#not super easy to discuss something like ELECTROCONVULSIVE THERAPY in brief??

[sjweminem]

This might be a dumb question but. How do they know when you can stop doing ect? Is it just when you feel better lol?? Like when are you ready? Do you have to tell them or??? Do they tell you??? How can they tell it's worked well enough that you don't need to come so often???

not dumb!! to many this is still a rather mysterious kind of treatment!

before and after each session, at least at the highly acclaimed hospital at which i'm fortunate enough to be treated and is accessible to me locationally, there is an extensive catchup and evaluation with your whole team. they administer periodic depression screenings as well to monitor changes- positive or negative. very much a team effort all around, and i imagine planning your session-tapering and long-term maintenance appt schedule would be no different. if they know you're still suffering they're certainly not gonna just kick you out of the program, even if you've already received the "standard" number of sessions. i have already received more than double that and haven't even begun to taper off (i.e. i still go 3x a week) because of my poor state.

it is also very much my responsibility to be honest (admittedly in careful, calculated ways that don't lead to legally-obligated, forced admission to their inpatient psych program.....i'm no rookie to toeing that very thin line lol) and, VERY importantly, advocate for myself. there's a reason the intensity of my treatment has increased four times so far. this aspect was a bit strange at first; i'm not used to psych professionals really, truly listening to me. i've been in the MH system for two decades and had gotten used to those professionals defaulting to THEIR expertise and abiding by THEIR protocols regardless of my desperate assertion of my own misery. i've gotten used to only making vague allusions to my su*cidality to avoid involuntary commitment. all it takes is ONE slip-up, ONE wrong word, and once it's said there's no going back.

However (this paragraph is more of a side-note so feel free to skip) my wonderful ECT doctors and nurses trust that i'm getting this treatment because i WANT to get better, and that when i tell them something isn't working, or that i don't think i can endure long enough to "wait and see" due to my severe su*cidality, it's the truth, and also proves i'm not ready to give up. yesterday, actually, for probably the first time, i spoke frankly about exactly how i would kill myself should this not work. i've planned out every detail. i even admitted to fantasizing about it all the time- all details about which no one else in the world knows, but i explained it all to the psychiatrist in my post-tx meeting because i trusted she understood and listened to me. i trusted she would connect the dots between a.) my showing up to each session and verbalizing my needs, to b.) the fact that you CAN be su*cidal without automatically being a danger to yourself, and have to be put away.

since my treatment approach has crossed over into more Hardcore territory, when i reach and my own desired version of wellness and stability (i say "when" instead of "if" bc i'm trying to be optimistic for once in my fucking life), and i've been in that mental state long enough to feel safe and confident in it and have expressed as such, we will begin the weaning/tapering process. there are several methods for doing so, in my case likely a combo of reverting to the "beginner" tx settings and coming in 2x per week instead of 3 and seeing how i do; if i remain stable; then following the same process of lower-impact settings and fewer visits. the goal is to reach "maintenance" territory, in which i'd only need to come in once per month, like a booster. i would remain on my medication cocktail.

it's all very personalized and, at this wicked high quality clinic at least, the patient seems to have the final say. idk what it's like elsewhere but if you google "mclean hospital" you'll get what i mean lol (i have lots of history w them too which is nice). it also helps a lot that the ECT staff is so experienced, so they know what to look for in their recovering patients, AND warning signs for which to watch out, that the patients themselves may not personally recognize. you won't just be thrown to the wolves.

all in all it's about trust. and i quite literally trust my team with my life.