Anxiety and Depression  |  Psychotic Disorders  |  Treatments

My Experience with Electroconvulsive Therapy: Bipolar Disorder

BY YOHANNA ABDULLAH

3 February 2021  |   5 min read

I underwent Electroconvulsive Therapy (ECT) once a week in 2019 to prevent my mania from being triggered. Back then, my psychiatrists felt that my bipolar disorder was very fragile and needed to be treated preventively with ECT on top of daily oral medications and monthly injections.

In my struggle with bipolar disorder, I experience extreme mood swings that include emotional highs (mania) and lows (depression). In my manic state, I will sing and dance at the top of my voice and may be aggressive. When I was depressed, I stayed in my bed most of the time and found it difficult to eat, bathe, do chores, and take care of my children.

In 2018, my worst year ever, I was hospitalised in the Mood Disorder Unit (MDU) of the Institute of Mental Health (IMH) after experiencing three episodes of mania within seven months. ECT would always bring me rapidly out of mania.

ECT is a procedure where a small controlled amount of electric current is applied to the brain through electrodes placed on the patient’s scalp. The procedure is done under general anesthesia with a muscle relaxant.

To check if the patient is suitable for ECT, a psychiatrist will first assess the patient’s condition and healthcare needs. A medical officer will then do the necessarily physical and laboratory investigations. An anesthetist will also review the patient’s suitability for general anesthesia and will be present throughout the treatment to closely monitor the patient’s vital signs and brain waves.

ECT treatments are generally given 2-3 times weekly for 3-4 weeks. It can be administered both as inpatient or outpatient care.

According to Dr Joshua Kua, Psychiatrist and Visiting Consultant at Agency for Integrated Care (AIC), ECT is purported to cause changes in brain chemistry that can treat symptoms of certain mental health conditions such as:

  • Severe depression, particularly when accompanied by detachment from reality (psychosis), a desire to harm self or refusal to eat/drink, or when depression did not respond to medications or other treatment
  • Severe mania, a state of intense euphoria, agitation or hyperactivity that occurs as part of bipolar disorder.
  • Schizophrenia that does not respond adequately to standard treatment

ECT is one of the fastest ways to relieve severe symptoms. It could be used in tandem with other treatment options such as medications, counselling, repetitive Transcranial Magnetic Stimulation (for depression).

ECT is a greatly misunderstood treatment. It is not a ‘quick-fix’ that replaces long-term treatments. Neither is the patient painfully shocked out of their conditions.  

Dr Joshua Kua noted that though ECT is generally safe, it is like any other medical procedures with risks and side effects. Nausea, headache, jaw pain, muscle ache may be experienced on days of treatment. Some patients also experience confusion and temporary memory loss.

The feeling of letting go was scary initially but overtime, I got accustomed to it and grew to like the feeling of floating to nothingness.

Many people have discouraged me to go for ECT because of the side effects. For me, I infrequently get a mild headache, a jaw ache or a sore palate from the tube that has been inserted into my mouth. Nonetheless, I am well enough to make my way back home by myself. For some patients, the effects may last longer and they are advised to rest after the treatment.

The whole process which lasts for less than a minute, is entirely painless. What I was more concerned with was the effects of general anesthesia.

It is always with trepidation when I undergo general anesthesia. I would say a little prayer, leave my life in God’s hands, and enjoy the sensation of drifting quickly off to oblivion. The feeling of letting go was scary initially but overtime, I got accustomed to it and grew to like the feeling of floating to nothingness.

The frequency of my sessions progressively decreased to once every three weeks. Since stopping ECT altogether in August 2020, I am happy to say that I have been well.

ECT treatments helped to regulate my mood. Although at times there were short periods of depression that followed after, I would always bounce back to normalcy for relatively longer periods of time.

Nonetheless, there were other factors that played a part; I kept a strict adherence to both oral medications and two injections administered monthly, followed a regular sleep routine, paced myself at work, and resolved my personal issues.

I hope my experience with ECT will help more people understand this treatment. Consult your doctor to find out more on ECT.

The article is contributed by Yohanna Abdullah, with inputs from Dr Joshua Kua.

Yohanna Abdullah is a Part time Rehab Executive and Freelance writer at Club HEAL.