Electroconvulsive Therapy (ECT)
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Electroconvulsive therapy (ECT) involves brief electrical stimulation of the brain. Often, electroconvulsive therapy is used to treat severe psychiatric disorders when other treatment options have not been successful for patients. Medical treatment has been proven to successfully treat symptoms of a number of severe mental illnesses including major depressive disorder, severe psychosis, catatonia, suicidality, and schizophrenia. Electroconvulsive therapy has also been used to treat other conditions such as neuroleptic malignant syndrome.
The discussion of mental health treatment may often be centered around psychotherapy and medication. While these treatment methods can be effective for many people, others may find that they don’t impact their symptoms as hoped.
Therefore, becoming aware of other treatments that are available, such as brain stimulation and electroconvulsive treatment, may be helpful. One such treatment is called electroconvulsive therapy (ECT). Although somewhat controversial, there may be benefits to this practice.
ECT therapy for depression and other psychiatric conditions
Electroconvulsive therapy is a medical procedure that involves administering electrical pulses to the brain while an individual is under a short-acting anesthetic or a muscle relaxant. It may simulate seizure activity in the brain.
This medical procedure may cause changes in brain chemistry and brain function that can significantly alleviate symptoms associated with major depression and other severe mental health conditions.
How does electroconvulsive therapy (ECT) work?
Researchers are still unsure how electroconvulsive therapy improves symptoms in individuals with severe mental illness. Several theories are that the electrical activities produced in ECT might trigger new brain cells to develop, shift the activity of current brain cells at the synapses, and increase neurotransmitters such as dopamine or serotonin.
Individuals typically undergo between 6-12 sessions of electroconvulsive treatment, depending on how their symptoms respond to the multiple treatments.
Is electroconvulsive therapy effective for mental health conditions?
In randomized controlled trials, ECT has been proven to be an effective treatment method for individuals with severe mental illness. According to extensive research on ECT efficacy, ECT significantly reduces symptoms of depression for about 80% of individuals. ECT early treatments may also be considered for people with bipolar disorder who are not responding to other forms of ongoing treatment.
Studies have shown that as long as electroconvulsive therapy is provided safely, it can provide sustained recovery with minimal to no side effects. Researchers recommend maintenance treatment in order to sustain the improvements provided by the initial acute electroconvulsive therapy.
Types of ECT treatment
There are two types of treatment:
- Unilateral ECT may be right unilateral ECT or left unilateral ECT. It occurs when the electric current only passes through one side of the brain,
- Bilateral ECT is when the electric current passes through both sides of your brain. It may be high or moderate dose bilateral ECT.
Benefits and risks of ECT
While electroconvulsive treatment may be considered generally safe, it also comes with several significant risks. This is why individuals who take part in this form of treatment are constantly monitored using a blood pressure cuff as well as other standard monitoring techniques to keep an eye on their vital signs. If you decide to partake in this treatment, you may first want to read up on the side effects and potential concerns published by research journals.
One concern is that some patients undergoing electroconvulsive treatment are started on an electrical current that exceeds their seizure threshold, leading to long-term side effects.
While short-term memory loss is sometimes a side effect of ECT, some patients may experience severe memory loss that lasts for longer periods of time. Cardiovascular complications and cognitive impairment can also occur a small fraction of the time. Elderly patients are at an increased risk of experiencing complications.
Side effects of ECT
Following an ECT procedure, an individual might experience side effects from general anesthesia, including nausea, headache, and confusion. They may also experience memory loss or amnesia, according to information from clinical trials.
Short-term memory loss
One of the medical complications that can occur from electroconvulsive treatment is short-term temporary memory loss in some individuals who have trouble remembering events from the weeks or months leading up to the ECT treatment. Many individuals find that their memory problems subside after a few months, while others may experience more long-term challenges with ECT.
Consider weighing these potential risks with the benefits of ECT treatments. Individuals who don’t experience symptom relief from medications or cannot tolerate medication may want to consider the treatment.
