Electroconvulsive Therapy (ECT)

Most people know electroconvulsive therapy as 'shock therapy'. It is usually a last resort for patients with severe forms of major depression that have been unresponsive to other treatments.

It has been very effective for those with severe melancholic depression or delusional depression, which affects a small percentage of people with major depression. It is sometimes used for patients who are suicidal because the results are quicker from ECT than medication. Electroconvulsive therapy is not an effective treatment for mild depression (dysthymia).

It is a very controversial treatment; there are those who swear it saved their lives and those who claim they suffered grave harm as a result of ECT including permanent deficits in memory and mental functioning.

The controversy surrounding ECT may have as much to do with unpleasant images of people going into induced seizures as the potential for negative side effects such as impairment of memory and cognitive functioning.

An anesthetic and muscle relaxant is given to the patient before a seizure is induced with an electric current conducted through electrodes attached to the scalp. Patients have no memory of the treatment. The treatment is administered several times over about a month. Memory is usually impaired during the course of the treatment and often for a short while after the treatment has ended. There is the potential for permanent memory impairment. The risk increases if the treatment is improperly administered.

Recently ECT has made a bit of a ‘come-back’, after years of controversy and a history of abuse. If the person is healthy, and a qualified staff and anesthesiologist do the treatment, it is considered quite safe.

However, potential for mistakes caused by human error in administering the ECT is frightening. There have been horror stories about people receiving too high a current and being burned or suffering from severe memory loss and confusion. Of course, people undergoing surgery place their lives in the hands of the anesthesiologist and surgeon – the vast majority of which are competent.

Anyone considering ECT should make sure the staff is experienced and has a good track record. Though the response to ECT may be quicker than the response to other treatments, there is still a high chance of depression recurring if not followed with other treatments such as antidepressant medications and/or psychotherapy.

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