Electroshock therapy, or electro convulsive therapy (ECT) works by administering an electrical current to the brain, which induces a convulsion or seizure of the nerve cells in the brain. This is a procedure done under general anesthesia to treat severe incidences of depression, or incidences of psychotic behavior that might be manifested by bipolar condition. Unlike in films where “shock therapy” if often depicted as a thing forced on patients, this is not the case. There are only a few reasons why electroshock therapy might be used without patient consent, including depression so severe that a person is at constant risk for suicide or is no longer eating or drinking, and usually if the person will not or does not respond to drug treatment for their condition.
While electroshock therapy can help end an incident of severe depression or psychosis, it is not a cure. Patients usually require more than one treatment, more often between six to twelve treatments to end a depressive episode. These treatments have between 70-90% rate of effectiveness in ending that specific episode, but this does not mean depression is gone. Of patients undergoing electroshock therapy, a full 50% will at a later point have another bout of severe depression and may require treatment again. Some studies, which focus on the use of both ECT and medication, suggest that full-on psychosis or severe depression is less likely to recur if a person is on suitable medications after the treatment.
There are some risks to electroshock therapy. Though the seizures it causes are thought mild, it can be associated with some memory loss, especially dating to a few weeks before and after treatment begins and ends, and some people feel very confused upon waking from the treatment. There is no evidence to suggest that permanent brain damage occurs from effectively administered ECT. However, many feel that it is still difficult to gauge this, and see electroshock therapy as a treatment of last resort for patients whose symptoms are not resolved through medication. Additionally, any procedure requiring general anesthesia has some inherent risks.
Some people are not good candidates for electroshock therapy. Women who are pregnant generally don’t undergo the procedure. Patients usually have full physical evaluations before undergoing ECT, and for minors or those in custodial care, every attempt is made to inform caretakers of risks versus benefits.
The procedure isn’t recommended for everyone, and some recommendations prior to administering ECT include making sure the patient is currently undergoing a massive major depressive, manic or psychotic episode, that has not responded to at least two separate medication trials. Special care is taken when ECT is recommended for adolescents, and memory assessments before and after treatment are recommended. ECT usually is not recommended for pre-adolescents.
