TREATMENT: Electro Shock Treatment (ECT) and Transcranial Magnetic Stimulation

[BPDFamily.com]

My sister has been diagnosed with severe depression, I think she is BPD, as her behaviour fits with all I have read here.

I had to have her admitted to a mental facility and they were looking at giving her EST.

I spoke with her GP and with the staff at the facility and they told me that they have had great success with EST.

The staff told me that it resets the brain and seratonen levels,the only side effect that they told me about was memory loss of about 1 hr.

Has anybody heard of EST being used for BPD? Any other side effects?


Tee

[tee42people]

My sister has been diagnosed with severe depression, I think she is BPD, as her behaviour fits with all I have read here.

I had to have her admitted to a mental facility and they were looking at giving her EST.

I spoke with her GP and with the staff at the facility and they told me that they have had great success with EST.

The staff told me that it resets the brain and seratonen levels,the only side effect that they told me about was memory loss of about 1 hr.

Has anybody heard of EST being used for BPD? Any other side effects?


Tee

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[JoannaK]

I don't know about EST with BPD.  I do know that the more recent EST treatments aren't at all as damaging and disabling as older such treatments, but there is still some concern about memory loss.   But depression alone, even severe depression, is different than BPD.

[flex60]

According to clinical trials I read about in pubmed, those with BPD, progressed dementia, eating disorders, and extreme depression, have serotonin transmitters, SERTS,  probems.  They found about fifty percent were empty, in all four cases, how the transmitters work is a mystery.  The author proposed a theory in the eating disorders, in that those folks serotonin level changed rapidly, when it went up, they overate, then when it dropped they vomited their food.

I would think if EST would reset the seotonin level, it should be explored at length.

Please put EST in google search and you should learn a lot.

I do have an acquaintance that I work with, no meds helped him in the slightest, he has EST twice

and says nothing to it.  His first he got five years ago, and tells, if he fell over dead today, it would have been worth it.  He is about thirty years old, and must have had a miserable life up to the point of EST.

flex

[nevergiveup]

I have a friend with schizophrenia who has regular EST. He says it really helps him mentally, totally clears his delusions, but leaves him with a constant headache. Don't know anyone with BPD who has had it.

[Bdawn]

My stepfather had EST back in the seventies and it helped him immensely. He had been in a catatonic state for weeks and the EST snapped him right out of it. There was memory loss in the beginning but eventually pretty much all of his memory returned. I find the idea of EST frightening but I have read that it has been very successful in treating patients with chronic depression. I have never heard of EST being used to treat any personality disorders.

[Abigail]

  It is supposed to be helpful in cases of severe depression that does not respond to medication.  I don't think it is used for BPD but it may help if the person has depression.  Have you mentioned to them the possibility that she might have BPD?

  Abigail

[bart11]

I believe the preferred term is Electro-Convulsive Therapy (ECT).  They don't like the word "shock" in the title of the treatment.  It is thought that the convulsions are what cause relief from depression.  They used to use large doses of insulin to induce convulsions but they found that electricity was safer.

Most of us know of the procedure from the movies or TV.  Hollywood spends little time on accuracy and goes for dramatic effect instead.  Today, ECT no longer resembles what was seen in ONE FLEW OVER THE CUCKOO'S NEST.  The procedure is done under a general anesthesia as is given during surgery.  Patients are monitored as with any surgical procedure.  Muscle relaxants are given as well to minimize physical convulsions of the body (toes twitch but that's about it).  It can be done to one hemesphere of the brain or both, depending on electrode placement.

Kitty Dukakis has a couple books out detailing ECT's use, effects and side-effects.  She has had ECT treatment for a number of years.  I think anyone considering the treatment for themselves or others should research the subject, both pro and con.

All that said, I would only use ECT as a very very LAST resort.  Medicines for depression are very good, but those who do not respond to talk therapy along with many attempts at antidepressant treatment may then consider ECT, but ONLY with proper information.

Best of luck

Bart

[free]

I agree that the research is very important, and weighing out the pros and cons. A friend of mine had ECT many years ago. There are large swaths of memory gone. She also suffers from many physical symptoms that she attributes to receiving ECT. It was no help over the long term, and she has very bad feelings about it.

