ECT – Weighing the Pros and Cons

If medication and therapy aren’t helping your depression, or severe manic episodes are destroying your life – or that of a loved one – despite treatment, then you need to find a better treatment option. For some people, the answer for severe mood symptoms is electroconvulsive therapy.

Typically referred to as ECT for short, electroconvulsive therapy (or “shock therapy”) is a medical procedure that sends currents of electricity through your brain. But if you’re considering ECT, chances are good you want answers. Is it safe? Will it work quickly? What are the side effects? Following are some brief facts regarding this often-controversial treatment:

What is ECT?

Formerly called electroshock therapy, ECT utilizes electrical currents to produce a short convulsion, or seizure, which changes your brain chemistry. These seizure help relieve the symptoms of mood disorders and certain other psychiatric disorders.

ECT is administered in a controlled medical environment, usually on an outpatient basis. Before a treatment session, you’re given a muscle relaxant and often general anesthesia as well. Medical professionals deliver the currents by way of electrodes attached to your scalp. It’s estimated that nearly 100,000 Americans undergo the procedure every year.[1]

The Pros of ECT

ECT is much safer than in years past. Perhaps you’ve seen the movie, “One Flew Over the Cuckoo’s Nest”, and remember the disturbing scene in which Jack Nicholson’s is given ECT. Fortunately, ECT today has little resemblance to that depiction.

In the early years of ECT, the electrical currents were delivered in more powerful doses. It was also often administered without anesthesia. The result was a therapy that was painful and had serious side effects, including broken bones. ECT is a much safer treatment now because it uses lower levels of electrical currents. The use of muscle relaxants and anesthesia has also reduced the severe spasms that generated injuries in the past.

ECT brings about fast results. The change in brain chemistry due to ECT is essentially instant. This results in the immediate relief of symptoms of some mental illnesses. The electrical current lasts for only a few seconds and the seizure lasts for up to a minute; in fact, you can expect to spend most of treatment time in preparation and recovery. Typically, patients begin to see significant improvement after just 2 or 3 treatments. Since medications sometimes take weeks to be effective, electroconvulsive therapy may be an ideal option if you’re struggling with suicidal thoughts or experiencing a debilitating manic episode.

ECT often works when other treatments have failed. There are times when talk therapy and medication simply aren’t working – or aren’t working quickly enough. Medical professionals may use electroconvulsive therapy for hard-to-treat cases of several psychiatric disorders, including:

  • Depression
  • Schizophrenia
  • Severe mania
  • Catatonia
  • Tourette syndrome
  • Obsessive compulsive disorder

ECT works for those who can’t or won’t take medication. If you can’t tolerate your medication’s side effects or have episodes (e.g. psychotic or manic) in which you refuse to take prescription drugs (e.g. due to paranoia), ECT may help. Instead of taking medications every day or every few hours, you’ll visit a medical facility several times a week. Since general anesthesia is often used, you’ll also need to arrange transportation to and from treatment. That means at least one additional person will be around to make sure you get the help you need.

The Cons of ECT

ECT does have its dark side, and is still considered a controversial treatment by many healthcare professionals.

ECT can cause adverse mental side effects. Some patients, especially seniors, experience a period of confusion immediately following ECT treatment. The confusion often lasts from a few minutes to a few hours, although in rare cases it can linger for several days. This side effect may make it impossible for you to return to work or other responsibilities right after treatment.

Another mental side effect of ECT is memory loss, which can take several forms. For instance, some have trouble remembering events that happened in the days or weeks prior to treatment. Other people will have trouble recalling things that happened after the treatment ended. This can be a significant side effect, as it has the potential to impact the things you do every day, like caring for your children or performing well at work. Studies suggest, however, that problems with memory loss typically improve within a few months.[2]

ECT can have physical side effects. Some report headaches and muscle pain, while others report nausea. For most people, the physical side effects of electroconvulsive therapy disappear within an hour or so and last for a far shorter period than side effects from conventional medications.

ECT can have medical complications. Like other medical procedures, ECT does carry the risk of complications, and those risks increase when anesthesia is used. For instance, since ECT can elevate your heart rate and blood pressure, it might be a riskier procedure if you have any kind of heart condition. Always talk to your primary care doctor before choosing electroconvulsive therapy to find out if you’re at risk for health complications.

ECT is expensive. This type of therapy does come at a price. The treatment is often prescribed in a series of 6 to 12 sessions, and insurance companies may not cover the entire cost. Before getting ECT, always check with your insurance provider to confirm if they’ll pay for all or part of the therapy. While it can be expensive, keep in mind that it is likely less costly than living with an untreated or under-treated medical condition. If your mental illness is severe, it can be hard to keep a job or take care of yourself.

The benefits of ECT aren’t permanent. Although it can be very effective in the short-term, ECT is not a permanent solution. You may need to undergo regular treatment to keep symptoms at bay. Your treatment provider may also recommend that you continue other forms of treatment, like medication or talk therapy, to reduce the risk of relapse.

Make no mistake; due to the risk of side effects like memory loss, ECT is considered a high-risk treatment by some medical and mental health professionals. However, the benefits can outweigh the risks for people living with debilitating, treatment-resistant disorders. If you suffer from depression that’s so severe you can’t get out of bed to make breakfast or if you have serious manic episodes that make it impossible to hold down a job, then ECT may be an option worth considering.

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