Understanding Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is sometimes called shock therapy. This may sound painful, but ECT doesn’t hurt. It’s often the safest and best treatment for severe depression. It can also be used to treat other mental disorders, such as bipolar disorder or schizophrenia.

What is electroconvulsive therapy?

ECT is used to treat people who have severe, treatment-resistant depression . It’s mainly used when other treatments, such as antidepressants, have failed. Often it may relieve feelings of sadness and despair after 2 to 4 treatments.

Common symptoms of major depression

Symptoms of major depression include:

  • Feeling deep sadness that doesn’t go away

  • Losing all pleasure in life

  • Feeling hopeless or helpless

  • Feeling guilty

  • Sleeping more or less than normal

  • Eating more or less than normal

  • Having headaches or stomachaches, or other pains that don’t go away

  • Feeling nervous, “empty,” or worthless

  • Crying a great deal

  • Thinking or talking about suicide or death

How is ECT therapy done?

Before an ECT treatment, you’ll be given anesthesia to keep you pain-free. You’ll also be given medicine to make you sleep, relax your muscles and control your heart rate. Your healthcare provider then places electrodes on your head. You may have one above each temple (bilateral ECT). Or you may have electrodes on one temple and on your forehead (unilateral ECT). While you are asleep, your brain is stimulated very briefly with an electric current. This causes a seizure, usually lasting less than a minute. Because you are under anesthesia, your body will not move even as your brain goes through great changes.

What are the risks?

When done properly, ECT is quite safe. Right after the treatment, you may be confused. This often lasts for less than half an hour. You may have a headache, nausea, or stiff muscles. But these symptoms often go away quickly. Your bladder may relax, causing urine to leak out. It's a good idea to bring a change of clothes just in case this occurs. A more serious possible side effect is memory loss. Commonly, people have short-term (temporary) trouble remembering information that they learned recently. And they may have little recall of the time when they received treatment. Less commonly, people may have long-lasting (permanent) spotty recall of major past events. In rare cases, there may be memory loss for larger blocks of time.

Looking to the future

In most cases, ECT doesn’t cure depression. But it can improve symptoms for a period of time. You may need a series of ECT treatments to continue feeling the benefit. You may also need to take antidepressants to help prevent symptoms from returning. But with ongoing treatment, you can have a full and healthy life.

To learn more

Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Paul Ballas MD
Date Last Reviewed: 3/1/2020
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