a spot of education, dear reader. . .

ElectroConvulsive Therapy

Electroconvulsive therapy (ECT) is a form of treatment for certain severe psychiatric disorders that involves applying a mild electrical shock to each side of the skull. ECT is performed by a physician while the patient is monitored closely and kept pain-free.

What Is ECT?
ECT is a form of treatment for certain severe psychiatric disorders that involves using electrical shock. In ECT, a physician applies a mild electrical shock (20 to 30 milliamps) to each side of the patient's skull near the area of the temples. The procedure is done under anesthesia*, and the patient is monitored carefully. The shock is applied until the patient experiences a tonic-clonic seizure*. Normally, this would produce strong muscle contractions, causing the body to thrash about. However, the patient also is given a medication to relax the muscles, which prevents this kind of whole-body response. Instead, the seizure occurs just within the brain, where it lasts for a minute or so.

Who Benefits From ECT?
In the United States, about 100,000 people each year receive ECT. The types of mental disorders that are treated with ECT include schizophrenia, severe depression, mania, and delusional states. ECT is particularly effective as a short-term therapy for sudden, severe episodes of depression associated with suicidal tendencies. Because medications take several days or more to have an effect on severe depression, in some cases ECT is a way to provide immediate relief and protection from suicidal intent. About 60 to 70 percent of people who receive ECT experience some benefits. ECT is used with both children and adults.

Why Is ECT Controversial?
Despite its proven benefits, ECT is still somewhat controversial. The debate about its use today is based in part on the treatment's history.

Earliest Treatments
ECT was first tried in Italy in 1938. It soon was used to treat mental disorders that were resistant to other types of treatment. However, in the early days of ECT, few considerations were given to the patient's overall health. In addition, many people experienced pain from the shock itself or injuries from the whole-body seizures that resulted. Nevertheless, ECT was found to be an effective treatment for conditions such as severe depression, acute psychosis, and mania.

Modern Treatments
Modern improvements have made ECT a much safer and more comfortable experience for the patient. These improvements include the use of medications to produce a pain-free state and prevent violent muscle contractions. In 1999, the U.S. Surgeon General's report on mental health concluded that ECT was a safe and effective treatment for certain severe mental disorders when used according to current standards of care. Even so, the states of California, Texas, and Tennessee still prohibit the use of ECT with children and adolescents.

*anesthesia is a state in which a person is temporarily unable to feel pain while under the influence of a medication.

*tonic-clonic seizure is an episode in which a person usually loses consciousness, stiffens due to muscle contractions, and lets out a loud cry as air is forced through the vocal cords during the tonic phase. In the clonic phase, the muscles of the body contract and relax rhythmically, which causes the body to thrash about.

On the Horizon
Transcranial magnetic stimulation (TMS) is a new, painless treatment that uses magnetic pulses to stimulate brain activity. In some early studies, TMS appeared to work against depression. About one-third of the patients treated with TMS experienced temporary, mild headaches after the treatment, but there seemed to be no other side effects. If TMS is shown to be as effective as ECT, it may become another treatment option for severe depression in the future.

Media Portrayals
Some of the lingering debate about ECT is based on its portrayal in movies, television shows, and novels. In the movie One Flew Over the Cuckoo's Nest, for example, ECT was used as a punishment for unwanted behavior. Unfortunately, this kind of depiction often frightens people unnecessarily, keeping them from using a treatment that can be highly effective and even lifesaving.

Modern electroconvulsive therapy (ECT) is not like the shock treatments depicted in old movies. Patients receive medications to relax and sedate them before treatment begins, and many patients with depression find that ECT is a faster and more effective treatment than medication.

How Does ECT Work?
Scientists do not know for sure how ECT works, although research now is being done to find answers to this question. Most of the research is focused on ECT's effect on part of the brain called the hypothalamus*, which, among its many functions, regulates emotional expression and controls the endocrine glands. Changes in endocrine* function are often seen after ECT treatments.

