Medical Approaches to Mental Illness
Drugs ("good" and "bad"), psychosurgery (cingulotomy, capsulotomy, leucotomy), and ECT are all medical approaches to mental illness. Peter Breggin states in the ECT film that all of these practices affect the brain, and in many cases cause lasting brain injury.
How do you feel about the family's situation in the ECT film? Was it appropriate for ECT to be used in this case? do you think, based on the Robertson and Pryor article, that she received informed consent (from what you could gather from the film)? What were your thoughts about her situation?The brain controls the expression of our very souls, our "selves," and so when the brain is injured, or hampered in functioning, it may change who we are, and in many cases this change may be permanent. Given what you have learned thus far about the range of medical approaches to mental illness listed in the first sentence above, which treatments should be made available to people and why? Would you use any of these approaches ? which ones, and why or why not?
Answer all these questions thoughtfully, and then comment on at least 2 of your classmates posts, with evidence for your agreement or disagreement.
I had a hard time when I was reading the article by Robertson and Pryor when it stated, "ECT remains an important treatment option for the management of severe depressive illness." It is not a treatment option. Even with medication, it does not treat anything, it simply alters the severity of symptoms a person may be experiencing. I do not agree with ECT. I think it is not OK. If you went to the doctors with a cold and they told you that you need to take 5 pills of medicine a day and write you a prescription, you're not going to fight with the doctor because they "know" what they are doing. Doctors have a bigger impact on society and the way it is run more than people acknowledge. They (doctors) might say ECT is the best thing for that person, talk about the positive effects of ECT and then quickly list some of the negative side effects (not discussing the full extent), but if the doctors are truly in favor of ECT, they will know the right things to say to convince the patient, which is not informed consent since it's an altered way of preconceived consent. Michelle Usry is fully capable of giving consent, but the first time you see her before she starts to seize, she takes a deep breath because she knows what is about to happen hurts and is horrible. Say you have a broken legs and every time you hit your head on a cement wall, the pain from your broken leg would temporary go away, would you bang your head on the cement wall? Even though it is bad for you, but it is the only way you know how to temporary relieve the pain. No, you wouldn't. The difference between banging your head and ECT, is that ECT permanently alters your brain. When anything permanently happens, your mind it automatically perceive that as a positive. People are seeing a permanent effect from ECT and they are unable to separate positive permanent effects from bad and unhealthy effects. I think sometimes medication can be a positive way of temperately helping people who have mental illnesses, but only if they are on a low enough dose where it can help the person without causing permanent side effects and they can easily be tapered off the drug without permanent side effects. Medication can alters a persons way of thinking while they are on it, but can be snapped out of it when they stop taking the medication, a person who has ECT done, cannot alter permanent side effects they get from the drug which can cause a permanently altered mind.
ReplyDeleteAshley, I totally agree that the permanent side effects are awful when the change who the person really is. The mind is so influential and vulnerable that we have to be careful what we do to our mind and bodies. Like you I see the positive effects of medications sometimes but the dose needs to stay low. I was prescribed ADD medication one time in high school when I was having a really hard time but the dose was so high that I zoned out and almost drove off the road. Thank goodness I only had my permit at the time so my mom happened to be in the passenger seat but it was so scary. I didn't like the way it made me feel, it changed my personality and I felt like a zombie. Needless to say I don't take any medication now but I still struggle everyday, it makes me who I am. I remember how fast the doctor was to prescribe something for me and that is scary because I can only imagine how bad the side effects from other strong drugs and treatments could be.
DeleteAshley, I absolutely love your reference of a broken leg and banging your head off a wall to relieve the pain from the broken leg! To me that puts ECT into more of a perspective that I hadn’t thought about. I also agree with your statement about permanent side effects, and how doctors are so quick to pull out their prescription pad and just prescribe a drug for everything and anything. As a child I was diagnosed with systemic JRA (arthritis) and was constantly put on and taken off drugs. I constantly heard my parents asking about side effects and never really understood what they meant by it, until one day I was put on prednisone (a nasty but incredible drug) that made me gain about 30-40 pounds as a six year old. Thats when I finally realized what side effects are, and now since I have been on that side and have experienced these side effects that doctors talk about but just push to the side, I pay close attention to any medication that a doctor tries to push on me. So long story short, I’m on both sides of medication. I believe in it, because I wouldn’t be in remission right now, but at the same time, I don’t believe in it because there are other ways to feel better with certain illnesses then jumping to medication.