On the other hand, I know someone who had tried many types of antidepressants, had done years of therapy, and tried everything she could. She received a couple of treatments of ECT and didn't suffer from depression again.

Like everything else, the response and perception is completely personal and can't be applied to everyone. I know that ECT seems barbaric, and I've certainly had concerns about it... .but it's also cruel to keep someone alive who is in severe emotional pain all the time--I think that's barbaric too.

Free

[ian]

From what I understand ECT in moderation does not cause any real long term problems, but if performed too frequently it can damage memory.

[suzani]

ECT is becoming much more popular.  Kitty Dukakis puplished a book about her battle with depression and how ECT is the only thing that works for her. (Maybe I have that wrong, maybe she just does not want to take the meds?)  As others have mentioned, the treatment now is not nearly as harsh as what they used to do in the past.

Stanford has a special center for treatment-resistant depression.  They have recently purchased more ECT equiptment.  They have a 6 week waiting list to get in for ECT.

However I have never heard of it being used for BPD.  Does anyone know if it is frequently used for PTSD, because if so then it might be logical to try it for BPD.

[suzani]

Schnitzel,  I have to disagree that there is no science behind ECT and its effect on depression.  There is no definitive scientific proof of exactly how ECT helps with depression, but something is going on because the APA says ECT has an 80% success rate, while meds have only a 50-60% success rate.  Depression is a state of abnormal brain chemistry.  Sometimes you can correct the chemical imbalance by therapy, exercise, etc., sometimes you need meds.  ECT is usually a last resort because it does lead to some memory loss, headaches, etc.  But sometimes it helps where nothing else did.

The brain is really complex, there is not even a complete understanding of how antidepressants work.  I had a psychiatrist who told me that sometimes when he had a hospitalized patient and nothing else was working, sleep deprivation would somehow snap them out of it. (don't do this on your own!)

I can understand not wanting to do it, but there are a thousand medical journal articles out there that says it DOES relieve depression.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[suzani]

Well, of course it is great if therapy alone can alleviate depression, but so often that is not the case.  The truth is that no one knows how many of the approved drugs out there work (just like ECT).   The reason that they are allowed to be sold is that (1) they are not toxic/poisonous (or if they are, they are being used for something like advanced cancer, so it is better to tolerate the nasty side effects to kill the cancer cells) and (2) they have been proven to have an effect in clinical trials.  So we know that if you take X, you will get better (although we don't know why you get better).

I hope that none of you  ever have full blown, never-ending depression.  When you have it, unless you really have no sense of self-preservation, or no one around to help you, you try many things to feel better.  You keep moving down the list of possibilities.  For some people, ECT is the only thing that works.  It isn't electrocution, it is a medical procedure that is done very carefully, and it is definitely not the 1st, 2nd or 3rd choice for treating depression.

I just don't want someone on the board to feel like an idiot or a freak because they are getting ECT.  Depression can be just as nasty as schizophrenia, and if you get depressed enough you can even have a psychotic break.  The longer you have depression without getting it relieved in some way, the worse it gets and the harder it is to treat.

[free]

Well, of course it is great if therapy alone can alleviate depression, but so often that is not the case. 

The longer you have depression without getting it relieved in some way, the worse it gets and the harder it is to treat.

Suzani,

This is so true. For many people, therapy alone is not enough to relieve depression; a change in body chemistry is also needed. I did years of therapy, bodywork, breathwork, art therapy, journal writing, etc and still had life threatening depression. I was fortunate to finally find an antidepressant that was effective without terrible side effects.

A psyc. that I saw had a theory that working through painful childhood stuff was very stressful on the body (although necessary to do). She believed that reliving a lot of the pain was a stressor especially on brain chemistry. She had worked with women who had been abused for over 25 years. She saw many women who had done extensive therapy and personal work, and sometimes needed antidepressants for several years in order to heal more fully. She was not quick to prescribe meds or ECT, but she felt they had an appropriate place.

I believe there is a difference between situational depression and chronic depression. The first more likely will respond to therapy and if possible, the change in circumstances. Chronic depression--not so likely. Also, once you have had a major depression, you are more likely to have more of them. When you have a string of untreated major depressive episodes, the treatment is much more difficult.

