ECT Therapy for Wife with BPD and depression - feeling anxious

Hi again @Determined

What the doctor is saying is that certain various sources is "hearsay" and does not equate scientific evidence of proof. In a court of law it would but science evaluates things differently. For there to be proof it has to be scientifically analysed under a controlled environment over a period of time......and then it can be not sufficient as evidence as various other reasons for the outcome have to be ruled out. It's complicated.

Basically with borderline personality disorder there is no evidential chemical imbalance in the brain that causes this mental illness - but a combination of psychological factors usually triggered by abuse of some sort in the past that basically results in low self esteem - the sufferer constantly questioning their worth and the "emotional pain is the agony". In this regard ECT which seeks to "jolt the brain to rebalance the imbalance" would be ineffective. And in my knowledge "there is scientific proof". This mental disorder does not originate from a chemical imbalance pure and simple.

But when major depression is debilitating, perhaps from a combination of this disorder and hormone imbalance and the like (combination of ills), medication is usually called for. If that does not help lift the depression after a "significant time" is allowed for it to take effect etc - then ECT is a last resort. And you have every right to a say in how you want your wife's depression treated (I had little say and am still feeling the sting of this years later).

Personally due to my own life experience I feel allowing the appropriate anti-ds to take "full effect" would help your wife to get out of bed and feel stronger to face the day. First step. Then yes, persuading her somehow to recommence the therapy/psychologist that was helping here is a must for long term benefits. That is where your wife has to take the step for self-help - hopefully she will be more up to this when the meds take effect. Yes, when the side effects subside as initially it can be harder.

How long ago did your wife stop counselling?

The hospital stay will help take the pressure off your wife where she can rest (is probably feeling drained resulting in the "I can't do this anymore" thinking); and in a few weeks time you should start to see improvement. Take heart. And with your undying love and support this will ease the symptoms of her BPD - truly you would be helping her more than you know. But she needs to recognise her own value as a human being to get to the root of the problem (raise self esteem) and to change old ways of thinking (pessimism) that may have been learned in childhood - especially if other family members have suffered similar. Low self esteem and pessimism mixed with chronic fatigue and ongoing stress for a period of time without reprieve, will result in depression.

There is a lot of work ahead but with the love you have for each other will see you both through. Prenatal and post natal depression and the responsibilities with nurturing a baby can take its toll physically and when the body is weak the mind follows (perhaps why she gave up counselling....?). The rest will do both your wife and yourself good I feel. Please keep us updated. 🤗

Hi,

I am a bit late to this conversation but really wanted to give you my perspective as somebody who has had ECT. I had ECT after a couple of years of severe depression and bipolar. I eventually had between I think about 15-20 sessions as an inpatient. After the first couple of "sessions" I didn't notice much of a difference but after they went from unilateral to bilateral treatment, I started to notice a great deal of difference. Although there have been some small bumps in the road, I don't regret it for one minute. Some of my own personal experience/observations were:

• the general anaesthetic can be the one thing that takes toll. I was having three ga's a week.
• the difference wasn't immediately noticeable, but it was like a dense fog slowly lifting.
• i did struggle with memory, but for me it was like somebody had "shaken the filing cabinet". Memories were there but I needed to find them. I have worked hard at this, for example, going back to the hospital where my child was born and walking through the memories. I also sought out professional brain training to work on my short term memory.
• Three years on, I work as a high level professional. I have retained all cognitive functioning, although the only thing that I struggle with is vocabulary. Sometimes I have trouble finding the right words.

i know it is not for everyone and your treating team will help you to work out if it is right for your wife. However if you have any other questions about my experience I am happy to answer them.

kind regards,

Hi @Surviving85

Thankyou for your feedback, never too late 🙂

Hi @Former-Member

Thank you for the additional thoughts. I tried replying late on Monday but got almost to the end and lost it all so gave up before I broke something (Wasn't a good day).

I understand what you are saying about the basis for scientific evidence but in our current situation just feel that is a cop out to side step my concerns. Having said that the Dr is for my peace of mind trialing something different and allowing some more time before making a decision and we were speaking to a nurse on Monday (at my wife's admission into hospital) who is happy to go over the whole process with us (something I feel Dr should have already done). Nurse doesn't think it would be helpful to have that discussion just yet so we will touch base again towards the end of next week if things are not improving. The current plan is for 2 weeks of rest away from the stress of home routine and stopping a med that I am convinced is causing most of our current problems. Dr has basically said that if there is no improvement at this time there are no other options but ECT. I personally would have liked to wait minimum 4 weeks but did not want to push it as I need to be seen as supporting my darling.

