Doctors swear by new-look "shock" therapy in fighting depression Successful treatment much more humane and accessible today despite stigma based on early procedures

Former Massachusetts Gov. Michael Dukakis and his wife, Kitty, Monday, Nov. 19, 2007. Adams (AP Photo/Elise Amendola) Former Massachusetts Gov. Michael Dukakis and his wife, Kitty, Monday, Nov. 19, 2007. Adams (AP Photo/Elise Amendola) Photo: Contributed Photo/ (AP Photo/Eli, Contributed Photo Photo: Contributed Photo/ (AP Photo/Eli, Contributed Photo Image 1 of / 3 Caption Close Doctors swear by new-look "shock" therapy in fighting depression 1 / 3 Back to Gallery

When many people think of "shock therapy," they associate it with horror rather than healing.

They think of disturbing images portrayed by Hollywood, like the scene in "One Flew Over The Cuckoo's Nest" where Jack Nicholson, held down by doctors as the treatment is administered, wakes up seizing and writhing in pain.

But experts say this is not the reality today.

The procedure, now called electroconvulsive therapy (ECT), is a gentler, more humane and much more effective way to treat people with severe depression that hasn't responded to medications.

"It's lifesaving, absolutely lifesaving," said Dr. Charles Herrick, chairman of the psychiatry department at Danbury Hospital.

But he recognizes that the idea of sending electric currents through a human body is still one that makes people shudder.

"Some of the resistance comes from ignorance, essentially," Herrick said. "They don't have experience with it and it seems barbaric."

When the procedure was first done, in the 1940s, it was primitive -- administered without anesthesia, using currents so strong that the resulting seizures sometimes broke bones.

Now, controlled electric currents are passed through the brain while a person is under general anesthesia, causing a seizure that generally lasts less than one minute. The patient feels no pain and wakes up in five to 10 minutes. Side effects include memory loss, headache, upset stomach and muscle aches.

Dr. Donna Pellerin, director of ECT services at Danbury, said, like in any medical procedure, a doctor has to weigh the risks and benefits.

"The risks of not having ECT are worse than having the slight memory impairment," said Pellerin, who said she prescribes the treatment only to patients she believes will tolerate it well.

Scientists are unsure how electric current works to relieve depression, but it appear to produce many changes in the chemistry and functioning of the brain, according to the National Institute for Mental Health.

At Danbury, Herrick said, treatments have doubled in the last decade as the hospital took up the slack left from the closure of other facilities in the area that offered ECT. Twenty to 25 procedures are done weekly, treating about 250 patients each year.

Pellerin said her patients range in age from 18 to 95 and come from many ethnic backgrounds. Many feel their depression symptoms lessened, and for some, the symptoms are eliminated.

One of the best-known patients to undergo ECT is Kitty Dukakis, wife of the former governor of Massachusetts and Democratic nominee for president.

Following years of addiction to diet pills, Dukakis became severely depressed. When the symptoms would come, she said, she didn't want to get out of bed and would often drink herself unconscious to numb the pain.

Her husband said he almost lost hope during one of her last deep episodes of depression. He recalls asking himself, "Why does she have to experience this kind of pain?"

A mother of three, Dukakis had ECT for the first time in Massachusetts 15 years ago and continues to have maintenance treatments to keep her depression away.

"What I say over and over again, to myself and to others, is that I wouldn't be alive today without this program," she said last week.

Dr. Sarah Lisanby, who has performed and studied ECT for years, said some of the false perceptions of ECT come from the fictionalized accounts of the treatment in movies and on the Internet.

"It is important to distinguish fact from fiction," said Lisanby. "Depression kills: ECT saves lives."

Most private insurers and Medicaid cover ECT, hospital officials said. And since passage of the Affordable Care Act, more people nationally are likely to be covered for this and other mental health treatments.

The act requires that most individual and small-employer health insurance plans, including all offered through the Health Insurance Marketplace, cover mental health and substance abuse services.

Lisanby, professor and chairwoman of the psychiatry department at the Duke University School of Medicine, said the ACA is predicted to affect mental health treatment in several ways, including the removal of the restrictions on patients with pre-existing conditions.

Secondly, she said, ACA's promise of parity of coverage means patients with psychiatric conditions will get the same level of insurance coverage for their psychiatric conditions as for medical conditions.

Additionally, expansion of Medicaid eligibility means that people with disabling conditions, including many serious psychiatric conditions, will be able to obtain care, she said.

"In short, the impact is predicted to be positive," Lisanby said.

Connecticut was the first state to expand its Medicaid program, which includes coverage for ECT treatments, in 2010.

Department of Social Services spokesman David Dearborn said that before 2010, a low-income adult without a dependent child would only qualify for Medicaid if he/she was 65 or older, had a disability or was pregnant.

The state has 178,000 people insured in the expanded group out of total of 720,000 people enrolled in the state's Medicaid program, HUSKY Health.

Still, there are still people who don't know ECT exists, and if they do, some struggle to find a place to get the treatment, Kitty Dukakis said.

This is one reason the Dukakises continue to advocate for the procedure. They speak publicly about their experiences because "people are so misinformed," she said.

"It is so upsetting to read things that are absolutely not true about the treatment."

mrigg@newstimes.com; 203-731-3370; @mackrigg