News & Observer | newsobserver.com | Electroshock reborn as valid therapy

Published: Jan 13, 2008 12:00 AM
Modified: Jan 17, 2008 12:12 PM

Electroshock reborn as valid therapy

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WHO SHOULD CONSIDER ECT?

Patients must be referred by their psychiatrists to be considered for electroconvulsive therapy. According to the Mayo Clinic, ECT is most commonly recommended for people with:

* Severe depression, accompanied by psychosis, suicidal intent or refusal to eat.

* Mania that hasn't been improved with medications.

* Schizophrenia, when symptoms are severe or medications aren't sufficient.

For more information online: www.mayoclinic.com/health/ electroconvulsive-therapy/MH00022

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CHAPEL HILL - Jack Gregory says he lived one step from suicide until he found a way to ease his severe depression. He let doctors run an electric current through his brain.

Since starting electroconvulsive therapy in March 2006, Gregory, 62, has found a degree of stability that eluded him when he relied on antidepressants and talk therapy.

"Literally, I was ready and willing to kill myself two-and-a-half years ago," Gregory said as he was prepped for a treatment under general anesthesia in Chapel Hill early this month. "This can be a life-saving therapy for the right person."

Electroconvulsive therapy, discredited in a previous incarnation as "shock therapy," has gained acceptance from patients and doctors alike in recent years. As the means of administering the electric current have grown more sophisticated and less harmful, the benefits of the treatment have become more apparent, especially for people suffering depression.

The Mayo Clinic estimates that 100,000 people a year undergo the treatment in the United States -- a number that has roughly tripled in the last 25 years.

"It's becoming a treatment of next resort instead of a treatment of last resort," said Gregory's psychiatrist at UNC Hospitals, Dr. Michael A. Hill.

Electroconvulsive therapy enters its eighth decade this year: An Italian doctor developed its use in 1938. Doctors don't know its exact mechanism, Hill said, but an electrically stimulated seizure can affect the brain the way restarting affects a computer.

The therapy is still controversial. Last month, the American Psychiatric Association agreed to a new review of its literature on electroconvulsive therapy, known as ECT.

"There are still some researchers and practitioners who think the treatment is just absolutely terrific with no problems, and others that feel it has significant problems, but not enough to keep them from doing it," said Dr. Vaughn McCall, a Wake Forest University psychiatrist who is editor of the academic Journal of ECT.

The treatment's inability to prevent recurrences is one point of contention, McCall said.

"The second is the realization that cognitive problems from ECT may be more problematic than was recognized even 10 years ago," McCall said.

And there remains a stigma. The treatment has long been portrayed as a form of torture, with flailing patients strapped to gurneys and involuntarily subjected to jolts of electricity while awake, as depicted in the 1975 movie "One Flew Over the Cuckoo's Nest."

"It used to be done without anesthesia," Hill said. "Using electricity to generate seizures while the patient is awake is a brutal kind of treatment."

Jack Gregory, who is under general anesthesia during treatments, has no regrets.

"I don't think it's for everyone," he said, "but for people with deep, dark, down depression, it can be very effective."

A career comes apart

Gregory had a successful career in local and network television for years before he came to Raleigh in the late 1980s as a sports anchor on the former WPTF-TV, Channel 28.

After leaving the station in the early '90s, he took a series of jobs and tried to start his own business. The early 2000s brought a contentious divorce and a one-year suspended sentence on a drug charge.

Gregory was out of control and in deep trouble. He watched through a cloud of depression as his life -- marriage, family, job and all -- got crushed under the weight of his mental illness and substance abuse. Friends and former colleagues who remembered him as hardworking were saddened by his decline.

He went through more than a dozen hospitalizations and several suicide attempts.


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