Telling people I've had ECT is a real conversation killer. People seem more forthright these days  about discussing depression. Hell, the cashier in the grocery store told me yesterday that she's on Prozac. But ECT is in a different class. For months I have glossed over ECT's contribution to the end of my depression in my conversations with most people. But lately I've been thinking, 'Damn it. I didn't rob a bank. I didn't kill anybody. I have nothing to be ashamed of.' I've started telling people about the ECT. My admission is typically met with uncomfortable silences and abrupt shifts in topics.
An acquaintance at a party is outraged. 'How could you let them do that to you?' I bristle and answer, 'I didn't let them do it to me. I asked them to do it.'
Manning returned to a successful clinical practice and the care of her family.
Yale University professor of surgery and noted author Sherwin P. Nuland, M.D., (2003) recently related his experience in the early 1970s:
From my late thirties until my early forties, I underwent a period of depression that gradually deepened into an intensity that I finally required admission to a mental hospital, where I stayed for more than a year. Neither medication, psychotherapy, the determined efforts of friends nor the devotion of the few people whose love never deserted me had even the most minimal beneficial effect on my worsening state of mind. Finally, faced with my resistance to all forms of treatment till then attempted, the senior psychiatrists at the institution in which I was confined recommended the draconian measure of lobotomy.
I was, in fact, completely disabled by pathological preoccupations and fears. Obsessions with coincidences; fixations on recurrent numbers; feelings of worthlessness and physical or sexual inadequacy; religious anxieties of guilt and concerns about God's will; ritualistic thinking and behavior--they crowded in on one another so forcefully as to occupy every lacuna of my mind. I cowered before them, not only emotionally but physically, too--my hunched-over posture reflected my decline into helplessness.
I was saved from the drastic intervention of lobotomy by the refusal of a twenty-seven-year-old resident psychiatrist assigned to my case to agree with his teachers. At his insistence, a course of electroshock therapy was reluctantly embarked upon. I would learn later that virtually everyone familiar with my case despaired of the possibility of recovery.
At first, the newly instituted treatment made not a whit of difference. The number of electroshock treatments mounted, but still no improvement took place. The total would eventually reach twenty. Somewhere around the middle of the course, a glimmer of change made itself evident, which encouraged the skeptical staff to continue a series of treatments they had begun only to mollify a promising young man in training. I recovered so well, in fact, that in the four remaining months of hospitalization, I lost all but the dimmest memory of the obsessions and saw my depression disappear entirely.
Nuland returned to surgery, teaching and writing and, in the decades since, has written widely acclaimed books. His symptoms were evidence of an agitated psychotic depression with obsessional features, a condition that is eminently responsive to ECT. The obsessions, in all probability, led to the consideration of psychosurgery. A tragedy was averted by the courage of a subordinate physician in standing up for his beliefs.
The most recent physician witness to the tragedy of manic-depressive illness is Leon Rosenberg, M.D., former dean of Yale Medical School, head of pharmaceutical research for Bristol-Myers Squibb and now professor of molecular biology at Princeton University (Rosenberg, 2002). In 1998, around his 65th birthday, awakening in an agitated state after restless nights of insomnia, he attempted suicide by drug overdose. He was admitted to the closed ward of a psychiatric hospital. Electroconvulsive therapy was prescribed: "However groggy I still was, I registered surprise. I thought that ECT had been abandoned years before." Treatment began:
After the fourth ECT, I was noticeably less depressed. My appetite returned, as did my ability to sleep. After eight treatments, my mood was fully restored. I experienced no confusion, memory loss, headache, or any other symptom sometimes attributed to ECT. I felt so well that, with some trepidation, I prepared to go back to work.
Lithium(Drug information on lithium) (Eskalith, Lithobid) continuation sustained the benefit. He decided to bear witness.