DeleteI couldn't agree more Ashley! ECT is NOT a treatment option and all it does is alter the symptoms. I also agree with you on the fact that we tend to not question doctors when it comes to medication. We just assume they have good intentions and are doing what they went to school and are trained for. Im not saying that all doctors are intending and giving out medication when it's not needed and that all doctors need to be questioned. But I do think that people need to be careful and really make sure that they are going to the doctors and coming out with the best advice, treatment, or medication possible for their situation!
DeleteI think that the families situation was just as unique as every other one. I understand the reasoning behind trying ECT and while personally I don't think I would ever do that or see someone I know go through that it doesn't mean it shouldn't be available. Appropriate, maybe? The family made it seem necessary and maybe it was but again, the "side effects" more like the negative consequences were far worse especially considering it didn't work for her. I don't believe she received the amount of informed consent that should have been presented to her, what she received was the doctors opinions and only the side effects he has ever seen. Her husband mentioned that he thinks they should have stopped after three but what I want to know is how changes were being monitored and why the treatments were so close together? I think that there should be a range of options, all medical approaches have negative effects and yet some work for some people and others don't. Yes they create changes some of which can be reversed depending on the medical approaches but isn't that the point? Even with therapy the goal is to change the way the brain thinks to stop the behavior from occurring or to change the mood. What the issue is, is the permanent change in oneself. Personally I would stick to medication and therapy for that reason of being able to keep the uniqueness of oneself. I think this for a few reasons, I have seen medication used and have a positive effect on individuals and while I can see and understand the negative effects I don't think I would have the relationship I have with my family today without the positive effects that medication has. Therapy is also something that I would use because it is a completely voluntary process throughout the whole thing.
ReplyDeleteHey Kylie, I fully agree with all your statements but I was wondering if you agree with medicine because of the permanent change that it makes on someone, or if you disagree with it? I personally disagree with it to a point. Last year I was put on an antidepressant and in my head I felt as though I was the same person I always had been, but to my family and friends I was a completely different person. I was happy go lucky 24/7 to the point that I got into a relationship that I was very happy in when I was on the medication, but once I got off the medication my normal self came back and I soon realized that that wasn't really a relationship I wanted to be in. The medicine completely changed my views on almost everything and made me someone I’m not, and I didn’t realize it until I was off of it.
DeleteKylie I agree! I think the families pretty much had the same kind of situations and went with ECT as a last resort. And I think you put it in the best words was by saying that these weren't "side effects" but more "consequences"!
DeleteHi Kylie! When you say, " I don't think I would ever do that or see someone I know go through that it doesn't mean it shouldn't be available," that is a very powerful statement! ECT can alter a person's way of thinking in many more ways than we can count or even know of. Do you think it should be provided to individuals who are being mentally altered from ECT, but are completely unaware to it? I could agree if a person was aware, but when someone because permanently altered where a piece of them is taken away, is where I have a hard time with actually getting consent from the person.
DeleteMegan, I disagree with it to a point as well. It is okay when the medication does what it is supposed to do and the patient is happy with their lives while on the medication. In your case it had some negative effects on your life and that's not okay and its good that you came off of it before it made permanent changes. Unless the permanent changes are good for everybody, then I guess that can be good depending on the situation. Its hard to say I agree or disagree to all or nothing.
DeleteAshley, I'm slightly confused by your question. I think it should be provided to those who know exactly what they are getting into and choose that option. They have to be aware, yes. If your talking about repeating the process after the person has been permanently altered, that's where it becomes tricky. I wouldn't want to see someone have it done just because they are supposed to get exactly 6 or whatever for there specific case...
DeleteI feel badly about the families situation in the ECT film, not only that Michelle’s family had to go through that but also that Michelle felt that that was a last resort for her and that she was dependent on it to help her feel like life was worth living again. ECT is literally a last resort, and personally I feel like there must be a better way to feel better then sending electrical shocks through your brain. I do believe that ECT was used appropriately for Michelle since she had done most everything else, but at the same time I feel like there was something else that could have been done that wouldn't of been so traumatic. Michelle received informed consent but it could have been more informative. I feel that the doctors left major parts out, and only told her what they have seen and not what else could happen. I also feel like her family pushed her into this procedure, and that she wasn't fully for it. Throughout the video I was hoping that Michelle would have the best outcome that there could have been and it was upsetting to know that the treatment did not work but it was relieving to know that Michelle did not have any major side effects like Liz received.
ReplyDeleteI agree that Michelle thought ECT was her last hope and that she became dependent on it. She stopped after only having 6 out of the 8 treatments and her depression came right back after a few days. But, she then says that she would like to have ECT again, because she had some (very) short-term relief from her depression during the treatment. I think she felt this way because in my opinion the treatment was glorified and pushed on her. I don't believe she was fully informed about all of the possible effects or how serious they could be.
