medically reviewed by Dr. Lindsay Israel
Getting ECT (electroconvulsive therapy) is a serious decision.
You’re not alone in exploring this option.
Antidepressants don’t work for the majority. Only 30% find relief with meds! And, as the prescription loses effectiveness it gets more difficult to find a med that works.
The first treatment prescribed for depression is usually antidepressants and psychotherapy.
But after weeks, months, years of little improvements, treatments such as ECT can be the next course of action.
Let’s explore ECT and some less invasive options…
Here’s what we’ll cover:
What is ECT?
Electroconvulsive Therapy (ECT) is a depression treatment that involves the stimulation of the brain with a controlled electrical current.
This stimulation deliberately triggers a brief seizure in the brain that lasts for less than 60 seconds.
How does ECT work?
Well, the actual therapeutic benefits come from the brain’s reaction to “rescue itself” and stop the seizure. When that happens, various neurotransmitters are released, causing chemical changes in the brain.
ECT treatment method provides fast relief to the patient. An ECT session lasts roughly 1h. All these are done while the patient is under general anesthesia.
Patients typically undergo ECT treatment when other treatment methods fail.
History of ECT
When ECT was first created in the 1940s, it was created as a backup plan, in case other treatments failed. It is still considered the “last resort” when antidepressants fail or for people who cannot take antidepressants due to side effects.
ECT is still administered to an estimated 100,000 people a year. It works quickly unlike other treatment methods like medications or psychotherapy that can take weeks or months. This delay associated with conventional treatment methods could prove costly as depression may grow into a more severe and critical stage or even lead to death for patients who have suicidal tendencies.
ECT is mainly administered by a team of trained medical professionals that include a psychiatrist, an anesthesiologist, and a nurse. ECT is only performed in a hospital environment, never an outpatient clinic.
What is the ECT Procedure Like?
Here’s what you can expect before, during, and after ECT therapy.
Step 1) Full Medical Examination
Just like every other medical procedure, a full medical examination will be carried out.
Your medical history will be carefully investigated to ascertain if there’s an underlying medical condition to be worried about.
Step 2) Tests before ECT
Bloodwork, head CT, xrays of chest and spine as well as an electrocardiogram (ECG) is also carried out to ensure you’re able to withstand the treatment.
The doctor or anesthesiologist explains to you the risk of anesthesia and the procedure itself. Once these details are verified and your consent or that of your legal guardian (in case you are not in the state to make decisions for yourself) is received, you are good to go.
Step 3)Administering Anesthesia
Typically, you will be asked not to eat 24 hours before the procedure.
After you arrive at our facility for the procedure you are prepped, you will have an intravenous tube inserted into your arms so medications and other fluids can be passed. You will then be anesthetized, putting you to sleep for about 5- 10 minutes.
You will also receive a muscle relaxant that will minimize the seizure, prevent movement of muscles and injury.
Step 4) ECT Therapy
Cardiac monitoring pads will be placed on your chest to monitor your heart and lung conditions during and after the treatment.
4 electrode pads will be placed on your head either unilaterally or bilaterally.
– Unilateral ECT is done with the electrical current focused on just one side of the brain.
– Bilateral ECT is done with an electrical current focused on both sides of the brain.
2 of these 4 electrodes monitor your brain waves, the other 2 deliver the electric impulse to the brain.
The ECT treatment is only effective when it causes a seizure.
Step 5) Recovery
After the anesthesia wears off, you will be taken to the recovery room where you will recover from the groggy feeling that comes after such a procedure.
All these take about 45 minutes to 1 hour. The procedure takes place at least 3 to 4 times a week and with a total of 6 to 12 sessions spanning 2 or 3 weeks. Your sessions may be less or more depending on how fast or slowly your condition progresses.
You cannot drive during the ECT course, especially on the days of treatment. You need to be driven by someone each treatment day.
What Does ECT Treat?
