She can't remember her kids or her wedding. And she's okay with that.

By MAMAMIA TEAM

Natalie Deeth doesn’t remember her wedding day.

She knows she has kids, but she doesn’t remember the day each of them was born. She doesn’t remember giving birth, she doesn’t remember holding them in her arms. She doesn’t remember raising them.

Natalie used to have a job as a nurse but if you put her in a hospital today, she probably wouldn’t remember how to do the job she trained for and worked in.

In total, Natalie has lost three decades’ worth of memories.

And the most amazing part of this story?

Natalie’s okay with that.

Natalie says losing three decades’ worth of memories is better than the previous life she was living; a life in which she was “suicidal to the point where (she) was self harming”.

Natalie told her story on SBS’s Insight program earlier this week. In an episode that focused on electroshock therapy and the role it continues to play in Australian society, as form of psychiatric treatment.

Electroshock therapy (or electroconvulsive therapy) is a form of psychiatric treatment in which patients are placed under general anesthetic while “a carefully-controlled electrical current is passed through the brain, affecting the brain’s electrical activity and producing an improvement in depressive and psychotic symptoms”.

And it’s a controversial therapy to say the least.

Many people assume that electroshock therapy (also referred to as ECT) is something that hasn’t been used by doctors since Jack Nicholson starred in One Flew Over the Cuckoo’s Nest.

There’s a widely held belief in the community that this is something that belongs to history. That it’s a therapy not condoned by modern medicine.

But that’s actually not true at all.

There have been significant developments in electroshock therapy over the years and today it is still used as therapy which can help people who are battling severe depression, bipolar disorder and psychotic illnesses.

But there are risks involved.

And this one of the reasons why the therapy causes controversy.

This is from The Conversation:

With improved knowledge of ECT administration over the past few decades, we have been able to minimise its side effects although some remain.

There are always risks associated with undergoing a general anaesthetic, although the anaesthetics used for ECT are usually very brief and rarely cause problems.

The most significant side effect is memory impairment. In most patients this is confined to a brief period around the time of the ECT treatment. More rarely, it can affect short-term memory.

These impairments can be difficult to distinguish from memory lapses caused by depression itself but nonetheless cause substantial distress. They’re certainly significant enough to justify ongoing attempts to improve ECT and develop alternative treatment options.

Natalie Deeth, the mum who doesn’t remember having her children, knows about the risks.

She was suffering from bipolar disorder and stared electroshock therapy over ten years ago to help treat the depression that came with it. To date, Natalie has undergone more than 100 treatments.

“I was extremely suicidal to the point where I was self- harming, trying to just get rid of the pain that seemed real, and I would burn myself quite severely with cigarette lighters from cars and things like that just to get rid of the pain and it wasn’t working and so they admitted me to hospital to protect myself,” Natalie told Insight host Jenny Brockie on Tuesday night, adding the ECT had changed all that.

“It’s allowed me to be a mother to my children and a wife to my husband again, which I know confidently with the depression and the suicidal thoughts that I had, I wouldn’t be if I hadn’t had ECT,”she said.

“I feel a lot better actually, which is probably hard to imagine. Just brighter and well and I feel like I can do things, I can physically go home and do things around the house.”

As mentioned earlier, Natalie lost almost all of her adult memories as a result of the therapy.

But she says that she would not be alive if it hadn’t been for the treatment. Natalie says that her quality of life now – even with severe memory loss – is better than it was before.

The memory loss that Natalie has experienced is one of the possible side effects of ECT but it’s one of the extreme ones. Other patients, like a man named Michael who also appeared on the show, are less severe.

Michael says he chose to have ECT to combat the depression and anxiety he’d been suffering from for 20 years.

“I was able to function, but I’d cycle from a particularly bad bout of depression to sort of achieving a normal state and I guess I started to look at ECT as an option when all the other options started to run out,” Michael said.

He’s since had around 30 treatments and says he is no longer suffering like he used to.  And if anything – Michael says his memory is better than it was before.

Doctor Josh Green, who also appeared on the program, said ECT was only considered as a therapy for people in “very extreme situations”.