Free

[ThursdayNext]

Not sure which board to post this on so am posting here. Have just had panic-stricken phonecall from BPDsis, who has been in high dependency mental health ward for some months now (and on and off all year) after her 4th suicide attempt this year. She had day leave on the weekend and, being suicidal (still) but not having told staff that, decided to hitch-hike to another city and throw herself in front of a train. She stopped at a local town to see her boys, who are with an aunt, having been removed from her care. This was, in my  understanding of the orders, in breach of her current visiting rights but the aunt was very nice about it and allowed her to visit. The visit with them reminded her that suicide wasn't a good choice and she then drove her car (which is in no state to be driven) back to the hospital, having stopped off at the side of the road several times to while she battled her desire to run away and kill herself.

After having heard this from her yesterday, I phoned the nursing unit manager this morning to check that she knew what BPDsis had been up to on the wkend and that BPDsis now had her car parked in the hospital grounds and so was a flight risk and also had a vehicle for further suicide attempts if she chose to use it that way.

The panic stricken phonecall just now was to say that (a) her day leave has been cancelled due to her behaviour on the weekend (surprise, surprise) and (b) that the second-opinion psychiatrist who saw her last week had agreed with her treating psychiatrist that they want to try 6 ECT treatments. That if she didn't agree to it they would seriously consider treating her under the mental health act, which allows them to make the decision for her.

She is obviously terrified but has also decided that this is just proof that she shouldn’t have returned to hospital – that it’s punishment. Sigh.

The Drs have told her that they think it possible that her depression is not as related to her BPD as previously thought and that by using ECT they can establish this – sounds logical but also sounds like a rather brutal way of finding out. Their hope is that by doing this they can jolt her neurotransmitters to better levels very quickly, so that she will then be more responsive to medications and counselling. She’s currently not responding to most medication courses tried and is refusing to engage with therapy.

My question: does anybody have any experience of ECT in relation to a BPD in their life/acquaintance that they would be prepared to share?

My concern: that if ECT doesn’t ‘work’ according to my BPDsis’ definition  (i.e. makes her better) then she’ll be even more likely to kill herself. Mind you – at the moment that’s likely to happen anyway.

Thanks, people. I know there’s not much to be said here – BPDsis is a pretty severe case although her borderline behaviours are usually more on the ‘middle range’. She still has this attitude of waiting to be rescued, for someone to ‘fix’ it without her really participating in her recovery, which is very difficult and frustrating for all concerned. Main reason I’m still engaged with this in any way is because of her two small boys and her older children. 

[samsara]

An old friend of mine was treated with ECT for bipolar disorder.

She felt that it did help her when medication was no longer working, but it did strip away a fair amount of memory.  

She's on disability now, but at least she is no longer actively suicidal.

Are there no other medications that can be tried to help your sister?

Is anyone acting as her medical advocate and/or does she have a legal guardian to help with these healthcare decisions?

ECT is pretty heavy-duty stuff - defintely to be used as a treatment last resort when little else has worked.

I understand why you are trying to help your sister, but it is also a very heavy burden to carry.  If there was anything I could share, I would say to find someone who can be a legal medical advocate for her while she is hospitalized.   If anything to protect yourself (and your sister) should the docs treat her with the ECT.

[blackandwhite]

Thursday Next,

xoxox

My mother had it. I was a small child, in the 70s, so my memories are jumbled and techniques have likely changed. I've heard it's much easier to handle now, but haven't done any research myself.

She did stop trying to kill herself after it, though I don't what causal connection there is, if any. She was very depressed as well as BPD. She left the hospital very bitter toward the mental health system, again, I'm not sure if that was due to the ECT.

Not sure how relevant, but feel free to PM me if you want any more info.

B&W

[LivingWell]

Carrie Fisher, aka Princess Lea is bi=polar she talks about it.  I actually knew her in the 70's and 89's and I believe she is also BPD.  A couple months ago she was on the Charlie Rose show talking about her life and mental health.  She has ECT almost monthly.  Says she couldn't do without it.  You may want to goole the Charlie Rose show and then sign in to see the interview.  She's a very interesting person.  Somehow she doesn't seem quite normal but she's definitely in better shape than your sister.  She swears she couldn't do without it. Says it does decrease short term memory for a period of time before the treatment.

