tried ‘various drugs’. Tristan said there was very little progress and he became reluctant to leave his wife by herself. His wife tried several times to harm herself and took an overdose. She was sectioned after taking the first overdose and spent some time in a local psychiatric unit. Tristan thinks it was during this admission that ECT was offered as a treatment. His wife was ‘fast-tracked’ into ECT due to the perceived urgency for her to bond with her new baby. His wife had six treatments over six weeks. He noticed a big difference in his wife’s mood after only 2-3 ECT treatments and up until then Tristan had no idea whether his wife was ever going to get better. She did, however, have a relapse about 6-10 weeks later – a development that Tristan found very hard. 

Tristan felt that he and his wife took all the decisions about ECT together. Tristan was positive about ECT in the first instance, even though he had various reservations. He doesn’t think ECT was a well-understood treatment and didn’t know whether it was going to have a long-term impact on his wife. He can remember the consultant being positive about ECT, and was told repeatedly that the side effects on memory would ‘more than likely be short-lived’ and that there would be no long-term effects. In hindsight, Tristan would have probably wanted to see more of the evidence to back up what the consultant told him. Instead he felt he was being ‘sold’ the treatment. Tristan said that in some ways he was given a lot of information as he was told about what was going to happen in a lot of detail, but that the general approach of the staff was to speak to his wife as ‘less than an equal’. Tristan was shocked at being separated from his wife when she went into hospital, as up until that point he had been with her all the time. He felt the weight of the decision for her to have ECT and wondered whether he was making the right decision at the time.

Tristan said that the short-term memory loss from ECT was very noticeable and disturbing, particularly when he didn’t know that it would revert back to normal quite quickly. He said that she returned to her ‘normal self’ really quickly and that the psychotic thoughts disappeared. However there were one or two instances where she reacted with ‘an almost euphoric state’. Tristan thinks the biggest breakthrough was her change of medication and also the sedative effect of the medication that allowed her to sleep. He thought that sleep was a huge factor in her recovery. Now she is on an antidepressant that seems to suit her. He said that his wife told him that this medication took something off ‘both ends of the spectrum’ of sadness and happiness. Tristan thinks his wife has nearly totally recovered and her memory is 95-98% of what it used to be.

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