The Royal College of Psychiatrists has recently published a leaflet on men and depression. Men, it says, “seem to suffer from depression just as often as women, but they are less likely to ask for help.” There is a short section on ECT:
“Electroconvulsive therapy (ECT for short) can be used:
- in severe depression, if the person’s life is at risk and they need urgent treatment
- in moderate or severe depression, when no other treatment has helped.
ECT involves passing an electric current through the brain, so is always given in hospital under general anaesthetic. Some people have memory problems after ECT. See our leaflet on ECT for more information.”
“Some people have memory problems after ECT” is refreshingly straightforward. Unfortunately, the link to the Royal College leaflet on ECT takes you to a more typical account of the effects of ECT on memory in which psychiatrists attempt to defend ECT by suggesting that the memory problems may be due to the “depressive illness or other factors”. They also say that “around 1 in 10” people experiencing severe side-effects is a “low level”. I think one in ten is quite a lot.
The ECT leaflet is even more confused on the subject of using ECT in the treatment of moderate depression. In answer to the question “Who is ECT likely to help?” it says:
“It should not be used routinely in moderate depression, but should be considered for people with moderate depression if their depression has not responded to multiple drug treatments and psychological treatment”, only to contradict this in the answer to the next question “Who is ECT unlikely to help?”: “ECT is unlikely to help those with mild to moderate depression or most other psychiatric conditions.” The leaflet on depression and men is again more straightforward on the subject of ECT and moderate depression.
I have always wondered how useful the distinction between severe and moderate is when it comes to depression, but the fact remains that psychiatrists generally seem to find it easier to defend ECT as a treatment for severe depression and keep quiet about its use in moderate depression.