ECT

I read an interesting article on the BBC website about ECT today, proving that there is occasionally a worthwhile story to be found. The article gives a good account of the early history of the treatment and then looks at reasons for the decline in its popularity. The observation is made that:

ECT was indiscriminately used on people it would never help. In 1946, two psychiatrists from Siena, Italy wrote, “Today there is no mental illness where [ECT] has not been tried.” This included homosexuality, which the first three volumes Diagnostic and Statistical Manual for Mental Disorders (published between the 1950s and 1980s) categorised as a form of mental illness. Such widespread use – often without the patient’s consent – was a way to control uncontrollable patients. After a session, patients were in a dazed, sleepy, and therefore more manageable, state. It was custodial, not curative.

Sylvia Plath's The Bell Jar and the film One Flew Over the Cuckoo's Nest helped reinforce the image of ECT as a brutal and primitive therapeutic tool. The the use of ECT declined after the 1960's:

This was partly due to the rise in prescription drugs – though these were often less effective in severe depression – and partly due to the bad press ECT received in books, films, and the mass media. In the 1970s, historians David Healy and Edward Shorter write in their book Shock Therapy, a growing anti-psychiatry movement spearheaded by the Church of Scientology claimed that ECT ‘destroys minds’.

Clearly there is far more money to be made from a person on antidepressant or antipsychotic medication than from that same person receiving intermittent electric shocks, often at intervals of several months. The former needs to:

• purchase the medication on a regular basis
  (often for the remainder of the person's life)
• visit a doctor or psychiatrist to obtain the script for the medication
• be tested regularly by pathologists to monitor drug levels in the person's bloodstream
• sometimes take additional medication to counter the side-effects of the medication

This is tremendously lucrative to the medical industry (doctors, psychiatrists, pathologists) and the pharmaceutical industry (lifetime dependance) and any person presenting at the local medical centre with symptoms of depression is perceived as having a flashing neon dollar sign above their head. Compare this to the returns to be made from ECT and it's clear why the treatment was targeted and disparaged.

However, as the article observes:

Interest in ECT is returning. According to a recent report, a growing number of people are deciding to undergo the treatment. Between 2015 and 2016 in the UK, 22,600 sessions of ECT were performed, an 11% increase over the previous year. And ECT has been joined by more selective forms of electric therapy such as Deep Brain Stimulation (DBS) and Transcranial Magnetic Stimulation (TMS), both of which are growing in support and popularity in the treatment of depression, Parkinson’s disease, and other mental disorders.

The medical and pharmaceutical industries are not interested in a cure for depression and psychosis, just as they are not interested in a cure for cancer. There is too much money to be made in the treatment and absolutely no money to be made in the wake of a cure.