Understanding Electroconvulsive Therapy

What is electroconvulsive therapy?

Electroconvulsive therapy (ECT) is a treatment that sends a brief electrical signal to the brain to treat severe depression. It may also be used to treat other mental health issues, such as bipolar disorder or schizophrenia.

ECT is mainly used when treatments such as talk therapy and antidepressants have not worked. Often it may ease feelings of sadness and despair after several treatments.

Common symptoms of major depression

Some of the symptoms of major depression include:

Feeling deep sadness that doesn’t go away
Losing all pleasure in life
Feeling hopeless or helpless
Feeling guilty
Sleeping more or less than normal
Eating more or less than normal
Feeling nervous, “empty,” or worthless
Crying a great deal
Thinking or talking about suicide or death

How is ECT therapy done?

ECT therapy is done in the hospital, often as an outpatient. Follow your healthcare team's instructions on how to prepare. You may be told to not eat or drink before the treatment. You likely will be advised to urinate just before the treatment is done. You’ll be given anesthesia so you will not be awake during the treatment. You’ll also be given medicine to make you sleep, relax your muscles, and control your heart rate. During the treatment, you will be closely monitored by the anesthesia team, psychiatrist, and specially trained nurses.

Your healthcare provider places patches (electrodes) on your head. You may have one above each temple (bilateral ECT). Or you may have electrodes on one temple and on your forehead (unilateral ECT). While you are asleep, your brain is stimulated very briefly with an electrical current. This causes a seizure that lasts about a minute. Because you are under anesthesia, you will not be aware of the seizure.

What are the risks?

When done correctly, ECT is quite safe. Right after the treatment, you may be confused. This often lasts for less than half an hour. You may have a headache, nausea, or stiff muscles. You may also have some urine or stool leakage during the treatment. Your healthcare team will help through all of these. And these symptoms most often go away quickly. You may have short-term (temporary) trouble remembering information that you learned recently. And you may have little memory of when you got the treatment. Less commonly, you may have long-lasting (permanent) spotty recall of major past events. In rare cases, you may have memory loss for larger blocks of time.

Looking to the future

ECT doesn’t cure depression, but it can ease symptoms for a period of time. Most people treated with ECT need to continue with ongoing treatment. These include talk therapy, antidepressant medicines, and regular follow-up with their healthcare provider. You may need a series of ECT treatments to continue feeling the benefit. But with ongoing support and treatment, you can have a full and healthy life.