You may want to look up the interview. 

[LivingWell]

What a mess to be going through.  The stress of trying to keep someone alive for their children,  concern for the boys, planning a funeral. And the whole time your sister has been, is, and will blame you.

It really all sounds like too much.  The hardest part is choosing the pictures, especially if you choose then all by yourself. If it's feeling like too much then slow down on the funeral.  It will get done when it needs to get done.

You may think you are doing this because you are the only one at home during the day. You are doing it because you care. Caring makes it hard. 

What you are saying is your sister isn't going to get any better because she doesn't care and isn't going to try.  Unfortunately you are probably right.  xoxox 

I will be thinking about you.   xoxox

[MiddleOne]

Thursday Next:

I'm very sorry to hear about your sister's current condition.  What type of hospital is she in? General, specialized, private, public?  My mom was hospitalized for bipolar disorder in all types of facilities and communication varied greatly from place to place. Pyschiatrists at a public hospital have taken over a week to respond to my phone calls which I attributed to overwhelming case loads rather than indifference.  Does the hospital know that you are the family's point person?  If yes, then the psychiatrists should return your calls, although they are unlikely to respond to a request for information over the weekend. Have you tried calling the nursing station and raising a little fuss about needing information?  Sometimes the nurses are so helpful in delivering a messages to the docs. I don't have anythng to offer regarding ECT, but I might ask the doctors if there are any less drastic steps that can be taken before trying ECT.  If you have the resources you might consider hiring a private social worker to help you navigate the hospital system and come up with a treatment plan. In the end, there's not much you can do to improve the situation if your sister is intractable. Sparing your niece this anguish is admirable of you.

MO

[ThursdayNext]

Good news! The psychiatrist called me yesterday - I left a message in the morning saying I wanted to speak to her *before* BPDsis began ECT - thinking that might tweak her tail a little and it obviously did. Good but intense discussion. Am relieved that ECT is not the 'bottom of the barrel' treatment BPDsis implied. If this fails to get the response medicos are hoping for they will keep her in hospital and start Lithium treatment. Dr wasn't keen on this cos it's very dangerous in the hands of people who are inclined to overdose, as my sister is.

Anyway, it was a reassuring phonecall, although she did make it clear that if BPDsis didn't agree to ECT, they would almost certainly treat her anyway under the mental health act - but only because dr is really quite confident that the depression is the key and getting in the road of BPDsis' response to therapy. So ECT starts tomorrow. Still not sure how I feel about this but if it stops the suicide attempts and thinking, then that's gotta be a start.

Another complication, though: BPDsis' eldest child was adopted out and has variable contact with her mother and some half-sibs. She phoned my niece yesterday (the one who's next-of-kin) and hit the roof when heard about ECT for BPDsis and is now wanting to talk to me about changing the treatment etc. She's had nothing to do with case management all year so this is... .irritating, if understandable. So today I have to talk to a young woman I've never met about her mother's medical treatment.

Would it surprise you all to know that this niece was originally diagnosed with rapid-cycling bipolar but the diagnosis was changed to BPD and she’s on a medication that didn’t work for BPDsis and doing DBT? I hadn’t realised her diagnosis had been changed til I talked to BPDsis this morning. So there’s another one in the family and again, I get to deal with her.

Got a bit snarky this morning and said to mum: ‘Just as well for everyone else that I’m home sick, isn’t it?’ Not nice but am feeling rather used at the moment.

LivingWell: thanks, but went through assessement for food and chemical sensitivities five years before I developed ME/CFS and again after I was diagnosed in case there was an alteration in sensitivities, so I’m already on carefully controlled diet for those reasons. It’s mostly gluten free. Mum has extreme food and chemical sensitivities so I’m very aware of the problems. And no, 3hrs gets very little done – and I’ve also found that talking is one of the most energy-draining things I can do. So all these phonecalls at the moment are really burning through limited energy supplies.

