Mike Andrews floated in a wetsuit, mask and snorkel in a spring off of the Florida coast, careful to stay as still as possible as he kept an eye out for a remarkable creature.

Then a giant manatee swam over, its big distinctive nose appearing inches from Mike’s face.

“They’re huge, far bigger than a dolphin. You get to see their features. The majority that we saw were resting on the bottom of the lagoon, feeding on seagrass,” Mike said.

But this particular manatee seemed to recognize a fellow soul who might appreciate a life-affirming “hello.”

“It was magical, absolutely amazing, just to be that close to a docile creature of that size,” said Mike.

Mike and his partner, Nancy Perry, also got to see a nursing calf cozied up beside its mom.

“Seeing a baby was really a bonus,” said Mike.

The experience with the manatees was nothing short of a miracle. Mike got to be out in the world, relishing nature and celebrating the transcendent experience of seeing the elusive, peaceful animals.

The contrast with Mike’s life just a couple of years earlier was stark.

Now 76, Mike suffered a severe mental health crisis in 2021. It was so bad that all he could do was spend 20 hours or more each day in bed, shaking with fear.

Once before in his life, Mike experienced a similarly debilitating bout of what he thought was severe depression. But he had been a high achiever most of his life. He had earned a doctorate in biophysics from Georgetown University, had done research on bacterial viruses, had worked for medical device companies and had served as a consultant.

Outside of work, he enjoyed spending time with four sons and eight grandchildren, doing woodworking and taking photos of wildlife and wild places.

When the crisis hit in 2021, Mike faced an onslaught of obsessions and paranoid thoughts.

“I was afraid that I would take too big a bite of food, and I was going to choke. I thought all of my accounts had been hacked. The sun was too bright. I was trembling and afraid of the world around me,” Mike said.

He never felt suicidal but did feel powerless.

“Throughout my life, I had been pretty good at solving problems, but I couldn’t find a resolution to this problem,” Mike said.

Thanks to unrelenting help from Nancy, whom he had started dating in 2019, Mike finally found transformative care. Nancy is a licensed clinical social worker who had experience working in psychiatric units. As Mike descended into an abyss of mental illness, Nancy kept careful notes on his symptoms and pressed medical providers for help.

The couple eventually learned that anti-depressant medications Mike had been taking for twenty years were harming rather than helping him.  A medication change the month before Mike met with the UCHealth team had left Mike groggy, confused and so unsteady on his feet that he fell down a full flight of stairs at the Westminster home he and Nancy share.

Mike finally connected with psychiatrists at UCHealth who gave him a proper diagnosis. It turned out that he was suffering from undiagnosed bipolar disorder, not depression. His team recommended electroconvulsive therapy, also known as ECT, a therapy that proved transformational for him.

ECT for bipolar disorder: In dire need of help, electroconvulsive therapy offered a lifeline.

When Dr. Konoy Mandal first met Mike, his patient was in rough shape.

“He was emaciated. He was down to about 125 pounds. He was experiencing long periods when he was staring into space, unable to speak much. He was having Parkinsonian tremors and wasn’t able to interact with his kids or grandkids,” said Mandal, who is a psychiatrist and an expert in ECT who cares for patients at the UCHealth Behavioral Health Clinic at Longs Peak Medical Center in Longmont.

ECT treatments have changed dramatically over the years, and they are now an excellent option for people, like Mike, who are suffering from bipolar disorder and have been unable to get relief through medications or other treatments.

ECT also can work for people with severe depression.

What is ECT? And how fast do patients respond if it’s working?

Patients who get ECT come for sessions at an outpatient clinic where they receive brief doses of electrical stimulation to the brain. The patient is anesthetized during the sessions, and it typically takes longer for the team — including the doctor, specialty nurses and anesthetists — to prepare the patient for the procedure that it does for the patients to receive brief bursts of electricity.

During the initial phase of treatments, patients typically receive ECT about three times a week. Over time, doctors reduce the frequency and number of treatments, then phase them out over time.

The treatments for Mike worked relatively quickly.

“Within about three-and-a-half weeks of starting his treatments, he was markedly better,” Mandal said.

It’s typical for ECT patients to experience dramatic results after as few as two weeks of treatments, he said.

With Mike, Mandal said the changes were as obvious as a light that switched on.

“He came in and was talking, smiling and joking, and he hasn’t looked back since,” Mandal said. “It’s always incredible to see these breakthroughs.”

Altogether, Mike had 32 ECT treatments over a period of 18 months. He had his last treatment in March of this year.

“We were able to wean him down to fewer and fewer treatments, then he successfully finished,” Mandal said.

If three months have passed since a patient’s last treatment, and they have not had a relapse, Mandal said there’s a 95% chance that the patient will stay well over the long run.

Does ECT work for both bipolar disorder and depression?

While Mike long believed that he suffered from depression, his psychiatric diagnosis was actually more complex. Along with bouts of depression, he also experienced some highs, known as mania. And only after the 2021 mental health crisis did he learn he had bipolar disorder.

ECT works well for both depression and bipolar disorder, Mandal said. But many people with bipolar disorder don’t respond to medications. They have what’s known as medication-resistant bipolar disorder, and that’s why ECT can be so valuable for them.

“ECT works a lot better for bipolar disorder than medications. ECT is great for major depressive disorder too. But some drugs also are pretty good for depression,” Mandal said.

Does ECT cure mood disorders? Or do the treatments provide temporary relief?