At the very least I am hoping for enough improvement to buy us some more time. Saying that I feel bad as I don't want to be seen as delaying a treatment that potentially may have a huge positive impact on our lives (especially my darlings). My concern is however fueled by the fact that there is some evidence (scientific or not) that the ECT is less effective for people with BPD.

DBT therapy has been very successful for my darling in the past so I am hoping that we can find enough improvement to revisiting this first. It was partly my fault she stopped seeing the psycologist as I usually made the appointments but was constanly having to ring and cancel as it was not convient for her, unfortunitaly my response was to let her make her own appointment, it dint happen. Part of the problem is that the amount of travel involved in order to see see someone she can actually conect with and the cost of the visit. Just a waining game now for the next couple of weeks, will let you know how we go.

Hi @Determined

Good to hear from you again. I possibly didn't explain myself clearly in my last post - for BPD there is "no scientific proof" that ECT would be effective at all". BPD (borderline personality disorder), is "not" based on the premise/trigger of "a brain chemical imbalance" but on "psychological triggers, abuse, trauma etc". Therapy is the line of treatment there which has already been proven to work for your wife in the past. I agree with you - I think the psychiatrist is giving a cop out to side step your concerns.

"The goal of ECT is to "correct a brain chemical imbalance". If there is no mental disorder that suggests a brain chemical imbalance is present such ECT treatment would "be ineffective" but only result in unnecessary side effects. I share your concerns of ECT treatment for this disorder.

Major depression, bi-polar and the like could be a brain chemical imbalance and is another story. Given your wife's history that you have stated on the forum, the latter is not likely the cause - borderline personality disorder is (together with possible chronic fatigue).

Please do not be pressured by the psychiatrist. If you want to give the treatment 4 weeks please do so. It would take at least that amount of time for the anti-ds to take effect - 6 weeks is when they start to work fully. Given that your wife will stop a med and start another, her body will need time to adjust. " In two weeks time she will be going "through the worse of the side effects".

I know you are under extraordinary pressure, but being someone who has gone through similar to your wife - "please do not be pressured by the psychiatrist". Follow your instincts. Giving the meds two weeks extra time equalling 4 weeks is not unreasonable, and in my opinion "is the best course of action." You are paying the hospital bills etc - you have the last say regarding her treatment. Seek a second opinion if you are not happy.

There should be therapy sessions in the hospital your wife will be admitted to - if she makes the most of this it could improve her depression quite significantly since it's based on BPD.

I have your wife's and yours best interests at heart, please know that. And with the life experience I have under my belt - I feel the same concerns as you. Will be thinking of you and look forward to updates. It's hard now but it will all work out my friend - follow your gut instincts and knowledge when it comes to your wife's treatment and make yourself heard. Hugs 🤗

Hi @Former-Member

Thank you for the additional comments, this puts into words what I have been feeling but did not know haw to explain. Just to clarify the drs decision to suggest the ECT is for major depression not actually the BPD however I believe that the current depression is being fueled by the BPD and is environmental (The result of current circumstances triggering a BPD response).

Thankfully with some rest (currently in hospital) and ceasing a particular med that was causing some severs side effects she is doing much better and wants to talk to the dr this ave about being able to come home for the weekend 🙂 I am really hoping this improvement will give us the extra time needed for things to settle down and provide an opportunity to return to some therapy.

Just in a tricky situation as I need to support my wife without looking too negative and being seen as un-supportive. Often my best intentions can be misinterpreted 😞 I have expressed my concerns the best I can now so feel I have to just accept the decision and whatever that may be and move forward. Looking good at the moment though 🙂

Thank you for your feedback and concern. It helps to be able to talk to someone who has a greater understanding of the specific illness. Everyone on this forum has been exceedingly helpful - thankyou to all 🙂

Hi @Determined

Thats great news that your wife has improved already - that is a real positive sign as major depression does not usually pick up that quickly - it sounds like your wife may have been suffering a bit of burn out (stress/exhaustion) that pronounced her BPD and the rest is doing her well. I so hope she pursues the therapy and the right anti-d for her, as this together with the rest I really feel things will vastly improve.

You are a wonderful husband and she is lucky to have you. Please keep us updated 🤗

Hi @Determined

Your most welcome - glad to be of some help.

How did the day outing go with your wife? I do hope it cheered her up some. She must miss her family a lot.

Well tomorrow is another day, another hope, another beginning. I hope with all my heart that it's the beginning of your wife's healing and a better day for you all. Keep us posted 😊

Hi @Former-Member

Outing as a family went very well. We have not seen my darling that well in a while.

Have had a couple of low days since but working through it.