Thanks for the info re Bernie Siegel. I’ll persist with it on my own account, although I think it’s mostly stuff I’ve been doing for years. I’m pretty sure it won’t apply to BPDsis because, like everything else, it will require her to engage with her healing, which is a significant part of the problem. One that she recognises, mind you – but she explains it as ‘she’s not made that way’ or ‘she’s never been an A type personality’. I had a talk to her today about the fact that working on something didn’t necessarily require you to want to do it or feel like it or believe in it. Nobody likes cleaning the bathroom or scrubbing floors – it’s just something you have to do because it needs to be done. But then she’s always had a problem doing anything she doesn’t *want* to do – it’s all about the feelings. Very BPD.

[ThursdayNext]

Update: boy, is BPDsis into a Pity Party and Negative Nestbuilding at the moment! She's had three ECT treatments and is now crankysulkysullen cos 'it's not working'. Obviously, despite her previous statements, she'd done the B&W thinking/absolutes again.

But it is soo hard to talk to her at the moment! She only wants to talk about what a victim she is, how terrible her life is, how unfair everything is, how mean the aunt who his caring for her boys is (cos she won't bring them to visit every weekend - it's 1.5hrs each way and the aunt works during the week!) etc etc etc.

And, as usual, instead of doing the things she's supposed to do to help herself through black spots, she's indulging her negative thinking. It's a competition, I swear. If you make a positive statement, she seems to have this little internal demon that wants to see how quickly BPDsis can turn what you've said into a negative. And if she can't, she gets even more sulkysullencranky.   

S’okay, I’m just venting here.

But boy, there are some things I would *love* to say! Like, ‘Stop throwing a temper tantrum just cos people aren’t doing what you want them to’ (she doesn’t dare ask but she implies that now that mum’s on school holidays she should fly out to visit her ‘dying’ daughter). And ‘try taking some responsibility for your mental health’. But if I even go near to saying such things – i.e. diplomatically and using SET – then she uses that as an excuse to dive into the ‘I’m such a terrible no good very bad person, you’d all be better off without me’, glorying in her self-hatred. 

I’m running out of ways to talk to her. No. I *have* run out of ways to talk to her.

Basically I’m at the point of listening to her self-pity and self-castigation for five minutes, maximum, then saying, ‘Well, you know what I think about that, we’ve discussed it before. You know what I think you should do.’ And then moving onto other things – like books, reading, Christmas preparations etc. So she goes monosyllabic and resentful and says she has to get off the phone. Unless I get in first with, ‘You’re obviously not feeling like talking today so I’ll call again tomorrow or the next day.’

This is my T’s advice, by the way – to not feed the self-pity and drama by removing the audience. But it’s soo boring, repetitive and unproductive. And I can’t help feeling a bit angry with her afterwards – which is partly what she’s aiming for, I’m sure.

Anybody got a magic wand?

:'(

[ThursdayNext]

Update (long): sorry, have had/still have a cold and it's not combining well with my chronic immune etc dysfunction so have been quite ill and am still struggling.

BPDsis finished her course of 7 (they upped it by one) ECTs and somehow they convinced her to agree to a second course - must have caught her on her one rational second that day. Anyway, she didn't respond well initially but turns out the first four treatments were unilateral, which is notoriously hard to target and produces very mixed results. The bilateral seems to be working better, although BPDsis is convinced it's making her worse. This is because she's beginning to feel things again, which means she's coming out of the bottom-of-the-barrel bleak don't-care-about-anything phase.

She's extremely angry again now although it comes across as passive agressive. She's doing everythingi she can to sabotage her treatment and resents anybody telling her she has to think more positively and that she's responsible for her healing.

As mum’s on holidays from work, she’s been doing more of the daily phonecalls – we take turns. I lost my voice with the virus for about 8 days, including Christmas, which had the positive side of putting mum in the position of having to make the daily phonecalls I’d been doing for nearly 2months during Term4 last year when mum was too busy, too tired, or too late home or whatever avoidance it was that time. (Though she’d claim she wasn’t avoiding – and I don’t think it was deliberate, more subconscious). She found the daily phonecalls and dealing with BPDsis’ ups and downs exhausting and emotionally difficult – which gave me the chance to say, ‘yeah, well, now you know what I’ve been dealing with’. It also meant that when a crisis came up about BPDsis’ house (ie. Where she lives when not in hospital), mum had to deal with it as I had no voice to make the multiple calls. All of that has, at this stage, produced some small but significant changes – although whether they last into the first teaching term of this year is another matter.

