Matt Renaud gets ready for his ECT session at Providennce Care Hospital.
By: Lindsay Kennedy, Communications Officer, Providence Care (located in Kingston, ON)
After years of suffering from treatment resistant depression, 36-year-old Matt has finally found relief and positive results through electro-convulsive therapy (ECT), which he started in February 2024 at Providence Care Hospital in the Outpatient Interventional Psychiatry Clinic.
“Before starting these treatments, my mental health was quite bad," Matt explains.
“Part of it was the time of year – winter is historically challenging for me. I was self-isolating and not really getting out of bed. I had intense suicidal ideation and was engaging in some self-harm. Everything was very chaotic – challenges with clear thinking and not a lot of energy. It was the worst winter in a decade. So, I knew I needed something different, despite taking prescribed medication at the time. I've been on almost every major class of medications and combinations of medications, but nothing was working."
ECT offers potent efficacy and rapid onset of response with an exceptionally broad therapeutic spectrum. ECT involves the application of electrical currents to the brain via electrodes placed on the scalp of a patient under general anesthesia. It is painless, safe and effective in multiple psychiatric illnesses, where other treatments haven't been effective. It works by changing brain chemistry, neural activity and connectivity. Matt had experienced a couple of seizures a few years back and noticed a significant mood improvement. He wondered then if there may be a connection to ECT, given it induces a brief seizure.
Dr. Yuliya Knyahnytska who is overseeing Matt's care, is a Psychiatrist and Medical Head of Interventional Psychiatry who began at Providence Care in September 2023, after a 15-year career working at the Temerty Centre for Therapeutic Brain Intervention with the Centre for Addiction and Mental Health.
Dr. Knyahnytska says that ECT has undergone considerable modifications over the years thanks to research and scientific advances, playing a critical role in determining its efficacy and side effects. When Dr. Knyahnytska began her role at Providence Care, the team rapidly adapted to a new approach with the incorporation of ultra-brief pulse ECT, which allows for significantly fewer adverse effects for the patient.
“ECT has been traditionally seen as a last resort, however, with treatment resistance rates on the rise, and more and more patients not responding to traditional psychopharmacological and psychotherapeutic interventions, we advocate strongly that ECT should be utilized sooner given its unparalleled efficacy and safety," explains Dr. Knyahnytska.
Matt is an example of a young patient who has suffered with his mental health for years and ECT was not considered until he met Dr. Knyahnytska.
Now in his fifth month of treatment, Matt has his vitals taken in the clinic at Providence Care Hospital and proceeds to the treatment room, surrounded by dedicated and passionate staff.
From start to finish, the procedure is 12 minutes long, with a period of recovery from the anesthesia afterward. During the procedure, small electric currents pass through the brain, intentionally causing a brief seizure.
Dr. Knyahnytska says that how ECT works within the brain is very complex. ECT changes brain chemistry and these changes can quickly improve symptoms of certain mental health conditions.
“I was quite depressed before this. I have been ill for about a decade now. I've had decent connections with various medical and health care services. Things work for a little while, and then it hasn't tended to last. It's also incredibly challenging to medicate when there are larger social systemic issues too. For example, medications that aren't covered by the provincial government, and importantly, the lack of broad social safety nets such as Universal Basic Income."
The results Matt has seen in four short months of ECT treatment are inspiring. He says he is smiling more, has reduced anxiety and hyper-vigilance, his suicidal ideation is gone and he has a lot less “noise" in his brain. Matt has a general sense of enjoyment in life now and has recently taken up hobbies like reading, baking sourdough bread and learning French. Things he has always wanted to do but wasn't able to because of his depression.
Dr. Knyahnytska echoes similar feelings of inspiration following Matt's journey.
“Matt's progress is a remarkable case. He has struggled with very complex mental illness for a long period of time. After treatment number seven or eight he started to report some benefits. What's interesting to see is how somebody who's been depressed for a very, very long time – how they react to the benefits of this treatment. We hear it a lot. For patients who have struggled for years now they are starting to feel better – it is almost like an entire turn of identity, for some people. It's like a new person has emerged."
Matt says the entire ECT team has treated him incredibly well and his experience has been very positive. “It works incredibly fast. It was intense how quickly things changed."
While ECT treatment has been a game-changer for Matt, he says there are certainly still hard days.
“I definitely still have tough days and tough moments. But the valleys aren't quite as deep and not as abrupt. There is a lot more even-ness and things don't hit as intensely."
Looking to the future, Matt is excited to continue with education in his pursuit of an undergraduate degree and will be looking to re-enter the workforce in a part-time capacity.
“Life has been extremely challenging for over a decade and there has been so much time that is just a zero to me. But even accounting for these times in my life, I still consider myself overall quite lucky. My experiences might not be representative of everyone. I've gone to hospital in crisis, but I haven't spent months there. I've completed college, had positive, stable employment, and the support of many wonderful people. All these factors confer protective benefits to the significant hardship and pain I've experienced. I consider myself relatively lucky in this regard compared to a lot of other situations."
For anyone suffering through the dark days of severe depression, Matt says it's a personal journey, but for him, education led to the realization that his struggles weren't solely his fault, instead understanding the impacts of larger systems has been a major turning point. And of course, access to ECT treatment.
And at Providence Care, ECT isn't the only option for patients who are suffering from treatment resistant depression. Repetitive Transcranial Magnetic Stimulation (rTMS) and intravenous ketamine are also treatments within the Interventional Psychiatry Clinic.
“There are certainly options available based on patients clinical presentation and symptoms. rTMS is a non-invasive technique that involves a series of magnetic pulses being directed to the brain, while ketamine is a fast-acting anesthetic that's being used to treat people with depression who have not responded to other treatments. Our clinic is proud to provide close, hands-on management, following our patients throughout their journey to wellness," says Dr. Knyahnytska.
Are you or someone you know looking for support for your mental health, substance use health and addictions? Visit AccessMHA.ca for help.