Rethinking ECT Through Lived Experience With Sarah Hancock

Send us Fan Mail What happens when a treatment designed to help may also carry injuries we rarely measure? We sit down with Sarah Price Hancock, co-founder and trustee of the Ionic Injury Foundation, to unpack ionic injury as a physiologic framework for understanding electrical exposure—including ECT—and the real-world consequences that can follow. Sarah shares her lived experience after 116 ECT sessions, the profound memory loss that reshaped her life, and the delayed neurologic symptoms that only made sense once she studied electrical injury research outside of psychiatry’s usual lanes. Together we map the biology: rapid perfusion spikes, bradycardia, and reperfusion injury; blood–brain barrier shifts that may invite inflammatory cascades; and potential acquired channelopathies that present as episodic weakness, spasms, or exercise intolerance. We contrast short-term ECT outcome data with the lack of long-term tracking and the high variability in dosing, electrode placement, and anesthetic choices. The conversation stays grounded in practice: what to add to intake questions, which referrals actually help (neuropsych, central auditory and visual processing, vestibular and balance testing), and how to route patients toward rehabilitation and accommodations that restore function at school and work. This is also a story about trust and agency. Sarah lays out simple tools for rebuilding a sense of control, and we discuss how clinicians can presume competence, partner on decisions, and stay curious when symptoms fall outside familiar patterns. Whether you support ECT, question it, or simply want better outcomes, this episode offers concrete steps to assess, document, and treat possible electrical injury with the same rigor we give any other trauma. If this conversation sparks ideas or challenges your assumptions, share it with a colleague, subscribe for more, and leave a review with one change you’d make in your practice today. Let’s Connect Dr Dan Wesemann Email: [email protected] Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner LinkedIn: www.linkedin.com/in/daniel-wesemann Dr Kate Melino Email: [email protected] Dr Sean Convoy Email: [email protected] Dr Melissa Chapman Email: [email protected]