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

翻译人员: Evan Xu 校对人员: x Vicky

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

在1982年，一个年轻的护士 饱受持续的严重抑郁症困扰。

She couldn’t work, socialize,

她不能工作，社交，

or even concentrate well enough to read the newspaper.

甚至不能集中注意力阅读报纸。

One treatment changed everything.

一次治疗改变了一切。

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

在两次电休克（ECT）疗程之后， 她的症状得到改善。

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

她重新工作，然后去了 研究生院，取得高分成绩。

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

一开始，她公开谈论改变她人生的治疗。

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

但当她意识到很多人 对ECT有非常负面的印象时，

she stopped sharing her experience.

她不再分享经验。

ECT carried a deep stigma,

ECT背负着深深的污名，

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

历史遗留下来的污名， 即认为它和现代做法相去甚远。

The therapy was first used in medicine in 1938.

该疗法在1938年第一次 在医学得到上运用。

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

在早期，医生会对大脑施加强电流，

causing a whole-body seizure during which

导致全身痉挛，

patients might bite their tongues or even break bones.

期间病人会咬舌甚至折断骨头。

Modern ECT is very different.

现代ECT则非常不同。

While a patient is under general anesthesia,

病人处于全身麻醉时，

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

电极将轻微的电脉冲输进大脑。

This causes huge numbers of neurons to fire in unison:

这使大量神经元一齐激活：

a brief, controlled seizure.

带来简短、可控的发作。

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

肌肉松弛剂防止痉挛蔓延全身。

The only physical indication of the electricity flooding the brain

电流涌入大脑的唯一身体反应是

is a twitching foot.

脚痉挛。

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

治疗时长为一分钟， 并且大多数病人

to resume normal activities about an hour after each session.

在一小时之后能恢复正常活动。

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

ECT主要用于治疗其他疗法无效的

in patients who haven’t responded to other therapies,

重度抑郁或燥郁症病人，

or who have had adverse reactions to medication.

或是对药物有不良反应的病人。

Half or more of those who undergo treatment experience an improvement

一半及以上接受治疗的病人

in their symptoms.

得到好转。

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

多数接受ECT的病人在连续几周内， 每周都会接受两到三次的治疗。

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

一些人仅在一次治疗后症状就有所改善，

while others take longer to respond.

而其他人则需要更长时间。

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

病人通常会继续治疗，但降低频率， 从几个月到一年不等，

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

而有些病人在余生需要偶尔进行维持治疗。

Modern ECT is much safer than it used to be,

现代ECT比以前更加安全，

but patients can still experience side effects.

但依旧有副作用。

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

治疗之后，病人可能会感到疼痛、虚弱或恶心。

Some have trouble remembering what happened right before a session—

一些病人则会记不起来治疗之前发生的事，

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

比如他们前一天晚餐吃了什么。

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

极少有的情况下， 病人会记不起几周几月前的事。

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

大多数病人的失忆情况会随着时间改善。

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

有意思的是，尽管ECT证实有效，

we still don't know exactly why ECT works.

我们依旧不知道它究竟为什么起作用。

Neurons in the brain communicate via electrical signals,

大脑中的神经元通过电信号交流，

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

影响大脑化学性质， 进而影响情绪和行为。

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

ECT引起的大量电子活动 改变了这种化学性质。

For example, ECT triggers the release of certain neurotransmitters,

例如，ECT促进释放神经递质，

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

传递神经元之间的信号从而影响精神健康。

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

ECT也可以刺激荷尔蒙流动， 帮助缓解抑郁症症状。

Interestingly, ECT maintenance works better when paired with medication,

有趣的是，搭配药物可以 更好的维持ECT疗效，

even in patients who were resistant to medication before.

既是对之前抗拒药物的病人 来说也是如此。

As we come to a better understanding of the brain,

随着我们对大脑进一步了解，

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

我们可能可以使ECT更加有效。

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

1995年，在第一次接受ECT治疗的十多年后，

the nurse decided to publish an account of her experience.

那名护士决定出版她的经历。

Because of the stigma surrounding the treatment,

因为这项治疗有很多骂名，

she worried that doing so might negatively impact

她担心这样的做法或许会影响

her personal and professional life,

个人和职业生活，

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

但她知道当其他疗法不管用时， ECT可以造福病人。

Though misperceptions about ECT persist,

尽管关于ECT的误解依旧存在，

accounts like hers have helped make doctors and patients alike

像这名护士这样的经历 已经帮助医生和病人意识到

aware of the treatment’s life changing potential.

ECT疗法很可能会改变人生。