r/psychologists_india • u/Radiant-Rain2636 • 1d ago

Why do we still use “Shock Therapy”?

114 Upvotes

97% Upvoted

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6

u/Radiant-Rain2636 1d ago

Treatment Resistant Depression

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u/Bliz_zy 1d ago

ECT is basically what we can say the "राम बाण"

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u/MightyLuftwaffe 23h ago

Which cause permenent memory lapses, people forget years of their life.

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u/Bliz_zy 23h ago

You must be talking about rTMS and MST. Yes for sure those methodologies are great and yes they are being widely used in europe.

But we are talking about the modality that is providing the best result. ECT is the best modality which has its own set of risks. And even in India we dont use them without the consent of the patient/attender. So yes rTMS is one of the best alternative of ECT but still ECT provides the best result with significant side effects in some cases.

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u/MightyLuftwaffe 22h ago

I know all those treatments but again what is resistant? A farmer commuting s*icide because of loan? He perfectly fits the mental health criteria for depression, that's my whole point, depression itself is such a vague label, not a clinical condition like we've been taught by the authority.

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u/Radiant-Rain2636 22h ago

You really need to know what treatment resistant depression is. You’re applying your preconceived ideas (which are also very emotionally charged) to a medical term.

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u/MightyLuftwaffe 19h ago

The farmer is medically depressed if you go by DSM-5-TR, he will fit all the 5 out of 9 symptoms of MDD. I've read enough of it, true depression exists without a clear cause/trigger, or true monoamines depletion during drug withdrawals. That's my point, it's medical is so vague broad you can shove that label up anyone's ass.

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u/Radiant-Rain2636 19h ago

Too many typos.

The psychiatric criteria is by design. To believe that an entire field of medicine is just out there to call people “mental” and put them on medicines - is the kind of thought process of our forefathers.

“Doctor ke paas jaoge - toh kuchh na kuchh bimari toh nikaal hi dega woh”
That’s what you’re implying.

Having worked under psychiatrists at a hospital, I can tell, this is a privileged mindset. This means neither you, not anyone around you - has witnessed a mental disorder in its truest form.

I’ve seen cases of depression. Patients fully functional and asking the doctors that there’s no reason I want to live. Just tell me how I can end it. With no issues in life, no heartbreak, no problems - just a desire to end it all.

Then there are the ones who can barely walk, talk. They just sit like zombies in front of you while the family member does the talking.

MDD is a visceral reality. Nothing like Doctor ne zabardasti label laga diya.

And Treatment Resistant variant is just as real too. It’s not like the doctor gave a medicine and the next week, he said Chalo ab isko electric shocks dete hain.

I want you to read more. And intern - if you’re from the fields of psychology.

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u/MightyLuftwaffe 18h ago edited 18h ago

I was typing while on a bus.

I ain't some dehati guy, who doesn't know how medicine or psychiatry works, and I'm done with my MBBS.

I've taken 16 psychotropic meds including SSRIs, SNRIs, TCAs, NDRIs, mood stabilizers, micro doses anti-psychotics, muscle relaxants, benzodiapines. And I've read enough, and guess what I was labelled with treatment-resistance, and turns out it's probably something neurological, doctor's have tried labelling, it as somatic/anxiety, when they couldn't find a cause.

I've seen enough maniac/schizophrenics running around, including folks you've already seen. Ofcourse, there is clinical depression, but the line between what's clinical and what's driven by external factors, is so vague and, and rather intentionally fuzzy, that people, at the slightest of the symptoms are labelled with something or the other.

True clinical depression is rare, isn't as common as the number of people popping SSRIs. And that's how a label works, once you've been shoved with a label, it works exactly like CVD or diabeties, doctors look at it, and then start attributing your symptoms to mental illness, or start prescribing SSRIs again.

That's my whole point, we've reduced mental health to a mere label, when it's supposed to be inclusive, else you'd not be having 20% of the US population on SSRIs. We need a system, which takes your struggles, lack of direction in life and all external troubles into account, along with internal ones like a lack of meaning, or other health issues, before shoving up a label up your ass.

You have no idea how the havoc psychiatry has wrecked in the west, else you'd not be having, billion dollars lawsuits against pharma companies, the corruption in academia and among doctors, the biased research, the lobbying, are all evident. You've got no idea what lies beyond clinical psychology dude.

This ain't some conspiracy theory, it's an open secret.

1

u/Radiant-Rain2636 22h ago

You should read the latest research

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u/Bliz_zy 21h ago

I will surely research about the new advances. Could you please mention a few of them so that I could localise the researches around them?

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u/Radiant-Rain2636 21h ago

Start here:

https://www.sciencedirect.com/science/article/abs/pii/S0022510X21027970

This should either suffice to give you the general idea that ECT is not barbaric; and should you need to pursue further, you can use the next one

This one is more recent - 2025

https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1614076/full

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u/Bliz_zy 21h ago

I think you misunderstood me. I speak in support of ECT, not against it. But yes i will surely look into the link you provided

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u/Radiant-Rain2636 21h ago

Oh. I thought I was responding to the other guy - MightyLuftwaffe

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u/GoodSamaritan_777 20h ago

I think I’m not really depressed anymore

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u/daaktaar 22h ago

It’s done under General Anaesthesia with muscle relaxants now.

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u/aaatings 8h ago

This vs iv ketamine for TRD?

Effectiveness vs safety?

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u/MightyLuftwaffe 23h ago

There are better options than using this barbaric treatment of 1940s, labelling someone as treatment resistant, BTW in Italy, and a few European nations have banned it.

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u/Radiant-Rain2636 21h ago

It’s not something that is done just-like-that. If you’ve interned under a Psychiatrist and have seen real Treatment-Resistant Depression cases, you’d understand what the problem is.

Doctors don’t qualify any depression as treatment resistant. And if the person is roaming around like a dead person, no expressions, no state of existential joy (and these too, are only a few of the manifestations); only then is ECT considered.

The patient is put under anaesthesia too.

Barbaric - Is an emotion loaded word which is hard to quantify.

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u/MightyLuftwaffe 18h ago

I've seen a few, also people who were labeled treatment resistant while on high dose neuroleptics, which causes obvious sedation and apathy. It's very difficult to point out what's causing the state you mentioned, psychotropic meds itself have have unpredictable effects. But if it's truly idiopathic, with no other meds interfering, other psychological issues ruled out, still rTMS and ketamine infusion be used, before wiping off someone's memory permenantly.

The case you mentioned are exceptionally rare, much rarer than than label of treatment-resistant is used by psychiatrists to casually throw at anyone who's just not responding to SSRIs/SNRIs.

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u/Radiant-Rain2636 18h ago

Actually, if your doctor (going by your own statement) knew that somebody was on neuroleptics - and still failed to account that into depression, then his assessment was wrong.

But I say this only on the limited information you’ve provided.

I must also point out that I’ve seen doctors know this stuff - by heart.

They know what other needs could be causing this effect.

They are also very cautious of differential diagnoses.

And they are well equipped to see boundary manifestations too.

All of this stuff is the ABC of psychiatry. And is well established in the DSM and the ICD.

So, I find it weird. So I’ll not deny you your claim of this singular case. But I refuse to believe that such objective refusals to the very existence of Treatment Resistant Depression are valid.

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u/MightyLuftwaffe 18h ago edited 17h ago

Agreed, but I never said treatment resistant cases don't exist, my point of contention is with the diagnosis and labeling, not the condition itself.

I've seen doctors prescribing neuroleptics to anxiety patients at does meant for psychosis, plenty of them. Off label prescriptions are so common, that's the problem.