CHAPEL HILL, N.C. — Jack Gregory says he lived one step from suicide
until he found a way to ease his severe depression. He let doctors run
an electric current through his brain.
Since starting electroconvulsive therapy in March 2006, Gregory,
62, has found a degree of stability that eluded him when he relied on
antidepressants and talk therapy.
"Literally, I was ready and willing to kill myself 2 1/2 years
ago," Gregory said as he was prepped for a treatment under general
anesthesia in Chapel Hill early this month. "This can be a life-saving
therapy for the right person."
Electroconvulsive therapy, discredited in a previous incarnation as
"shock therapy," has gained acceptance from patients and doctors alike
in recent years. As the means of administering the electric current
have grown more sophisticated and less harmful, the benefits of the
treatment have become more apparent, especially for people suffering
depression.
The Mayo Clinic estimates 100,000 people a year undergo the
treatment in the United States — a number that has roughly tripled in
the last 25 years.
"It's becoming a treatment of next resort instead of a treatment of
last resort," said Gregory's psychiatrist at UNC Hospitals, Dr. Michael
A. Hill.
Electroconvulsive therapy enters its eighth decade this year: An
Italian doctor developed its use in 1938. Doctors don't know its exact
mechanism, Hill said, but an electrically stimulated seizure can affect
the brain the way restarting affects a computer.
The therapy is still controversial. Last month, the American
Psychiatric Association agreed to a new review of its literature on
electroconvulsive therapy, known as ECT.
"There are still some researchers and practitioners who think the
treatment is just absolutely terrific with no problems, and others that
feel it has significant problems, but not enough to keep them from
doing it," said Dr. Vaughn McCall, a Wake Forest University
psychiatrist who is editor of the academic
Journal of ECT.
The treatment's inability to prevent recurrences is one point of contention, McCall said.
"The second is the realization that cognitive problems from ECT may
be more problematic than was recognized even 10 years ago," McCall
said.
And there remains a stigma. The treatment has long been portrayed
as a form of torture, with flailing patients strapped to gurneys and
involuntarily subjected to jolts of electricity while awake, as
depicted in the 1975 movie
One Flew Over the Cuckoo's Nest.
"It used to be done without anesthesia," Hill said. "Using
electricity to generate seizures while the patient is awake is a brutal
kind of treatment."
Jack Gregory, who is under general anesthesia during treatments,
has no regrets. "I don't think it's for everyone," he said, "but for
people with deep, dark, down depression, it can be very effective."
Gregory had a successful career in local and network television for
years before he came to Raleigh in the late 1980s as a sports anchor on
the former WPTF-TV.
After leaving the station in the early '90s, he took a series of
jobs and tried to start his own business. The early 2000s brought a
contentious divorce and a one-year suspended sentence on a drug charge.
Gregory was out of control and in deep trouble. He watched through
a cloud of depression as his life — marriage, family, job and all — got
crushed under the weight of his mental illness and substance abuse.
Friends and former colleagues who remembered him as hardworking were
saddened by his decline.
He went through more than a dozen hospitalizations and several suicide attempts.
"Before March 2006, I was on medications and doing talk therapy,
but I was going belly up every other day," Gregory said. "I was
bouncing off the walls."
By March 2006, he was ready for something — anything — that could
help him deal with his mental illness. Gregory agreed to take part in
electroconvulsive therapy at UNC-Chapel Hill's Department of
Psychiatry.
At UNC-Chapel Hill, doctors oversee 30 to 45 electroconvulsive
treatments weekly. The treatment continues to evolve, but it's not the
subject of as much research as behavioral drugs, Hill said.
"It's been studied for years, but the reality is, since the drug
companies aren't involved, there isn't a lot of money available for
ECT," he said.
Treatments using electric stimulus usually begin with a course of
six to 12 sessions, scheduled three times a week for a month or so.
Some patients, such as Gregory, return for maintenance treatments.
"What the field is focused on in recent years is to try to improve the success rate while minimizing side effects," Hill said.
"We are looking to use the lowest amount of electricity — the less
energy you use, the better," he said. At most, he noted,
electroconvulsive therapy uses about a third of the amount of energy
that typically jolts a heart patient during defibrillation.
Gregory said 2007 was the first calendar year in at least five in
which he had no psychiatric hospitalizations. Richard Wynne, pastor of
St. John's Baptist Church in Raleigh, said he remembers Gregory's
trials before he tried electroconvulsive therapy. "When he first became
a member, there were times that we knew he was depressed," Wynne said.
"He would be so depressed that he'd take his medication and when it
didn't work, he'd take more of it. He ended up overdosing."
Gregory now talks to people with depression about electroconvulsive
therapy, hoping others with the illness might be able to retreat from
the brink, too.
"I will have these obsessions or diagnoses for the rest of my
life," he said. "With the technology available to me now, I will have a
better than even chance of stability."
WHO SHOULD CONSIDER ECT?
Patients must be referred by their psychiatrists to be considered
for electroconvulsive therapy. According to the Mayo Clinic, ECT is
most commonly recommended for people with:
- Severe depression, accompanied by psychosis, suicidal intent or refusal to eat.
- Mania that hasn't been improved with medications.
- Schizophrenia, when symptoms are severe or medications aren't sufficient.
For more information online:
www.mayoclinic.com/health/electroconvulsive-therapy/MH00022