Improvements for treatment-resistant mental health conditions
Since ECT and maintenance therapy in a controlled setting has been proven highly effective against treatment-resistant depression, it may be worth trying for those resistant to medications or therapy. ECT treatment may improve symptoms faster than medications, which could take several weeks to work. Also, ECT’s effectiveness is recognized by the American Psychiatric Association and the APA task force. The National Institute of Mental Health also discusses the efficacy of electroconvulsive treatment for severe mental health disorders.
You may also find that the treatment aids in other distressing symptoms, such as anxiety, hallucinations, or mania. Talk to your primary care physician and mental health care team provider before deciding. They may help you determine whether the treatment will work for you.
Practitioners in psychiatry typically prescribe ECT therapy for cases that don’t respond to firstline treatments
Typically, electroconvulsive treatment is considered after an individual has not seen a substantial improvement in their symptoms from medication or therapy. Therefore, these methods may be recommended first before considering ECT. It may also be used in severe scenarios where a patient requires a rapid treatment response, such as thoughts of suicide.
If you continue to experience severe depression or psychosis after trying other treatment methods, you may want to find a doctor who you can consult with about electroconvulsive treatment.
Alternative psychiatry options to ECT treatments
Patients with mental illnesses may consider other brain stimulation treatments if they don’t think that electroconvulsive treatment is the right medical treatment for their needs.
Vagus nerve stimulation
Vagus nerve stimulation uses a device to send electrical impulses to the vagus nerve. The device may be surgically implanted under the skin or held against the skin. Vagus nerve stimulation may be used to treat patients who have bipolar disorder or Alzheimer’s disease. It’s also been shown to successfully treat depressed patients who haven’t responded to other types of treatment such as therapy or antidepressant medication.
Transcranial magnetic stimulation (TMS)
During transcranial magnetic stimulation, an electromagnetic coil is placed on a person’s scalp close to their forehead. The coils send short, magnetic pulses into the area of the brain that controls a person’s mood. TMS can be used to treat OCD, PTSD, severe major depression, substance use disorder, and other mental illnesses.
Therapy as an alternative to ECT treatment
Suppose you’re experiencing depression and want support but don’t feel comfortable with the risks of electroconvulsive treatment. In that case, a mental health counselor may offer resources, personal attention, and support to benefit you during this time. If you’re uncomfortable visiting a therapist in person or find it difficult to leave home, online therapy may be a suitable choice.
Online therapy has been found to be as effective as in-person therapy, and a University of Zurich study found that it can be more effective in the long term. The study showed that depression could no longer be detected in 53% of online therapy users by the end of treatment (compared to 50% of in-person therapy users). At three months post-treatment, this number increased to 57% for those who had used online therapy (and decreased to 42% for in-person treatment).
Efficacy of these treatments for severe depression and other psychiatric conditions
Another review of multiple studies about online CBT found that the treatment significantly reduced anxiety and depression symptoms and was influential in treating PTSD, panic disorder, and specific phobias. If you feel more comfortable telling your symptoms and experiences in person, you might consider signing up for an online therapy platform such as BetterHelp.
Takeaway
Electroconvulsive therapy (ECT) may be effective in treating severe mental illness. However, because it can come with considerable side effects, it may be recommended only for those who have tried other treatment options and didn’t see improvement after a long period.
Online therapy is an effective option for treating depression for many people. Part of this success is due to the virtual nature of online therapy. Studies show that most individuals feel most comfortable at home.
If you’d like to try therapy as a treatment option for depression or other mental and general health concerns, consider taking the first step by reaching out to a counselor.
What mental illness does electroconvulsive therapy (ECT) treat?
ECT is a medical treatment mainly used to treat those who live with a serious mental illness such as bipolar disorder or major depression. In most cases, ECT brain stimulation is only used when a person has not responded to previous treatment such as therapy or antidepressant medication. Electroconvulsive treatment is administered while a patient is under anesthesia and involves brief electrical pulses that stimulate the brain. This has benefited mental illnesses such as bipolar disorder, schizophrenia, and major depression, and electroconvulsive therapy is generally accepted as a beneficial treatment for these conditions. If you believe this form of treatment may work for your condition and no other treatment options have had success, reach out to a doctor and look into your options for electroconvulsive therapy.