DeleteHi Megan, I agree with you and unfortunately feel saddened that Michelle felt that that was a last resort. A lot of treatments are only discussed usually if the doctor is in favor of the treatment which is horrible. I think that there could be a lot of other treatment options if they were discussed whether or not the doctor agreed with the treatment. I also think a lot of time with whatever treatment the doctor is in favor of, the negative side effects often get not fully discussed like they should be. I don't think there is a survey or anything that could help with doctors disclosing everything they should or should not because more people are unaware of treatments or medications they are talking about.
DeleteI think that ECT is a very controversial treatment option, but personally I don't think it should be a treatment option at all. There is still a lot that is unknown about ECT. As stated in the Robertson and Pryor article, there is a "lack of formal research on ECT's effects on the executive functions of the prefrontal cortex". I don't believe Michelle fully received informed consent from her doctors regarding the extent of the serious and permanent side effects that could result from this treatment. Her doctor seemed to be very pro-ECT and told her only what he had seen from his experience. I feel as though ECT was pushed on Michelle and made to seem like it was her only hope to treat her depression. And in the end, ECT did not work. A few days after Michelle stopped treatment, her depression was back. I think Michelle was given false hope and assurance about ECT. After she had stopped treatment, and her depression came back, Michelle said she wanted to have ECT again. She had experienced some short-term relief from her depression during the treatment process, and she thought with more treatments that relief would eventually last. Michelle did not even complete the full 8 sessions that her doctor had originally wanted, and it only caused harm instead of good. I think ECT causes too much harm and virtually no benefits. It should not be used in practice due to the lack of research and understanding regarding the treatment and its detrimental effects. Personally for treatment options, I would always choose therapy first, and then medications next. Medications can also sometimes cause permanent negative effects and impairments so they should be used carefully in low doses.
ReplyDeleteAfter reading the article I was aggravated with the fact that they said "ECT remains an important treatment option for the management of severe depressive illness". ECT is not a treatment, it is simply a way to alter symptoms. And I think that these doctors know this to be true but put a "medical" spin on it to twist words in order to make it sound like it's a treatment option. I do not agree with ECT and I think it should have never been allowed to be made legal. it is simply not okay! I think that Michelle was frustrated and thought this was her only option. I think that she "looked" into ECT and believed that it worked because of other cases in the past. But I can understand her pain and wanting to not be depressed anymore. Wanting to be able to live a normal life and not want thoughts of wanting to kill herself. The fact that there was risk of Michelle losing her memory of her life and the person she was should have been a deciding factor to not have ECT! It is very understandable that she wanted to have a happy life, but the fact that this was a possibility is crazy! Why wouldn't someone with depression and thoughts of suicide look further into medication. Also the husband was so willing to let Michelle go through with the ECT and what, live her life and memories for her. I think that if it wasn't for the husband's mother, the husband would have left her. There should definitely be a wide range of medical approaches for people with mental illnesses, but anything that has to do with ECT should automatically be voted out or even considered. Do I think loading people with pills is a great idea either, no! But people now a days are so quick to go to the doctors for something simple in hopes for medication. Medication should be given out at a reasonable explanation along with a reasonable dose.
ReplyDeleteYou hit it on the head when you said, " ECT is not a treatment, it is simply a way to alter symptoms. " I agree with that 110%. I also want people to be aware that is does not just alter you, it mentally alters your brain activity in a way that will never be able to be fully explained. Very scary stuff.
DeleteI feel that ECT may not have been the right choice. The brain is not meant to be tampered with. For instance, I work with people who have suffered from brain injuries and after their accident, the person is not the same. They seem to lose apart of themselves; or never really become whole again. It’s an interesting method, but it’s a very risky and unsafe one. I don’t think ECT should have been used, unless it was the very last method anyone could have thought of for this family.
ReplyDeleteAs for informed consent, I think Michelle knew only what the Doctor told her. When you meet with someone who holds a doctorate, you’re not going to fight them on their knowledge about the subject, but listen and follow what they say. I honestly think Michelle should have gotten a different opinion. It seems she just went with what her Doctor thought was best for her. I think a second or third opinion would have been ideal. I can understand the decision making that she and the family went through. They were at their last resort and went with it. Most families would probably do this, thinking it’s the best decision, but just knowing that this could potentially change my process of thinking and my life! I would have researched both the pros and cons of this method.
