Contrary to its negative image, electroconvulsive therapy or ECT is still being used in the treatment of major depression. Actually, it is the best option if all else fails, i.e. if medications were not able to help in the symptoms of the patient.
“Psychiatry now generally accepts that electroconvulsive therapy is effective and necessary in adults with serious depression and other illnesses who do not respond to medication. It may even be preferable to medication in some cases because it works so rapidly and is safe,” wrote Edward Shorter PhD.
ECT has been around since 1950’s. The methods have been modified now in order to make it more humane compared to the practice of early days. That’s correct. Nobody really wants to see their loved ones get “electrocuted”. This also renders the patient traumatized and would not continue for another session. This article will discuss how ECT works and help people with depression.
“ECT was once considered a barbaric form of therapy,” said Sal Raichbach, PsyD, LCSW. “Pictures illustrating patients strapped to a chair, with a device placed over their head and a wooden stick in their mouth to avoid biting their tongue is what many remember about ECT. Thankfully, real electroconvulsive therapy looks a lot different.”
The neurophysiological theory on why depression occurs is because of the imbalance in neurochemicals in the brain. The neurochemicals serotonin and dopamine are believed to be decreased, thus contributing to the clinical manifestations of depression.
This understanding leads the mental health professional to conduct ECT to help regulate the neurochemicals. By introducing a low voltage of electric current to the brain, the brain cells are somehow alerted or wakened up to produce more of these neurochemicals correcting depression and other mental health disorders.
Indications For ECT
ECT is not only used for major depression alone. Other mental health states can benefit from ECT like catatonic schizophrenia or stupor, when a person refuses to eat that can lead to nutritional deficiencies, bipolar disorders (mania and depression), manic disorders, if the person is at high risk of suicide, and with the previous history of ECT in their medical treatment plan.
After a thorough explanation from the psychiatrist, informed consent to proceed with the procedure is required from the patient and family.
Modified ECT is now being practiced to lessen the complications of the procedure. Before, there were no pre-medications administered. Therefore, patients sometimes suffer from fractures, respiratory distress, choking, and ruptured bladder.
With the administration of the pre-medications like a muscle relaxant, anticholinergic, and mild anesthesia agents, these complications are now averted. Oxygen supply is also on standby to treat any form of respiratory distress.
The mental health providers are there to assist the patient during the procedures. ECT is performed by placing two electrodes on the temporal side of the head and 120 volts is initiated to create a grand mal seizure. As the patient experiences the tonic-clonic phase of the seizure, medical staff observes the patient until he is rested and calmed down.
“Since it works so quickly, ECT can be very beneficial to patients who are extremely depressed, suicidal, or acutely manic. They usually don’t remember the treatment itself, and may experience a brief period of confusion following ECT,” wrote Cheryl Lane, PsyD.
The seizure episode can create transient memory loss. The nurse or medical staff immediately reorient the patient about the time, place and person to bring awareness on what just transpired.
The number of sessions will depend on the degree of the mental health state and the response of the patient to the procedure. Under normal circumstances, the sessions are carried out from 3 to 12 times with an average of six.
A lot of fallacies have been given out regarding ECT like it really does not help the patient but instead can aggravate their current psychological state. So far, evidence-based research and scientific communities can vouchsafe on the safety and therapeutic effects of the procedure. For more information, or if you have other questions pertaining to ECT, the best source of reference would be your doctor.