ECT treats severe resistant depression and although it is exactly unclear to scientists and researchers how ECT is so effective, it has proven to be quite effective.
ECT can teat:
A kind of depression leaves you detached from reality, deeply sad, suicidal, and loss of appetite.
Catatonia is often associated with psychiatric disorders such as schizophrenia, catatonia is characterized by lack of speech, lack of movement, and starvation.
The kind of depression does not respond to antidepressants or psychotherapy.
Bipolar behavior includes hyperactivity, risky behavior, substance abuse, detachment from reality, and agitation.
These are a few examples of depressive symptoms the ECT procedure has been able to help transform or the very least, improve.
How Effective is ECT for Depression?
Over the past 2 or 3 decades, research has shown that about 47% to 75% of patients who have undergone the procedure have fully recovered from their depressive symptoms.
After about 6-12 sessions of ECT treatments, the outcome has mostly been remarkable and lasting.
People who stop their sessions halfway after seeing certain signs of improvement often relapse after a few weeks. So one key to a full recovery with the ECT treatment is finishing your sessions.
Side Effects of ECT
Electroconvulsive Therapy is a generally safe treatment for depression but like every other treatment, there are a few side effects.
After every session, there are a number of big immediate side effects that you may experience
Side effects of ECT include:
1) Memory loss
3) Soreness in the muscles and
Confusion may last for several hours and on rare occasions up to a few days.
Memory loss is another side effect that shows up after every session. Memories around the time of treatment is lost and new memories are hard to hold on to after each treatment session. In most cases, memories are restored to normal function after a few days but in other cases, those memories may never be restored.
The risk of using anesthesia is the same for ECT as it is for other procedures such as minor surgeries. The use of anesthesia is riskier for patients with underlying heart conditions.
ECT vs Other Treatment Options That Work
Depression is one of the easiest mental illnesses to tackle today because there are many treatment options.
– CBT (cognitive behavioral therapy)
– ECT (electroconvulsive therapy)
– Meds or Antidepressants
– TMS therapy (transcranial magnetic stimulation)
You can even watch Dr. Andrew Huberman’s podcast on Understanding and Conquering Depression.
Let’s review ECT vs Meds vs TMS below.
Interested in learning more about how TMS compared to ECT? Check out our TMS vs ECT post.
Antidepressants are medications prescribed to depressed people to help them modify their brain chemistry.
These meds activate the receptors in the brain in the case of low brain activity or block brain receptors in the case of hyper brain activity. As you take them orally, these medications sometimes go to the wrong receptors in the body causing certain side effects.
The progress made with antidepressants is very slow, improvements may appear in two to three weeks but total recovery is usually a long shot. Antidepressants mostly work hand in hand with psychotherapy and both together have not proven to be the most effective treatment for depression.
Transcranial Magnetic Stimulation (TMS)
TMS is a non-invasive treatment method that involves using a magnetic field to treat depression.
TMS is proven to be far more effective than meds.
According to recent studies, with TMS 83% of people experience improvements, 62% achieve complete remission from their depression.
Unlike ECT, TMS does not cause seizures. TMS stimulates with magnets, NOT electrical current like ECT.
Side effects for TMS are minimal and temporary. TMS is usually administered four to five times a week for 6-8 weeks. TMS has also known to be a safe, effective, and stress-free depression treatment.
TMS is also covered by most insurance plans, Medicare, and in some states even Medicaid.
How We Can Help You
TMS is the future of depression therapy and we are excited to be a part of this movement.
With over 30 locations in 6 states and growing, Success TMS is here to help you, your family, friends, neighbors, and colleagues.
At Success TMS we truly understand the pains and frustrations of coping with depression, we understand firsthand the pain of losing a loved one to this deadly disease. We treat every patient that walks into any of our facilities with empathy and love.
You can live your best life free of depressive thoughts or symptoms.
You can live free and enjoy the wonders of life with family and friends.
You can do this, we can help.