Electroconvulsive therapy (ECT for short) is a treatment that involves sending an electric current through your brain. At the same time, this causes a brief surge of electrical activity within your brain (also known as a seizure). The aim is to relieve severe symptoms of some mental health problems.
The National Institute for Health and Care Excellence (NICE) recommends that doctors only use ECT as a treatment in certain situations.
This includes treating severe depression, if:
- You have a preference for ECT based on your experience of having it in the past
- You need urgent treatment, for example if your life is at risk because you’re not eating or drinking
- Lastly, other treatments haven’t helped, such as medication and talking therapies
The guidelines also recommend that doctors only use ECT as a short-term treatment if you have:
- Firstly, a severe or long-lasting episode of mania
- Catatonia, which is when you’re frozen in one position, or making repetitive or restless movements
- Lastly, repeated ECT for mania and catatonia is only recommended if you’ve previously responded well to the treatment. Or if all other treatment options have already been considered.
What Happens During the Electroconvulsive Therapy Procedure?
Before you receive the treatment, a doctor or nurse will place a needle into a vein in your arm (IV). That way, the medical team can easily give you the medications you need before and during the procedure.
Although you will be asleep during the treatment, the medical team will need to start preparing you for the treatment while you are still awake. The team will:
●Place sensors called electrodes on your head, so that they can measure the electrical activity in your brain. Therefore, to do this, they will use a device called an EEG, or “electroencephalogram.”
●Place electrodes on your chest, so that they can measure the electrical activity in your heart. Therefore, to do this, they will use a device called an ECG, or “electrocardiogram.”
●As well as wrap a blood pressure cuff around your arm, so that they can monitor your blood pressure during the procedure.
●Put a small sensor on one of your fingers called a “pulse oximeter,” which will allow them to measure the amount of oxygen in your blood. Being that, this will tell them if you are breathing normally.
●Give you oxygen through a mask or a tube that rests below your nose. Moreover, you will get oxygen throughout the whole procedure, until you wake up.
After connecting everything, the medical team will set the ECT device for your treatment. Next, a doctor or nurse will inject you with a medication (such as methohexital or Propofol) that will make you go to sleep for 5 to 10 minutes. When you are asleep, you will get another injection, of a muscle relaxant (succinylcholine). Given that, this will keep you from moving about during the treatment. The muscle relaxant may cause mild muscle soreness after the treatment, but this soreness will pass.
Once you’re completely relaxing your muscles and you are deeply asleep, your medical team will administer the electroconvulsive therapy treatment. Because you will be asleep, you will experience no pain during the treatment and will not feel the current or the seizure. Nonetheless, if you were watching the treatment instead of receiving it, you would see your toes wiggling or other parts of your body moving a little — but not much else.
What Happens After the Treatment?
When you wake up after treatment, you may feel confused. This is partially due to the anesthesia and partially due to the treatment. In most people, the confusion passes within an hour. You may also have a headache the day of the treatment. A pain reliever, if necessary, usually helps. In any event, other side effects, such as nausea, typically last only for a few hours.
Memory loss — You may have some memory loss until you complete all of your treatments. Important to realize, this memory loss should gradually reverse itself over the course of several weeks. However, you may never remember many things that happened to you shortly before, during, or soon after your course of treatment.
Meanwhile, to speed and improve recovery of your memory, use your brain. Read, ask questions, and watch continuing stories on TV. This is the best way for you to help your memory return.
Because of the short-lived side effects on your memory, it is important that you postpone any major decisions until a week or two after the ECT course. It is also important that you do not drive during your course of electroconvulsive therapy.
When will my depression lift? — Some people start to feel somewhat better after 2 to 4 treatments, but many do not get the full benefit of the treatment until later in the treatment course.
What are the Risks of ECT?
However, like any medical procedure, electroconvulsive therapy is has some risks. The treatment has been associated with temporary memory loss and temporary difficulty learning. Overall, some people have trouble remembering events that occurred in the weeks before the treatment or earlier. In most cases, memory problems improve within a couple of months. Given that, some patients may experience longer lasting problems, including permanent gaps in memory.
