The general population pictures therapy as reclining in a stiff chaise, bawling into a gratuitous amount of tissues, and talking about how every problem can be traced back to an obscure childhood experience. Few would ever imagine that it would consist of electric shocks- the image conjured is one of an unenlightened time, when medical professionals didn’t understand how to help those suffering from various mental issues. It sounds archaic, akin to leeches and blood-letting, and more likely to harm than help a patient. However, ECT (Electroconvulsive Therapy) is still used to treat sufferers of anxiety, depression, and other mental ailments, and may surprise you with just how beneficial it can be.
The practice of using electricity for mental illness treatment dates to the 16th century, though the techniques used then are antiquated and no longer practiced. Today, electrodes are placed either unilaterally (on one side of the head) or bilaterally (on both temples), and the exact dose administered or duration of treatment is decided on a per-patient basis. The goal is to cause a seizure to obtain therapeutic benefits, but not cause cognitive impairment by using an overly potent dose. Despite the precautions taken, there are still considerable risks: confusion, memory loss, nausea, muscular aches, and even heart problems in rarer cases.
So why would someone willingly undergo such a stigmatized procedure? Because it works. In the U.S., about 100,000 people have ECT administered annually to fair success; approximately 80 percent of patients experience positive effects after six months of having ECT. Though it used to be a last resort for severe cases, it can now be used for depression, mania, schizophrenia, catatonia, and other mental illnesses that don’t improve with more traditional therapy or medications. The American Psychiatric Association, the American Medical Association, and the National Institute of Mental Health all recognize the effectiveness of ECT, especially in cases where quick results are needed (for those in danger of suicide), the patient is pregnant and doesn’t wish to harm the fetus, or cannot withstand the side effects of other drugs (such as elderly patients).
Despite all the benefits that ECT can bring to patients, the treatment is still largely stigmatized by the general public. In years past, when ECT was referred to as electroshock therapy, the procedure was done without anesthetics, and often times without patient consent. This resulted in many botched procedures where patients were rendered worse off than before. As antidepressant usage slowly grew more popular through the mid-20th century, ECT became more obsolete, with the Surgeon General warning of the associated risks due to a lack of safety procedures before administering the therapy. The novel One Flew Over the Cuckoo’s Nest released in 1962 solidified public distaste of ECT, and it has remained largely controversial ever since. However, when all other options have been extinguished, ECT can be a potentially lifesaving procedure; it is no longer the same risky treatment that G.B.C. Duchenne, the Father of Electrotherapy, popularized in the 19th century.
While it is easy to endlessly laud ECT, there’s still some undeniable risks and short comings. It is admittedly risky that traditional therapy and medications, and the potential for memory loss or other side effects turns many away from pursuing it. In the end, ECT is often a last resort for more severe cases, and isn’t a permanent cure. After treatment, it’s still necessary to find other therapies to prevent relapse. When debating whether ECT is a viable option, it’s important to weight the risks with the potential benefits- knowledge is truly power, and to fully understand what ECT is and how it helps empowers potential patients to make an informed choice. Knowing what you are consenting to undergo is key to all treatments, not just ECT; while it historically is associated with a lack of understanding how to help mental illness patients, today it is part of an understanding that mental health problems are still somewhat elusive to us, and we still have a ways to go when it comes to finding the best way to treat them.
