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Quoting from https://slatestarcodex.com/2014/06/16/things-that-sometimes-help-if-youre-depressed/ https://slatestarcodex.com/2014/06/16/things-that-sometimes-..

Quoting from https://slatestarcodex.com/2014/06/16/things-that-sometimes-help-if-youre-depressed/ https://slatestarcodex.com/2014/06/16/things-that-sometimes-... on the subject of ECT: "Electroconvulsive therapy gets a bad rap from old movies where we see people who “misbehave” in the mental institution getting what look like very painful electric shocks. Modern electroconvulsive therapy is done with the patient sedated. You are pleasantly asleep, your limbs aren’t flailing about or anything, and it can be done on an outpatient basis with you going home as soon as you’re done. There are a lot of worries about side effects. Some people experience some memory loss, especially of the couple of weeks before the treatment. Most of the time these memories come back. Sometimes they don’t. But how much do you want to remember the week when you were so depressed you needed ECT, anyway? Longer-term side effects are less well-known. Some people think a lot of ECT isn’t good for your brain, but if the effect exists it’s small enough that people are still debating whether or not they’ve really picked it up. But the thing is, ECT really, really works. People get to the point where everything else has failed, and they’ve been on seven hundred different medications without feeling any better, and they’re ready to give up, and then they get ECT and start whistling happy songs and dancing the polka. I won’t say it works 100% of the time, because no medical treatment works 100% of the time. But in psychiatry, where expectations are always low, it’s the closest thing we’ve got to a miracle cure."

daniellarusso 6y ago
Honestly, I thought part of the point of the therapy is to ‘erase’ the most painful of recent memories, helping the person not fixate on such thoughts, since they are gone. I have no idea what I am talking about, though.
YeGoblynQueenne 6y ago
>> But the thing is, ECT really, really works. According to the article, studies on the subject of efficacy of ECT are few and far between, obsolete and methodologically flawed and there is not sufficient evidence to suggest that ECT "works" (in the sense of improving the patient's condition).
- Delk 6y ago
  I'm definitely not an expert, but my impression has been that ECT has been considered more likely to be effective at the severe or psychotic end of the spectrum (so not really something to be considered in milder or even moderately severe cases), and more effective in acute cases of severe depression than in long-term chronic ones. I don't know if this could be one reason for differing views regarding efficacy, or if it's just more anecdata and noise. edit: better choice of words
  - YeGoblynQueenne 6y ago
    Thanks. I'm not any kind of expert on the matter, either, and I'm going by what's in the article which claims there isn't enough evidence to conclude that ECT works.
    - perl4ever 6y ago
      TMS (transcranial magnetic stimulation) is a thing these days, I believe. I don't know why, or how it compares. I met a woman once (between 10-15 years ago) who had had ECT. She was...not negative about it? I think she said it had helped her. But her affect was very flat and dull and made me involuntarily think of brain damage and lobotomies and such. To be fair, I didn't know her beforehand, so I was unable to compare. I wish it wasn't too much to ask for people to focus research efforts on tools to determine what is actually happening in the brain at the moment of experiencing depressive or psychotic thoughts. Rather than developing random treatments with nothing behind them. When's the last time you got frustrated with debugging a program and started making random changes? Did it work? I have kind of never stopped being horrified at reading about how drug companies test their medications for mental illness by giving people surveys on how they feel. They are using super sophisticated technology to make the treatments, and fancy statistics on the results, but they can't objectively measure what is happening. It's GIGO. We need more and better tools like https://en.wikipedia.org/wiki/Optogenetics https://en.wikipedia.org/wiki/Optogenetics.
      - Delk 6y ago

daniellarusso 6y ago

Honestly, I thought part of the point of the therapy is to ‘erase’ the most painful of recent memories, helping the person not fixate on such thoughts, since they are gone. I have no idea what I am talking about, though.

YeGoblynQueenne 6y ago

>> But the thing is, ECT really, really works. According to the article, studies on the subject of efficacy of ECT are few and far between, obsolete and methodologically flawed and there is not sufficient evidence to suggest that ECT "works" (in the sense of improving the patient's condition).

Delk 6y ago
I'm definitely not an expert, but my impression has been that ECT has been considered more likely to be effective at the severe or psychotic end of the spectrum (so not really something to be considered in milder or even moderately severe cases), and more effective in acute cases of severe depression than in long-term chronic ones. I don't know if this could be one reason for differing views regarding efficacy, or if it's just more anecdata and noise. edit: better choice of words
- YeGoblynQueenne 6y ago
  Thanks. I'm not any kind of expert on the matter, either, and I'm going by what's in the article which claims there isn't enough evidence to conclude that ECT works.
  - perl4ever 6y ago
    TMS (transcranial magnetic stimulation) is a thing these days, I believe. I don't know why, or how it compares. I met a woman once (between 10-15 years ago) who had had ECT. She was...not negative about it? I think she said it had helped her. But her affect was very flat and dull and made me involuntarily think of brain damage and lobotomies and such. To be fair, I didn't know her beforehand, so I was unable to compare. I wish it wasn't too much to ask for people to focus research efforts on tools to determine what is actually happening in the brain at the moment of experiencing depressive or psychotic thoughts. Rather than developing random treatments with nothing behind them. When's the last time you got frustrated with debugging a program and started making random changes? Did it work? I have kind of never stopped being horrified at reading about how drug companies test their medications for mental illness by giving people surveys on how they feel. They are using super sophisticated technology to make the treatments, and fancy statistics on the results, but they can't objectively measure what is happening. It's GIGO. We need more and better tools like https://en.wikipedia.org/wiki/Optogenetics https://en.wikipedia.org/wiki/Optogenetics.
    - Delk 6y ago