Had really difficult conversation with BPDsis yesterday – it was my ‘turn’ to call her. She was in floods of tears, full of self-pity etc. I played it pretty tough – pointing out that the staff were right, she did need to be more positive and if she didn’t do the things she’d been taught and was advised to do then she wasn’t going to get better, that responsibility was hers etc. Was supportive and encouraging but firm. The ‘better of dead’ thing came up again and she had the hide to say (in response to something I’d said) that she ‘didn’t see how her death affects you or mum’ which I responded to rather tersely. She ended up hanging up on me because I wouldn’t play along and join the Pity Party or Negative Nest Building. She then phoned back two hours later and wanted to apologise – and do the same thing all over again. So I cut her off (nicely) and said I had to go and cook dinner.

Sigh. Although I’m managing them as best I can and applying all the things my T has taught me and advised, these calls are draining – if nothing else cos there are times when I want to slap her around the face and say ‘sit down, shut up, listen to what the doctors say and for once in your life do what you’re told’. Which, of course, is unhelpful to all parties.

Can only pray that there will be the small internal shift required – that she will accept responsibility for her illness and her need to learn to manage it differently. She’s currently playing an internal tape about how she’s ‘been trying to get help for years’ whilst ignoring the fact that she refuses any help that isn’t what she thinks she needs – which is someone to look after her 24/7 and take responsibility for housework etc. Community Services are placing her boys with the paternal aunt for 6months minimum, maybe 12months and BPDsis thinks this is unfair as ‘I need them’. Has no awareness of the boys’ needs. It’s all about her. As usual.

In other news, uNPD bro and family are almost certainly relocating o/s for a new job after he had to leave his previous one in early November09. This will place care of uNPD father principally on eldest sis, who is starting a post-grad medical degree in February. While I’m not going to get dragged into caring for father-dear-father, I have phoned him and will phone him monthly. I’m at the point where, after all the practice I’ve had with BPDsis and the help of my T, I can deal with FDF pretty easily – it’s predictable, if nothing else. BPDniece24 is emailing regularly and is now wanting family history, photographs etc – it’s all about her. (Very familiar!) As it’s email it’s easier to keep at a distance and respond as convenient. I’m also being firm about boundaries and her demands – as in, ‘I’m rather busy right now with poor health and your biological mother; now is not the time for me to be doing this’. Darling niece23 has virtually dropped out of dealing with her mother – just not coping with talking to her. I’m okay with this although it can make it difficult talking to BPDsis if she realises that I’ve had more conversations with her daughter than she has.

I’m determined that this year I’m not going to be put in a position where I feel forced to use all available energy to deal with the PDs in my family, both directly and with the consequences of their behaviour. I’m not confident as I’ve made that intention before. But I can try. Thanks again to everyone for the support. 

[ThursdayNext]

Update: okay, bad start to the year. Was just getting over the virus (onto second dose of antibiotics, which I'd hoped to avoid) and... .on Monday (4th) mum's leg collapsed under her - loud crack, lots of pain.

Long day in emergency resulted, eventually, in diagnosis of slipped kneecap that made small tear in ligament/tendon causing internal bleeding. Therefore extreme pain and huge swelling. Can't be bothered going into details but suffice to say that eldest sibs were not especially supportive and bro-in-law chose that time to blast off in my ear about why mum had brought this on herself. Quite how she can be held responsible for inherited osteoarthritis I don't know but there you go - that's my family. Great timing - and as usual, lots of opinions/advice and no practical help.

Mum was sent home despite being unable to walk – can’t put weight on her right leg at all. She’s to have total knee replacement in the first week of February and I get to care for her between now and then. That would be okay if she were more mobile. As it is we’ve worked out how to use a computer chair as an improvised in-house wheelchair, as an actual wheelchair is too expensive to hire and doesn’t fit through normal doorways.

But it means I have to get up two or three times in the night to help her to the toilet and, much as she hates it and is concerned for my health, she’s reliant on me for almost everything else. She’s being more sensible than usual – at this stage. We’ve discussed this.

