Electroconvulsive Therapy
The most common treatment of depression is with antidepressants and psychotherapy but there are other forms of treatment. One of them is ECT, (an abbreviation which stands for electroconvulsive therapy).
Despite all the rumours, ECT is an effective, quick and gentle treatment for depression. ECT is a safe treatment. ECT is the fastest working and most effective treatment of depression. The treatment can be used on both the elderly and on people who are suffering from heart disease or are otherwise frail.
Anaesthesia
You are fully anaesthetized, you are given a muscle relaxing injection. Doctors will induce a convulsive fit by giving a weak electric shock over temporal regions or over the right temporal region and the crown.
A very small part of the current from the electric shock reaches the brain. The current activates the nerve cells, and if they are activated sufficiently, it triggers a convulsive fit. The convulsive fit is a rhythmic, electric activity in the nerve cells which lasts for 25-60 seconds. As you are anaesthetized and completely relaxed, only small contractions in the muscles are noticeable.
It is in connection with this convulsive fit which have the antidepressant effect. There are no collective explanation to how ECT works. however, there are many hypotheses and many research results, which present a certain understanding of the mechanisms.
After the treatment, you rest for a short time while the nurses make sure that you have fully recovered.
It takes place in hospital
In most places, the number of treatments required often ranges between six and twelve but sometimes more ECT treatments are needed. It very much depends on the individual.
The ECT treatment always takes place in a hospital, often in a psychiatric ward. In most cases, you would be admitted for one day. You can also receive ECT as an out-patient and go home on the same day.
One of the doctors employed in the psychiatric ward will give you the treatment. A doctor from the Anaesthesia Department will give you the anaesthetic.
Severe depression
If you are suffering from severe depression with psychotic symptoms, we often recommend ECT.
We offer you ECT if your situation is life threatening or if you have serious suicide thoughts. In certain cases ECT can be life saving. ECT treatment can be another treatment option if your antidepressant medicine don't have any effect.
Compulsion
In rare cases, we are forced to use compulsory ECT treatment. This is only considered an option in severe, life threatening depressions, which cannot be treated in any other way.
Some people with depression can feel so low that they believe that the depression is a rightly deserved punishment. They do not believe that the depression should be treated. Some patients can get so bewildered and capricious that they cannot make a decision on the question about receiving ECT treatment.
If ECT has to be given compulsorily, you need to have a patient adviser, and all the requirements of the law must be obeyed.
Effective
ECT is the fastest working and most effective treatment of depression. From testing the effect of ECT, it appears that between 70 and 90% of patients become well (with regard to the actual depressive episode). The corresponding figures for patients who are treated with medicine range between 50 and 70%.
The effect of ECT sets in after one to two weeks while the effect of a medicinal treatment sets in after two to four weeks.
Unfortunately, approximately 50% of those who have improved after the ECT treatment have a relapse within 6 months. If we use both ECT and preventive antidepressants, the frequency of relapses is reduced.
Therefore, ECT is not a curative treatment. We always need to follow up the treatment with preventive treatment and monitoring.
Adverse effects
ECT is safe, but a number of patients do experience short term memory loss after the treatment while others don't have any adverse effects at all.
Some can have difficulties remembering events from the time during and around the ECT treatment. For most, the memory function returns to normal again after a few weeks.
Some patients can be confused immediately after the treatment. This confusion is short term and completely temporary. It disappears typically within a few hours.