Electroconvulsive Therapy (ECT)
ECT sounds far worse than it actually is.
ECT is a physical procedure used to treat severe, treatment-resistant depression and, more rarely, extremely suicidal patients and patients with treatment-resistant mania. It is not known how or why it works, but it does. Approximately 100,000 people are treated each year. ECT consists of giving electrical shocks to the brain under an anaesthetic. It sounds far worse than it is. It is usually given in courses of six to twelve treatments. The risks of treatment are related to the anaesthetic, memory loss and confusion following treatment. Anti-depressant treatment is usually started before and continued after a course of ECT.
It seems to have an effect similar to rebooting a computer: at some point the depressive pathways are bypassed and a normal mood takes over. The worst long-term side effect is memory loss. This has three parts: a number of existing memories seem to be lost beyond recall; memories of the course of ECT and surrounding events are often not stored; and, subsequently, it is harder to remember things than before. This does improve with time. It also improves as the depression lifts.
Despite its bad reputation, it is an effective therapy, and for those with severe depression it can be a lifeline. For some people, it is the only treatment that seem to work. There are now well-defined guidelines to help decide whether ECT is suitable for an individual, so if your psychiatrist recommends it, then consider the offer.
It is, however, likely to become a treatment of the past in the not-too-distant future as more focused treatment become available. An example of this is ‘direct brain stimulation‘ which is being researched now, involving focused energy targeting areas of the brain relevant to the problem, according to what is being revealed by neuroimaging.