The major problem is that I don’t suddenly have more energy just cos there’s a crisis. My health problems don’t go away at need or will. (Unfortunately!   ) So now it’s a matter of trying to get through the next few months, do what needs to be done to help mum prepare for her operation, keep up with the ‘all ordinaries’ (housework, cooking etc) and keep my health stable.

Not to mention the every-second-day phonecalls to BPDsis – mum’s taking turns at the moment. And those conversations are getting harder. The ECT seems to be breaking BPDsis out of the numbness so now the anger, resentment, despair etc are back. I don’t envy the staff who are responsible for her, I must say!

Anyway, thanks everyone for the continuing support. I think I have to accept that just surviving and staying reasonably healthy will be an achievement until mum has recovered and returns to work. Anything else will be a bonus.

[david]

I just saw a show on PBS last night. It was called Emotional life I think. There was a girl suffering from depression and meds did not work. She had a course of ECT treatments and it did help. Apparently from the show ECT helps the brain with new cell growth as do antidepressent meds. When meds do not work ECT is used and usually shows promising results. They showed rat brain studies before and after and it showed how parts of the brain ( I think it was the hippocampus) showed significant growth after the treatments.

[ThursdayNext]

Thanks, david: yes, have read about good results with ECT - and think that is happening and think that the medicos will try and talk BPDsis into another course of ECT after this one. Will be harder to get BPDsis to agree cos she sees it as 'peeling the layers off the onion' and she's having to 'feel' things again that she's been trying to avoid, come out of her numb state etc. We keep telling her that the only way out is through, she has to deal with those emotions, accept them, get therapy for them etc but she's fixated on the idea that the only solution is for someone to 'help her with her inability to organise herself, get her housework done' etc. In other words, it's all short-term solutions again and it's all about what *she* has decided is best treatment, not what the experts think. Sigh.

Anyway, some good news. Found a place today to get a wheelchair for mum, without having to pay a $600(Australian) deposit. So have rented it for a month. Mum spoke to eldest sis this afternoon who was as full of advice as usual but not available for helping unless this week or next. Wanted to rent every gadget under the sun - none of which we need. Didn't listen to most of what mum said etc. And uNPD bro and family fly out in two weeks to move to a new job o/s. anyway, at least we have a wheelchair today. And mum starts physio and hydrotherapy next Wednesday, after seeing rehab doctor today. 

[LivingWell]

You must be absolutely exhausted. Pushing that wheel chair is work.  I'm glad you were able to get something that would go through the doors. When is she going to the doctors again.   

Completely ironic that BPDsis is the one who's being most concerned and emotionally supportive in all this. (Black laughter on  my part).

How well I understand your black laughter.  They can take on other personalities very quickly. Before the illness was called "borderline", it was called "as if personality".  My mother had Alzheimer's for years. Sister would put on her Florence Nightengale act and  visit Mom every day for a week.  Then she would disappear for 3 to 18 months.    You've gotta laugh there is  nothing else you can do. 

Funny you should mention laughter.  I belong to a laughter yoga club.  I go every Monday.  Laughter is a great for stress reduction.      

I think about you, every day when I come here and wonder how you are doing.   xoxox

[ThursdayNext]

Will need to start a new thread very soon but just wanted to let you supportive people know how things are this week.

After the 2nd course of ECT, drs have decided not to give BPDsis any more ECT as 'it's not having sufficient effect to justify continuing'. So BPDsis is going to be released from hospital in a few weeks at the outside - and mum and I just went back to not sleeping very well. There's only a very small difference between how BPDsis was when she went in post-4thsuicide-attempt-of-2009 and how she is now. And she still refuses to move closer to help etc. Drs are going to try her on tricyclic antidepressants but of course those are easier to OD on. Good news is that they've put her in touch with PHARM, which is a group that helps mentally ill in country areas. Apparently they're going to try and help with getting her house clean/tidy and getting her into routine, helping with shopping etc. Be great if it actually happens and if BPDsis doesn't drive them away. Hopefully she'll go to DBT weekly in a town 2hrs away (closest available). Group also deals with addictions and I think that's an indirect issue - smoking (not drugs, these days) but also addicted to destructive relationships with revolting men, all of whom have been addicts.

