SYSK Selects: How Electroconvulsive Therapy Works

Know from House Stuff Works dot com. Hey, welcome to the podcast. I'm Josh Clark and there's Charles W. Chuck Bryant, which means it's time for Stuff you Should Know. Indeed shocking edition. See I take the rap for a bad pun, but you in fact said that before we recorded. I know I before we recorded. I have a public image. I have to carefully got um Chuck. Yes, have you ever seen or read or both One flu Over the Cuckoo's Nest? Yes? Both? Oh? Yeah? Did you like the

book more than the movie or vice versa? Both? The book was great. I've seen the movie a dozen times. Yeah. One of my faiths it is a great movie. I haven't read the book, although I was a Kinksi fan. I thought he was a cool dude. Yeah, I've read a few. It is. Um. What else did he write? He did the Well, actually he didn't write. That was Tom Wolfe that wrote the Electrical light Estra. But Kesi was figured prominently obviously. Oh yeah, he was the main

KESI wrote the crap. I'll come back to it. Okay, he wrote the what was it the book? Well, if you haven't seen or read one flu Over the Cuckoo's Nest, you totally should. It is, like Chuck was saying, one of the best movies of all time. It is a great book, apparently. And Um. One of the things that factors into it setting in insane asylum in the fifties

I would say maybe sixties. Um. And one of the I guess almost a character in this um movie or book is electro convulsive therapy, which the staff uses to basically keep the patients in check. Um. Just the very threat of getting electro convulsive therapy shock treatment, a type of shock treatment, we should say, is enough to just keep everybody very docile and calm and settle down when they started to get riled up. You can just ask them do you want some shock treatment? They're like no, No,

everything's good, Everything's fine. And apparently because of that and Keisi worked as an orderly in a mental institution in Oregon, so he saw his firsthand when he wrote it. Um, because of that, E. C. T. Got a pretty bad rap over the course of a couple of decades, the point where it's basically forced almost out of existence. And it wasn't just key easy um making this stuff up like he said, he was a he was a disorderly,

like like the fat boys. Um. But there was also a study in NY the National Institutes of Health that found like that was pretty common practice among antal institutions at the time because it was drug free. Yeah, it was just using electrical shock and it wasn't a lobotomy, right and um it was the effects were temporary and apparently it worked to keep everybody in line. But that's a gross abuse of this pretty effective therapy for mental illness, yeah,

for severe depression. And these days it is approved by the National Institute of Mental Health, the a p A, the a m A, and the U. S. Surgeon General, and they all say that if used properly e c T these days, and you know, tweaked diversion of what

they did back then is can be very beneficial. And Kitty Dukakus, wife of Michael du Caucus, former presidential nominee until he wrote in a tank, uh, wrote a book because she had it and it's called Shock, The Healing Powers of Electro Convulsive Therapy, and um, it helped her out. And I've read excerpts and reviews and stuff, and she doesn't like champion it for everyone or anything, but gives a lot of great history and then says how it

has helped her in her journey right through depression. Apparently also helped Dick cabin Oh yeah, yeah, it did not help so much. Um, Sylvia Platha in a steeming Way right, Um, but yeah, it's been it's been used on a decent amount of people. Apparently about a hundred thousand Americans a year undergo electro convulsive therapy. Six under who who got George the James cam Yeah yeah that's right. Yeah, yeah, we've already spoiled that show, so we might we should

just like do dramatic readings from scripts. Uh yeah, Um, so we we should also say before we go forward, It's very easy to call it electro shock therapy. It's kind of right. Electro Convulsive therapy is a type of shock therapy and shock therapies. The aim is to shock your system into having a convulsion, because as far back as Hyppocrates, it was noticed that people who have mental illnesses who experienced convulsions tended to feel a little better

after the after they experienced their seizures. Yeah, so what you're trying to do with any kind of shock treatment is induced a seizure and a convulsion because no one knows why still to this day, but it does something to your brain and can cure, whether temporarily or permanently, um mental illness. Yeah. I wonder how this I never

