Shock and Awe

The stunning comeback of electroshock and other harrowing treatments for the mentally ill

The things that have been done to Colleen Kelley's brain sound like scenes out of a retro psych ward where ice-pick lobotomies are still the norm and Nurse Ratched doles out electroshock. Her brain has been scanned, doused in experimental drugs, magnetized, and electrified. She has been cut open, prodded, and implanted with foreign objects. Her memory has been erased.

But Kelley isn't a "psychiatric survivor" fighting to ban electroshock, or a memoirist detailing her horror stories of a time long ago. She is an educated woman, never hospitalized or locked in a mental ward, who has spent the last decade volunteering for treatments that her doctor calls the "experimental edge of psychiatry." Kelley has submitted willingly and continues to offer her brain up for experimentation. "I want my brain drained," she wrote to the Voice during a series of e-mail and phone interviews detailing her years as a guinea pig for psychiatric experiments in Maryland and New York. She suffers from a severe, stubborn depression that doesn't respond to medication. Her doctor of 15 years describes her as chronically suicidal, and Kelley talks about offing herself as easily as others might speak about trouble with their in-laws.

She has a loving partner, a comfortable house half a block from the Anacostia River in Cottage City, Maryland, and, until her depression became debilitating, a satisfying career in graphic arts and desktop publishing. She insists—and her doctors agree—that her depression is biological, rooted in a dysfunctional brain. Her brain has turned against itself, eating itself from the inside out with thoughts of death. Kelley likens the suicidal urge to "a finger constantly wiggling at the back of your throat. You know you would—that you will—feel better if you only puke."

Illustration by Marco Marella

In addition to dozens of antidepressants, antipsychotics, and all manner of off-label and experimental drugs, she's also tried yoga, acupuncture, dietary changes, supplements, Lyme-disease treatment, mercury-amalgam removal, and flower essences. "The ignorant hope that there is something I can do to alleviate this misery keeps me going," she says.

To treat medication-resistant patients like Kelley—there are an estimated four to eight million of them in the U.S.—neurologists and psychiatrists are increasingly turning to the one tool they know directly changes brain function: electricity. The most infamous form of this is shock treatment—now called electroconvulsive therapy, or ECT—but new modes of electromagnetic-based treatments, broadly called brain stimulation, are being tested on willing patients at New York State Psychiatric Institute and Columbia University Medical Center.

Dr. Sarah Lisanby, who runs the brain-stimulation lab at the medical center, admits that the stigma from the old days of ECT still lingers, despite significant improvements in the procedure. "If you only see portrayals like [One Flew Over the] Cuckoo's Nest, naturally people would be afraid," she says. But ECT, as demonized as it is, has inspired strange and promising new treatments, such as surgery to implant electrodes in the brain or neck. In one configuration, wires under the skin connect electrodes to a pacemaker-like device implanted in the chest that administers regular pulses of electricity to the brain. Other, nonsurgical forms of experimental brain stimulation are less invasive, but no less fascinating: One treatment uses magnetic fields to cause a seizure similar to ECT, while another directs very-low-voltage currents to the brain while the patient is awake. In all of these treatments, the idea is essentially the same: to reboot the brain, changing the way it actually functions.

For some, the experimental therapies have had astonishing results: Patients with Tourette syndrome abruptly stop having tics, and depressed people snap back to life. Despite these promising results, doctors admit that much of what works—and what doesn't, and why—is still a mystery. They warn that these treatments are not cures, that they are very experimental, and that the long-term side effects are still unknown. But the patients who end up at the brain-stimulation lab are often willing guinea pigs, impelled there by the mystery of their illness—the causes of most psychiatric disorders are still poorly understood—and the desperate desire to fix their malfunctioning brains.

"It is a win-win situation," said Kelley. "You either die a hero during the procedure, thus donating your body to science while still alive, or you survive the surgery with an iota of a chance that the wacky theory and device just might work."

Kelley's journey into the labyrinth of experimental treatments began 15 years ago, when she was officially diagnosed with major depressive disorder at age 29. She had known for years that something was wrong: In college, where she graduated magna cum laude with degrees in English literature and fine arts, she consumed espresso by the pot, alcohol by the liter, and clove cigarettes by the carton, self-medicating the unnameable thing that kept her awake all night and numb all day. After accepting that it wasn't simply the blues, or hormones, or a dozen other ailments she was tested for, Kelley started on a pharmaceutical merry-go-round, trying out scores of antidepressants and other meds, none of which helped very much. Previously the chatty, likable life of the party, Kelley was transformed into an erratic and hostile mess. Deb, her partner of 23 years, remembers coming home to find Kelley slashing a stuffed animal with a razor blade or silently sitting in the closet.

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