Depression – the Term ECT Should Be Replaced With EBR, Part Two
Majid Ali, M.D.
An Important Proposal for People With Serious Depression and Those Who Love Them.
Here I propose that the term ECT (electroconvulsive therapy) be replaced with the term EBR (energetic brain rejuvenation.)
ECT and EBR Therapies for Drug-Resistant Major Depression
The words “Making Connections” begin the text on the cover of Nature of 10 November, 2016. In the first article of Nature Insight in it, Wyss-Coray writes: “Indeed, factors in the circulation have been shown to modulate ageing and to rejuvenate numerous organs, including the brain.”(ref. 1). Concerning brain rejuvenation, I offer some comments on the continuing use of the term electroconvulsive therapy (ECT) to treat major depression which is refractory to multiple drug regimens.
ECT was first used in 1938. Ever since, the issues concerning cons ent for treatment have drawn much attention. A 2008 national Scottish audit found that that 23% of patients who received the treatment were incapable of giving informed consent (ref. 2) A 2005 British review found that only about half of patients felt they were given sufficient information about ECT and its adverse effects (ref. 3).
Holistic-Integrative View of Neurotransmission and Depression
In the same Nature Insight, Canter and colleagues write the following: “Emerging functional data are also shifting the aetiological focus of the disease from a neuron-centric view to an integrated outlook that acknowledges the synergistic functions of the different cell types of the brain. Consistent with this holistic view, numerous disrupted processes are interconnected in AD and interact to provoke a cycle of dysfunction as the disease progresses.” (ref. 4)
The above words succinctly state my case fo r the science and philosophy of holism in understanding and treating depression (ref. 5), in addition to the case of Alzheimer?s disease, for which the above-cited paragraph was written. So began the thinking which led me to coin the term “energetic brain rejuvenation therapy” – the “EBR therapy,” for short.
I add that in my mind, brain rejuvenation means functional restoration of oxygen signaling (ref. 6), insulin homeostasis (ref. 7), brain cell membrane redox equilibrium (ref. 8), and generation of neuronal membrane action potential that releases neurotransmitters from vesicles which store them. In my view, all of this cannot be achieved without integratively addressing relevant issues of nutrition, metabolism, gut microbiota, hepatic detoxification pathways, and the matters of fears, anger, and anxiety. (ref.5-8).
- Wyss-Coray. Ageing, neurodegeneration and brain rejuvenation. Nature 2016;53 9:180.
- Ferguson G, et al. (2009) The Scottish ECT Accreditation Network (SEAN) Report 2009. Retreived 2010.05.24.
- Rose D, Wykes T, Bindman J, et al. Information, Consent, and perceived Coercion: Patient’s perspective on Ectroconvulsive Therapy. British Journal of Psychiatry. 2005;186:54-59.
- Canter RG, Penney J, Tsai L-H. The road to restoring neural circuits for the treatment of Alzheimer’s disease. Nature. 2016; 539, 187?196.
- Ali M. Depression – An Overview. http://drali1.org/depression.htm.
- A;I M. Oxygen and Aging. (2nd ed.) New York, Canary 21 Press. 2004.
- 7. Ali M. The Dysox Model of Diabetes and De-Diabetization Potential. Townsend Letter-The examiner of Alternative Medicine. 2007; 286:137-145.
- 8. Ali M. Oxidative coagulopathy in environmental illness. Environmental Management and Health. 2000;11:175-191.
Energy healing with appropriate technology used by well-trained professionals is the most effective treatment for serious depression that does not respond to multiple drug therapies. It was introduced in 1938 and has saved hundreds of millions of lives worldwide.
The word “convulsive” in ECT needlessly terrorizes patients who are not familiar with this form of energy healing. This is what the treatment really is, pure and simple – a completely painless use of energy to prevent hurtful cellular cross-talk among brain cells. This form of energy is intended to rejuvenate disturbed brain circuits, switching off neuronal connections that create unending cycles of fears and terror, so to speak. Below is a brief account of my early encounters with the treatment.