I didn't think about until just now. I wonder how it ties in with like a temper tantrum, like a kid feeling better afterward or more settled afterward, or an adult that just loses it, you know, and then you know, I think everyone's truly lost it before in some emotional way, and then afterwards you're like, boy, may feel like more relaxed now, right, like resetting after like a catharsis. Yeah, I bet you it's sort of similar pathways in the brain, right,

except this is with electricity exactly. So, um, let's talk about the history of shock therapies and electro convulsive therapy or e c T. That's easier to say. So. One thing that they did in the twentieth century, um, they started to experiment with insulin shock, where they would just dose the crud out of somebody with insulin and basically like bring them into a coma and in the comma

they would have convulsions. Is that right? Yeah? Right, that was the point, Like they figured out this guy named Ladislaus von Maduna, who was a Hungarian physician. Yeah, he figured out that if you take insulin and injected into somebody, puts him in a coma temporary coma um that you can bring him out of with glucose, and then while they're in the coma they have seizures. And he was one of the ones were probably the first modern physician

to suggest that there was a link between seizure or um. Yeah, seizures and the curing of mental illness. He took it one step too far and saying that schizophrenia and epilepsy were counter productive maladies. So if you had one, you couldn't have the other. Not true. He was wrong about that, but he was right about seizures having a curative effect on mental illness. Though interesting, but he was the one who started championing and champion championing using insulin to produce seizures.

So he led the way, followed by Italian scientists in the nineteen thirties who finally brought electricity into it. Well, hold on, there was another guy too before. Yeah, like right around the same time, they are all these competing shock therapies, um, and there was the insulin guy, and then there was another dude UM named Manfred's Sakel and he was testing something called metrozol, which is the respiratory stimulant. And when you give somebody this stuff, they have seizures.

And it's very reliable and it's very powerful, more powerful than insulin, and it requires less recuperation time in hospitalization time. The problem is it's so powerful. They're like of patients who had um shock therapy using metros all stuff suffered spinal fractures from because the convulsions were so hardcore. Yeah, like the Exorcist. Yeah, and then some now we're electricity Yeah, they discovered electricity. No, eight, that's not true. That was close.

I think it was like, um, these Italians, they were scientists, and they said, we can use this to jolt this guy like with these delusions. He's he's clearly suffering, Like shock him with electricity and the delusions receded after like several treatments, and then just a few years later in the nineties it was being used as a regular treatment in the US for schizophrenia, depression, bipolarism. Um, but it's not like it is today. No, you said they've tweaked it.

They've definitely improved it. They figured it out. Like we were a little barbaric before. No anesthesia back then. Yeah, so you're wide awake and conscious when they applied an electro shock, yet your brain like in cuckoo's nests. Yeah, violent physical reactions with the body that don't happen these days were very powerful. Yeah, because a there's anesthesia, and they also these days put um muscle relaxers and stuff everywhere except the big the big foot, the foot, eighth

single foot. Well, when it has a blood pressure cuffin, I'm sure it is the big foot. But yeah, they introduced it intravenously and then they put a blood press your cuff on your around your ankle, so your body isn't like convulsing anymore. But dick and tell it's going on by e G s and stuff. And then the foot single foots movement, Yeah, because you're keeping the muscle relaxer and I guess the anesthesia out of the foot. Yeah, so someone's actually a doctor looking just at your foot supposedly.

I haven't seen that anywhere else. I saw, Yeah, I saw that. Um like they even with the muscle relax and your fists are going to clench it on clanch in, your chest might heave, and they'll still put a tongue thing in your mouth to keep you from buying your tongue off. Right, But the the cumulative effect of it is not going to be felt at all by you because you're out under general anesthesia and you're probably feeling pretty good anyway. That's true thanks to Mr muscle Relaxer.

