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    Thursday, September 17, 2015

    Kitty Dukakis’s Chronic Depression

      She treated it in various ways. Early in adulthood and through the first years of her marriage with Mike, she treated it with amphetamine. This, actually, was not an unreasonable choice, as amphetamine is an effective treatment of mild to moderate depression and once was widely used for this. But she became addicted and Mike asked her to stop.

    Then, under the pressure of his political career, she started drinking, and held her consumption of alcohol in moderate bounds until he lost the campaign in 1998 against George H Bush. Then she started drinking heavily.

    In the beginning, alcohol was not an entirely irrational choice as an antidepressant, and for centuries beer and sherry had been prescribed by physicians for “nerves,” the old-fashioned term for what we call depression, or mixed depression-anxiety, today.

    But, again, she became addicted.  Her drinking got out of control, and Mike came home one day to find her crumpled and passed out on the floor.

    This was all described in a recent, excellent piece in the online news service Politico (link is external).  But not too long ago Dr Max Fink and I interviewed Kitty and Mike Dukakis one morning in their lovely home in Brookline, Massachusetts, and they both talked of how difficult Kitty’s various attempts at self-medication for her depression had been. For that interview, Mike cooked pancakes, and it became clear that both of them were totally committed to public service in the interest of  mental health.

    What were they committed to?

    This brings us to Kitty’s third attempt – a successful one – to treat her depression. One morning in June 2001, in the psychiatric department of the Massachusetts General Hospital, she made her way to the basement service for electroconvulsive therapy (ECT). She was full of apprehension and had seen One Flew Over the Cuckoo’s Nest.  But, strangely enough, there was no odor of burning flesh.

    She would have a series of stimuli, but even after the first one, as the Politico story tells us, “She felt better – lighter, happier. She and her husband were able to celebrate their 38th wedding anniversary that night in awe of the complete turnaround.”

    This success was not a miracle cure, but a typical ECT result. The treatment is safe  -- all that guff about complete memory loss is an urban myth – and highly effective. And it gave Kitty Dukakis her life back.

    That was essentially the story that Dr Fink and I got at the breakfast table. And it explains why Mike and Kitty Dukakis are so determined now to help lift the stigma from ECT and make people aware that it is the most powerful therapy that psychiatry has on offer.

    The Dukakis’s are now on the road. At a recent mental-health fundraiser in Cambridge, she received a five-minute standing ovation.

    A number of public-spirited health advocates whose lives have been turned around are now on the road on behalf  of convulsive therapy. It is currently being pioneered for the treatment of catatonic symptoms – including Self Injurious Behavior (SIB) – in children with autism and intellectual disability. SIB means that the children harm themselves, often by hitting their heads with their fists. This is catatonic in nature. And the catatonia dissolves with benzodiazepines and ECT.
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    This topic brought to you from psychologytoday.com
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