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What is Electro-Convulsive Therapy and How Does it Treat Depression?

Updated on January 3, 2014
This picture shows signals going to the brain.
This picture shows signals going to the brain. | Source

ECT, or electro-convulsive therapy, is the most successful treatment of severe depression. While some people may prefer different methods of therapy, like prescription drugs or herbal medicine, ECT is proved to help more than any other treatment.

ECT is particularly useful for those who suffer from the following disorders:

  • mania
  • psychotic depression
  • suicidal tendencies

It is also good for those who may have allergic reactions to antidepressants and women who are pregnant and cannot take many medications. The ideal patient for this kind of therapy is someone who is intent on suicide and would not want to wait a few weeks for the antidepressant to kick in. Suicide is extremely rare after electro-convulsive therapy.

How does ECT work?

So, how does this treatment work?

  1. About three times a week, the patient is put to sleep for a brief period of time so that the drug succinylcholine, a muscle relaxant, can be administered to them.
  2. Then, an electrode is placed above the temple on the side of the brain that is NOT dominant, and there is one placed on the middle of the forehead.
  3. A small electrical current passes through the brain, which produces a small seizure that the patient cannot feel. Since the muscles are relaxed, the body does not react, but the brain’s response is monitored as well as the heart rhythm.
  4. The seizure usually lasts from thirty seconds to one minute, and the patient wakes up about ten to fifteen minutes later.

This picture shows how a patient is under anesthesia and the muscles are relaxed. The electrodes connect to a machine, where the brain waves can be monitored and the heart rate can be watched.
This picture shows how a patient is under anesthesia and the muscles are relaxed. The electrodes connect to a machine, where the brain waves can be monitored and the heart rate can be watched. | Source
This woman holds her head in the temple area to try to rid herself of her headache.
This woman holds her head in the temple area to try to rid herself of her headache. | Source

What are the Immediate Symptoms after the Treatment?

Common symptoms after the treatment include:

- headaches

- confusion

- muscle stiffness

- weakness

These symptoms usually go away within twenty minutes to an hour and they are not life-threatening or immobilizing. Blood pressure may also drop and heart rate may increase, but both should return to normal levels within a short period of time. People with heart problems and/or high blood pressure should talk to a doctor before having ECT done. There are usually between 12 and 15 treatments before therapy is complete.

This is one of the first pictures ever taken of electro-convulsive therapy.
This is one of the first pictures ever taken of electro-convulsive therapy. | Source

What is the History of ECT?

Since the previous treatments of mental diseases consisted of being locked away in mental asylums, doctors developed ECT to combat mental diseases more efficiently. The first time electroconvulsive shock therapy was discovered was in 1937 in Rome, by Ugo Cerletti and Lucio Bini. Cerletti knew that an electric shock across the head produced convulsions because he was an epileptic specialist and he had done previous experiments on animals, such as dogs. Though that method of experimentation would probably be considered inhumane now, it helped him with the idea of using electro convulsive therapy to treat humans and the discovery of its treatment of mental disorders.

Why is ECT Considered Controversial?

In some cases, electroconvulsive therapy can cause brain damage to those that undergo it. While it is effective in the treatment of severe depression and mania, it can cause memory loss and can put a strain on the heart and blood vessels. Most evidence suggests that modern ECT does not cause brain damage, but there are still safety risks that should be taken into consideration before going through with treatment.

There are ethical issues, like whether it is morally “right” to put people under and shock their brain or whether there are more humane methods to fix depression. There are some cases where the procedure was not discussed with the patient beforehand, but nowadays ECT is a fairly safe and effective treatment, sometimes even more safe than prescription drugs or other similar medications.

ECT is explained in this 3 minute video.

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