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With guest host Jane Clayson.
Shocking the brain to treat depression. Does it work? Former presidential candidate Mike Dukakis and his wife Kitty say it saved her life. They join us.
Electroconvulsive therapy gets a bad rap. Remember that scary Nurse Ratchet in “One Flew Over the Cuckoo’s Nest?” But ECT can be an effective treatment for depression. Kitty Dukakis says it saved her life. She’s out on the hustings promoting the treatment. So is her husband, Michael, the former Presidential candidate. This hour On Point: Kitty and Mike Dukakis make the case for electroconvulsive therapy.
Kitty Dukakis, electroconvulsive therapy advocate and patient. Co-author, with Larry Tye, of the book "Shock: The Healing Power of Electroconvulsive Therapy." Also author of "Now You Know."
Gov. Michael Dukakis, former governor of Massachusetts. 1988 Democratic Presidential nominee. Professor of political science at Northeastern University and visiting professor of public affairs at UCLA.
Dr. Charles Welch, psychiatrist at McLean Hosptial. Kitty Dukakis is one of his patients.
From The Reading List
New York Times: Kitty Dukakis, a Beneficiary of Electroshock Therapy, Emerges as Its Evangelist — "Electroconvulsive therapy is not a one-and-done procedure. Mrs. Dukakis, 80, still receives maintenance treatment every seven or eight weeks. She said that she had minor memory lapses but that the treatment had banished her demons and that she no longer drank, smoked or took antidepressants."
The Atlantic: The Return of Electroshock Therapy -- "In the popular imagination, ECT—the application to the scalp of an electrical current strong enough to induce a brief seizure—is an archaic practice that might as well be relegated to a museum collection. But according to Lisanby and other leading researchers, the modern version of ECT, far from outmoded, is the most effective therapy available for severe, treatment-resistant depression and bipolar disorder (and even sometimes, when deployed early enough, schizophrenia)."
POLITICO Magazine: Michael Dukakis’ Final Campaign — "While her husband was in public office, the almost-First Lady was reluctant to share her battle with substance abuse and depression. But in recent years, it is a mantle that Kitty and Michael have actively sought out. Today, they are on an ambitious campaign to increase the accessibility of electroconvulsive therapy—which they say is a painless treatment that should only be used as a last resort for severe depression—but also to reduce the stigma of all forms of mental illness."
Kitty Dukakis Details Why She Decided To Undergo ECT
Jane Clayson: So, Kitty, what a journey you've had. Thank you for your courage and your willingness to talk about this with us. You've had a lifelong struggle with depression. Self-medicated with alcohol, with diet pills when you were quite young. Walk us through this if you will. When did your depression begin and how bad did it get?
Kitty Dukakis: Well, I've been free of depression since I started ECT, and that's about 20-something years ago. And as I talked about it in the book, I had some anxieties — everybody does with a new treatment — whether it's a new prescription drug, or an over-the-counter drug, I was a little bit apprehensive. But I was very fortunate in being one of the early ones — that is, somebody who had a reaction immediately to the very first treatment. And that doesn't often happen.
JC: Meaning it went away, your depression went away, right away.
KD: Not totally, but it was certainly something I could handle. And I went back and had more treatment, short bouts of treatment of ECT. And I'm feeling very much better and we're spending our 24th year in Los Angeles. Twenty fourth and three months, and we had a glorious day yesterday. Seventy degrees temperature.
JC: So I want to get into the details of ECT. But first take us back a little bit because I think people need to understand the severity of what you were going through to understand how great you're doing now. You've talked about and written about what those early days were like.
KD: I've been asked to read from the book which I'm more than happy to do, though I've paraphrased a bit. And let me just add at the outset, this was 10 years ago. That's a lifetime for certain diseases. So there are changes, and I will paraphrase a bit from my own writing when I read this.
JC: Let me get to that in a minute because I'd like you to tell us what those days were like when you were drinking, when you were self-medicating. You talked about how you'd see your husband off to work and then you'd start drinking. And you'd retreat to your room, and you'd pass out. What were those days like for you?
KD: Well they were horrendous. And one of the things that I have found is that there are many people who suffer with profound depression who turn to alcohol because other drugs and prescriptions and self-worth do not work. And so I was one of those people, not unusual. And it was abysmal. It was horrendous. And I was okay in-between times, but when that depression hit, it just was very, very severe.
JC: Mike, would you describe those times for us?
