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Myths and Facts About Electroshock Therapy

Myths and Facts About Electroshock Therapy

Yes, ECT is still used—and it’s saving lives.

You might have heard of electroconvulsive therapy (ECT), commonly known as electroshock therapy. If so, you probably have preconceived notions about what it involves. But this treatment has changed dramatically over the years; it’s now safer, has far fewer side effects and is helping to save people’s lives.

What is ECT? It’s a procedure typically used to treat severe mental illness when other treatments haven’t been effective. During ECT, a small electrical current is passed through a person’s brain while they’re under general anesthesia. The current causes a controlled seizure in the brain.

We are not exactly sure how this helps, but we believe it improves their brain chemistry and helps to ease their symptoms, says James Saccomando, MD, a psychiatrist from West Valley Medical Center in Boise, Idaho.

“With ECT, we use a tiny bit of electricity, much smaller than what comes out of a wall socket,” says Dr. Saccomando. “By doing that a number of times over about three or four weeks, people's moods get amazingly better. In fact, ECT is considered the best treatment for severe depression because it has such a high chance of working, and it's very safe.”

Despite this, many misconceptions about ECT still remain. Dr. Saccomando weighs in on some of the top myths surrounding this procedure and explains what to expect if you need ECT.

Myth: ECT is rarely used.

Fact: ECT is administered in psychiatric hospitals and outpatient clinics across the country. “More than 100,000 treatments of ECT are done each year in the United States. This is probably much less than it should be due to the negative stigma attached to this procedure,” says Saccomando.

People may require this procedure for a wide range of conditions, including:

  • Severe depression
  • Schizophrenia
  • Mania, or a state of intense hyperactivity
  • Catatonia, or a state in which a person is awake, but mentally absent or unresponsive. During those times, the person may even be unable to eat or drink.

Since it can be pricey and, like any medical procedure, it carries risks, it’s typically considered after other options have already been exhausted. But in severe cases, it’s often able to provide relief when medications and other therapies have failed.

“Incidentally, ECT is the preferred treatment for pregnant women with depression since the mother’s seizure will not hurt the baby,” says Saccomando. “Also, older people often experience the best results, making this the gold standard treatment for depression in the geriatric population.”

It’s sometimes used in emergency situations when other treatments aren’t possible, as well. For example, if someone is aggressively trying to complete a suicide and there’s no time to wait for antidepressants to start working, ECT may be necessary. If you or someone you know is considering suicide, call the National Suicide Prevention Lifeline at 1 (800) 273-8255.

Myth: ECT is outdated and inhumane. 

Fact: The procedure’s changed dramatically over the years; new techniques are far more safe and effective.

“We consider it to be safer than long-term medications because the drugs we use for ECT only stay in your body for about half an hour or so,” says Saccomando. “On the other hand, psychiatric medications are always in your system since you take them every day.”

You might have wondered about the serious risks associated with old versions of ECT, such as injuries from uncontrolled seizures, but those are no longer side effects today.

Instead, people might experience:

  • Mild headaches or jaw pain
  • Muscle aches
  • Anesthesia side effects like weakness and nausea
  • Short-term confusion

Mild memory loss—usually involving the time surrounding ECT—is also a possible side effect. For many, it improves within thirty minutes to an hour of their procedure. “Typically, within two weeks of finishing ECT, your memory is completely back to normal,” says Saccomando. “But looking back on the time of ECT will probably always be a bit fuzzy for you.”

More research is needed to confirm its long-term effects and some experts raise concern over the possibility of relapse. Additionally, the benefits might not outweigh the risk in every case. For example, ECT might not be appropriate for someone who is already seriously ill, especially if they have a heart condition.

Myth: You’re awake during ECT.

Fact: You’ll undergo general anesthesia.

You’ll receive sedation from general anesthesia, as well as a muscle relaxant during ECT. That keeps your body still during the procedure, protecting you from injuries. Once you’re asleep, the whole thing takes about 5 to 10 minutes. A nurse will place small electrodes, or sticker pads that transmit electricity, on one or both sides of your head.

A doctor will then send a small electrical current through the electrodes. That causes a controlled seizure that lasts less than about one minute. Doctors track this activity on a screen using an electroencephalogram, or EEG machine, which detects brain waves. You’ll be monitored closely the entire time to make sure your heart, brain and vital signs stay safe.

Because you’ll be recovering from general anesthesia, and because mild memory loss is a possible side effect, you should not drive a car during ECT or for two weeks after ECT is complete.

“You’ll be somewhat impaired with memory and thinking afterwards, so we always recommend that you have a friend take you home,” says Saccomando. “You shouldn't be buying a house, taking a new job, signing contracts or getting married between treatments either because your thinking isn't quite there yet and you might make mistakes.”

Myth: You’ll be cured after one session.

Fact: Most people require multiple sessions or routine ECT to relieve their symptoms. 

Your diagnosis and its severity will determine the number of times you need ECT. Often, it’s given about two to three times per week, for about three to four weeks.

Your symptoms should improve slightly after each session, and many people start to feel an improvement after about six sessions (two weeks). Even if you experience significant improvement, you’ll still need to continue with routine treatments like talk therapy to help control your symptoms over time.  

Studies conflict on exactly how long the positive effects of ECT last. Many people require routine or occasional ECT after their initial treatment series, especially when no medication seems to work. But there’s about a 70 to 90 percent chance that ECT will help somebody with depression improve.

“People are always very anxious when they get ECT for the first time,” says Saccomando. “But once they've done it a few times, they realize it’s nothing to really be worried about. Then they get enthusiastic because they start seeing the results.”

Learn more about depression treatment options and find a psychiatrist in your area. 

Read more from Dr. Saccomando.

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