The risks of general anesthesia, which is needed for ECT, are similar to the risks when anesthesia is used for other procedures such as minor surgeries. In addition, the most common side effects of electroconvulsive therapy on the day of treatment include nausea, headache, fatigue, confusion, and slight memory loss, which may last minutes to hours.
These risks must be balanced with the consequences of ineffectively treated severe psychiatric disorders. Hence, for some patients, the risks of ECT may be less than those of ongoing treatment with medications. it can work more quickly than medications. Regardless, it can be especially useful if a patient is suicidal, is not responding to medications or cannot tolerate the side effects of medication.
Because of the concern about permanent memory loss and confusion related to ECT treatment, researchers recommend that the treatment only be used as a last resort.
Does Electroconvulsive Therapy Help With Anxiety?
Does ECT also help with chronic anxiety? Specifically, if the anxiety is a symptom of a depressive episode, then ECT can be very effective for the anxiety. If the anxiety is due to generalized anxiety disorder or panic disorder, then ECT is not very effective.
Who Is Not a Good Candidate for ECT?
The NICE guidelines don’t recommend electroconvulsive therapy for ongoing management of schizophrenia. Also, they also don’t recommend ECT as a routine treatment for milder depression.
However, children under the age of 11 cannot receive an ECT treatment. An effective out come from the ECT rarely happens for the ages between 11 and 18. If a doctor is recommending it, a formal, second opinion has to be received before it’s given.
In short, doctors should also carefully consider whether to recommend the procedure if you have a higher risk of negative effects. For example, if you are:
- Currently pregnant
- An older person
- Lastly, living with a cardiovascular condition (that affects your heart or blood vessels)
And doctors should consider the following before offering anyone ECT:
- Firstly, the risks of general anesthetic
- Other medical conditions you might have
- Possible adverse effects, including memory loss
- Lastly, the risks of not having treatment
Series of Treatments
In the United States, electroconvulsive therapy treatments are generally given two to three times weekly for three to four weeks — for a total of six to 12 treatments. Subsequently, some doctors use a newer technique called right unilateral ultra brief pulse electroconvulsive therapy that’s done daily on weekdays.
The number and type of treatments you’ll need depend on the severity of your symptoms and how rapidly they improve.
Thereafter, you can generally return to normal activities a few hours after the procedure. However, some people may be advised not to return to work, make important decisions, or drive until one to two weeks after the last ECT in a series, or for at least 24 hours after a single treatment during maintenance therapy. In general, resuming activities depends on when memory loss and confusion are resolved.
Results
Many people begin to notice an improvement in their symptoms after about six treatments with electroconvulsive therapy. Full improvement may take longer, though electroconvulsive therapy may not work for everyone. Response to antidepressant medications, in comparison, can take several weeks or more.
Consequently, no one knows for certain how ECT helps treat severe depression and other mental illnesses. What is known, though, is that many chemical aspects of brain function are changed during and after seizure activity. Thereupon, these chemical changes may build upon one another, somehow reducing symptoms of severe depression or other mental illnesses. That’s why the procedure is most effective in people who receive a full course of multiple treatments.
However, even after your symptoms improve, you’ll still need ongoing depression treatment to prevent a recurrence. Ongoing treatment may be ECT with less frequency, but more often, it includes antidepressants or other medications, or psychological counseling (psychotherapy).
Articles About Electroconvulsive Therapy
-Electroconvulsive therapy (ECT)
https://my.clevelandclinic.org/health/treatments/9302-ect-electroconvulsive-therapy
-Electroconvulsive therapy: Peeling back the mystery
-Does electroconvulsive therapy cause brain damage: An Update
Have a Good One,
Cindee Murphy, One Voice In The Vastness Of Emotions
“So what is it actually like? You go in, have your blood pressure taken, sign a form, lie down, go to sleep, wake up with a slight headache and go home. And often, you feel instantly better.”—Lucy Tallon about ECT in “What is having ECT like?
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