EKT TEDAVISI PDF

Last time, I talked about death and dying. Laughter You know, ever since man had any notion that some of his other people, his colleagues, could be different, could be strange, could be severely depressed or what we now recognize as schizophrenia, he was certain that this kind of illness had to come from evil spirits getting into the body. So the way of treating these diseases in early times was to, in some way or other, exorcise those evil spirits. And this is still going on, as you know. When medicine became somewhat scientific, in about BC, with Hippocrates and those boys, they tried to look for herbs, plants that would literally shake the bad spirits out. So they found certain plants that could cause convulsions.

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Last time, I talked about death and dying. Laughter You know, ever since man had any notion that some of his other people, his colleagues, could be different, could be strange, could be severely depressed or what we now recognize as schizophrenia, he was certain that this kind of illness had to come from evil spirits getting into the body. So the way of treating these diseases in early times was to, in some way or other, exorcise those evil spirits.

And this is still going on, as you know. When medicine became somewhat scientific, in about BC, with Hippocrates and those boys, they tried to look for herbs, plants that would literally shake the bad spirits out.

So they found certain plants that could cause convulsions. And the herbals, the botanical books of up to the late Middle Ages, the Renaissance, are filled with prescriptions for causing convulsions to shake the evil spirits out. Well, along comes Benjamin Franklin, and he comes close to convulsing himself with a bolt of electricity off the end of his kite. And so people begin thinking in terms of electricity to produce convulsions.

And then we fast-forward to about , when three Italian psychiatrists who were largely treating depression began to notice among their patients, who were also epileptics, that if they had a series of epileptic fits, a lot of them in a row — the depression would very frequently lift.

Not only would it lift, but it might never return. So they got very interested in producing convulsions, measured types of convulsions. That always makes hair stand up and people shake a lot. So they went to the police and they said, "We know that at the Rome railroad station, there are all these lost souls wandering around, muttering gibberish. Can you bring one of them to us? So these three psychiatrists, after about two or three weeks of observation, laid him down on a table, connected his temples to a very small source of current.

Well, I have the following from a firsthand observer, who told me this about 35 years ago, when I was thinking about these things for some research project of mine. Laughter So they plugged him in again, and this time, they used volts for half a second.

And to their amazement, after it was over, he began speaking like he was perfectly well. He relapsed a little bit, they gave him a series of treatments, and he was essentially cured. But of course, having schizophrenia, within a few months, it returned. But they wrote a paper about this, and everybody in the western world began using electricity to convulse people who were either schizophrenic or severely depressed.

And of course, in those days, there were no antidepressant drugs, and it became very, very popular. They would anesthetize people, convulse them But the real difficulty was that there was no way to paralyze muscles. So people would have a real grand mal seizure. And then in the late s, the so-called "muscle relaxants" were developed by pharmacologists, and it got so that you could induce a complete convulsion, an electroencephalographic convulsion — you could see it on the brain waves — without causing any convulsion in the body except a little bit of twitching of the toes.

So again, it was very, very popular and very, very useful. Tofranil was the first. So the whole idea of electroconvulsive, electroshock therapy disappeared, but has had a renaissance in the last 10 years. And the reason that it has had a renaissance is that probably about 10 percent of the people, severe depressives, do not respond, regardless of what is done for them.

Now, why am I telling you this story at this meeting? This reason really is that I am a man who, almost 30 years ago, had his life saved by two long courses of electroshock therapy.

And let me tell you this story. I was, in the s, in a marriage. To use the word "bad" would be perhaps the understatement of the year. It was dreadful. Being someone who had had a very difficult childhood, a very difficult adolescence — it had to do with not quite poverty but close. It had to do with being brought up in a family where no one spoke English, no one could read or write English. It had to do with death and disease and lots of other things. I was a little prone to depression. So, as things got worse, as we really began to hate each other, I became progressively depressed over a period of a couple of years trying to save this marriage, which was inevitably not to be saved.

So, with the advice of my physician, I had myself admitted to the acute care psychiatric unit of our university hospital. That proved to be a lot of bovine stercus. Laughter I know some people who got tenure in that place with lies like that. Laughter So I was one of their failures. I could hardly see five feet in front of myself.

