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Comment by warrenmiller | Hacker News Reader

aren't the side effects of ECT quite severe though? "loss of creativity, drive and energy. difficulty concentrating. loss of emotional responses. difficulty learning new information."

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If you take away my creativity and ability to learn, you may as well just kill me. That sounds like a recipe for depression in itself.

You're depressed, which has already destroyed your creativity and ability to learn. Nothing has worked. Your option is to ECT, which may help, or have adverse side effects.

Would you try it? If you've not got much to lose, why not? It's not as if suicide is suddenly no longer an option afterwards.

> which has already destroyed your creativity and ability to learn

Don't think that's necessarily the case.

Loss of focus and difficulty retaining new information are common symptoms for major depressive episodes.

There are other options than ECT which may have fewer side effects.

Possibly, as an absolute last resort. Not before. It's very unlikely, and at that point it being "more effective" than ketamine is barely germane, since I'm scraping the bottom of the barrel anyway.

But that's what treatment-resistant depression is: either a life in misery, suicide or ECT/Ket as a hail-Mary maneuver. We are not talking about acute depression or people in midlife-crisis.

I only know one ECT patient personally but the side effects were horrible enough for me to wonder why it is even legal. The brutality of the treatment and lack of after treatment is astounding.

It's been 12 years since her ECT for post partum depression and she still has memory losses and a completely changed personality (agression is one).

Those are also the symptoms of depression.

Do you have a citation for that list, preferably that also has includes how common each side effect it?

https://www.mind.org.uk/information-support/drugs-and-treatm...

You already have all of those symptoms (and more!) if you have severe treatment resistant depression.

Those are also the side effects of severe depression so you're not missing out on much.

Hmm, that is starting to sound like nerve stapling.

So what are the upsides

"Not feeling incredibly depressed."

Or, more accurately, not reporting to the researchers that you're feeling incredibly depressed.

The same skepticism can be applied to any study, depression treatment or otherwise. Practically, self reporting is highly effective and well correlated with effects, especially for depression.

Of course.

It's just that sometimes, the easiest and least confrontational way to stop a treatment with serious side effects is to claim that the treatment is no longer needed.

Studies should find ways to control for such problems.

"The floggings will continue until morale improves!"

Severe depression has objective symptoms: severe sleep disturbances, psychotic like symptoms.

In my very unscientific opinion, severe sleep disturbances is usually a cause, not an effect.

Watch people get sleep problems, a few days of that, and then the mental health issues kick in.

Or cause sleep problems (stimulants or environmental), then see mental health issues produced.

The opposite can happen (mental health problem leads to sleeping problems) but in my circles I haven’t seen that as often. Of course then the mental health issues compound.

Fucking with your sleep is not healthy.

I strongly agree.

But if you’re sleeping 18 hours a day, that’s not just a cause of depression, it’s an effect.

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