Often referred to as "shock therapy", the use of ECT for the treatment of depression has a terrible reputation because of years of misinformation about ECT in magazines, books, radio, television and film (notably in One Flew Over the Cuckoo's Nest where severe shock treatments which bear no resemblance to the shock treatments given today were used to punish people). Contrary to its widespread media image, ECT is both a safe and valuable treatment for severe depression and certain other types of mental illness. This is particularly true for people who are so depressed that the likelihood of suicide is extremely real and something must be done quickly to help prevent a needless loss.

Before it is given, people will be given a short-acting anesthetic together with a medication to relax the muscles. This combination reduces the severity of muscle contractions triggered when the electrical current is delivered to the brain through electrodes attached to usually one side of the upper forehead but sometimes both.

When the current goes through the electrodes, the person might respond with a mild twitch or slight tremor, or the toes may curl briefly but these are the only outward sides of the inner convulsions caused by the electrical current. The whole procedure lasts less than 60 seconds, and people usually remain asleep for up to 30 minutes after the treatment has been given. Most people require 6 to 10 sessions, given over a period of several weeks, for the depression to clear. But there is no pain during the procedure, and headache, which can occur after the procedure, is usually well managed with analgesics. Mood can improve following ECT in as little as a week - much faster than the 6 to 8 weeks it takes an antidepressant medication to achieve the same effects. Some disorientation and short-term memory loss may occur following ECT. Mostly, people just don't remember the treatment itself very well.

Sensationalized media reports about people losing large tracts of their memory following ECT are just that - sensationalized reports. If people do experience loss of memory, it tends to be minimal and memory comes back within days or months of the treatment. As is true for antidepressant medications, it's felt that the low electrical current used during ECT affects virtually all of the brain chemicals implicated in depression.

In fact, research has shown that the changes in brain chemistry which occur following ECT therapy are more or less identical to those produced by longer-term administration of antidepressant medications. Generally reserved for people who do not respond to any of the currently available antidepressants, or, for example, the elderly or pregnant women in whom the use of potent medications may not be desirable, ECT has a real place in the treatment of mood disorders today.

Properly used, this approach can make a dramatic difference in the ability of someone who is terribly depressed and in urgent need of treatment to begin to function normally. ECT is also effective in the treatment of acute mania.

Back to Treatment of Depression