Electroconvulsive therapy (ECT) is an important, effective, and potentially life-saving treatment that can be used when someone is in a severely depressed, manic, or mixed episode.
While ECT has a somewhat checkered history, largely due to its earlier days when it was not combined with modern anesthesia, it has been extensively studied and shown to be safe and humane.
Still, the echoes and stigma of those earlier days and “electroshock” therapy, which could result in bone fractures and broken teeth, persist. When faced with the recommendation of having ECT, especially for the first time, it’s quite natural to have a negative, and even fearful, response. Getting up-to-date information will allow you to make an informed choice.
Modern ECT involves using rapid onset anesthesia, which both induces sleep and relaxes the muscles (this prevents injury). After the person is asleep, a measured dose of electricity is delivered through electrodes placed on one or both sides of the head (unipolar vs. bipolar ECT, please note the word bipolar is being used in a different context).
The current induces a seizure, which is observed via brain wave activity. (An electroencephalograph (EEG) displays the seizure.) Because muscle relaxants have been used, the body remains still. The seizure lasts for thirty to ninety seconds. The anesthesia wears off and the person wakes up. The entire procedure from start to finish takes about thirty minutes to an hour.
For depressed and manic episodes, several treatments will be required. In the acute phase these are typically given three times a week. Results are often quite dramatic, and the success rate, especially in a psychotic depression, is quite high (80 to 90 percent).