By Stephanie Thomas

Sometimes people who suffer from debilitating mental health issues test out countless medications and spend hundreds of hours in talk therapy to no avail. Situations like these must feel hopeless, even dire.

If you or a loved one find yourself there today, we want to make sure you’re aware of another option: electroconvulsive therapy.

What Is Electroconvulsive Therapy?

Brain wireframe graphic

Electroconvulsive therapy, or ECT, works to combat severe mental health issues through brain stimulation.1

Doctors usually reserve this form of treatment for when medicine and talk therapy fail to make adequate improvements. Still, some 100,000 patients undergo ECT each year in the United States, with the vast majority finding relief.2, 3

While modern ECT is considered one of the safest and most effective options available, you may have a few questions about how it works.1

What Does an Electroconvulsive Therapy Session Look Like?

Researchers are currently trying to understand what happens inside the brain during and after ECT. For now, the answers remain a mystery.2

We do, however, know what happens on the surface of the brain. To get there, let’s walk through a typical ECT session:

First, you’ll take a muscle relaxer. Then an anesthesiologist will put you under general anesthesia. Once you’re asleep, the doctor attaches electrodes to specific areas of your head.

He’ll apply an electric current that travels through the electrodes to your brain. Paying careful attention, the doctor uses this electric current to bring about a medically induced seizure in the brain.1

While seizures are something people try to avoid outside of the doctor’s office, a Recovery Unscripted podcast interview with Rolling Hills’ Medical Director Dr. James Hart explains that ECT is completely controlled. Medication to block muscle movement is used, and the patient only experiences going to sleep and waking up less than five minutes later. 4

According to Dr. Hart, “We use anti-seizure or anticonvulsant medicines in psychiatry to treat mood disorders. With ECT, we cause the brain to have a seizure while you’re under anesthesia. Brains don’t like to have seizures, so they have their own mechanisms to stop a seizure from occurring. We think it’s inducing those mechanisms to stop the seizure that treats the underlying mood disorder. It does it in a way that’s more effective than any medication by itself … You’re inducing the brain to create its own natural medications, if you will.”4

The procedure is quick and purposeful. When you wake up, you may experience temporary confusion or memory loss. Thankfully, these feelings are usually short-lived.1

Experts call out one clue that may be the start of our understanding: medicine simply can’t hit specific brain circuits in the way that a brain stimulation treatment can.3 Just one month of repeated ECT has the power to produce a much happier, healthier patient.1, 3

Who Should Consider Electroconvulsive Therapy?

Maybe you’re wondering if ECT is right for you or your loved one. After all, ECT offers the possibility of a quick turnaround in moments of great mental distress — a worthy desire if ever there was one.

ECT is found to be one of the most effective treatments for patients with suicidal tendencies, severe, treatment-resistant depression and bipolar disorder, and even schizophrenia in early phases.3

The American Psychiatric Association helps us to identify more nuanced situations in which you may consider ECT by offering the following comprehensive list:

  • “When a need exists for rapid treatment response, such as in pregnancy
  • When a patient refuses food and that leads to nutritional deficiencies
  • When a patient’s depression is resistant to antidepressant therapy
  • When other medical ailments prevent the use of antidepressant medication
  • When the patient is in a catatonic stupor
  • When the depression is accompanied by psychotic features
  • When treating bipolar disorder, including both mania and depression
  • When treating mania
  • When treating patients who have a severe risk of suicide
  • When treating patients who have had a previous response to ECT
  • When treating patients with psychotic depression or psychotic mania
  • When treating patients with major depression
  • When treating schizophrenia”1

If you or your loved one exhibit any of the symptoms above, be sure to reach out to your doctor for more information about ECT. And preferably sooner than later. As Sarah Lisbandy, a director at the National Institute of Mental Health explains: “Depression kills, while ECT saves lives.”3

How Do Patients Feel After Electroconvulsive Therapy?

Lisanby illustrates the positive power of ECT with a story about one session she observed decades ago — long before the medical advancements of the treatment as we know it today.

Prior to being connected to the electrodes, the female patient Lisbany watched existed in body and necessary functions only. Lisbany says, “She was mute, had stopped eating, was just wasting away, and was going to die from her depression, it was so severe.” Soon after waking up from ECT, she talked. In Lisbany’s words: “A miracle.”3

One-off stories are encouraging, but statistics can help to boost confidence in medical procedures that feel unfamiliar and, thus, concerning.

First, a word of caution: some studies struggle to prove that ECT is beneficial. Some researchers insist that effectiveness has not been adequately proven past the first four weeks.2

And now, let’s see what others studies have to say about the hopefulness of ECT:

  • ECT has been shown to improve symptoms of severe depression by 80 percent.2
  • 98 percent of people who completed ECT say they would enter treatment again if depression returned.3
  • Improvements resulting from ECT can last for six months to one year without supplemental medication.3

If electroconvulsive therapy sounds like something that could help you or a loved one, it’s worth having a conversation with your doctor about this often misunderstood treatment. It could be the treatment that finally offers the hope and healing you’ve been seeking.


Sources:

1Electroconvulsive Therapy and Other Depression Treatments.” WebMD, February 8, 2017.

2Electroconvulsive Therapy (ECT).” Mental Health America, Accessed February 14, 2018.

3 Hurley, Dan. “The Return of Electroshock Therapy.” The Atlantic, December 2015.

4Responding to Psychiatric Crises with James Hart.Recovery Unscripted, Episode 30. Podcast. July 26, 2017.