Shock therapy shatters depression's darkness

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Kitty Dukakis spoke at the M.V. Hebrew Center on Oct. 30. Photo by Ralph Stewart

By Pat Waring - November 8, 2007

Trim, composed and personable, wearing a tailored slack suit whose warm rust tones complemented her dark auburn hair, Kitty Dukakis showed no outward scars of her battle with addiction and depression. But as she recounted her years of struggle to a rapt audience at the Martha's Vineyard Hebrew Center last week, and told of the blessed relief she finally gained thanks to electroconvulsive therapy (ECT), it was clear that she knows this dark disease all too well.

Former first lady of the Commonwealth (her husband Michael was a three-term Massachusetts governor and the 1988 Democratic presidential nominee), Ms. Dukakis now is on the road delivering her own personal message. She wants to bring ECT into the public consciousness and let those who are struggling with the burden of clinical depression know that this treatment could well provide relief. She is hoping her book and her lectures will encourage people to press their doctors to take ECT more seriously and that in time it will be considered a common treatment option rather than the one of last resort.

Along with spreading the word about ECT, Ms Dukakis was here to promote her book, "Shock: The Healing Power of Electroconvulsive Therapy," written with Larry Tye (Penguin Group, 2006). But she seemed genuinely intent on demystifying the treatment and guiding her listeners to information and resources, not just boosting book sales. Nonetheless, many audience members lined up at evening's end to purchase the volume and have a personal chat with Ms. Dukakis while she signed their books.

Betty Burton, adult programs coordinator at the Vineyard Haven library, gave Ms. Dukakis a warm introduction and referred to "Shock" as "an important and powerful book about ECT and its comeback." The library sponsored the Oct. 30 talk. Throughout the evening, Ms. Dukakis spoke in a manner both sincere and clear, mixing personal reminiscence with facts and statistics, and making an easy connection with the audience.

Shock
"There is no treatment in psychiatry more frightening than electroconvulsive therapy..." writes Ms. Dukakis in her preface, going on to explain the procedure in graphic terms. "There is also no treatment in psychiatry more effective than ECT."

Ms. Dukakis described ECT, the treatment process, and the effects on patients. "It is a very different treatment today than what we saw through the lens of "One Flew Over the Cuckoo's Nest," she said. "There is a stigma about this treatment that is totally unfair and unwarranted." Instead of being a cruel and abusive technique, she said that ECT had been "a miracle in my life and in our lives."

Ms. Dukakis talked openly and without embarrassment about her own long struggle with bouts of depression. For at least 17 years the paralyzing episodes would alternate with periods of relative normalcy and productivity. Soon she learned to recognize the signs and could predict when depression was about to recur and put a halt to her everyday life once again. As a young woman she had become addicted to diet pills. In vain she sought other remedies for the depression, and turned to alcohol to ease the pain. And at last she found ECT. She shared with the audience what her husband Michael remembers about her first treatment. "He came into my room and I was smiling for the first time in a long time," she said.

Offering statistics and personal stories of those who had been helped by ECT, Ms. Dukakis called it "a treatment that is under-used." She said that although it is used rarely in the United States, a number of European countries have utilized it successfully for many years and that she and her husband received a good reception during a European speaking tour about ECT and her book.

"We have a long ways to go in this country," she said. "We have a broken health system, and it's particularly broken when it comes to mental health issues."

She decried the fact that ECT is a treatment of last resort, only slowly coming into regular use in the United States, and that doctors will often allow a psychiatric patient to suffer for years if not decades before offering it. "How long is too long [to wait]? One needs to ask that question," she said.

One audience member told of her own struggle with clinical depression and said that when she approached psychiatrists about possible ECT treatments "they pretty much laughed at me."

"Any psychiatrist who is laughing at you or not taking this seriously ought not to be in the treatment of psychiatry," responded Ms. Dukakis passionately.

Ms. Dukakis described the procedures that she undergoes during an ECT treatment, from getting her vital signs taken to receiving a muscle relaxant and falling asleep. She awakens soon afterwards with no memory of the treatment, and although she may feel "a bit fuzzy," she later goes about her normal activities. Her hospital visit lasts a little less than two hours. "It's a very quick, very safe procedure," she said.

ECT is not a cure, explained Ms. Dukakis. Depression often will appear again, but the treatment provides relief for an extended period. She returns for another round of treatments about every ten months. It has its pitfalls, she said, including a likely loss of recent memory, the severity of which varies from person to person. But for Ms. Dukakis, the benefits are well worth it. "It's a trade-off," she said. "I'm willing to lose those memories."

When she commented during a lecture that she had forgotten a trip she and Michael had taken to Paris, he called out from the rear of the auditorium, "I'll take you back, sweetie."

Ms. Dukakis cautioned that despite the vast benefits of ECT it must be administered knowledgeably. She said that patients should research the treatment meticulously and explore it fully with their doctors before making a choice. In her own case, ECT has offered great benefits, she said.

"I feel blest today, I have a very fully life," said Ms. Dukakis. "It has been a wonderful six-year period. This treatment for me is one that works and works very well."

The audience included many who had been touched by depression or seen its devastating impact on loved ones. They were here to learn, ask questions, and find guidance. Ms. Dukakis responded warmly and knowledgeably to their questions, offering ideas, resources, and understanding based on her own experiences.

"I hope my book is helpful to people," said Ms. Dukakis after her talk. "I hope it helps people and their families understand what it's like to be depressed and how safe and simple this treatment is."