And then the you know what, the way you've always seen it on TV, even when they portray modern like on six ft Under, they show people are always rendered this like zombies, like lobotomized essentially, and that's that's not what's going on these days. No, well, even back then, it was kind of a caricature of what a person looked like coming out of it, because there is memory loss associated with it. Yeah, and there still is. Yeah,

there was then, there still is now. So I think that it's almost like that's what that's what some artists rendering or some directors rendering of what somebody with memory loss looks like. And so that's what just kind of got picked up in the popular culture following e. C. T. As you're just like catatonic, lobotomized, zombie like. But really

it's that's shorthand for it. There's weird memory loss. Yeah, and these days are going to check you out a lot more beforehand, I think, especially in the media portrayed as you know, some like a McMurtry and one flew with the cuckoo's nest. He's causing problems, so let's just drag him in there, strap him down and shock him.

These days are gonna five disorderly to hold them exactly. Uh, you're gonna go through a battery of pre treatments um like blood test, electrocardiograms, They're gonna give you a physical they're gonna give you a mental and they're gonna make sure you're a good fit all the way around for

this kind of treatment. It's you know, it's not as I don't know if it was willing only back then, but that's how it appeared to be at least, and there was there's actually a decision by the f d A it's an electro convulsive therapy machine is a Class three I believe device, just the strictest and classification. And so it was up for reclassification for a little while, and um, they said, you know what, we're gonna stick with this classification because it's used for electro shocks. And

a lot of people said, whoa old stuff. Yeah, you guys, this is this is you're still looking at it under this the medieval use from the forties and fifties. Things have changed by then. But I have to say, I mean it's I kind of am comforted by the fact that you still have to go to a doctor. It's not like the same thing as going for like laser hair removal, like you can also get e c T in the same office. Like it's very much medicalized, and I think it should be because we still don't understand

what the mechanisms are. Yeah, that's true. Um, they will pulse your brain. You know, you've got these little things about the side of a quarter, these pads on the side of your head, either on both sides or one side, and they pulse you with for one millisecond, even though I think recently even shorter like millisecond point to five to point three seven milliseconds. Yeah, that's what they're starting to use. And I guess that that's like, is it

for more humane purposes or works better? Yeah, I think they're finding that it works at least as well. But there's also fewer side effects, like apparently a one millisecond pulse of electricity is enough to like really interrupt memory, right, consolidation, I guess, whereas like a quarter of a millisecond it's not so bad. All right, these days, you're gonna get it two to three times a week for three to four weeks, is a typical treatment. Yeah, that's of course,

five or ten minutes at a time. Yeah, from the time that they inject you with the the anesthesia till the time you start to wake up is about ten minutes, which I mean, like that doesn't sound like much. But if you're doing that two to three times a week for several weeks, all but that's a period of your life that you have a lot of trouble remembering much of. I don't think it's a picnic still, no, because you're you are still coming out of it. You're still groggy

coming out of anesthesia. You can still be confused. What's ironic is now that they use anesthesia, you probably look more like the portrayal of people coming out out of e c. T in the fifties than they did because they were anestecized. Yeah they weren't. No, Yeah, that's what I mean that today. That's funny. I didn't think about it like that. UM I found one staff. I found one stat that said it is effective in of people these days with severe depression, whereas any depressants are only

UM effective about six in the time. Yeah, and that's what pretty much what they're using it for is just like major depression is pretty much the thing that they found, like, Okay, it's really effective for this. Like when drugs don't work well, that's usually when they're turning to it. UM is after an adepressant, after antidepressant, hasn't worked. But this is like a pretty significant rebound, a hundred thousand people a year getting this and coming under wide medical and public acceptance.

UM because just as as recently in the eighties, there's a stat in this article that says between eighty five and two thousand two, the use of e c T in England dropped by half, and that was because there was a rise of anidepressants. It's like, you can take these pills, or we can put electrodes on your brain and zap you. What do you want to do? But then as people were as physicians, I guess we're finding that there were plenty people out there who don't respond

well to UM antidepressants. Shock therapy is a great alternative. And if you're if you suffer from major depression and you are suicidal or at risk for suicide, they may hop right to act because the results are so much faster.

