The body electric

Our son's condition kept getting worse, and everything we tried to help him failed. Then we discovered there was one final option: Electroshock therapy.

By Ann Bauer

Read more: Mental Illness, Autism, Life

June 19, 2007 | At the age of 3, my older son withdrew, becoming sullen and cross-eyed overnight. He stopped speaking and lost the ability to follow directions, vanishing inside a body that only rocked and swayed and arched away from human touch.

Together with my then-husband, I coaxed this little boy back: reading him poetry, drilling him with flashcards, crawling the floor in circles at his side. And when he returned to us, recovering in a way most autistic children never do, I believed the worst thing that would ever happen to us was done.

So when -- after more than a decade of progress -- my son began to regress, I didn't see it. I couldn't. I called it depression, anxiety, teenage sloth. I didn't realize the enormity of what was happening until my 18-year-old son could no longer climb a flight of stairs or tie his own shoes. Even then, it took us another year to figure out that he had a condition called autistic catatonia: a second withdrawal, even more cruel and dangerous than the first, which occurs on the far end of childhood.

About a month ago, I wrote a story about my son's misdiagnosis of schizophrenia during that yearlong period, as well as his frightening response to a couple of commonly prescribed antipsychotic medications, Abilify and Geodon. I cited a New York Times article about psychiatrists in Minnesota (where we live) receiving kickbacks for prescribing exactly those drugs and went on to report that my ex-husband and I finally took our son to Mayo Clinic, where he was correctly diagnosed and appropriately treated. I told how doctors there admitted a mute and feral young man, working in choreographed teams to figure out exactly what he needed, magically finding the person inside and bringing him back again.

What I did not report was that they used electroconvulsive therapy (or ECT) in order to do so.

I had two reasons for omitting this information. First, the point of my original essay was to bring attention to the misuse of antipsychotic drugs in children, adolescents and people of all ages along the autistic spectrum; I believed including the information about ECT (also commonly known as shock treatment) would hijack the piece, drawing attention away from the issues of overprescription and autistic catatonia.

But also, frankly, I didn't feel like going through a hailstorm of reader outrage and Frankenstein jokes. Because even after seeing the benefits of electroshock for myself, I remained ambivalent about the treatment, protective of my son and simply raw.

So why go public now? Because after that original essay was posted, I received literally hundreds of messages (in fact, I continue to receive them, all these weeks later), from readers who had children, brothers, sisters or friends suffering from something similar. And these people were desperate for answers: How was my son cured? Did it last? And where could they go to obtain the same treatment for their son, daughter, brother, sister or friend.

I was in the process of responding individually to each of these queries when I received a letter from Max Fink, the doctor who had referred us to Mayo -- and whose book "Electroshock: Healing Mental Illness" I used to research ECT -- asking me to set the record straight. "I recognize the tremendous stigma attached to this treatment," it said. "But if you wish to help other parents of such adolescents, you should disclose the fact that, despite its stigma, electroshock is one of the most effective treatments in medicine; that it has been in use for more than 70 years; and that its benefit-to-risk ratio [for acute patients] is very favorable."

Everything he wrote is true.

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Convulsive therapy was introduced to modern medicine in 1934 by the Hungarian neuropsychiatrist Ladislas Meduna. He had observed that delusional patients who suffered spontaneous seizures often were miraculously cured and developed a theory that mental illness and epilepsy were "antagonistic" conditions: Those with the first had a deficit of neuroglia (branched cells that form the network for communication between neurons), whereas those with the second had a surfeit. By inducing seizures with an injection of Metrazol, Meduna believed he could "grow" neuroglia in the addled brain, thereby reversing disease.

Proponents of ECT no longer believe this. In fact, they can't say exactly why it works, only that it does, swiftly and consistently, in roughly 90 percent of catatonia cases, and 60-70 percent of patients with severe depression, mania and intractable psychosis. Recently, neurologists have begun recommending regular electroconvulsive therapy sessions for patients with movement disorders, such as Parkinson's, saying that it minimizes tremors and reduces the need for drugs such as L-dopa, which has notoriously negative side effects. (ECT has proved ineffective, however, when used for dysthymia, anxiety, substance abuse and personality disorders.)

The prevailing theory today is that ECT somehow repairs and sensitizes various neurotransmitter receptors, such as the ones that bind to serotonin, dopamine, glutamate and cortisol. But the truth is, no one really knows.

"Think of it like rebooting the brain," one clinician told me. "You don't know exactly why your computer isn't working, but if you shut it off and turn it back on, nine times out of 10, it'll come back online and function just fine."

This is small consolation on a chilly, blue morning in May, as I drive to Mayo before dawn and walk through the still-sleeping ward. Inside my son's room I stand at his bedside, reading the form I've been handed, then take a deep breath and sign so the doctors who have assembled six-deep can take him to a surgical suite, put him under a "light" general anesthesia, attach electrodes to his temples, and shock him until he has a seizure. Under any other circumstances, this young man -- 19 years old, of normal intelligence, and legally in charge of his own medical decisions -- would not need parental consent. But here's what it means to be clinically catatonic: Though he is burly and muscular, my son's mind is spinning so fast his body has stopped functioning altogether and he cannot exert enough pressure to use a ballpoint pen. His signature at the bottom of the sheet is illegible.

Next page: Electroshock as medicalized torture?