Electroconvulsive Therapy (ECT)

ECT not only has a higher success rate for severe depression, but it is also an effective form of treatment for schizophrenia accompanied by catatonia, mania, and manic depression

Recently, there has been an increase in the interest of ECT as it has become a safe option in the treatment of the illnesses mentioned above.  The public has been influenced by what they have seen on television and in movies such as, "One Flew Over the Cuckoo's Nest", whose associations with ECT start with the electric chair and move on to such treatments as harnessing the power from lightning bolts, and electric eels to perform primitive forms of ECT.  This makes for an uneasy conversation about the subject. Let's turn that misconception into the truth about ECT.

This is an ECT

This is first hand knowledge of how an ECT is performed.  The patient is sedated using a very short-acting barbiturate and a drug called succinycholine.  The succinycholine is used to temporarily paralyze the patient's muscles to keep them from contracting during the treatment which could damage the muscles or cause bone fractures.

The physician places an electrode just above the temple on the non-dominate side of the brain, and then places a second one in the middle of the forehead.  This form of ECT is called unilateral.  Another form of ECT called bilateral has one electrode placed just above both temples.  Once the patient is sedated, the process begins.  A very small amount of current is sent through the brain, which produces a seizure.  Since the patient is totally relaxed from the anesthesia, they sleep peacefully through the process while the seizure is being monitored by an electroencephalogram, and their heart rhythm is being monitored by an electrocardiogram

The actual electric current is only applied for about a second, during this time the patient is breathing pure oxygen through an oxygen mask.  The seizure caused by the ECT usually lasts from thirty seconds to a little longer than a minute. During the few seconds that follow the actual ECT current, the patient may experience a temporary drop in blood pressure.  This is often followed by a notable increase in heart rate, which may cause the blood pressure to rise.  Disturbances in heart rhythm are not unusual, and generally will subside without any complications. The patient usually takes roughly ten minutes to wake up after the treatment.  When the patient wakes up, they usually have a brief period of confusion, muscle stiffness, or headache.  These effects usually diminish after about thirty or forty minutes. 

If a patient has a history of high blood pressure or any other cardiovascular problems, they should tell the physician so they can have a consultation with a cardiologist before any treatment could be considered.

I am an ECT patient. I have had numerous ECT treatments; too many to count. When I was in a severely manic state and could not recover from medications, ECT treatments would rapidly bring me back to a stabilized mood. Also, if I was in a severely depressed state they would bring my mood back to stable.

This is a personal opinion. I am not a medical professional. For any patient who has undergone many medication changes and therapy to no avail, I would strongly encourage you to consider ECT.

It is particularly useful for people who suffer from psychotic depressions or intractable mania, people who cannot take antidepressants due to problems of health or lack of response and pregnant women who suffer from depression or mania. A patient who is very intent on suicide, and who would not wait 3 weeks for an antidepressant to work, would be a good candidate for ECT because it works more rapidly.