Electroshock Therapy

The most common treatments of depression are antidepressants and psychotherapy but there are other forms of treatment. One of them is ECT, (an abbreviation for electroconvulsive therapy), which is also called electroshock therapy. Despite all the rumours, ECT is an effective, quick, and gentle treatment of depression. Electroshock therapy can sound like an old-fashioned and dangerous treatment but the truth is that ECT is a safe form of treatment. ECT is the fastest working and most effective treatment of depression. The treatment can be used on both the elderly and on people who are suffering from heart disease or are otherwise frail.

Anesthesia

You are fully anesthetized, and you are then given a muscle relaxing injection. A convulsive fit is induced by giving a weak electric shock over both temporal regions or over the right temporal region and the crown of your head. A very small part of the current from the electric shock reaches the brain. The electric current activates the nerve cells, and if they are activated sufficiently, it triggers a convulsive fit. The convulsive fit is a rhythmic, electric activity in the nerve cells which lasts for 25-60 seconds. As you are anesthetized and completely relaxed, only small contractions in your muscles are noticeable. The exact explanation on how ECT works in the treatment of depression has not yet been found but there are many hypotheses about its effectiveness. After the treatment, you rest for a short period of time while your doctor makes sure that you are feeling well. After a few hours you are on your feet again.

It takes place in hospital

In most places you receive ECT treatment three times a week. The number of treatments required often ranges between six and twelve but sometimes it is necessary to give more ECT treatments. It very much depends on the individual. The ECT treatment always takes place in a hospital, often in a psychiatric ward. In most cases, you would be admitted for one day. It can happen that you receive your treatment on an out-patient basis and you go home on the same day. A psychiatrist will give you the treatment. An anesthesiologist will give you the anesthetic.

Severe depression

If you are suffering from severe depression with psychotic symptoms, ECT may be recommended. It is so painful and sometimes dangerous to be suffering from severe depression that this treatment is recommended even though you are nervous about ECT. Most of those who have received ECT would like to receive ECT again if they develop another depression. If your depression prevents you from taking in enough food and water for your survival or if it causes you to have serious suicide thoughts, ECT is highly recommended. ECT is also offered if your antidepressant medicine is not effective.

Compulsion

In rare cases, compulsory ECT treatment is employed. This is only considered an option in severe, life-threatening depressions, which cannot be treated in any other way.

Some people with depression can feel such low self-esteem that they believe that the depression is a rightly deserved punishment. They therefore do not believe that the depression should be treated. Some patients can get so bewildered and capricious that they cannot make a decision about receiving ECT treatment. If ECT has to be given compulsorily, you need to have a relative who is going to sign the consent for the procedure.

Effective

ECT is the fastest working and most effective treatment of depression. Studies show that between 70 and 90% of patients become well (with regard to the actual depressive episode). The corresponding figures for patients who are treated with medicine range between 50 and 70%. The effect of ECT sets in after one to two weeks while the effect of a medicinal treatment sets in after two to four weeks. Approximately 50% of those who have improved after the ECT treatment unfortunately have a relapse within 6 months. If ECT and preventive antidepressants are used together, the frequency of relapses is reduced.

ECT is therefore not a curative treatment. Follow up treatment is necessary to monitor your progress.

Adverse effects

ECT is safe but a number of patients do experience reduced short-term memory after the treatment. Some do not have any adverse effects at all but some can have difficulties remembering events from the time during and around the ECT treatment. For most, the memory function returns to normal again after a few weeks. A few can have problems for a few months but there is no scientific basis for permanent memory problems. Very few have experienced permanent memory problems. But whether that was caused by the ECT treatment is very uncertain. Some patients can be confused immediately after the treatment. This confusion is short-term and completely temporary. It disappears typically within a few hours.