CHAPEL HILL, N.C. – Jack Gregory says he lived one step from suicide until he found a way to ease his severe depression. He let doctors run an electric current through his brain.

Since starting electroconvulsive therapy in March 2006, Gregory, 62, has found a degree of stability that eluded him when he relied on antidepressants and talk therapy.

“Literally, I was ready and willing to kill myself two-and-a-half years ago,” Gregory said as he was prepped for a treatment under general anesthesia in Chapel Hill early this month. “This can be a life-saving therapy for the right person.”

Electroconvulsive therapy, discredited in a previous incarnation as “shock therapy,” has gained acceptance from patients and doctors alike in recent years. As the means of administering the electric current have grown more sophisticated and less harmful, the benefits of the treatment have become more apparent, especially for people suffering depression.

The Mayo Clinic estimates that 100,000 people a year undergo the treatment in the United States – a number that has roughly tripled in the last 25 years.

“It’s becoming a treatment of next resort instead of a treatment of last resort,” said Gregory’s psychiatrist at UNC Hospitals, Dr. Michael A. Hill.

Electroconvulsive therapy enters its eighth decade this year: An Italian doctor developed its use in 1938. Doctors don’t know its exact mechanism, Hill said, but an electrically stimulated seizure can affect the brain the way restarting affects a computer.

The therapy is still controversial. Last month, the American Psychiatric Association agreed to a new review of its literature on electroconvulsive therapy, known as ECT.

“There are still some researchers and practitioners who think the treatment is just absolutely terrific with no problems, and others that feel it has significant problems, but not enough to keep them from doing it,” said Dr. Vaughn McCall, a Wake Forest University psychiatrist who is editor of the academic Journal of ECT.

The treatment’s inability to prevent recurrences is one point of contention, McCall said.

“The second is the realization that cognitive problems from ECT may be more problematic than was recognized even 10 years ago,” McCall said.

And there remains a stigma. The treatment has long been portrayed as a form of torture, with flailing patients strapped to gurneys and involuntarily subjected to jolts of electricity while awake, as depicted in the 1975 movie “One Flew Over the Cuckoo’s Nest.”

“It used to be done without anesthesia,” Hill said. “Using electricity to generate seizures while the patient is awake is a brutal kind of treatment.”

Jack Gregory, who is under general anesthesia during treatments, has no regrets.

“I don’t think it’s for everyone,” he said, “but for people with deep, dark, down depression, it can be very effective.”

At UNC-Chapel Hill, doctors oversee 30 to 45 electroconvulsive treatments weekly. The treatment continues to evolve, but it’s not the subject of as much research as behavioral drugs, Hill said.

“It’s been studied for years, but the reality is, since the drug companies aren’t involved, there isn’t a lot of money available for ECT,” he said.

Treatments using electric stimulus usually begin with a course of six to 12 sessions, scheduled three times a week for a month or so. Some patients, such as Gregory, return for maintenance treatments.

“What the field is focused on in recent years is to try to improve the success rate while minimizing side effects,” Hill said.

“We are looking to use the lowest amount of electricity – the less energy you use, the better,” he said. At most, he noted, electroconvulsive therapy uses about a third of the amount of energy that typically jolts a heart patient during defibrillation.

Gregory said 2007 was the first calendar year in at least five in which he had no psychiatric hospitalizations. Richard Wynne, pastor of St. John’s Baptist Church in Raleigh, said he remembers Gregory’s trials before he tried electroconvulsive therapy.

“When he first became a member, there were times that we knew he was depressed,” Wynne said. “He would be so depressed that he’d take his medication and when it didn’t work, he’d take more of it. He ended up overdosing.”

Gregory now talks to people with depression about electroconvulsive therapy, hoping that others with the illness might be able to retreat from the brink, too.

“I will have these obsessions or diagnoses for the rest of my life,” he said. “With the technology available to me now, I will have a better than even chance of stability.”



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