Demystifying ECT

As a courageous survivor of ECT (Electric Convulsive Therapy), I am often asked to speak to consumers and their family members about ECT. Many have the same exact questions I had when I was first asked to consider ECT as a treatment invention for my clinical depression back in 1990. Today, 18 years later I’ve had over 50 ECT treatments.
During my four major bouts with clinical depression, ECT has become my “ladder out of the depression pit.”

Like many of you, I, too, was terrified at the thought of how ECT was given and more importantly what others might think of me afterwards. You see the media has portrayed ECT as a barbaric treatment; a treatment only given to “crazy” people on the back wards of psychiatric hospitals. This mental model is as far from reality as it can be.

It is still unclear why ECT helps patients with severe depression. Some feel that the electrical shock and subsequent seizure somehow simulate the brain’s neurons and reconfigure chemicals in the limbic system that regulate and balance the emotions.
Alte
atively, the seizure may alter the body’s hormonal system to relieve depression.

Electroconvulsive therapy is again coming into favor as a treatment for severe depression. According the American Psychiatric Association, its success rate is 80 percent whereas medication has a success rate of betwee
40 and 45 percent.

To provide a better understanding of ECT, following is what a patient encounters:nthe patient lies on the treatment table, an intravenous line is attached to the right armn(the IV contains, anesthesia and muscle relaxant), blood pressure cuffs are attached to the left arm and the right calf, a pulse oximeter is attached to the right index finger (monitorsnpulse), EKG leads are on both shoulders and center of chest (monitors heart), EEG leads are placed over left eyebrow and behind the left ear (monitors brain), a bite block is inserted into mouth (prevents patient from biting tongue), and an oxygen mask is placed over face (muscle relaxant prevents spontaneous respiration).

The treatment itself takes place. Sodium chloride gel is applied to the right temple and the parietal area on the top right of the head. Electrode plates are held against these two areas. The electric current is adjusted to intensity and duration. The doctor applies the electrical stimulus by pressing a button on the end of one ECT handle. The brief pulse stimulus lasts 1 to 2 seconds. One ECT course consists on 6 to 12 treatments.

As the patient, the biggest challenge for me was accepting ECT as a viable treatment option. It was easier for me to understand the treatment than it was for me to accept the treatment. ECT has become my “treatment of choice.” The positive outcome from ECT outweighs the stigma surrounding ECT. I consider ECT my “silver bullet” in dealing with severe clinical depression. Now that you understand ECT, I trust it seems less terrifying.