What is the success rate of ECT for depression and other mental health conditions?
Electroconvulsive treatment is a highly effective form of therapy that has helped as many as 80-85 percent of patients who experience it. For many, the effects and symptoms of major depression or severe depression disappear for many months after the treatment. This form of brain stimulation is still being researched. Still, it’s widely believed to be effective when reducing the risk of major symptoms from severe depression or bipolar disorder. If you believe this therapy may be beneficial for symptoms of bipolar, depression, or other mood disorders you are experiencing, it can be important to focus on trying to find a psychiatrist first. However, note that ECT is a form of treatment that is typically only used when all other first-line treatment methods have failed, due to the nature of its side effects.
What are the negative side effects of ECT?
ECT effectively treats the symptoms of various mental health conditions, but there have been some reported side effects from this treatment. Symptoms such as memory problems, confusion, physical side effects, nausea, and low blood pressure have been reported in the past but are not considered common. Find a doctor and speak with them about the risks of bilateral ECT or unilateral ECT (which involves unilateral electrode placement rather than bilateral) if you wish to understand the potential side effects. For some people, other approaches with milder side effects such as transcranial magnetic stimulation (TMS) may be considered.
How long is an ECT session?
Most electroconvulsive treatment sessions can be expected to last around one hour. A patient is in the treatment room for around 15-20 minutes and then spends the rest in a monitored recovery room. Still, given the nature of ECT treatment through brain stimulation, a doctor may request you to stay for a little more time to ensure your present health.
Can ECT change your personality?
ECT will not change a person’s personality and is not used to treat personality disorders. After undergoing ECT, one may come in for a medical examination by a doctor a few times a week shortly after, but this is to ensure there are no short-term memory problems or other side effects.
How does electroconvulsive therapy work?
ECT works by sending an electrical current to the brain, often for only a few seconds. Electroconvulsive therapy devices (ECT devices) use a very small current, and the electrode pads placed on your head can be either unilateral or bilateral. ECT is typically considered for severe clinical depression and bipolar disorder. Beyond these indications, ECT may also be used for other types of psychiatric illness and mental disorders such as treatment-resistant schizophrenia and suicidality. ECT may be administered in psychiatric hospitals or other settings.
What is the most serious side effect of electroconvulsive therapy?
One of the most serious side effects of electroconvulsive therapy is temporary memory loss or retrograde amnesia, which involves loss of memory from before the treatment. Permanent memory loss is not common, but it can occur. Given these risks, it is important for medical professionals to conduct a thorough psychiatric assessment, give detailed information about the procedure, and obtain informed consent before starting treatment. One study found that only about half of patients were satisfied with the amount of information they received about ECT before beginning treatment.
How does ECT help depression?
ECT is used to treat depression by sending a brief electrical stimulus to the brain. Extensive research has demonstrated the effectiveness of ECT for depression. For instance, a meta-analytic review of randomized controlled trials available through American Psychiatric Association Publishing found ECT to be an effective therapeutic tool for depression.
What happens after ECT treatment?
After the procedure, you will be monitored by trained health professionals as you wake up from anesthesia, and then you will likely spend time in a monitored recovery room. After this, you may have follow-up appointments, and in some cases, maintenance ECT may be considered.
Is electroconvulsive therapy safe?
ECT has some risks and possible negative side effects, such as memory problems, nausea, and confusion, but it is generally considered safe. Patients do not typically find ECT painful as it is typically done under anesthesia and muscle relaxants. However, for some patients with existing cardiac disease, ECT could increase the risk of cardiac complications, so it is important to talk with your doctor about your medical history. It may also pose higher risks for individuals with elevated intracranial pressure.
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