Am not hopeful, am worried/anxious etc but nothing I can do other than continue phone support etc.

Good news is that I’m now in email contact with another one of BPDsis’ daughters – one who doesn’t have major mental illness. So now have contact with two daughters from one relationship, and the one who was adopted out when BPDsis was much younger.

Mum’s knee surgery isn’t officially booked yet but *should* be first week in Feb. At the moment I’m just about killing myself trying to keep up with all the things she wants done before surgery – we’ve been having some ‘chats’ about the fact that it isn’t in fact necessary to spring clean the entire house and make sure the garden is in picture perfect order before she goes to hospital but it doesn’t seem to be getting through. Main thing is getting her classroom displays done for her supply teacher – that’s an essential. Great news is that mum  has plenty of leave to cover surgery and recovery so that’s one less concern – big relief.

Am trying to pace myself but it’s not made easy by the fact that mum is so busy focusing on things she wants to get done she forgets that many of them are things she shouldn’t in fact be doing as they put the wrong kind of pressure on her knee/s, so I have to jump in do it instead as she’s usually halfway through something that can’t be left.

Eldest sis is still on her high horse or up righteous row or whatever and hasn’t been in touch for 2wks – obviously *very* concerned about mum’s welfare. Presumably as she and BIL have given us the benefit of their opinions and advice, they consider they’ve ‘done their bit’. Grrrrr.

uNPDbro sent mum a text from his o/s posting so that’s good – relieved mum’s mind so one less worry.

Anyway, thanks all for the support. I’ll start another thread soon – depending on how rocky the rollercoaster gets, I guess. Thanks again – it’s been great to have the hand-holding and moral support through BPDsis’ ECT and this really difficult phase. As I said to T the other day, it would really be good to be able to talk to him/post here and say, ‘you know what, I’ve had a whole 2wks/4wks/whatever without a major family drama’. Sigh. Wishful thinking, I guess. Will keep plodding and keep knitting – it’s good for reducing adrenaline levels!

[Skip]

This is a helpful writeup... .

www.health.qld.gov.au/rbwh/docs/ect.pdf



What is ECT? 

Mental illness can be described as a chemical imbalance effecting the neurotransmitters in

the brain, resulting in the individual experiencing changes to their feelings, thoughts and

behaviours. These changes are interpreted clinically as ‘symptoms’. 

Electroconvulsive Therapy (ECT) is a medical procedure available for the treatment of a

number of different mental illnesses. It involves the application of an electrical stimulus to the

scalp, which induces the brain to release neurotransmitters, assisting in the reduction of the

severity of the illness and frequency of symptoms. 


Why is ECT used? 

While a number of misconceptions and misgivings exist around the use of ECT, it has been

proven to be an effective & safe treatment: 

~ For people experiencing extreme psychotic symptoms. 

~ For people experiencing acute mania or severe depression. 

~ Where previous responses to ECT have been effective. 

~ Where other treatment strategies have been ineffective. 

~ Where rapid treatment response is required. 


How does ECT work?

While the effectiveness of ECT has been shown, the mechanism of action remains unclear. It

is known that the treatment has a positive effect on the brain’s neurotransmitters, however

theorists are unsure of why. A number of explanations have been suggested, including: 

The mild, brief seizure induced by ECT has a positive effect on the brain’s

neurotransmitters. 

The brainstem releases chemicals in response to the controlled electrical stimulus used in

ECT. 

more information... .

[lalaland]

Our 25 year old daughter has BPD.  

We are about to embark on a very expensive treatment for her, which includes TMS.  Are you familiar with this?  Transcranial Magnetic Stimulation.  I found this method on the web after looking up EST... .or ECT, Electroshock therapy... .TMS offered a similar neurological scenario w/o the traumatic shakeup of the nervous system, memory loss, etc.  However, this is as yet unproven and I cannot find much info visavi the BPD.  If anyone out there has an opinion, information or knows someone who has undergone this particular therapy, please post it.

Best, L

[sosadandone]

I would be very concerned about a very "expensive new technique"

Sounds like it could be quackery to me. Its terrible but I learned that there are just tons of creepy people looking for different ways to make money from desperate BPDs looking for some cure. Reminds me of Laetral years ago

So sad