I shuffled when I walked. I was bowed over. I rarely bathed. And it was clear — not to me, because nothing was clear to me at that time anymore — that I would need long-term hospitalization in that awful place called a "mental hospital. It was founded in the 18th century, the largest psychiatric hospital in the state of Connecticut, other than the huge public hospitals that existed at that time.

And they tried everything they had. They tried the usual psychotherapy. They tried every medication available in those days.

And they did have Tofranil and other things — Mellaril, who knows what. Nothing happened except that I got jaundiced from one of these things. And finally, because I was well-known in Connecticut, they decided they better have a meeting of the senior staff.

All the senior staff got together, and I later found out what happened. They put all their heads together, and they decided that there was nothing that could be done for this surgeon who had essentially separated himself from the world, who by that time had become so overwhelmed, not just with depression and feelings of worthlessness and inadequacy, but with obsessional thinking, obsessional thinking about coincidences.

And there were particular numbers that every time I saw them, just got me dreadfully upset, all kinds of ritualistic observances Remember when you were a kid, and you had to step on every line? Well, I was a grown man who had all of these rituals, and it got so there was a throbbing, there was a ferocious fear in my head. So they decided there was no therapy, there was no treatment. But there was one treatment, which actually had been pioneered at the Hartford Hospital in the early s, and you can imagine what it was: it was prefrontal lobotomy.

Well, as in all hospitals, there was a resident assigned to my case. He was 27 years old, and he would meet with me two or three times a week. And of course, I had been there, what, three or four months at the time. He asked to meet with the senior staff, and they agreed to meet with him, because he was very well thought of in that place. They thought he had a really extraordinary future. And he dug in his heels and said, "No. I know this man better than any of you. I have met with him over and over again.

I really honestly believe that the basic problem here is pure depression, and all of the obsessional thinking comes out of it. Any of the results along the spectrum, from pretty bad to terrible, terrible, terrible, is going to happen. If he does the best he can, he will have no further obsessions, probably no depression, but his affect will be dulled, he will never go back to surgery, he will never be the loving father that he was to his two children, his life will be changed.

They agreed to humor him. Big deal. And at 10, I noticed a real change. And he went back to them, and they agreed to do another Again, not a single one of them — I think there are about seven or eight of them — thought this would do any good.

They thought this was a temporary change. But, lo and behold, by 16, by 17, there were demonstrable differences in the way I felt. By 18 and 19, I was sleeping through the night. And by 20, I had the sense, I really had the sense, that I could overcome this, that I was now strong enough that by an act of will, I could blow the obsessional thinking away.

I could blow the depression away. But I need a formula. I need some thing to say to myself when I begin thinking obsessionally, obsessively. Well, the Gilbert and Sullivan fans in this room will remember "Ruddigore," and they will remember Mad Margaret, and they will remember that she was married to a fellow named Sir Despard Murgatroyd.

And she used to go nuts, every five minutes or so in the play. And it was very simple. It was, "Ah, fuck it! And it worked! My God, it worked. Every time I would begin thinking obsessionally — again, once more, after 20 shock treatments — I would say, "Ah, fuck it.

I joined a group of surgeons, where I could work with other people, in a community, not in New Haven, but fairly close by. I stayed there for three years. At the end of three years, I went back to New Haven, had remarried by that time.

I brought my wife with me, actually, to make sure I could get through this.

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Vijind Adolescent, electroconvulsive therapy, treatment refractory. All cases were given doses of propofol an additional mg until the eyelash reflex disapperead. JavaScript is disabled for your browser. The first ECT ejt data of each patient was not included in the study in order to provide base-line values of energy level. He hospitalized for treatment because of to intensify his symptoms in spite of treatment in the last 6 months.

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EKT (Elektro Konvülsif Tedavi) Nedir?

One treatment changed everything. After two courses of electroconvulsive therapy, or ECT, her symptoms lifted. She went back to work, then on to graduate school, where she earned high grades. At first, she talked openly about her life changing treatment.

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