‘Should I try ECT?’

Delicate Dynamoes! Graham here.

This week, a rare guest post. One I’m supremely excited to share. 

This issue is by a long-time Big Feels Clubber, Amie, who writes about her recent experience of reaching that ‘here we go again’ place.

You probably know this place yourself. 

That place where you’re on your fourth or fifth time down the crisis rabbit hole, and still don’t feel like you really have any answers. That place that so many Big Feels Clubbers have written in to tell me about, time and again. That place where you ask yourself...

‘What the fuck am I supposed to do now?’

A place where you’re willing to try, well, anything that might help.

Over to Amie...

Small mercies

I’m sitting in a waiting room. 

There is nothing else to do while I wait for my name to be called, so I find myself watching the morning show that’s playing on the TV. One of those shows where they switch seamlessly between deeply disturbing news and segments on the latest celebrity diet. 

It’s nice to be able to find at least one positive in my current situation, despite all the obvious negatives:

My psychiatrist says the ECT might mess with my short-term memory. So… at least I won’t remember having watched this shit?

Why was I in hospital?

Last year didn’t go all that smoothly. 

I feel like I want to explain it with a phrase like “2020 was not my year” or some kind of spiel about the various world events that made it a pretty full-on twelve months for most people I know. But the truth is, I don’t think I’d say any of the last few years have been “my year”. So it’s a bit of a lie to pin down 2020 as some kind of anomaly. 

For whatever reason, I just seem to find life a bit hard, most of the time. Sometimes, a bit hard turns into really fucking hard. 

The reason I was in hospital was that the end of 2020 had become one of those really fucking hard times.

“Just ask for help”

I’m sure you’ve seen those ads and mental health campaigns assuring us it’s okay to “ask for help”, that there is no shame in struggling with your mental health and that you can get better with the right treatment. 

This is all well and good, but after asking for help countless times over the years, seeing a bunch of different mental health professionals and trying various treatments, the “just ask for help” message can start to feel like it just doesn’t apply to you.

Don’t get me wrong, I’m glad that people are talking more openly about mental health these days, and I know for a fact that this kind of approach genuinely works for some people. For example, a while back I had a conversation with a work colleague (at the pub after work, where all the best conversations are had) about why I was working part-time. Fuelled with some liquid courage, I told him honestly that I need to reduce my hours when my mental health is particularly bad. He told me excitedly that he had struggled with depression as well, in one of those “I’m part of the club too!” moments. It was the kind of conversation that might not have been possible just a few years ago.

Luckily for him, he found that taking medication made a huge difference. He asked for help, and the help actually helped (whaaat?). But when I told him that the drugs have never helped me all that much, our fleeting connection turned into another well-meaning round of “let’s fix Amie”.

“But… have you tried {insert SSRI here}? Did they play around with the dose?”

I know I’m not the only one who doesn’t fit the neat, “just ask for help and you’ll feel better” narrative. But it sure can feel that way sometimes.

Three reasons I find it hard to ask for help

The thing is, being someone that doesn’t respond to the usual treatment options can put you in a bit of a pickle, for a few reasons:

1. When you are used to feeling crap a lot of the time, it can be difficult to keep track of just how crap you’ve been feeling. 

Going downhill, for me at least, doesn’t necessarily involve an obvious dip in my mood. I just slip a little bit further down the existential crisis hole every time I find myself having one of those days. 

In fact, sometimes this can go hand in hand with moments of feeling really good. Like really good, and then EVERYTHINGISGOINGTOBEFINEANDLIFEISFANTASTIC! So, while the idea of asking for help when things are tough makes sense in theory, it relies on you realising that you need help in the first place.

2. When you’ve asked for help several times in the past, and it hasn’t helped, why would you do it again? 

Isn’t that pretty much what Einstein is supposed to have called the definition of insanity - doing the same thing over and over and expecting different results?

3. You can become pretty hesitant about asking for help too much.

Is this who I am now? A professional mental health patient?

So, I guess when things started going downhill last year, it took me a while to recognise it as worse than usual. I wanted so badly to be able to figure it all out for myself, and I didn’t want to admit that it was not working out like that. There was a part of me that was certain I could do it on my own, if I just took it more seriously, if I was more committed.

If you could just stop fucking this up, you’d be fine. Do you reckon you could just… be a better person?

By the time shit hit the fan it was pretty clear that if I didn’t make a decision about getting treatment myself, it would eventually be forced upon me. So when I agreed to have a stay in hospital, I wasn’t really sure what I was intending to do while there, or what I would get out of it - I just needed to do something. And there weren’t any better options.

Making big decisions when you’re deeply depressed 

A few weeks before my hospital admission, I found myself in a supermarket staring at rows upon rows of egg cartons. 

I was in one of those I-need-quite-a-large-personal-bubble moods, where I don’t really want anyone to come near me or make eye contact, so I was already flustered by the time I had to make this all-important ‘which eggs to buy’ decision.

