ECT is a safe, efficient, and sometimes life saving therapy used to treat specific mental health conditions. Although it’s controversial, this was very much rooted in the past. ECT is much safer today, and is provided in a highly controlled setting for the best possible outcome with the fewest possible risks.
Electroconvulsive therapy (ECT) is a procedure to treat more severe psychiatric conditions. It's carried out under general anaesthesia, where small electric currents are passed through the brain. ECT is often effective in patients when other treatments have not been successful. However the full course of treatment should be completed. It should be noted that ECT may not work for everyone.
ECT treatments are practised in several countries across the world, but it is not common, only around 1 - 5 people in 10 000 are treated with ECT every year. Treatment consists of about 6 - 8 sessions. During an ECT session, a small dose of a well controlled electric current is administered near the forehead to stimulate the brain cells. This produces convulsions (small and controlled seizures) for just a few seconds. The procedure is done under general anesthesia, so patients are unaware of the passage of the electrical current or the seizure, and they feel nothing. The whole procedure lasts a few minutes. After about 15 to 20 minutes, the patient regains consciousness. ECT is administered by a specialist team consisting of a psychiatrist, an anaesthetist, and nursing staff. Patients are monitored closely during the procedure. Consent for an ECT can only be provided by you as the patient and must be provided in writing. It can be withdrawn at any time.
It is believed that ECT causes certain chemical changes in the brain, leading to the development of new connections across different nerve cells. Scientists have found that following ECT, there are changes in the levels of neurotransmitters in the brain. It's thought that these may be responsible for improvements seen with ECT. Scientific research into ECT is continuing to determine exactly why this therapy can be so effective where other treatments fail.
If a patient is suffering from a severe mental disorder like depression, schizophrenia, or mania, doctors may consider ECT if other treatments have not been effective. They will take into account safety, the patient's preferences, their response (or lack thereof) to psychiatric medications, and whether the person needs fast relief from debilitating psychiatric conditions and symptoms.
ECT may be considered in the following circumstances:
If a patient's psychiatric condition – particularly depression – is severe and there is a high risk of suicide.
If a patient's physical health is jeopardised as a result of the psychiatric condition, for example refusing food or fluids.
When patients are highly excited or agitated, endangering their own life or the safety of others.
When medications are ineffective in relieving the symptoms of the psychiatric condition, or where medications are causing severe side-effects and cannot be continued.
ECT is a safe procedure for pregnant and nursing women when proper precautions are taken. It can often be the preferred treatment where the psychiatric condition needs to be treated urgently, as many psychiatric medications are not safe for use during pregnancy. The effect of ECT is not permanent. You will need medication to maintain any improvement achieved by ECT and may require more sessions of ECT depending on your specific situation.
ECT can be quite a controversial treatment, mostly due to how it was administered in the past. There are a number of myths circulating about the treatment, so it's important to separate the myths from the facts:
ECT causes memory loss.
If someone is admitted to a mental health facility they will be given ECT without their knowledge or consent.
ECT is painful.
ECT causes brain damage and may reduce intelligence or change someone’s personality.
ECT treatment is a punishment.
If ECT has been suggested by your doctor, it means that other treatments are not working and your condition is hopeless.
Temporary forgetfulness is a side effect and is largely mild, limited to recent events and reversible. Your memory will remain intact after an ECT course is completed.
ECT is only given after your doctor has discussed the treatment with you, and only if you provide written consent for the procedure. You can withdraw your consent at any time. ECT is performed under anesthesia – you do not feel the electric shock or any pain.
ECT does not cause brain damage. It may cause temporary memory lapses of events around the course of the ECT. It also has no effect on personality or intelligence.
ECT is not a punishment. It is a safe treatment, administered by professionals to treat certain mental health conditions.
ECT is generally suggested by doctors as the best option for you at the time. If you do not wish to receive an ECT, your doctor will suggest the next best option.
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