I just read Kitty Dukakis’ new book (Shock: The Healing Power of Electroconvulsive Therapy, Avery/Penguin, September 2006) in which she wrote about her profound depression that responded only to electroconvulsive treatments (ECT). There are some 21 million American adults who suffer from depression, and 10-30 % of those people are said to be suffering from Treatment Resistant Depression (TRD). These are people whose depression is so profound they don’t leave their beds for years, or who have tried suicide many times. For them, ECT might be an option, but my concern is that this book will encourage more patients, less severely debilitated, to seek this drastic treatment course.

Since 2001, Kitty has had eight courses of ECT (each course could be 4 to 8 shock treatments), and she said it worked when nothing else did. She acknowledges that she can’t remember what she had for breakfast or her appointments, but she said it’s a price she has been willing to pay.

It is the promise of our Founding Fathers that Americans are entitled to life, liberty and the pursuit happiness. It has become virtually un-American to feel anything but joy in every moment. New pills and procedures advertised directly to avid consumers promise rapid relief from any suffering, and we are seeing more people willing to trade potential long-term consequences for immediate relief.
Kitty had standard electroshock therapy applied directly to the brain, but there is now a miniaturized electric shock device, an electrical pulse generator that simulates the vagus nerve, called vagal nerve stimulation (VNS). The electrical impulse is produced by a pocket-watch sized device implanted in the chest that costs $15,000 and another $10,000 to surgically insert it. But long-term studies show that the vagal nerve stimulator shows no significant improvement over control groups that have not been stimulated.

My heart goes out to Kitty Dukakis; she has not had an easy life experientially or genetically. Before her TRD, Kitty had other serious psychiatric problems; she was addicted to amphetamines, then turned to alcohol, and was later diagnosed as manic-depressive for which she was prescribed lithium. I want to sound this cautionary note: when it comes to dealing with emotional pain and depression, drugs work much better in conjunction with psychotherapy and will relieve most clinical depression.

Work hard at finding inner peace before you become convinced that you need to obliterate your mind to get peace of mind.