My husband has severe melancholic depression and I’m overwhelmed with the choices we have to make

[Ascot]

My bestie was admitted to a private menatal health facility eight weeks ago suffering from severe depression brought about by the year from hell. This beautiful man is usually well, healthy and engaged, but his depression started in January and we didn’t treat it quickly enough. On entry to the hospital they filled him with medications. including an antidepressant and then added another one as the first was not working alone. They also gave him another drug for anxiety, yet another one for back pain as well as medication for sleep.

Bestie was discharged last Friday even though I felt he wasn’t ready, but he was so keen to be free of the hospital environment. He lasted only three days at home before he had to be readmitted. He had been so excited to get out of the institution and then when he got home of course it just wasn’t right and he plummeted quickly.

On re-admission I have sought a second opinion from a psychiatrist which was given yesterday. I just thought they could change his meds to a different of medication but all they keep pushing is ECT. Bestie and I were completely against it the moment we got in there. We saw it as the last resort. Another huge scary drug added into his current concoction is the next option, and the last recommention is changing meds, which they have said will take time and they have a responsiblility to clear up beds for new patients needing help.

He’s so very unwell and a shell of himself at the moment with no emotion or engagement. I don’t recognise him and it’s breaking my heart.

How do I make this decision about what is right for my darling man. I’ve had two psychiatrists both tell me ECT is best as we are in such a bad way. But they were saying that when he first got in there too ...

Are my fears about ECT unfounded? I don’t know what to do ...

[Former-Member]

Hey there @Ascot thanks for posting, it sounds like you care about your friend deeply. This is a really beautiful thing, even though it must be so painful watching him go through this journey - he is very lucky to have you in his life. Unfortunately members can't speak to ECT in a "professional advice" sense as per our community guidelines, but certainly some will be able to share their own experience of ECT if any of them have tried it. There's a really good info sheet here by Blackdog about the process as well.

How is he travelling now? How is your own self-care amongst all of this? No doubt it can feel pretty heavy at times. Our Sane Help Centre is staffed 10am-10pm on weekdays, we have a phoneline (1800 18 7263) as well as webchat here. I don't doubt some of the members of the community will stop in soon and provide some further support. Thank you for joining our little community, and keep us updated on your friends progress and whether or not he engages in ECT, there's also a list of other treatments you might find interesting here such as tms and other.

[Former-Member]

@Ascot 

This is a good resource too

https://www.yourhealthinmind.org/treatments-medication/ect

[Ascot]

Thanks Nashy. During an agonising day on Friday of indecision, fear and anxiety, I had some conversations with some wise family members, one of whom helped me realise I didn't really have a decision to make about this at all. With three medical professionals (all psychiatrists) recommending ECT as the best, most effective and quickest way to treat my Bestie who had further regressed into deep untreated depression with psychotic behaviours, I realised I had to be guided by their professional experience, skill and expertise rather than my own feelings.

Bestie has just had his second ECT session this morning (Wednesday). He had his first on Monday. Signs are good - I think. I hope. He is certainly much calmer and called me by my nickname yesterday, something he hasn't done in about five weeks ...

[Former-Member]

How are things going @Ascot ?

[Ascot]

Thanks for reaching out, Darcy.

The news is mixed. My Bestie has had seven ECTs now, hopefully the last one yesterday, after which he was discharged from his three month stay in the only private mental health facility in this city - so he will be home for Christmas.

While ECT has been successful in really easing his depression and associated anxiety, I think there have been some other side effects which I was unprepared for and which are, to be honest, of almost equal concern. I was of course expecting the issues with memory and concentration, and understand that time will help with that - although not everyone recovers fully from the memory issues. My biggest concern - and it’s filling me with anxiety myself - is my Bestie seems to have lost all capacity to feel and display usual emotional responses. He is wooden. No empathy. His communication is limited, and he is not responding to usual conversation patterns.

I raised my worries with the treating psychiatrist when the issues became apparent on Saturday, who suggested that ‘cognitive dysfunction’ can be a side effect of ECT and that maybe we would now stop the treatments. 

I just want my husband back. He is/was the most compassionate and empathetic man - and now there’s just nothing there. 

Is it naive for me to just hope it’s early days yet and that it will take some time for things to settle? 

[Former-Member]

Hi @Ascot 

My hubby was quite out of it whilst having his ECT (which he had 3 x times a week). I guess it is different for everyone but things did pick up. My hubby has marked memory loss for quite a time period which appears to be permanent, at the time of the ECT he was however psychotic and suidal and in conjuction with a medication change he managed to pull through, he is in remission from major symptoms (still has residual anxiety and medical complications from an attempt) but I am grateful he has not been suicidal or psychotic since.

Emotional blunting is also a well documented side effect of a number of psych medications.

When it comes to mental health, often it is a marathon not a sprint. If you find that you are on a marathon, management is the key. As with other illnesses, medication is only a part of the equation, doing the hard yards of lifestyle and therapy is the other part. As a caregiver having a bit of support to help us cope is helpful. 

Have you got any support for yourselt through this process? 

[Ascot]

Thanks for sharing your story Darcy. May I ask how many treatments your husband had altogether? And it’s intersting that my initial research into ECT - when I was stressed off my head - really didn’t mention the emotional blunting at all. It was just all about memory issues, physical side effects immediately after treatment. I have since seen lots of stuff, especially out of the UK about ‘loss of emotional responses’. My heart is breaking because the love of my life has vanished ...

But as you say, it’s a a marathon, not a sprint. (I always hated PE at school!!)

And I am blessed with an extraordinary supportive family - two wise parents and two equally wise siblings and their spouses who provide beautiful and frank personal support. I do think I need to access some more targeted support though for those caring for partners with mental health issues. There’s a good network here and I will contact them after the Christmas break.

Thank you so much for your support @Former-Member. 🙂

[Ascot]

@Former-Member, do you think it’s the ECT or the medications which cause the emotional blunting? Just curious about your experience ...

[Former-Member]

@Ascot 

Mr Darcy had a lot of ECT, the first lot was 12 sessions. The second lot was interrupted by a serious attempt, was recommenced and then stopped as  I gather he switched to mania. He went downhill fairly quickly after that, ECT was recommenced and for a while after that had maintenance ECT. Most was done under  an involuntary treatment order.

Mr D's emotional blunting was a side effect of medication.