Depression Support Group
Depression is a real and debilitating condition that is often misunderstood by family and friends. Its meaning can range from a prolonged period of sadness to an actual mental illness with specific symptoms. Find and share experiences with others who are going through the same struggles.
What is ECT Therapy (Electro-Convulsive Therapy)? When is it used? Does it hurt? Is it safe?
Answer:
ECT (Electro-Convulsive Therapy) is a treatment currently in use for severe depression. It involves the deliberate provocation of an epileptic fit by the passage of a small electric current between two electrodes placed on the scalp of the patient. The patients are being fully anaesthetized and given muscle relaxants to reduce the physical manifestations of the fit.
ECT is used for the treatment of severe depressive illness and it may be life-saving, because it acts more quickly than drug treatments. The greater the number of typical features of depression, the possibility grows for a good response to ECT. It is particularly effective in treating depression with psychotic features. It is also used in the treatment of certain types of schizophrenia and in mania. It is essential to continue drug treatment with anti-depressants after a successful course of ECT.
It is considered a very safe method of treatment. There are no absolute contra-indications to its use. There is no evidence that it causes brain damage or permanent intellectual impairment and the risk of death is similar to that of general anaesthesia for minor surgical procedures (2 deaths per 100000 treatments).
Once a commonly used - and controversial - treatment for a variety of mental problems, ECT still bears a stigma despite advances which have made it far safer and more effective.
ECT involves placing electrodes on the temples, on one or both sides of the patient's head, and delivering a small electrical current.
The aim is to produce a seizure lasting up to a minute, after which the brain activity should return to normal.
Patients may have more than one treatment a week, and perhaps more than a dozen treatments in total.
Used to treat depression
Modern ECT is used primarily in the treatment of severe depression, and psychiatrists say it has proved the most effective treatment in many cases.
It is also used in some cases of schizophrenia and mania.
But mental health campaigners say that, although it may work in the short term, it is unclear what its long-term effects are.
Charity Mind says it is often used against people's will and it wants to see a ban on this, but psychiatrists say that would mean about 20% of patients who now receive the treatment would not get it despite being most in need.
They argue that some people are incapable of giving or denying consent.
The first official figures for ECT to be released for eight years show 2,800 people in England and Wales were given the treatment in the first three months of 1999.
The death rate from ECT used to be quoted as 1 for every 1,000 patients, but with smaller amounts of electric current used in modern treatments, accompanied by more safety techniques, this has been reduced to as little as 4.5 in 100,000 patients.
Patients are treated with short-acting anaesthetics, muscle relaxants and breathe pure oxygen.
However, despite the fall in death rates, there are still side effects to the treatment.
The most common are headache, stiffness, confusion and temporary memory loss on awaking from the treatment - some of these can be reduced by placing electrodes only on one side of the head.
Memory loss can be permanent in a few cases, and the spasms associated with the seizure can cause fractured vertebrae and tooth damage.
Patients can also experience numbness in the fingers and toes.
No evidence for brain cell loss
However, modern studies have yet to reproduce these findings in the human brain.
Experts say that given the correct staff training, and when used for the right clinical conditions, ECT can "dramatically" benefit the patient.
An audit of ECT in Scotland between February 1996 and August 1999 said concerns about unacceptable side effects, effectiveness of the treatment and disproportionate use on elderly people were "largely without foundation".
It said that in nearly three quarters of cases people with depressive illness showed "a definite improvement" after ECT.
Women were more likely to receive the treatment than men, but the auditors said this was because they were twice as likely to suffer from depression.