What Happens During ECT Treatment?
ECT is performed in a hospital setting under the careful guidance of a physician. First the patient is given anesthesia and muscle-relaxing medications. Then the patient receives a mild electrical shock to each side of the skull. Thanks to the medications, the patient feels no pain, and the body does not convulse. Once the procedure is over, the patient awakens after 5 to 10 minutes, much as someone would after minor surgery. ECT generally is given in a series of 6 to 12 treatments over a period of a few weeks.

Many people experience some memory loss after ECT. Usually, this loss is temporary, affecting mainly memories of events from the days, weeks, or months just before or during the series of treatments. In most cases, the memories return within several weeks after the completion of ECT.

*the hypothalamus is part of the brain that controls (among other things) the autonomic nervous system*, the endocrine glands, basic drives such as hunger, thirst, and aggressive and sexual drives. The hypothalamus also regulates emotional expression.

*autonomic nervous system is a branch of the peripheral nervous system that controls various involuntary body activities, such as body temperature, metabolism, heart rate, blood pressure, breathing, and digestion. The autonomic nervous system has two parts—the sympathetic and parasympathetic branches.

*endocrine refers to a group of glands, such as the thyroid, adrenal, and pituitary glands, and the hormones they produce. The endocrine glands secrete their hormones into the bloodstream, and the hormones travel to the varous organs in the body that they affect. Certain hormones have effects on mood and sometimes are involved in symptoms such as irritability, emotional swings, fatigue, insomnia, depression, suspiciousness, and apathy.

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(and please don't forget to help yourself
to a Crunchie on your way out!
it is Friday, after all. . .)
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(or it will be, when you read this)
,

(or some popcorn, if your name is mel!)

oops. . .

so I go to what in a just over a month will be the new abode, to measure up for curtains

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now it probably would have been a good idea to do this before I ordered the curtains, but the fabric was on sale and I got an extra discount for taking out a storecard, so I saved £££££s

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and now I have three sets of curtains that don't quite fit the windows - but hey! I saved ££££££s

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which I'm thinking of spending on a piece of art for above the mantel piece - only the art I would love to have is too big (see, I measured the mantel piece and then asked for the dimensions of the piece of art. . . so at least I got that in the right order)

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and then it really bothered me that I loved this piece of art, but it didn't "fit" the physical space where I'd like to have it - so what should I do? not buy it would seem the sensible option, but it is beautiful and it has been crying out to me every time I pass it (I'm on the street, walking a pace in my usual striding fashion like I have meaningful things to do and a real purpose to be doing them with; it is in a gallery, just hanging about in a nonchalant kinda way, waiting to be picked up by a new lover) - and it doesn't just cry out, it doesn't sob or winge, but it kinda calls to me in a siren-type way "take me home! I'm yours! you know we are meant to be together". . .

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maybe I need to change the route I walk, to avoid it? I wonder how many other people it cries out to? perhaps it is fickle, and cries out to all who pass? perhaps someone else has already succumbed to its potential and taken it home!

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I would never have thought I'd turn into the kind of person who (a) buys curtains because the fabric is on sale, (b) takes out a store card to get an extra discount, (c) considers buying a piece of art, (d) might not because it doesn't "fit the space" where I'd like to put it - am I middle-aged now or what? (actually, don't answer that) why am I tying myself up in knots about such trivia. . .

