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Comment by keketi | Hacker News Reader

> After fleeing to the United States, Mr. Rodriguez said he had a “nervous breakdown” within a year. He was hospitalized and treated with electroconvulsive therapy.

I had no idea that electric shocks are still used to treat mental issues.

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It has that 'barbaric and probably pseudoscientific treatment that we surely abandoned 50 years ago' feel, doesn't it? But I remember reading in this SSC post (at point 7) that it actually works well, and isn't quite as scary as it sounds, although the long-term effects are still uncertain: https://slatestarcodex.com/2014/06/16/things-that-sometimes-...

Memory loss is a very real problem with ECT. Most professionals downplay this and I find that a bit disgusting.

This is an anecdote, but I believe relevant.

I studied psychology as a mature student. One of the other adult students on my pre-degree course (kind of equivalent to community college I guess) had been a train driver. After two suicides on trains he was driving he'd developed clinical depression and been treated with ECT. This was around 2002, so it would have been the modern 'safer, targeted form of ECT'.

Ultimately despite an enormous amount of academic support on our programme he had to drop out. His permanent memory issues - a form of anterograde amnesia, were so bad he couldn't function academically, even at the limited level required to pass the course.

Depression is awful, monstrous, indescribably horrific and dehumanising. Losing ones mind, to me that's worse. As Hemingway said after his ECT (right before he committed suicide), "It was a brilliant cure but we lost the patient.”

EE here.

Electricity disrupts nerves. For better or for worse.

Its very artificial to help, and not solve the root problem. But, it does 'something'. And in Medical, something has a potential use.

Its really grasping at straws to solve this person's problem, but sometimes it helps.

Labotomies are still done too. They are now more scientific and are used to control things like eplilepsy, but still involve cutting/burning through brain to sever connections.

Nobody performs lobotomies anymore — haven’t since the ‘70s. You’re thinking of corpus callostomies, which sever hemispherical connections in order to limit the spread of epileptic signals. While they prompt fascinating questions regarding neurological integration of the self, they don’t cause the cognitive, emotional, or behavioral changes lobotomies do.

That is one form. There are also therapies, occasionally in the frontal lobe, that use much smaller electrical devices to heat sections of brain to sever connections. Some also use lasers. It is all about cutting connections, a direct evolution from the dark days.

Kind of OT, but talk of lobotomies reminds me of this classic question and answer from The Straight Dope [1]: "In medicine, what’s the difference between an -ectomy, an -ostomy, and an -otomy?"

[1] https://www.straightdope.com/columns/read/607/in-medicine-wh...

I know someone who has been through ECT, and I had a similar reaction when I learned about it. It's not a treatment to be taken lightly (this followed a suicide attempt), but at least in their case did cure severe depression in conjunction with more traditional treatment.

My very lay-person understanding of the process is that the patient is knocked out with drugs before the electricity is applied - it sounds like a sort of hard reset of memories in the brain. The most obvious and lasting side-effect is memory loss; this person can't remember significant chunks of their life history, so has had to re-learn it from conversations, home movies, photos, etc.

I'm wondering if the use of 'this' in '...this person can't remember...' was a mistake and was meant to be 'the'? I ask because I was looking for, if there was no mistake, confirmation that in your acquaintances specific case significant memory loss occurred.

Yes, sorry, my writing is terrible...

My acquaintance underwent ECT treatment, lost memories, and rebuilt some of them.

They are, and they are one of the most effective single treatments. But usually only when treatment options are exhausted.

ECT is very commonly used still. Its considered the best treatment for drug-resistant depression.

Not for long (fingers crossed)

https://www.statnews.com/2019/02/12/depression-drug-related-...

https://slatestarcodex.com/2014/06/16/things-that-sometimes-...

This article seems to paint Ketamine as the worse of the two options for extreme depression.

In simple terms, some patients are so unwell with depression they will either never get better or die from malnutrition/debilitation. This justifies the use of ECT, which is conducted under very careful conditions, involving general anaesthesia. It is often effective in a very short time frame.

It made a huge comeback and is apparently very effective when used properly.

tbh that bit sounded like a masked torturing thingy going on for him — but hey, hope he's ok

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