Huh that makes sense, I know. Well. One of the interesting things they pointed out too was that UM, once you've had e c T, if drugs were not previously effective on you, then the antidepressants can extend the good, uh, the good effects of the e c T longer, which was interesting because like I guess they can work in concert if you go e c T first, which makes it sound like like the e c T goes in there and like shake things loose, and then the drugs

come in and like keep their functioning going, keep the new and improved functioning going. And we should say, like, all this is theory. We don't no one knows specifically what e c T does to the brain. We just know it works. Then we should also say, no one's exactly certain how anidipressants work right or what effects they have on the brain. But there's a couple of theories,

um that are kind of brain based. One is that UM, the the idea is that the electricity UM changes how blood flows or how cells metabolize things, and UM that leads to some sort of improved function. Yeah. The other one is they think it might release certain chemicals that can help out UM, and everything I've read sort of likens it to a like a control all delete, reset, or like some sort of reset function on your brain.

I think they likened it in here to turning the stereo down, like there's just so much noise and this just sort of resets a troubled brain right. Yeah, there was a study in from Scotland in two thousand twelve where they did brain scans of people with major depression before ECT and after a round of e c T and UM they found that these regions associated with mood

and emotion, um, we're less active. And so they said that they basically altered the functional connectivity of these regions between the regions so that the person could think more clearly, was less distracted, and they think that that had an effect on reducing their question well, and they tested with Placebo's two and I think like anytime you test with the placebo, you're gonna find that some there's gonna be a little bit of it that works. But yeah, you know,

but not always. And that's what they found here is that some of the people that were told that they received e c T put under didn't you think this is kind of mean? Yeah, they would put them under and say they did it and not do it. Um that the people with e c T did recover UM faster, but there were some that received the fake treatment that did recover as well. So they think that might have just been because they received that extra TLC from a

proper clinician and the free drugs. That's true. So um, we should say there are risks to it. Like there's at least two types of memory laws associated with e C t UM. One is you have trouble making memories around the appointment, UM, which is to be expected. That usually fades. UM. Then there's larger member reloss that of past events long before your ect therapy. UM. But that also fades not in old people though, So there is like memory laws associated with it. With zapping the brain

with electricity, who who would have thought? Um? And then uh, you can also die. UM. One in ten thousand patients undergoing it dies but they they say that that's how many one in ten thousand, So every year ten people die from from in America. But they say that that's typically a reaction to or a result of anesthesia, like just going on right, Yeah, it's dangerous in and of itself.

You're gonna get headaches obviously, in some muscle pain. But UM, I don't I don't think it's anything quite like the old days as far as muscle pain and stuff like that. Yeah, and you will still find people that poop po would of course, but this article points out a lot of those people are the same people that are pretty anti psychiatry in general and stuff like this. That seems like a bit of a leap to me. What from the author to say that, Yeah, at least she wasn't just

like scientologists hate it. Um, have you got anything else? I got nothing else. Let's go try this out. I would certainly try it out if I needed it. Okay, yeah, would too, you know, because there's something appealing to me about using electricity over drugs. Yeah, drugs are some great thing to pump your body full of love. Yeah, it's just I don't know. I wonder if it's going to become more and more widespread, you know. Yeah, and if it comes back Gangbusters, man, that's really going to be

impressive because it was almost gone. Yeah. You know, imagine if the little botomy came back. Yeah. I know it's still around, but it's not back. But you know, ect is back, baby, maybe a little blood letting lit leaching. Right. If you want to learn more about electro convulsive therapy, type that word in the search bar how stuff works dot com. Let's see if you can do it on

the first try. And since I said search bar, um, I guess it's time for message break mm hmm, and now listener mail yes, and I'm gonna call this misheard song lyrics. Um, oh yeah, I can't remember which one. We asked hand Canal was yeah, okay, um, everyone has misheard sound lyrics. Excuse me while I kissed this guy, Jimi Hendrix wrapped up like a douche Hanford man, that's not what he's saying. No, it wrapped up like a deuce, like a is talking about craps. Is he craps or

some other sort of gambling. I don't think so. Because Springsteen wrote the song and it was cut loose like a deuce, and he's tung about a car engine. I've heard gambling. Springsteen wrote it and then man for man changed it. And it's funny. Springsteen has come out and said, you know, that song didn't become popular to what it became about feminine hygiene, and then it was like a big deal. Or there's a bathroom on the right CCR instead of a bad moon. Right. I hadn't heard that one.

