As I prepare for the possibility of having either Deep Brain Stimulation (DBS) or Focused Ultrasound Surgery (FUS) over the next few months, I am reminded today that it was three years ago that I had my first attempt at curing my depression through neuromodulation. It was in mid-September of 2015 that I attempted to have my first course of treatments of Electroconvulsive Therapy (ECT) or electroshock therapy done at the Centre for Addiction and Mental Health (CAMH). ECT is a very effective treatment for depression, with a success rate of greater than 50%, so I was keen to try it to see if it would cure my depression. When many people think of ECT, they think of the scene from One Flew Over the Cuckoo's Nest.
The reality of ECT is much different. It is a relatively simple procedure where you are put to sleep and powerful muscle relaxants are used to prevent most of the physical effects of the convulsion. When you wake up, it's like your head is in a fog for a little while. I don't know if that is from the anaesthetic or from the convulsion, but it goes away relatively quickly. I would recommend ECT to anyone that is having difficulty recovering from depression.
For most people there are no significant side effects, except for some slight memory loss. However, I was one of the very few people that had significant side effects. The day after my third treatment I went into an "acute confusional state". My memory of that time is not very good, but those around me tell me that I was completely confused and did not know what was going on for three days. The best way that I can describe it is that I was like an old man with dementia for three days. This rarely happens, but it happened to me.
Despite that bad experience, in March of the following year we attempted to do ECT again as I was still suffering from depression. This time, instead of doing three treatments a week, we would only do two. After my sixth treatment I again began to feel confused. It wasn't as bad as the first time that I tried it, but it was still rather noticeable. We again stopped the treatments and they won't do ECT on me anymore because of the potential for these rare side effects.
With my depression still not getting better, we decided in the spring of this year to try repetitive Trans-Cranial Magnetic Stimulation (rTMS) at Toronto Western Hospital. This is a different type of treatment where they use magnetic pulses to induce an electric current in the brain and by repetitively doing this, change your thought patterns. I tried two different protocols of rTMS. The first involved placing the magnet over the front part of my head and doing fast repeating magnetic pulses for three minutes. They did this on both sides of my head. The magnetic pulses hurt. They felt like a shock going from the top of my head right down to my teeth. I did that 13 times with no results. The second protocol involved placing the magnet on the right side of my head near my temple and doing slower magnetic pulses for about 5 minutes. Each one of these pulses hurt more than with the first protocol, but because they were done at a slower rate, it seemed more manageable. I did this protocol 15 times with no results.
ECT and rTMS are the two least invasive forms of neuromodulation and they should be tried first, before trying more invasive forms. Usually rTMS is tried before ECT, but I did ECT first. They are tried after psychotherapy and medications fail. Most people will get some improvement after trying ECT and rTMS. If ECT and rTMS don't work, then more invasive forms of neuromodulation can be tried. The more invasive forms are DBS and FUS and that is what I am attempting to try now.
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