In 1961, on my bicycle I took my 12-year-old sister, Majida Begum, for what was described as electric shock therapy. The treating psychiatrist asked me to firmly hold the back of her head between my hands during the treatment. On the return trips, the cycle trips were uneventful. My sister did not complain of any symptoms. We usually rode in silence. I was then a third-year medical student at King Edward Medical College, Lahore, Pakistan. In 1968, I received the diploma of the Fellow of Royal College of Surgeons, England. The memory of cycle trips with my sister receded during the remaining years in the medical college. In England as a surgeon and later in the United States as a pathologist (Columbia University, New York and Holy Name Medical Center, Teaneck, New Jersey), I heard the term ECT, sometimes the full term of electroconvulsive therapy, mostly with indifference. Whenever I did recall the images of my sister’s head between my hands, it was jolting, hence, I think, the indifference on most other occasions.
In the late 1970s, my focus shifted from preoccupation with the pathology of diseases to a study of health and molecular biology of oxygen. In The Cortical Monkey and Healing (1990), I devoted large sections of the book to shapes and scales of suffering. I described how I observed people with serious depression were relentlessly tormented by the “monkey-in-the-head” to recycling past misery, and when that was not enough, precycling feared, future misery. Major depression, of course, has many other dimensions. Sometimes I imagined waves of scorpions in the mind colliding with each other chaotically. How does one plumb the depth of anguish of a young father who attempts to abandon his younf children to escape those scorpions. That is not just about pebbles or concrete slabs on the chest as described by many patients.
Below is text from my commentary e-published in the journal Nature (2016;539:187-196):
Many patients with major depression not responding to multiple drug regimens ask me for advice about ECT. Our conversation proceeds something like the following:
“My psychiatrist has recommended ECT treatment. I “Im in terror of it. What do you think?” the patient asks.
“It is considered the most effective treatment for severe depression which does not respond to antidepressant drugs. I suggest an informed second opinion before you take ECT,” I reply.
“You do know what ECT is, don?t you?” the patient asks tersely. ”Yes, I do.” ”What does ECT stand for?” the patient asks rhetorically. ”ECT is short for electroconvulsive therapy,” I respond. ”Those words terrorize me,” he protests.’ ”Well, well ?” I search for the right words. ”Well what? Is this what you want me to do? Convulse to get better? Is that your idea of healing?” he fires his questions with rising frustration.
I look at him in silence, wondering how I myself might react to the possibility of receiving ECT. In earlier years, I had not heard the expressions like “re-booting the brain,” and “clearing the cobwebs of the brain” for explaining how ECT works.
One day, I saw a patient who was palpably tormented by intense suffering of unrelenting depression. He engaged me in a similar conversation. I tried to plumb the depth of his suffering for some moments, then stammered, wishing to say the following:
“We can call ECT energy therapy. That is what ECT really is. It is energy that filters and re-directs cellular cross-talk in the brain. Really, that is all what ECT is – an energy therapy, just like electronic devices for pain control. It is energy that first puts you to sleep. You do not feel any pain. You wake up just as you do after sleep. Honestly, that is all what ECT is.”
As words rolled from my lips, I saw the face of patient soften somewhat. We looked at each other in silence for long moments. Encouraged I continued. This healing energy works by silencing hurtful voices in the brain, switching off cycles of fear and panic, so to speak. Obliterating deep despair of falling through black bottomless abyss of depression.
The patient looks at me intently and then takes some deep breaths. I continue. Years ago, my younger sister received this form of energy therapy. She did not complain of pain, may be a little headache sometimes. Nothing more. Honestly, nothing more. I stop. Again, we look at each other, searching for the meanings of the words.
“Energy healing, eh!” he says with doubt. ”Yes, energy therapy.?” I reply mat ter-of-factly. ”Energy healing to change cellular cross-talk in the brain, as you put it.” ”Yes. Yes. It is energy that rejuvenates the brain, in a manner of speaking.” ”It is really that simple, is it” he asks, tensing up again. ”I can complicate it if you want,” I try to lighten up the conversation. “We could call it brain re-birthing. Or may be just energy brain rejuvenation.”
The remaining text of my commentary e-published in Nature is highly technical. I present it in Part Two of this article.