Electroconvulsive Therapy (ECT) for Depression

For some people with severe or hard-to-treat depression, electroconvulsive therapy (ECT) is the best treatment. This treatment (sometimes referred to as "electroshock therapy") has a bad reputation and is incorrectly viewed as a harsh, cruel treatment. However, it can be effective and sometimes lifesaving.

ECT works quickly, which is why it's ideal for people with particularly intense or suicidal depressions. In these cases, waiting for antidepressants or therapy to work might be dangerous. However, the drawback is that the effects of ECT usually don't last, and further treatments will likely be necessary.

How Electroconvulsive Therapy Works

With ECT, an electric charge is delivered to the brain and causes a seizure. For reasons that doctors don't completely understand, this seizure helps relieve the symptoms of depression.

The procedure itself requires a stay in the hospital. During the procedure, you will be under general anesthesia, so you won't feel anything. Your doctor will also give you a muscle relaxant. Electrodes will be applied to your scalp and deliver an electric current. This electrical stimulation causes a brief seizure. The seizure is controlled with medications so your body doesn't move. You will wake up a few minutes later without any memory of the treatment.

The number of required sessions varies. Many people have six to 12 sessions over a period of several weeks. After initial treatment, you might have further ECT treatments in addition to depression medicine and therapy -- in order to prevent your depression from returning.

Remember that ECT is never used on someone who doesn't want it.

Studies have shown that ECT works for many people who have treatment-resistant depression. One study of 39 people with treatment-resistant depression compared the effects of an antidepressant with ECT. After two to three weeks, 71% of people who received ECT had a positive response to treatment. But only 28% who received the antidepressant had a positive response after four weeks of treatment. The results were published in 1997 in the medical journal Acta Psychiatrica Scandinavia.

Risks and Side Effects of ECT

The most common side effect of ECT is short-term memory loss. However, some people report that they have long-term memory loss as well. Since ECT can trigger a heart attack or stroke in very rare cases, for people with heart disease the benefits must be carefully weighed against the risks.

ECT works very quickly but 50% or more people who receive this treatment will relapse within a year. Your doctor may try to prevent this by treating you with antidepressants or additional ECT sessions.