Also known as
shock therapy or
shock treatment. The
procedure is performed in a small room with a doctor and an
anesthesiologist present.
Electrodes are attached to the
head and
chest. The patient is strapped securely to a table and a
mouth guard is put in, then they attach the electrodes to a small
electric generator. No
jewelry may be worn. These days they give
general anesthesia and
muscle relaxants directly prior to the
treatment. The
doctors monitor the patient's
heart rate,
brain waves, and other
vital statistics. They put a
clamp-type device on either the
patient's
finger or
toe, I believe to measure the
pulse. Multiple treatments are administered either on an
inpatient or an
outpatient basis,
every other day. One course of treatment usually involves six to ten ECT procedures.
In the past anesthesia and muscle relaxants were not administered, vital signs were not monitored, the patient was physically held down by orderlies so as not to break any bones while convulsing, as portrayed in One Flew Over a Cuckoo's Nest. Portrayed more recently and accurately to modern methods in Requiem for a Dream.
The objective of ECT is to induce a seizure, generally, a longer seizure is considered better, over two minutes is considered a good lenth seizure. ECT is administered, usually as a last resort, to patients with severely debillitating depression, (and sometimes schizophrenia) when other treatments have proven insufficient. ECT is used as a temporary mood elevator to bring the patient to a point where other treatments, usually antidepressants, can help. ECT is not a cure. One of the scarier aspects of ECT is that although it has been used on mental patients for probably longer than fifty years, it is still not understood why it works. Supposedly the treatment was an evolution of the observation of epilepsey patients with depression. Other disconcerting aspects of ECT are side effects, most notably memory loss. Although the extent of the memory loss is usually portrayed as only affecting events immediately surrounding the time of treatment, it can permanatly erase or obscure memories from months around the treatment, and alter the subsequent quality of the patient's memory, although not in all patients. Other side effects are acute muscle and head pain following treatment due to the severity of the seizures.
People are affected very differently by ECT, with reactions ranging from mild discomfort, to severe emotional trauma. My experiences range on the severe side, and having ECT, especially the first course, was the worst experience of my life. It left me feeling fragile and mentally violated in a way that I can't imagine how to describe except that it was a bit like my entire self, my personality and psyche, had been wrested away from me and destroyed, except just enough so that I was fully aware of what was being done to me. I've tried to make several key people in my life promise never to let me go through it again. But not everyone reacts this badly, I know several people who feel that, except for the discomfort, it was a positive experience.