It’s hard to say what is the best treatment because it honestly depends on the person. Everyone is different and it’s a hit or miss, but for now I would have stuck with medication and therapy. I just feel that if you are ready to commit to ECT, you have better ask yourself, “did I do everything possible?”
Trevor, I love your point of view. The brain should not be tampered with, its awful not to feel like your the same person you were. The other thing about Michelle's case is that it is portrayed in a way that it seems like she has tried everything possible but as well as Michelle, we are seeing every side to the story. I agree with you, for now I think medication and therapy are where I would feel safest.
DeleteI like that you bring in knowledge and experience from your work, and I completely agree with all the points you made. I don't believe Michelle was fully informed about ECT or given an accurate picture of what it does. I think the doctor she saw was very much in favor of ECT and I believe he presented a bias view to Michelle. I agree that she should have gotten multiple opinions from different doctors.
DeleteI give Michelle’s family the most respect for their effort, time, love, and most of all, their patients. Her husband, Travis expressed multiple times of examples in which Michelle’s disease or illness made him feel at fault, “feeling like the bad guy”, and also made him feel depressed. It was soon after her first son was born when things began to change… she suffered from postpartum depression and was diagnosed with bipolar disorder. At this point in Michelle’s life, I believe it was appropriate for Michelle to undergo at least one ECT treatment because of the severity of her depression. Even her husband admitted, after having three ECT treatments, Michelle began to see the light at the end of the tunnel. As that was the first and only time she had felt the “black cloud” lifted off her shoulders, the doctors should have examined her behavior and noticed a positive behavior change, stopping ECT treatments, opposed to following the standard ECT procedures, which are most often generalized.
ReplyDeleteInformed consent, based on Robertson and Pryor article, was not communicated or received to Michelle. Even though the procedure was discussed throughout the documentary, proper consent was not effectively communicated. I believe this to be true because Michelle fears, before her first ECT session, she will lose her memory, stating “ I hope when I wake up I will be okay”. Also, the doctor described the ECT shock therapy process like a “9-volt battery to your head”. (sounds safe, right?) Thankfully because Michelle was not harmed or killed in any way, the doctors and hospital were not at risk for being sued, however had something went wrong I believe this would be a different story.
My first thoughts were empathetic. As I just recently found out, my former coach had undergone 3 or 4 ECT treatments two months ago, and barely remembers the month of April. Because Michelle had been so severely depressed, I couldn’t help but think? Does my coach have these feelings? Michelle was very lucky to have her mother in law there to help her and her husband, but I questioned the fact that my coach had a support system like that, or if he was alone? All in all, ECT treatments are definitely a last resort” treatment, otherwise medications, therapy, or exercise routines can substitute getting the brain shocked.
I give Michelle’s family the most respect for their effort, time, love, and most of all, their patients. Her husband, Travis expressed multiple times of examples in which Michelle’s disease or illness made him feel at fault, “feeling like the bad guy”, and also made him feel depressed. It was soon after her first son was born when things began to change… she suffered from postpartum depression and was diagnosed with bipolar disorder. At this point in Michelle’s life, I believe it was appropriate for Michelle to undergo at least one ECT treatment because of the severity of her depression. Even her husband admitted, after having three ECT treatments, Michelle began to see the light at the end of the tunnel. As that was the first and only time she had felt the “black cloud” lifted off her shoulders, the doctors should have examined her behavior and noticed a positive behavior change, stopping ECT treatments, opposed to following the standard ECT procedures, which are most often generalized.
ReplyDeleteInformed consent, based on Robertson and Pryor article, was not communicated or received to Michelle. Even though the procedure was discussed throughout the documentary, proper consent was not effectively communicated. I believe this to be true because Michelle fears, before her first ECT session, she will lose her memory, stating “ I hope when I wake up I will be okay”. Also, the doctor described the ECT shock therapy process like a “9-volt battery to your head”. (sounds safe, right?) Thankfully because Michelle was not harmed or killed in any way, the doctors and hospital were not at risk for being sued, however had something went wrong I believe this would be a different story.
My first thoughts were empathetic. As I just recently found out, my former coach had undergone 3 or 4 ECT treatments two months ago, and barely remembers the month of April. Because Michelle had been so severely depressed, I couldn’t help but think? Does my coach have these feelings? Michelle was very lucky to have her mother in law there to help her and her husband, but I questioned the fact that my coach had a support system like that, or if he was alone? All in all, ECT treatments are definitely a last resort” treatment, otherwise medications, therapy, or exercise routines can substitute getting the brain shocked.