Many people who go through ECT go into remission.

“They’re not cured, but the illness can be undetectable, like cancer.” Mandal said.

About 70 to 80% of people with major depressive disorder who go through ECT will go into remission after a course of treatments, Mandal said.

For bipolar disorder, about 60 to 70% of people will go into remission. While that’s a little lower than the remission rate for depression, the success rate is still quite high considering that as many as half of people with bipolar disorder do not respond to medications for their illnesses.

ECT is painless and does not involve seizures

Some people mistakenly think of ECT as painful or believe that it causes damaging seizures. Decades ago, doctors used stronger jolts of electricity on patients.

These days, ECT treatments are gentle, precisely targeted and painless.

“It’s not a seizure,” Mandal said. “ECT is an organized delivery of electricity. It’s similar to when we use paddles for people who are having an arrhythmia of the heart. We just do it on the brain.

“We now know that every single brain ailment — whether neurologic or psychiatric — has to do with electrical flow issues. This is true from Parkinson’s to multiple sclerosis to epilepsy to post-traumatic stress syndrome. That doesn’t mean that we treat all of them using ECT. But it means that there are certain conditions that create electric disturbances that respond to ECT,” Mandal said.

He likened ECT to radiation therapy, which used to be much more broad and now is highly targeted.

“Back in the day, if you needed radiation because you had stomach cancer, you’d get your entire abdominal area from the intestines to the bowels, liver and pancreas hit by the radiation. It was a shotgun approach. Now, we can use pinpoint accuracy. We know how the neurons interact with each other,” Mandal said.

Are there side effects with ECT?

Yes. For nearly all patients, ECT treatments affect a person’s memory.

But Mandal said that memory challenges typically ease over time, and he can minimize side effects during treatments.

“To reduce memory side effects, we can change the treatment or stop it,” he said. “Very few patients have longstanding memory issues.

“I don’t want to sugarcoat it. This is a major medical procedure that we do under general anesthesia. But for folks who have treatment resistant illnesses, ECT is miraculous for those who respond.

“ECT is far less negative than having incapacitating depression,” Mandal said.

Benefits of ECT far outweighed the challenges, side effects

For Mike and Nancy, the benefits of receiving ECT far exceeded the challenges.

Before Mike received his first treatment, the couple conceded that they both had the jitters.

“I was anxious about it at first,” Mike said. “But they put you under anesthesia. The staff members were great. And they had an endless supply of warm blankets. They were wonderful.”

Mike said he experienced very few side effects.

“It was not at all painful. I did have some short-term memory loss, but that was the extent of it,” he said.

“The improvements were incremental at first. Then I got to the point where I didn’t require 20 hours a day in bed,” Mike said. “I had lost nearly 20 pounds and I gained most of that back. I also regained my sense of humor, which was critical.”

‘Love is all you need’

On the wall of Mike and Nancy’s kitchen, a sign hangs that says, “Love is all you need.”

It’s the title of a famous Beatles song, of course, and for years, it’s been one of Mike’s favorite sayings.

It also became a mantra for the couple as they navigated their darkest days.

Mike and Nancy had met online and went out for their first date — a cup of tea — in August of 2019. They took things slowly, then gradually fell in love just before the pandemic hit.

Most people probably think of 2020 as the worst year in recent memory. For Mike and Nancy, now 69, the toughest times hit in 2021 and 2022.

Thankfully, Nancy had reservoirs of love and professional skills that proved essential to keep their relationship strong — and Mike alive — after he suffered his breakdown.

When Mike shook in bed, Nancy hugged him and offered comfort. She kept a diary to document his symptoms and behaviors. She connected with his siblings and his former wife, comparing notes about symptoms Mike had experienced 20 years ago during his previous breakdown.

When Mike’s former primary care doctor gave him medications that proved to be dangerous, Nancy pleaded for help and found new medical providers who would reconsider Mike’s diagnosis.

“The meds were terrible,” she said. “He was a zombie.  He was not getting better.”

Thanks to her clinical experience, Nancy knew Mike needed to see psychiatrists. When Mike was able to see Dr. Mike Allen at the Anschutz Medical Campus, everything changed, she said.

“Once we were connected with UCHealth, we were blessed. We were safe,” Nancy said.

Allen, who is a professor of psychiatry at the University of Colorado School of Medicine, gave Mike a proper diagnosis and connected him to Dr. Mandal.

“Literally, everything changed overnight,” Nancy said.

Mike credits Nancy’s determination and his medical team with rescuing him: “Nancy has made all the difference,” he said.

Nancy humbly gives credit to Mike’s medical team for helping him recover.

“They’re incredibly skilled professionals who made all the difference,” Nancy said.

Of Mike, she said: “He’s the kind of person you fight for. I love this man. He’s so kind, gentle and caring.”

The couple once again is venturing out on trips and to go hiking in their favorite places like Rocky Mountain National Park and Rocky Mountain Arsenal. Mike once again reads newspapers every day like he used to. He loves following sports, enjoys cooking and is doing puzzles again.

The couple’s back yard is an oasis where they love spending time watching birds and relaxing near the large koi pond Nancy built. She also has a stunningly beautiful Blue Fronted Amazon parrot that loves to show off and join in conversations.

Now that Mike has escaped from the darkness and hopelessness that gripped him for several months, the couple is enjoying simple pleasures.

Mike’s key message for others is quite simple: “ECT is not something to be afraid of. It’s a proven medical intervention and is life changing.”