This is a kind of psychiatric therapy that uses short electrical stimulus to the brain through tiny electrodes in the temples. The charge lasts from 1 to 4 seconds and it causes epileptic-like seizures to the patient. The patient is anesthetized and is given a muscle relaxant which would depress his breathing. Oxygen will be given until he is able to normally breathe again. A majority of patients would get 6 to 12 ECTs for a whole treatment, given one electrical charge per day, three times in a week.
Uses of ECT
This is sometimes recommended for people with severe cases of depression, most especially if all other treatments, like taking in anti-depressants, have failed to deliver. The use of this therapy is declining but its usage is still controversial. It could also used for people with severe cases of schizophrenia and bipolar disorder. ECT is only performed with the patient’s consent and after all the risks have been completely discussed with the patient and his family. The risks would include affecting the person’s life.
How ECT works
The mechanism of how ECT works is not fully understood but the following could be used to explain its effects:
- Neurotransmitter theory: this therapy works by altering how the brain receptors receive mood-altering chemicals, much like how anti-depressants work.
- Anti-convulsant theory: the ECT induces epileptic-like seizures to help the brain resist seizures. Inhibition of seizures regulates the unusually active brain circuits which stabilises the mood.
- Neuroendocrine theory: The epileptic-like seizures cause the release of chemicals that initiates change throughout the body. The chemicals are secreted by the hypothalamus. The epileptic-like seizures could release neuropeptides to regulate the mood.
- Brain damage theory: Shock causes damage to the brain and results to disorientation, euphoria and memory loss. These could create illusions to signal the brain that the problem has been solved.
- Psychological theory: guilt plagues the depressed people and ECT could satisfy their craving for punishment. After undergoing ECT, the patient would then feel as if he is being taken seriously due to the care he receives after. This is the placebo effect of ECT.
Controversies surrounding ECT
The controversies about ECT are about its safety, necessity and ethics. The side effects of ECT could outweigh the benefits and some health care services believe that this is true. Some believe that this worsens the patient’s condition and that some are administered with ECT against their will. Some of the specific reasons include the following:
- poor standards
- memory loss
- limited benefits
- deaths due to ECT
- psychological adverse affects