What is ECT?

 ECT (Electro Convulsive Therapy) is a type of Shock treatment used to treat some psychological problems. In this treatment, electric current is passed through the brain so that the patient gets fits (seizures). We don't know how but these fits (seizures) have been shown to help with these problems.

 

Do you mean that I will be getting fits for the rest of my life (i.e. will I have Epilepsy) ?
NO, NO. You will only have a fit when the treatment is given. Otherwise, you should not have any fits in between your treatments or after the treatment.

So, ECT TREATMENT WILL NOT LEAD TO EPILEPSY.


Is it not dangerous to give electrical shock to the brain? We hear all the time people dying due to electic shocks?

    The electrical shock you get in houses or in industries are from electrical wires and this kind of electricity is very very strong compared to the electricity passed into the brain in shock treatment. The electricity used in this is very very less. So, the risk of dying just because of the electrical shock is very low.

 

I have seen people getting burnt with electrical shock. So, does that mean that my skin will get burned and I will have burn marks all over my head if I take shock treatment?

 No. You must have seen small stickers being used to take ECG when your doctor is testing your heart's health. Nowadays there are machines which will deliver the electrical shock for treatment using similar stickers. Even if the stickers are not used, a kind of jelly is used which will prevent any burns / burn marks occurring at all. In western/developed countries or even good hospitals in developed countries, it is almost considered to be negligent practise if we get burns during shock treatment.

 

I can't bear even small pain. How can I bear electrical shock being given to my brain?
You will not feel any pain. You will not even be aware of the shock being given to you. This is because in all western/developed countries, in all good hospitals in developing countries, people are given General Anaesthesia before ECT. This means that you are unconscious when ECT is being given and hence do not "experience the shock".

In developed countries it is illegal or unprofessional to give ECT without Anaesthesia. Some of the Developing countries are now in the process of making this as a law .For example the draft Indian "Mental Health Care Act 2010" is planning to make it illegal to be treated with ECT without Anaesthesia.

 

How many times do I need to take the shock treatments?
It is impossible to predict how many times you will need to be given the treatment. The no of treatments per week or the no of weeks in a "course" of treatment  will bedetermined by your doctor, depending on your problem and your individual circumstances.

 

In what conditions would ECT / shock treatment be helpful?
According to UK guidelines, Severe Depression, Catatonia and Mania are the only conditions in which ECT can be given. Also, the UK guidelines say that in these conditions ECT is given when other treatments have been tried first and are not helping and when the condition is so severe or dangerous to life that fast recovery is warranted.

As per American Guidelines, in addition to the above, any depression/mania/mood disorder with psychosis can also be treated with ECT.

In developing countries, for example India, where there are no nationally accepted guidelines, there is a wide range of accepted/practised criteria for giving this treatment. Most important situation is a psychotic, depressed or a manic patient who is posing a danger to himself or others.

 

Are there any side effects for ECT?
Yes, like all other treatments, there are side effects for ECT as well. Some are

-Immediately after ECT
you may feel drowsy/sleepy and confused for several hours. You may feel nauseous, and can experience headaches.


Short Term effects:-

Memory problems.You may have amnesia (memory loss) for some time after the ECT treatment. You may start forgetting where you have kept your keys etc.


Long Term effects:-

Memory and other Cognitive problems may last longer in few people.

In addition there are obvious risks associated with injuries due to fits if anaesthesia is not given correctly and the risks from anaesthesia itself.

 

So, with all these side effects why should we use ECT?
ECT is one of the powerful treatments available for severe depression, mania, catatonia etc. But since it has the side effects as mentioned above, it is used when other treatments have already been used and found not working.

Also, ECT works fast. Antidepressants take weeks to act where as the action can be seen within days with ECT.

 ECT is used where other treatments have not worked and where speed of action is necessary.