“(In) a life and death immediate situation where people have stopped eating and drinking, where they’re intensely suicidal, then ECT is actually prioritised possibly in a first line treatment because it’s highly and rapidly effective,” Dr Geffen said.

“There’s another group of patients who have a more severe biological depression which is also associated with feelings like suicidal feelings, weight loss and an inability to function and then there’s another group of patients who’ve tried many different  therapies and they’re doing so because of, I’ve guess, a longer term frustration with the available treatments for their depression,” he said.

According to Professor Colleen Loo from the Blackdog Institute, there is a spectrum of memory loss associated with ECT but for most people, an improvement to quality of life is the most compelling reason to try ECT.

“Very interestingly a study in the US which asked people to rate their quality of life before ECT, immediately after ECT and six months later found that 87 percent of people had higher ratings of quality of life after ECT than before and that percentage was 78 percent at six months follow-up,” Prof Loo said.

And indeed, most people in the Insight audience who have had ECT agreed that the benefits outweighed the losses.

Ella was 16 when she first had electroshock therapy as a treatment for depression.

“I was at school at the time, I wasn’t coping as well as I was expected to, I was just very depressed. I required – I needed to be hospitalised several times. I had been through all the therapy, all the different anti-depressants more than I can even remember, and it sort of got to a point where they thought that that would be the best option for me,” she told Jenny Brockie.

Ella said the ECT didn’t work initially. “I was transferred from hospital, I was into a more high care hospital as an involuntary patient and by this point I had basically stopped, I’d stopped speaking, I’d stopped talking, I’d stopped eating, drinking, I was completely not responsive to anything or to anyone and so it was the idea was thought again and I wasn’t seen to be in a fit enough state to be able to make these decisions for myself,” she said.

And it was then that Ella’s case was taken to Mental Health Review Tribunal and she was ordered to have more therapy that doctors hoped would save her life. According to The Conversation:

All Australian states and territories (and most parts of the Western world) have provisions for the treatment of patients with severe mental illnesses without consent.

This occurs when the patient’s illness is believed to impair his or her capacity to understand the need for treatment, or where the patient is likely to put themselves or others at risk in some substantial way.

Legislation will typically allow for involuntary admission to hospital and, in some jurisdictions, pharmacological or other treatments without consent.

One scenario involving ECT is the treatment of those with severe depression. A patient may be so unwell that they stop eating and drinking, placing themselves at immediate physical risk.

Such depression is often associated with severe suicidal ideation, when patients will be constantly attempting to find the means to end their lives. This scenario is a medical emergency because even with close supervision, patients can be at substantial risk.

Under these circumstances, ECT is the only treatment available that’s likely to result in a rapid improvement in symptoms – potentially saving the individual’s life.

Involuntary ECT is possibly the most controversial form of the therapy, especially when it’s used on people like Ella who are under the age of 18. It raises important questions of consent and whether or not it’s ethical to make such extreme medical decisions for another human being who cannot or will not agree.

So how does Ella feels about the treatment now?

“I have mixed feelings about it. I think it was helpful to me. I don’t know if it was, I did feel a bit disrespected in that my rights were taken away from me, no one had a choice about it, it did help but I do feel like I would have recovered in the end,” she says.

“While it did lift me out of that, you know, very low state, it wasn’t a miracle fix. It did take years after that to recover, I was still very depressed for a very long time.”

Professor John Read from the University of Liverpool has some reservations about the therapy.

Prof Reed says that there is no evidence to suggest that ECT continues to work once a patient has stopped treatment.

“During treatment there is a small number of people who do get a very temporary short term lift in mood and what happens when you get a temporary improvement from a treatment but no long term benefit is then you do see people coming back over and over again because the treatment doesn’t work because it doesn’t have any long term benefits,” he said.

ECT’s effects have been well documented in fictional and non-fictional accounts over the year, leading to significant stigma. Whether or not that stigma is a well founded one today, is a matter of debate. Those who participated in the Insight program this week, certainly have varied experiences with the therapy.

What we know for sure is that it’s practice is far from over, meaning that it will remain a hot button issue for years to come.

You can watch that full episode on Insight here.