There's a bathroom. No, No, I know the song, but I mean, like, I've never heard anybody thinking he's same as a bathroom on their right. It's fairly common. Okay, all right, so we got one from Cheryl. Hey, guys, first of all, I want to say, you're still keeping me company on days when I get time to work on my art projects. You're still as great as ever.

I was just listening to Panama Canal and I thought i'd populo a quick note to give you a grin misinterpreted lyrics where my specialty as a kid far and away, and my most famous moment was when I was five or six listening to Madonna with my Auntie and I would sing Papa Dom bridge, I'm in trouble deep. She said.

Thing is this really made sense to me and logical logically, if a bridge is made out of Papa doms, which or do you know what those are, sort of like a like a flat bread, like a crispy tortilla, sort of, it's like a crispy flatbread. Uh So, if a bridge was made out of Papa doms, it would be bound to be weak, and if someone were to walk over it, they would it would break and they fall in the river below and hence be in trouble deep. And my

dad still teases me about that to this day. Does make sense and certain So yeah, Cheryl, Papa don Bridge, well done, that's funny. UM's mom. She's from Oking. Now she calls Madonna Papa, don't preach. How calls her that it's her name. She's like, are you listening to Papa, don't preach again? My friend Fox had the best Misshard song lyric ever and I was racking my brain earlier trying to remember it and I cannot. Yeah, there's some good ones out there. I'll try and I'll try and

remember and posted or something. I'll get in touch with Fox. It was a funny one nice. Do you got any good ones? I'm like racking my brain right now and I know I've got one and I can't remember it. Do you have one? Jerry? Terry looks like she does what Jerry just said. If you did not hear instead of voices, carry by until Tuesday. Horses scare me, keep it down, horses scare me. Don't attract any horses because

they scare me. Do you know that? Technically? Uh? Until Tuesday was the first band I ever saw alive at my first concert, Hall of Notes at the University of Toledo Colosseum. They opened up on Yeah, Until Tuesday opened up nice. Well. I never really thought about that because I always say, oh, my first concert was Cheap Trick. Yeah, I don't say it was John Waite who opened up for Cheap Track. Was it really John White? Yeah? Man,

I've to love to see that one. And those those are real concerts, like I went to Kenny Rodgers and stuff when I was a kid, and people like Cooney Rodgers is real. Yeah, it is about to say the same thing. I meant concerts that my family didn't drag me too, got that I paid my own money for it. And where I smelled marijuana for the first time, like a real concert. I didn't smell any marijuana at the Hall of Notes concert. Oh, I did a cheap drag. I was like, what is that. I'm sure I've never

smelled that before in my life. Cheap Trick, And everyone around me said that is the devil's smell. Stay away. Yeah, and you did good going, Chuckers. Uh Is that it? That is it? Thanks to Cheryl for um kicking off a pretty great little chap. You should get youmy's mom to call her Papa down Bridge now. Yeah, see you can't get that done. Hey listening to Papa don Bridge. Yeah, say, that's the papa don preachess Papa doan bridge? Uh what what do you want? Oh? If you have any great

marriage stories, we want to hear him. We haven't asked for that ever. We Yeah. And I don't mean wedding day fun. I mean marriage. I would take wedding day fun. Those are two different things, all right. Well, whatever you want to send related to marriage, you can tweet to us at s Y s K podcast. You can join us on Facebook dot com slash stuff you Should Know and it's always good. Check out our awesome website Stuff

you Should Know dot com. For more on this and thousands of other topics, visit how stuff Works dot com