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I used to write a lot about the phenomena of the mid-life crisis, of being an over-developed hunter-gatherer/caveman at heart (perhaps I should just get the Small People to paint their hands and mark the walls and ceilings of the new abode? might be messier, but would probably be cheaper in the long run) (and I'm trying to involve them in the decision making about the new place - The Teen said he wanted an "American Fridge", not because the current fridge isn't big enough for our needs, not because he wants ice-cubes, but so that there is more space INSIDE the fridge when you open the door. . .) and other such thoughts, and now here I am blabbing on about curtains and talking art work and white goods (well, silverish actually, he wants a chrome fridge)

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I think I need more coffee. . .

for my bestest crazy neighbour lady. . .

with lots of love

xxx

help

in a terrible panic

first thing to do: take meds

second thing: fags and coffee

third thing: have bath, to try and relax

fourth thing: go back to bed, to try and sleep

fifth thing: remember I'm supposed to take SP to school

sixth thing: remember last night, she and talked about pubes and becoming a Teen (she's only 10) and she fell asleep in my arms as I sang her The Teddy Bears' Picnic (I always used to sing them to sleep when they were babies/toddlers, but she had forgotten the Teddy Bear song and was fascinated by it)

seventh thing: remember yesterday evening, when I took them to see the new house; the boys love it; SP not happy (her room is the size of a small box), but was brave with me (a sure sign of terror), whilst telling The Teen she didn't like it, but for him not to tell me (being The Teen he told me anyhow, but how interesting that she confided in him - given that they hate each other, apparently, and call each other bitch and bastard most of the time and wish the other hadn't been born; I always say the fact they invest so much energy in fighting is because they love each other really and wouldn't bother with the other if they didn't)

eighth thing: general panic and confusion in my head despite the huge quantities of chemicals currently entering my system, the boys go off to school anyhow and SP remains fast asleep

ninth thing: seeing new shrink (CBT) person this afternoon and am f*ing petrified

tenth thing: resort to more fags and coffee

eleventh thing: (11 being my favourite number) please help yourself to a Crunchie and have a good day
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with much love
amidst the madness
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I,S,LTV

xxx

LARGE FRIENDLY LETTERS

DON'T PANIC

I'm in tail spin. . .
or head spin. . .

taking SP on hols to hot sunny place tomorrow and haven't purchased after-sun lotion (or, far more importantly, sun-tan lotion); haven't done legal/mortgage/insurance stuff I was supposed to do for potential new house "purchase"; did go to doc to get head meds and have breast exam (no lumps); haven't packed; do have passports and tickets and money, somewhere, I think. . .

actually,
I'm not really thinking straight right now
it's all bendy and loopy and backtofrontly
maybe I should get on with it all, instead of doing this
maybe I'll have a cup of tea and a smoke first tho, eh
where's THHGTTG when a girl needs some advice?

what the head doctor said

erm, I took notes. . .

• something about control (as in taking control of the aspects of my life that are within my "control"; making decisions or deciding not to make them; not being paralysed by CH's inability to decide)
  
• something about uncertainty (as in the bad news is often not as bad as waiting for the bad news/dreading the bad news - and the anxiety/panic that waiting/dreading provokes in me)
  
• something about deadlines (as in, agree with CH a deadline - so that I'm not sitting about waiting in an "uncontrolled" fashion for the bad news, but know when he will get back to me with a decision)

erm, I think. . .
as I said,

I took notes,
but possibly not very pertinent ones

myths. . .

achilles
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was famous for his heel,
wasn't he. . .

. . .we all have our
vulnerable points,
I guess

one of my favourite
stories is
Daedalus and Icarus

"remember your limitations"
said father to son
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more on this
and other fantastic thoughts
later!

have a good day

down, depths, deep. . .

. . .depression

why do they all begin with D

I suppose some words have to

I was thinking about how I got myself better last time - not by wallowing in it, once it had been diagnosed. . .

