The truth about electroconvulsive therapy (ECT) - Helen M. Farrell

Prevodilac: Ivana Krivokuća Lektor: Tijana Mihajlović

In 1982, a young nurse was suffering from severe, unrelenting depression.

Godine 1982,

mlada medicinska sestra je bolovala od teške, nepopustljive depresije.

She couldn’t work, socialize,

Nije mogla da radi, da se druži,

or even concentrate well enough to read the newspaper.

čak ni da se dovoljno koncentriše da bi čitala novine.

One treatment changed everything.

Jedan tretman je sve promenio.

After two courses of electroconvulsive therapy, or ECT, her symptoms lifted.

Nakon dva ciklusa elektrokonvulzivne terapije, ili EKT,

njeni simptomi su se povukli.

She went back to work, then on to graduate school, where she earned high grades.

Vratila se na posao, a zatim na postdiplomske studije,

na kojima je dobila visoke ocene.

At first, she talked openly about her life changing treatment.

U početku je otvoreno govorila o tretmanu koji joj je promenio život.

But as she realized many people had an extremely negative impression of ECT,

Ali pošto je shvatila da mnogi ljudi imaju izuzetno negativan utisak o EKT,

she stopped sharing her experience.

prestala je da iznosi svoje iskustvo.

ECT carried a deep stigma,

EKT je nosila duboku stigmu,

leftover from a history that bears little resemblance to the modern procedure.

što je ostalo iz istorije sa kojom moderna procedura nema mnogo sličnosti.

The therapy was first used in medicine in 1938.

Ova terapija je prvi put korišćena u medicini 1938. godine.

In its early years, doctors administered a strong electrical current to the brain,

Prvih godina, doktori su primenjivali jaku električnu struju na mozak,

causing a whole-body seizure during which

čime bi izazvali grčenje celog tela

patients might bite their tongues or even break bones.

za vreme koga bi pacijenti mogli odgristi jezik ili čak polomiti kosti.

Modern ECT is very different.

Moderna EKT je veoma drugačija.

While a patient is under general anesthesia,

Dok je pacijent pod opštom anestezijom,

electrodes deliver a series of mild electrical pulses to the brain.

elektrode daju niz blagih električnih impulsa u mozak.

This causes huge numbers of neurons to fire in unison:

To uzrokuje istovremenu aktivaciju ogromnog broja neurona -

a brief, controlled seizure.

kratki, kontrolisani napad.

A muscle relaxant keeps spasms from spreading to the rest of his body.

Mišićni relaksant sprečava da se grčevi prošire na ostatak tela.

The only physical indication of the electricity flooding the brain

Jedini fizički pokazatelj električne energije koja preplavljuje mozak

is a twitching foot.

je stopalo koje se trza.

The treatment lasts for about a minute, and most patients are able

Tretman traje oko minut, i većina pacijenata je u stanju da nastavi

to resume normal activities about an hour after each session.

sa normalnim aktivnostima oko sat vremena nakon svake sesije.

ECT is commonly used to treat severe cases of major depression or bipolar disorder

EKT se obično koristi za lečenje teških slučajeva depresije

ili bipolarnog poremećaja

in patients who haven’t responded to other therapies,

kod pacijenata koji nisu reagovali na druge terapije

or who have had adverse reactions to medication.

ili koji su imali neželjene reakcije na lekove.

Half or more of those who undergo treatment experience an improvement

Polovina i više onih koji prođu tretman dožive poboljšanje simptoma.

in their symptoms.

Most patients treated with ECT have two or three sessions per week for several weeks.

Većina pacijenata koji se leče EKT-om

imaju dva ili tri tretmana nedeljno tokom nekoliko sedmica.

Some begin to notice an improvement in their symptoms after just one session,

Neki počnu da primećuju poboljšanje simptoma nakon samo jednog tretmana,

while others take longer to respond.

dok drugima treba više vremena da reaguju.

Patients often continue less frequent treatments for several months to a year,

Pacijenti često nastave sa manje učestalim tretmanima

tokom nekoliko meseci do godinu dana,

and some need occasional maintenance sessions for the rest of their lives.

a nekima su potrebni povremeni tretmani radi održavanja stanja do kraja života.

Modern ECT is much safer than it used to be,

Savremena EKT je mnogo bezbednija nego pre,

but patients can still experience side effects.

ali pacijenti ipak mogu imati nuspojave.

They may feel achy, fatigued, or nauseated right after treatment.

Mogu osećati bolove, umor ili mučninu odmah nakon tretmana.

Some have trouble remembering what happened right before a session—

Neki imaju problema da se sete šta se desilo neposredno pre sesije -

for example, what they had for dinner the previous evening.

na primer, šta su večerali prethodne večeri.

Rarely, they might have trouble remembering up to weeks and months before.

U retkim slučajevima mogu imati problema

da se sete stvari od pre više nedelja i meseci.

For most patients, this memory loss does improve over time.

Kod većine pacijenata se vremenom poboljša ovaj gubitak pamćenja.

What's fascinating is that despite its proven track record,

Fascinatno je to što, iako je njen uspeh dokazan,

we still don't know exactly why ECT works.

i dalje ne znamo tačno zašto EKT deluje.

Neurons in the brain communicate via electrical signals,

Neuroni u mozgu komuniciraju putem električnih signala

which influence our brain chemistry, contributing to mood and behavior.

koji utiču na hemiju u našem mozgu,

čime doprinose raspoloženju i ponašanju.

The flood of electrical activity sparked by ECT alters that chemistry.

Bujica električnih aktivnosti izazvana EKT-om menja tu hemiju.

For example, ECT triggers the release of certain neurotransmitters,

Na primer, EKT pokreće oslobađanje određenih neurotransmitera,

molecules that help carry signals between neurons and influence mental health.

molekula koji pomažu u prenosu signala između neurona

i utiču na mentalno zdravlje.

ECT also stimulates the flow of hormones that may help reduce symptoms of depression.

EKT takođe stimuliše protok hormona

koji mogu pomoći u smanjenju simptoma depresije.

Interestingly, ECT maintenance works better when paired with medication,

Zanimljivo je da održavanje EKT-om bolje deluje u kombinaciji sa lekovima,

even in patients who were resistant to medication before.

čak i kod pacijenata koji su ranije bili otporni na lekove.

As we come to a better understanding of the brain,

Kako budemo dolazili do boljeg razumevanja mozga,

verovatno ćemo moći da učinimo EKT još delotvornijom.

we’ll likely be able to make ECT even more effective.

In 1995, more than a decade after her first course of ECT,

Godine 1995, više od decenije nakon svog prvog lečenja EKT-om,

the nurse decided to publish an account of her experience.

bolničarka je odlučila da objavi svoje iskustvo.

Because of the stigma surrounding the treatment,

Usled stigme koja okružuje tretman,

she worried that doing so might negatively impact

brinula je da bi to moglo negativno uticati

her personal and professional life,

na njen lični i profesionalni život,

but she knew ECT could make a difference for patients when all else failed.

ali znala je da EKT može biti od značaja za pacijente kod kojih ništa nije uspelo.

Though misperceptions about ECT persist,

Mada pogrešne predstave o EKT i dalje postoje,

accounts like hers have helped make doctors and patients alike

ispričana iskustva poput njenog su pomogla da doktori, kao i pacijenti,

aware of the treatment’s life changing potential.

postanu svesni potencijala ovog tretmana da promeni život.