Daily Archives: September 23, 2013

Depression & ECT

“I’m single. I don’t want to trouble my family. Let me end my life.”

She repeatedly stressed that she’s single (I’m quite sure when she was well she never minded it). She seeks for all different kinds of methods to end her life. But because of how caring and loving her family is, she is still living, and maybe to her, suffering. She has had at least one attempt of suicide in the past in which she cut her wrist.

This is a woman in her 60s, not married, currently staying with her nephew and nephew’s family. Her sister used to look after her, and live with her, but over months, sister was upset by her, affected by her negative energy and mood, and has temporarily withdrawn from her role of looking after her. She has a lot of very negative thoughts, lacking drives and interests, just feeling lazy and not wanting to go out, see anyone, do anything. She has lost interests to those that she used to find pleasurable (Remember I said in “Depression & Suicidal Risk”? Lacking interests & drives!)

I spoke to her nephew and nephew’s wife quite a number of times. They are both very empathising. They are feeling pretty helpless, not knowing how to look after a severely depressed auntie. Sometimes they have to lock her in the house or bring her everywhere with them, being worried she will commit suicide if she’s left unattended.

She’s still on quite a high dose of anti-depressant medication, she’s very regular with it, after all these years. Sometimes even the family is a bit doubtful whether the medicine is helping, the patient is the one that knows clearly things are going to be so messed up and so wrong if she stops it. But it seems that the medication has stopped working for her, as she grows more and more depressed and negative.

Consultant psychiatrist suggested Electroconvulsive Therapy (ECT) for her. On the day before her ECT, she jumped off the sea, and perhaps she’s meant to live a lot longer, a passerby saw her and dragged her back. She has had two sets of ECT done about 4 years ago. This does appear to be the fastest and perhaps the last resort for her current condition. It’s a controversial treatment, yet I’ve seen people benefited from it. Memory loss is one common side effect reported, yet perhaps it’s best for the patient to temporarily forget certain things?!

I’d say if ECT is likely to do more good than harm then people should really go for it, but it should always remain as the last resort, after patients have tried all other therapies.

 

Subsequent follow up of this patient: Can we allow a severely depressed patient to make the decision?