Electroconvulsive therapy
A series of short, sharp, shocks? ECT doesn't evoke the nicest of images. TheSite.org takes a look at this controversial treatment.
Short sharp shock
Made famous by its mention in Sylvia Plath's The Bell Jar, ECT doesn't evoke the nicest of images. It is estimated that in Britain 138,000 ECT sessions are carried out each year.
Why have ECT?
- ECT is usually given to people with severe depression that hasn't responded to other forms of treatment such as anti-depressants.
- However, it is sometimes used for those with a diagnosis of bi-polar affective disorder (manic depression) or schizophrenia.
- It is usually only given after the risks have been explained and with the person's consent, or in the extreme case when the person's life is at risk, for example when they are unable to eat or drink.
What does the treatment involve?
ECT is a psychiatric treatment in which a brief electrical stimulus is given to the brain via electrodes placed on the temples. The electrical charge lasts between one to four seconds, and causes a type of epileptic seizure.
How often do you need to have an ECT?
Most patients are given a course of between six to 12 ECT sessions at a rate of one a day, three times a week. In severe cases, ECT can be given without the patient's consent under UK legislation.
Why the controversy?
Controversy surrounds the safety, ethics and necessity of ECT. In particular, some people who use mental health services believe that the side-effects can be quite severe and that they have had ECT administered to them either against their will, or without their knowledge (in cases where people are so depressed that they are unaware of what is going on around them).
The UK Advocacy Network's survey of people who had received ECT treatment found that 30% of people who had received ECT found it helpful or very helpful, while over 50% found it unhelpful or damaging. Specific complaints include:
- Poor standards: Inspectors appointed by the Royal College of Psychiatrists found that many ECT clinics did not follow safe and humane practices.
- Limited benefits: Clinical trials do not demonstrate long-lasting benefits of ECT beyond a few weeks. However, doctors argue that it is sometimes life saving to lift a person quickly out of a life-threatening depression, and allow the possibility that other therapies, or the healing effects of time, can begin to work. There have also been cases of immediate recovery following ECT.
- Memory loss: The UK Advocacy Network's survey of people who had received ECT treatment found that 73% of respondents reported memory loss (not all short-term).
- Psychological adverse affects: Some people say they find ECT extremely upsetting, reasons for this include feelings of fear, shame and humiliation, worthlessness and helplessness, and a sense of having been abused and assaulted.
- Deaths caused by ECT: Some reports claim that there as many as 4.5 deaths per 10,000 ECT patients.
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