And I just. Couldn’t. Decide.

The longer I stood there, the more anxious I felt - like making the wrong decision was a really big deal. 

What if I make the wrong decision and suddenly I’m a terrible person, or I’ve screwed everything up?

Fast forward a couple of weeks, and I’m sitting on my hospital bed, having just spoken to my psychiatrist about two possible treatment options. The first is to try a new medication, which is actually a really old medication that is hardly used any more, and which will mean I can’t eat cheese (seriously, you couldn’t make this stuff up). The other option is to try electroconvulsive therapy or ‘ECT’, which will almost certainly affect my short-term memory. 

I end up choosing the ECT, but at no point do I feel like I’m making a ‘good’ choice.

How am I supposed to make a big decision like this when I can’t even buy a carton of eggs?

The loneliness of choosing the ‘right’ treatment

The worst part of having to make this decision is that I have no way of knowing which is the better option - or if either option will make any kind of difference. I can talk it through with people I trust, weigh up the known side-effects and stats on treatment efficacy, but in the end it really just comes down to me making a choice and seeing what happens. 

That familiar feeling, that I am the guinea pig in some ongoing, lifelong experiment...

At this point, I’m not even sure that I’ve explained what is going on for me well enough for my psychiatrist to suggest the right treatment. I am constantly questioning the way I explain what’s happening inside my head. Some days, I feel like I’m just saying what they expect me to say, things that match the type of wording used on a depression questionnaire.

I’m not sleeping well, and I have no appetite, and I feel pretty hopeless about the future.

I realise this one day, and challenge myself to come up with my own explanation for what’s going on. But you know what? It’s really fucking hard to put into words. So instead I just say...

I don’t know how I feel.

Me taking group therapy very seriously

When you feel like you can’t fall much farther, you’ll try anything

So I do the ECT. Three times a week, for the length of my hospital stay.

It’s actually the second time I’ve tried it, having first tried it several years ago when I found myself in a similar place.

I never thought I’d consider doing it again. Not because it invariably brings up images of that scene in One Flew Over the Cuckoo’s Nest, but because, despite having forgotten a fair bit of that first ECT experience, I do remember thinking that it was a waste of time.

But here’s the thing. When you feel like there’s not much farther to fall, past decisions that you were absolutely certain you would stick to can start to feel like vague ideas from a different lifetime. 

Sitting on my hospital bed, tired of ending up in places like this and feeling like a complete loser for not being able to manage my own life, I'm ready to try anything, anything that might help.

So… did it help?

Yes… but not how you might expect. 

The ECT itself mainly just screws with my memories. Most of my hospital stay is a blur, plus a few other periods in the months leading up to it (in truth I don’t actually know how much it messed with my memory - how could I?).

The real benefit is finally accepting that the conventional approach is just not going to be the answer for me. 

Perhaps this is a decision we make and remake a few times in the course of our lives. It’s certainly not the first time I’ve had this thought. But in the wake of the headaches and memory loss and generally feeling no better than when I went into hospital, I find I’ve been left with a kind of clarity.

This isn’t the path for me anymore. 

And it gives me the motivation to start looking into alternatives. I start reading. I read Ethan Watters’ Crazy Like Us. I read Johann Hari’s Lost Connections. I start reserving all the mental health and philosophy books in my local library. The book pile near my bed reaches structurally unsound proportions.

And I find out something I kind of already knew, but that I desperately needed to hear. That my experience is not as unusual as I once thought. 

It’s hard to listen to the constant barrage of “just ask for help”, knowing that you’ve already walked that path. Knowing that, for you, that path is more like a loop and you’ve been walking in circles for years. But for me there’s a kind of relief in it too, for now at least.

It’s okay, that’s not my path.

All this walking in circles has made me... pretty fit? That doesn’t mean I know where I’m going, or feel any less overwhelmed by life. It doesn’t mean I won’t get lost a few times along the way. But one thing is for certain. I’m ready for a new path.

Tell Amie what you think?

That was long-time Big Feels Clubber, Amie, sharing a bit of her story. 

If you’d like to offer words of encouragement or solidarity to Amie, or just tell us what reading this brought up for you, click this big pink button and I’ll pass on what you share:

Meanwhile, we got a really amazing response to our last issue, where my Big Feels co-pilot Honor Eastly outlined some of the big, positive changes coming to Victoria’s mental health system. Many of you told us you had a little cry reading it (and we had some tears in our eyes reading your comments too). 

As I read Amie’s story, I’m struck by two things. One, just how fucking resourceful we each have to be, individually, to find our way with this stuff. And two, how it shouldn’t have to be such a lonely experience. So if you haven’t read it yet, Honor’s piece is a timely reminder that things don’t have to be this way - that there’s a glimmer of hope that, just maybe, we might be able to forge that ‘other’ path together.