Mike Dukakis: Well, Kitty, for no apparent reason, Jane, in her early forties began experiencing these recurring cycles of depression. And they would hit about every eight or nine months, for no reason, they had nothing to do with anything. She was busy, she was active, doing lots of good things, but every time we'd hit that eight or nine months mark, she'd start going down. She was being treated, she had therapy. She must have taken five or six anti-depressants over that period of time, and nothing worked. And so for a three or four month period she'd be in one of these deep, deep depressions. Then she'd kind of come out of them, and she'd be okay, Jane, for another eight or nine months, then she'd go back in, and that happened for 17 years. Until somebody said, 'Why don't you see Charlie Welsh at the Massachusetts General Hospital, he's the ECT specialist.' And she did — we did. And he's a wonderful guy, and a great doctor, and has become a good friend. And he showed us a tape of some of his patients and their experiences. And Kitty was at the end of her rope and so she said at that time, look, when it happens again, I want to have this treatment.
And it just so happened that I had a couple of speeches to make, in Barcelona, of all places. We decided to tack on five days in Paris. And I thought we were having a great time and Kitty was starting to go down again. And we got back to Boston, and she was so shaky the night before her first treatment with ECT that she didn't trust herself to come home, and asked Doctor Welsh to hospitalize her. So, I didn't take her to the Mass General, she was there, and I arrived about nine o'clock in the morning to pick her up. And the first treatment had ended the depression, like that. My smiling, charming, lovely wife was back! And, as I think she said this in the book, we were driving up Storrow Drive, it was the 20th of June, our wedding anniversary, and Kitty said, 'Let's go to dinner,', I said, 'Are you serious?' And she said, 'Well it's our anniversary isn't it?' And we went off to dinner that night, celebrated our anniversary.
She continued to cycle. So, eight or nine months later, she started going down. But this time, she recognized it, and so for the first year or two, she would have five or six treatments, and she'd be fine, only to being to go back into a depression in eight or nine months. And finally, Dr. Walsh decided to put her on what is called ECT maintenance. So she now has a treatment about every six weeks (KD: six, or seven, or eight), and now has them at McLean hospital where Dr. Welsh is. And she's been fine for years as a result of this, and because of her experience, obviously has now become an advocate.
JC: Kitty tell us about your treatment. What is it like to have electroconvulsive therapy?
KD: After so many years now, and it's close to twenty-plus years, I hardly feel the needle going in for the electricity that I have minutes later for ECT. And I'm asleep within a very short time, I see my doctor beforehand, and if I have any questions about anything, I can talk to him then. But usually if I have questions I will talk to him before my treatment. And I'm awake I guess within 45 minutes or a half hour.
JC: Are there any physical manifestations?
KD: It's so hard to remember two decades later. I do remember feeling a bit foggy when I first woke up. These days I'm able to lecture after I've had an ECT treatment.
JC: So there are no side effects?
KD: I'm tired. And I often sleep for an hour or two. But the initial feelings are just very minor for me. I had a little bit of memory loss but that is not an issue and not a problem now.
JC: Have you come to terms with the idea Kitty Dukakis, that you will need to do this treatment, ECT, for the rest of your life? Do you ever think, 'I'm doing fine, I don't need to keep doing this'?
KD: [chuckles] No, I'm not gonna say that. I'm not gonna say I'm doing fine that definitively, however, if I have to do this for the rest of my life — and I just turned 80 — that does not bother me, that does not trouble me. And it is, for me right now, a benign treatment and I know that it'll help my mood if I am feeling a little down. And that's about it.
JC: Governor Dukakis, why do you think this treatment is so reviled? The movie "One Flew Over the Cuckoo's Nest" and Jack Nicholson.
MD: Jane, that was then, it's certainly not the case now.
JC: Right, very different. Was that an accurate representation of this treatment?
MD: At the time, well, back in the 40's and 50's, it was a very tough treatment. But it's been refined and improved, it's totally painless. Actually when the needle goes in, Kitty is getting anesthesia. And so she's not aware of the treatment taking place. But doctor welsh will tell you about this, but the number of people getting ECT these days is increased dramatically. I think Kitty's example and her advocacy has something to do with that. But the fact of the matter is, that while for some people medication is very helpful, and for other people therapy is helpful, a very large percentage of folks who suffer from severe depression get no relief from these treatments. And that's why ECT is so important.
Thanks for transcription help to Jeremy-Miles Rellosa.
This program aired on January 17, 2017.