A Shocking Solution: Why Electroconvulsive Therapy Can Help With Depression

Hollywood scriptwriters like to use “shock therapy” to strike a horror note in films about mental hospitals. The scene usually includes a terrified patient, a vindictive doctor or nurse, and an underlying agreement between the viewer and the scriptwriter that using electricity to treat mental illness is a barbaric practice akin to torture that we no longer abide in the developed world. ​

Electroconvulsive Therapy (ECT) may play the villain in Hollywood films, but in modern life it’s helping people who suffer from depression and other conditions when medications and talk therapy fail. 

Mayo Clinic says, “Much of the stigma attached to ECT is based on early treatments in which high doses of electricity were administered without anesthesia, leading to memory loss, fractured bones and other serious side effects. ECT is much safer today and is given to people while they’re under general anesthesia.”

How ECT Works

“It is believed that the seizure in the brain caused by ECT influences many chemicals in the brain,” reports Familydoctor.org. “These chemicals, called neurotransmitters, deliver messages from one brain cell to another. ECT’s effects on these chemicals can make the brain cells work better. A person’s mood will improve when his or her brain cells and chemical messengers work better.”

ECT is usually administered under general anesthesia, either in the hospital or as an outpatient treatment. Treatments are typically scheduled three times a week, and two to four weeks of treatment is the usual course to relieve depression (though as many as 20 treatments are sometimes given). 

The electric shock is very brief, lasting 1-2 seconds, and causes a mild seizure. The effects of the seizure are controlled by the anesthesia and by muscle relaxers, which are given intravenously prior to the treatment. The patient wakes up 5-10 minutes after the treatment and rests in a recovery room until the anesthesia has worn off.

When Is ECT Used?

ECT is an option in cases of severe depression that don’t respond to medication. It’s also used in cases where medication can’t be tolerated, such as pregnancy. Psychiatrists usually choose ECT for specific situations, like suicidal or catatonic depression, aggressive dementia, or severe mania. 

Side Effects of ECT

Muscle aches, upset stomach, and headache are the most common side effects of ECT. Short term memory problems, especially with memories just before or after the treatment, are possible. Researchers are finding that memory problems are more likely to occur with traditional “bilateral ECT,” where electrodes are placed on both sides of the head. Many psychiatrists prefer unilateral ECT, with electrodes placed only on the right side, are  preferred for this reason. Memory loss also seems to be reduced by administering the electricity in several short bursts rather than a single constant dose.

Is It Effective?

The use of ECT is on the rise, especially among female patients over the age of 65. The treatment is still controversial, with many researchers recommending it only as a last resort. According to Mental Health America, “In some cases, the numbers are extremely favorable, citing 80 percent improvement in severely depressed patients, after ECT.  However, other studies indicate that the relapse is high, even for patients who take medication after ECT.  Some researchers insist that no study proves that ECT is effective for more than four weeks.”

Electroconvulsive Therapy is not the monster Hollywood makes it out to be, but it’s not a proven panacea, either. Today’s ECT is much gentler than its older relatives, and is proven to offer at least short-term relief for treatment-resistant depression in a remarkably high percentage of cases. If your doctor recommends this course of treatment for you, be sure to familiarize yourself with the modern realities of the procedure and don’t be put off by its poor public image.