Therapist’s Own Treatment a Shock : Psychiatry: Martha Manning wrote in her upcoming book what she wouldn’t have disclosed in a job interview--her experiences with ECT. She hopes to update its image and to change the way people view depression.

When she thinks about having lain on a table with electrodes on her head while a doctor hit a switch that caused her to suffer a seizure, Martha Manning asks herself this question:

“Are you insane?”

Hardly. But as a clinical psychologist who twice has undergone electroconvulsive therapy for depression, Manning does have an unusual perspective on the illness that brought her to the brink of suicide and the treatment that yanked her back to life.

She shares it in an upcoming book, “Undercurrents: A Therapist’s Reckoning With Her Own Depression,” being published by Harper San Francisco in March.

“Undercurrents” chronicles a period in Manning’s life that began with a messy house in January 1990 and culminated in six sessions of ECT 10 months later.

The story doesn’t end there.

Manning spent another year recovering not only from the depression but from the loss of confidence and self-esteem that came with it, a result of her sudden metamorphosis from doctor to patient.

“I had been in a place where no drug could touch me,” said Manning, a friendly, forthright woman who radiates both fragility and strength. “ECT was like a huge crane that pulled me out and let me back down on land. But I still had to walk the rest of the way.”

Manning turned to ECT after various antidepressant drugs failed to relieve her worsening symptoms.

As a psychology professor and psychotherapist with her own private practice, she knew about ECT’s impressive track record in alleviating major depression, and she knew its use was once again on the rise. She also was aware that modern equipment, anesthesia and muscle relaxants had transformed ECT into a relatively benign procedure.

As a patient, however, she knew no such thing.

That dichotomy arises repeatedly in her story, as in this passage about the night before her first ECT treatment, as her psychiatrist provides one last description of the procedure she’ll face in the morning:

“I listen to this with the cool demeanor of a fellow professional. He asks if I have any questions and I tell him calmly that between the reading material he provided and our discussions, I feel prepared. However, on the inside I am screaming, ‘HOW DO I KNOW YOU’RE NOT GOING TO FRY MY BRAINS? WHAT IF THE MACHINE SHORT CIRCUITS? WHAT IF YOUR HAND SLIPS AND YOU PUSH THE DIAL TOO FAR? WHAT IF I TOTALLY LOSE MY MEMORY? WHAT IF I DIE?’ I conclude that he probably has no answer to these questions, so I spare him the hysteria.”

After an ongoing struggle with “peaks and valleys,” Manning, who suffers from a form of manic depressive illness, underwent a second course of ECT last year. She now takes a mood stabilizer as well as an antidepressant, a combination that seems to be working.

Her experience has made her a better therapist, she said, partly because it’s made her more aware of psychotherapy’s limitations. “The best therapist in the world can’t help a person with that deep a depression,” she said.

Still, “the first place I felt the stigma was in my own circle of colleagues and friends. But to see me before and after--many said they’d never thought of ECT as a treatment until they saw it work for me.”

Manning decided to go public with a disclosure she said she wouldn’t make in a job interview in the hope of updating ECT’s image from the frightening procedure of the past to a safe and effective option for people who need it.

She’s also hoping to change the way people view depression, an illness everyone talks about but few truly understand.

“Depression’s become trivialized,” Manning said. “Everyone thinks they’ve been depressed. You hear people constantly say things like, ‘I’m really depressed today.’ You don’t hear people say, ‘I’m really paranoid schizophrenic.’ ”