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Car accident, depression, antidepressant not effective enough. Is ECT used for this and is this common?

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Practicing since : 2005
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On August 1st I was in a car accident. A woman that was texting rear ended me when I was stopped at a light. I was wearing my seat belt. My head hit both the head rest and the window on the drivers side. I was unconscious for a while then blacked out again a while later. I don't remember the accident or anything until the car had been moved and suddenly I was surrounded by EMS and firemen.

My neck and shoulder were injured and I got a concussion. They had to remove me from the car and take me to the hospital. They did xrays and a CT Scan then the removed the neck brace. The ER doctor has said he explained everything to me and gave me instructions to follow after leaving. I don't remember that at all and was upset that he didn't talk to me and give me the results.

On the way home my vision was blurred and I had a headache. Since then other symptoms developed. I'm having a lot of pain down my left side and when my muscles tighten in my neck and shoulders the headache get much worse. Also, my memory has been affected. I can be talking about something and as I'm talking I forget what I was talking about. This has never happened before. I have always had a remarkably sharp memory and recall things in minute detail both recent and distant past. Now when I think of something, at work, that I need to do or an instruction to someone else I have to write it down immediately or I forget it. My concentration is horrible. I'm unable to keep my mind on a book I want to read. I can read a page and not know what it said afterwards.

Now something that is fairly bizarre to me. Not all the time but quite often when things get quiet I hear music. I thought it was someone down the hall playing the radio and didn't mind because it was the type of music I like. Then I went down the hall to see who it was and there was nobody there. I plugged my ears and the music was there. It appears to be on the left side. Other times there is a loud continuous high pitched tone.

I have suffered from severe depression for many years. The current episode has not responded well to antidepressants. Since the accident it is much worse. I am irritable and extremely impatient. Light hurts my eyes, quite often I can't stand to listen to music or watch TV. I'm overreacting to things that shouldn't bother me that badly. The guy I work with, we are IT department managers, has said that I've asked the same questions multiple times. It's as if I'm more sensitive. There are some other things but I think you get the idea.

Okay, just now I've forgotten what I wanted to ask.

My psychiatrist wants me to go to a Neuropsychologist. She said they will do tests like memory tests. I don't actually see the point. I've looked up what they do at the mayo clinic and it shows mostly testing of movement, intelligence, etc. Then she wants me to go to a Neurologist.

From all the reading I've done there isn't a lot they can do other than treat the symptoms. But one thing has me concerned. Out of the blue my psychiatrist talked about ECT. She said it is nothing like it used to be done which was horrible. She explained a bit more but I've forgotten.

Now my question. I've read that ECT can be used to treat the serious depression that may get worse because of the injury. My depression has gotten much worse. I'm exhausted. I work but my work is not good. I only go to work and home. I'm not interested in anything at all. I think of suicide many times a day. My therapist is aware.

Is ECT used for this and is it common? Is it effective? I doubt I will allow ECT to be used primarily because it doesn't seem that they know how it works. I don't like that at all.

Any words you might have would be helpful.

Thank you,

High Blood Pressure

Migraine Headaches

Severe Depression/Anxiety, Panic Attacks











Posted Mon, 1 Oct 2012 in Depression
Answered by Dr. Piyush Ostwal 3 hours later
Thanks for the query.

ECT is commonly used for depression which is not responding to adequate trial of medication. The fact that the exact mechanism of its action is not known should not be the reason not to take ECT. Biology and medical science is very complex and only piece by piece over years and decades do we understand and gain new insight into things. However hypertension and memory problems are relative contraindications for ECT which means you can still be given ECT but chances of side effects are more.

Neuropsychologists will not only assess you but they may also provide you with strategies to improve your day to day performance with respect to memory, concentration etc.

The injury to your brain was probably significant and forgetfulness, abnormal sounds in ear is the residual effects of that injury. Memory problems are also likely to be linked to depression and improvement in that should enhance memory.

If there are more queries I would be happy to answer.

Good luck.
Above answer was peer-reviewed by
Follow-up: Car accident, depression, antidepressant not effective enough. Is ECT used for this and is this common? 29 hours later
A month and a half before the car accident I hit my head on the overhead compartment in an airplane. It was on the same side of my head and I was knocked out. A doctor on the plane monitored me until we landed. The EMS checked me out but I did not let them take me to the hospital. For about a week after I had a headache.

Could this have an effect on the current injury? Also, my psychiatrist is making the arrangements for me to see a neurologist. Can you tell me what kinds of treatment are used for this type of thing?
Answered by Dr. Piyush Ostwal 13 hours later
Since you were knocked out (i assume it means you were unconscious), that injury too must have been hard and it could have additionally contributed to your current problems. For the deficits due to concussion like memory problems etc there are no definite medications available. Mental exercises under the guidance of a neuropsychologist is the best treatment option. Neurologist will also assess you for any other deficits due to the injury. However overall treatment options are limited.
Hope I have answered your queries. If there are more you can get back to me.
Good luck.
Above answer was peer-reviewed by
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