Electroconvulsive Therapy (ECT) For Depression

Electroconvulsive Therapy (ECT) For Depression Bipolar Disorder Treatment Print How ECT Is Used for Treating Depression By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial policy Marcia Purse Updated on September 30, 2019 Depression Overview Types Symptoms Causes & Risk Factors Diagnosis Treatment Coping ADA & Your Rights Depression in Kids Istockphoto.com/Stock Photo/KatarzynaBialasiewicz In This Article Table of Contents Expand ECT Definition How It's Done Does ECT Cure Depression? What ECT Treats Who's a Candidate Side Effects Overall Safety Alternatives View All ECT, or electroconvulsive therapy, is an alternative therapy for certain psychiatric illnesses that are not responding to traditional treatments. Learn more about this therapy, including potential side effects, and what its like to experience ECT. Overview First developed in the 1930s by Bini and Lenletti, ECT continues to have an important role in the treatment of resistant psychiatric conditions. ECT works by sending an electric current through the brain. This electrical current, in turn, is thought to alter the chemicals in the brain related to mood. Though it has been misunderstood by the public, electroconvulsive therapy (ECT) can be a relatively safe procedure for some people with major depression which is resistant to typical therapies, like antidepressants and psychotherapy. How Its Done ECTs are given in safe environmentsâ€"usually recovery rooms in hospitals where medical professionals and equipment are present. An anesthesiologist and an attending psychiatrist give the treatments, along with ECT trained nurses. A person is gently sedated, with an anesthetic, and relaxed so there is no pain. The ECT produces a type of seizure in the brain. The treatment lasts only a few minutes. Observation of the treatment might reveal a wiggling of the patients toes. Shortly after the treatment, the patient wakes up, is checked thoroughly by medical personnel, and is allowed to go back home or to the hospital. After an ECT, the patient may have a slight headache, some drowsiness, and temporary confusion, but anything more serious is extremely uncommon. What to Expect During Electroconvulsive Therapy Does ECT Cure Depression? Its important to note that ECT is not a cure. Rather its a method of buying precious time to find treatments which do workâ€"for those individuals who are worsening or not responding to current treatment and/or medications. What ECT Treats ECT is mostly used to treat major depressive disorder, but it may also be used to treat other psychiatric illnesses, like mania or schizophrenia. For catatonic depression (catatonia), in particular, ECT may result in response rates as high as 80 to 100 percent  and appears to be more effective than any other treatment currently available. Can ECT Be Used to Treat Anxiety? Anxiety disorders are common psychiatric illnesses and include: Obsessive Compulsive Disorder (OCD)Panic DisorderSocial PhobiaGeneralized Anxiety Disorder ECT may have a role in people who have an anxiety disorder that is not responding to traditional treatments and that is complicated by severe major depression. The concern of some psychiatrists is that while ECT may help with depressive symptoms, it could worsen anxiety symptomsâ€"like worsening obsessional thought or panic attacks. Schizophrenia Just as people with depression who are not responding to available treatments may benefit from ECT, those with schizophrenia who are not responding to antipsychotics may benefit from this treatment. Parkinsons Disease Depression and other mood disorders are very common in people with Parkinsons disease. There has been a lot of research in recent years looking at the role and benefit of using ECT or Parkinsons related depression. Whos a Candidate ECTs are for people who are not responding to medication and other treatment methods for depression. The classic example is the use of ECT for a person with major depressive disorder who does not respond to large doses of an antidepressant and psychotherapy. ECT is sometimes given in combination with other therapies in hopes that the combination will improve a persons symptoms more than ECT alone. Side Effects Over the short-term, side effects of ECT may include headaches, nausea, muscle aches, and confusion. These symptoms are usually self-limiting and resolve in a matter of days. Retrograde amnesia may last longer than these other symptoms  but rarely persists. Long-term cognitive changes can be a side effect of ECT, with memory lossâ€"mostly loss of memory regarding recent eventsâ€"most common. A doctor will commonly ask memory or orientation-related questions after a person undergoes ECT to assess their degree of cognitive loss  if any. More severe possible side effects include cardiac pulmonary  and brain-related effects. There is an increased risk of heart attack and heart rhythm disturbances in those who have coronary artery disease, and your doctor may recommend consulting with a cardiologist before having ECT. It is important that patients are aware of this risk and all other potential risks and benefits of ECTs before consenting to treatment. Overall Safety Despite a general sense by the public that ECT is dangerous and outdated  when used based on careful selection criteria, it can be a relatively safe way of getting severe depression under control. Certainly, the risk of ECT needs to be carefully weighed against the risk of severe depression which is not responding to treatment, such as suicide risk and more. Why Isn't ECT Done More Often? ECT has a negative public perception or stigma. In addition, there is both a lack of awareness among primary care physicians of the role ECT can play  and a lack of providers who perform the procedure.Its important to note that ECT is a procedure that is performed when treatments such as medications and psychotherapy are ineffective in relieving severe depression or other psychiatric illness such as schizophrenia. When this is the case, the quality of life of a person is very important to keep in mind when considering the treatment. Alternatives Before considering ECT, its important to consider the possible alternatives. Your psychiatrist may have had you try several different antidepressants from different classes. We still dont know why some people may respond better to one class than another, but it is probably related to the balance of neurotransmitters in the brain which can lead to depression. Psychotherapy is also a mainstay and should be tried before considering ECT. One alternative to ECT that has been used more often in recent years is transcranial magnetic stimulation. Transcranial Magnetic Stimulation for Depression A Word From Verywell ECT is believed to be a safe intervention in carefully selected people that can be very effective in alleviating distressing psychiatric symptoms. As with any intervention, procedure, or medication, please speak with your doctor about any concerns you have before undergoing ECT. The 7 Best Online Help Resources for Depression