HA! another D

. . .but by taking control

back then, I looked up healthy, anti-depression eating and found out about the benefits of turkey sandwiches and almonds at bedtime, about why bread and salad covered in nuts and seeds are good for your brain chemistry (which makes perfect sense if you think it is only a few millenia since we've been hunter/gatherers) (nuts and seeds, seeds especially contain all sorts of good things that your brain needs for its chemistry)

I exercised, I relaxed, I did some self-healing as well as some introspective stuff, I did interesting things, made plans for the next few days - not too far ahead, just enough to cope with

and, eventually I beat it

so, this week I have:

• been swimming (twice)
  
  
• joined a yoga class (even invested in a pair of "yoga trousers" - not my ideal sartorial style, but one has to make compromises)
  
  
• been to a life drawing class :-)
  
  
• I gave a present and I received a present
  
  
• done a teensy-weensy bit of retail therapy (in the sales - saved myself £££££££££££s)
  
  
• talking of pounds, I have been taking my medication properly (one of the tablets makes you gain weight - PAH; one of the others makes you loose weight - HA HA; so I have remained my perfect size 10), taking the anti-anxiety meds at the right time so that they don't affect my driving to school pick-up, (such that CH's car insurance is not invalidated should someone prang me) (can you believe that they give you tablets which invalidate your car insurance?) (no, me neither), have worked out the perfect timing to take my sleeping tablet
  
  
• eaten really well, dug out the juicer from the cellar and juiced all the fruit and veg I bought but wasn't able to eat; when the children complained about a lovely meal I made I threw it in the bin and ordered them pizza and charged it to CH's account and just didn't give a damn, quite frankly
  
  
• looked up "emotions after divorce" on the internet and realised I am not in fact mad, but just going thru what a lot of people go thru (yeah, right - try telling the head doctor that)
  
  
• had my hair put back to its natural colour (that's blonde, people, blonde; Swedish blonde in fact)
  
  
• I have had lunch with one friend, a spontaneous coffee with the other (YEAH!! I have two friends!!) (and they have me)
  
  
• had a nice hug from someone
  
  
• made contact with someone vaguely interesting whose number I lost (thank g*d for FaceBook - and whichever one of you lovely lot it was made me sign up for it)
  
  
• and I have a plan for Saturday night, so I'm not sitting here all on my tod
  

and it's only Thursday!!

happy Thursday. people

and I did a lot of thinking when I was in the Head Hospital

and I made list after list of all the things that I still like. . .

. . .like the views!

and mermaids, and lighthouses, and sunset, and stars, and music, and art

there was a poster on the wall in one of the corridors of a Hepworth sketch that made me so sad because it reminded me of all the photos I'd lost when I destroyed my laptop and some of the binding designs I'd made last year; but it also made me happy - which was bittersweet - because I loved looking at it (it was the only good thing in the whole corridor)

and it made me think

because what was interesting about the sketch was not the lines or the fact she had put lines where she had put them - but the spaces between the lines that the lines made you focus on

the gaps

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I don't mean the clothes store or the Tube BTW

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the holes

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nothing hiding here, honest

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the empty sections

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no, there is nothing here!

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and that is when it occurred to me, that of all the stories I know - I only know the parts of the stories that I know, I don't know the bits that I don't know

and I started to think about some of the things that I don't know: the parts that have never occurred to me before - were their happy times in my parents' marriage? could I replace the images and photos I have lost with new ones? can I research Hepworth and find out more about her thinking

that sort of thing

and those thoughts were more interesting than the one thought I had gone into hospital with

and so, after five days of silence and refusing to speak or be spoken to, I picked up a pen and did some writing and then some charcoal and did some sketching and I also wrote down the soundtrack that I'd been assembling in my head and I started listening to some music again

*EUREKA!!*

urethra?

ether?

no - ethernet!

so. . . today I learnt what an ethernet cable is

why didn't someone tell me before. . . stupid computer, useless BT HomeHub. . . even my new laptop (kindly purchased for me by CH, who sadly drove off in his silver soft top before checking I'd read the instruction manual) (d'oh) (I think Homer will be my mentor forthwith) (and there I was, thinking I was a cross between Marge and Lisa) (yes, Small People are watching tv in the background again) failed to work when I tried to go Sip 'N' Surfing at Cafe Nero. . .

it's all been very sad

but,
tomorrow no doubt will be a new day
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sleep well

crazy