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Comment by H8crilA | Hacker News Reader

Regardless of the answer to the question posed here keep in mind that high powered psychiatric interventions can be very effective, even if they don't last forever. Whether it's ketamine or electroconvulsive therapy - it's certainly better than suicide. At least promise yourself to try such things first (in a hospital setting! yes they have those in hospitals in developed countries) before you make the conclusion that your life has become too painful to live it.

PS. there are many other treatments that doctors may give you before reaching for the big guns; those can be very effective too.

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>PS. there are many other treatments that doctors will give you before reaching for the big guns; those can be very effective too.

This part can sometimes be difficult if you are in crisis. There’s lots of other options like you mention but they tend to take longer to see an effect. Ketamine can be very immediate in that regard. I remember it being like a light switch and thinking “wow this is how others must feel!”. And just seeing, even once, that it is at least chemically possible for your own brain to work/think like that can be very inspiring and hopeful esp when it feels like it hadn’t been worked correctly for a long time (or ever)

How would you compare this feeling with taking psilocybin?

My personal experience. With ketamine you can see/feel your problem outside of you in many ways. With psilocybin you can dive straight into problem's answer.

Both ways can terrifing. Also It can be unpleasant or rewarding.

If that makes sense.

Thanks. Some day I will have the courage to try. Until then Erowid

The DeepMind researcher's letter elsewhere in this thread suggests to me that ECT is infinitely worse than suicide.

When it comes to anything depression related, you should never rely on anecdotes alone.

The world is a big place. Many people have tried depression treatments. You can always find someone who had a very negative experience with something.

For a counter-anecdote: I know someone whose mother was deeply suicidal and unable to function for years. Eventually they tried ECT and it was the turning point in her depression. This was decades ago and she’s still doing okay today.

Do not let internet anecdotes steer depression treatment. ECT is an extreme example. I’ve seen countless people who avoided any depression medications for years because the internet told them SSRIs were evil drugs, only to experience life changing results for the better when they finally listened to their doctor and accepted treatment.

I don't think he really blames ECT for what has happened to him. It's more like "ECT didn't fix it either", which is a possibility - ECT isn't a guaranteed cure. For example:

> They [the NHS] couldn’t prevent this. Hundreds of hours of therapy couldn’t prevent this. A large network of friends and family checking in with me constantly over the last year didn’t prevent this. Psychiatric hospitals certainly couldn’t prevent this. ECT couldn’t prevent this. The only person who could have prevented this was me.

And the memory loss he's talking about (which is indeed a common side effect of ECT) doesn't seem to be as severe as he claims to be. For one he is actually able to recall the events of his life well enough to write this letter. For another he has abused ketamine to the point of having a month long psychosis episode that ended in involuntary stay in a mental hospital, which could have had its own effects. For yet another depression itself slowly erases memories.

Someone close to me did ECT for half a year after ketamine (in a clinical setting) became less effective.

The memory loss was worse than they were led to believe: near-dementia levels of short-term memory loss during treatment, and still now a year of missing memories from around the time of treatment.

The treatment itself left them without time or energy to do anything whatsoever on the days of treatment, and still weakened on the days off treatment.

And, it did seemingly nothing to address their depression.

So, YMMV.

I’m not sure what this means, but it’s not true. I have met people that are happy to be alive after ECT

> PS. there are many other treatments that doctors may give you before reaching for the big guns; those can be very effective too.

Further, everyone reacts differently to different treatments. It's very, very common to need to try several things out (or even come back to things in different combos) to find the one that works best for you.

Heck, sometimes during the course of treatment a drug that didn't previously work for you will start working as intended.

I had a happy evening last July.

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