Electroconvulsive Therapy for Severe Depression
Electroconvulsive therapy (ECT) is a procedure that is used to treat severe depression. ECT may be used for people with symptoms such as delusions, hallucinations, or suicidal thoughts. It may be done when other treatments have not worked. These other treatments may include psychotherapy and antidepressant medicines. ECT is also used for other psychiatric and neurological conditions. These may include schizophrenia and Parkinson disease.
Before ECT, you are given anesthesia to make you sleep. You are also given medicines to relax your muscles. Electrodes are put on your temples or elsewhere on your head. Where they are placed depends on the health condition being treated and the type of ECT used. The electrodes are attached to wires. The wires lead to a machine. An electrical current is briefly sent to the brain through the wires and electrodes. This causes a short seizure in the brain. The electrical current lasts up to 8 seconds. Because of the anesthesia, the seizure does not cause the body to convulse.
It is not known exactly how this kind of brain seizure helps treat depression. ECT may work by acting on brain chemicals in a similar way that some medicines do. The brain chemicals affected may include neurotransmitters such as dopamine, serotonin, natural pain relievers called endorphins, and adrenalin.
ECT treatments are done 2 to 3 times a week for 2 to 4 weeks. Ongoing ECT may be done one time each week down to one time each month. They may continue for several months to a year. These ongoing ECT treatments help to reduce the risk of relapse. ECT is usually used along with other treatments. These may include medicines, psychotherapy, family therapy, and behavioral therapy.
What to expect after treatment
Because of the effects of anesthesia, you may not remember the procedure. You may have some short-term memory loss, confusion, nausea, headache, and jaw pain after ECT. These effects may last several hours. Some people have reported long-term memory loss
Why it is done
ECT is used to treat severe depression. It is also used for other psychiatric or neurological conditions such as Parkinson disease or schizophrenia.
ECT may be used for older adults who are not able to take medicines for depression because of other medicines they are taking. ECT may also be used for people who can't tolerate the side effects of medicines used for depression.
How well it works
Studies have shown that ECT is an effective short-term treatment for depression. It is important to have ongoing ECT or follow-up treatment with medicine. This helps to reduce the risk of relapse.
In rare cases, ECT may cause an increase blood pressure or changes in heart rhythm. It may cause seizures that last longer than expected. These effects will likely occur right after the ECT treatment and can be treated by the ECT healthcare providers as needed. Often, these effects will quickly go away without treatment.
The risks of untreated, severe depression are often greater than the risks of ECT.
Other side effects of ECT may include headaches, muscle pain, and nausea. Short-term and long-term memory problems are also possible side effects.
What to think about
A person having ECT will have a complete physical exam prior to the treatment. Depending on where they live, a person may be required to complete a consent process.