Electroconvulsive therapy (ECT), also known as electroshock therapy, is a controversial medical treatment that induces a seizure by passing electricity through the patient’s brain. ECT was a common psychiatric treatment until the late 20th century, when it fell into disuse as better drug therapies became readily available for more psychiatric conditions. It is now reserved for severe cases of depression in such illnesses as major depression and the depression associated with bipolar disorder. It can also be used to treat a manic episode.
It is believed that ECT works by using an electrical shock to cause a seizure (a short period of irregular brain activity). ECT may be given during an inpatient stay, or just for outpatient quick treatment. ECT is given up to three times a week. Usually no more than twelve treatments are needed. Treatment is given by a psychiatrist. This seizure releases many chemicals in the brain. These chemicals, called neurotransmitters, deliver messages from one brain cell to another. The release of these chemicals makes the brain cells work better. A person's mood will improve when his or her brain cells and chemical messengers work better.
In electroconvulsive therapy, an electric current is sent through the scalp to the brain. ECT is one of the fastest ways to relieve symptoms in people who suffer from mania or severe depression. ECT is generally used as a last resort when the illness does not respond to medication or therapy. It can be used when a patient cannot take medication, such as during pregnancy. It is also used when patients pose a severe threat to themselves or others and it is dangerous to wait until medication takes effect.
Prior to an ECT treatment, the patient is given a muscle relaxant and put under general anesthesia. ECT, when done correctly, will cause the patient to have a seizure, and the muscle relaxant is given to limit the size of the episode. Electrodes are placed on the patients scalp and a finely controlled electric current is applied that causes a brief seizure in the brain. Because the muscles are relaxed, the seizure will usually be limited to slight movement of the hands and feet. Patients are carefully monitored during the treatment. The patient awakens minutes later and does not remember the treatment or events surrounding the treatment.
Side effects may result from the anesthesia, the ECT treatment or both. Temporary short-term memory loss can be one of the side effects; this memory loss usually goes away one to two weeks after treatment. Some people may have longer-lasting problems with memory after ECT. General side effects like confusion, nausea, headache, and jaw pain are also common. These side effects may last up to several days after the procedure. In extremely rare cases, ECT can cause heart attack, stroke, or death. People with certain heart problems usually are not good candidates for ECT.
While the majority of psychiatrists believe that properly administered ECT is a safe and effective treatment for some conditions, a vocal minority of psychiatrists, former patients, antipsychiatry activists, and others strongly criticize the procedure as extremely harmful to patients’ subsequent mental state. In the early days of use, ECT was administered without anaesthesia or muscle relaxants. Patients were frequently injured as a side effect of the induced seizure.
ECT has been commonly misused in the past, sometimes as a punishment for patients hospitalized in mental institutions. ECT was sometimes abused by unethical mental health professionals as a means of punishing and controlling unruly or uncooperative patients. Many people came to view ECT unfavorably after negative depictions of it in several books and films. The use of ECT is still a controversial.
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