ECT & Med Ineffectiveness
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Q:  ECT & Med Ineffectiveness

Dr. Phelps

i have been bipolar for at least 42 years tho not dx'd until 17 years ago..  self medicated most of my life until 1987 when dx'd and put on lithium/depakote.  had a large mix of different combos as the ones that workd well would suddenly stop working all together so we always had to try lots of combos etc..

i had ects in eiter 1995 or 1996 and it seems my whole system is very different since then.  my window of treatment is almost non existant, and very minute amounts of meds drug me out totally, and it appears to worsen as time goes on...

i was wondering if the ects and med ineffectiveness were somehow connected.

thank you

Dear mark -- 
Sorry, since I don't do ECT, I don't have enough experience from which to answer this one, nor have I ever seen anything in the literature about it.  However, "med ineffectiveness" getting worse over time, as was happening to you even before ECT, is quite common; so I suppose one could also wonder whether ECT just "happened to come along at a bad time" and that was seemed like a worse state of affairs afterward was what was going to happen anyway (obviously this kind of wondering can be applied to medications "working" as well -- i.e. that the person was going to get better anyway and the medication just 'happened to show up at the right time"; in mental health we rarely get a good "clean" look at cause and effect.  However, if you had a clear pattern before the ECT and the pattern was clearly different afterward, it certainly could be "somehow connected" -- in other words I certainly can't say your wondering is wrong.  

There's a good phrase from Latin that captures this dilemma, that they teach in logic courses to watch out for:  "post hoc, ergo propter hoc" -- roughly, "after this, therefore because of this".  In other words, we always have to watch out for our brain's natural tendency to link things that follow other things as having been caused by the preceding event -- and yet, sometimes, that's going to be correct!

Dr. Phelps

Published August, 2004



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