Electroconvulsive Therapy (ECT)
Many adults struggle with mental health disorders that, unfortunately, do not improve with therapy or prescription medication. But this does not mean that people in these circumstances are beyond the ability to be helped. CenterPointe Hospital offers a variety of innovative and effective services to help people whose prior experiences with professional care have been less than successful. For people who meet certain criteria, we may recommend electroconvulsive therapy, or ECT.
What Is ECT?
Electroconvulsive therapy is a procedure that employs the brief application of a focused electric current to promote improved brain functioning among people who have been struggling with a variety of mental health disorders.
ECT has been used in the United States for several decades. The modern version of this process has proved to be both safe and effective. As documented in several studies, many people who had not previously benefited from therapy or medication have been able to experience considerable symptom relief through ECT.
Who Can Receive ECT at CenterPointe Hospital?
All programming decisions at CenterPointe Hospital are made on an individual basis following a close assessment of each patient’s progress, needs, and goals. This includes determining which patients can benefit from ECT and other elements of care at our hospital.
In general, we may recommend ECT for adults age 18 and older who have been struggling with one or more of the following mental health concerns:
- Major depressive disorder
- Bipolar disorder
- Schizoaffective disorder
For a person to qualify for ECT at CenterPointe Hospital, they must have had unsuccessful prior experiences while receiving mental health treatment services. This usually includes a history of taking prescription medication under the guidance of a qualified healthcare provider but not achieving relief from the symptoms of the disorder they have developed.
Treatment-resistant major depressive disorder is the mental health concern that is most commonly addressed with ECT. Electroconvulsive therapy has also proved to be beneficial for people who have bipolar disorder who have been having manic or hypomanic symptoms, as well as for those who have developed psychotic symptoms or episodes as a result of a mental health disorder.
ECT is not recommended for people who have been living with certain medical conditions, such as the following:
- Recent heart attack or other heart problems
- Recent stroke or aneurisms
- Brain tumors
- Chronic obstructive pulmonary disease (COPD) and other serious respiratory disorders
Before any patient receives ECT at CenterPointe Hospital, we conduct a thorough physical exam and a detailed review of their medical history to ensure that there are no health-related concerns that would prevent them from participating in this procedure.
How Does ECT Work?
ECT works by briefly passing a small electrical current through the patient’s brain.
- The electrical impulse lasts for a small fraction of a second, usually 0.5-2.0 milliseconds.
- The current prompts a surge of activity in the patient’s brain.
- The surge causes the patient to have a generalized cerebral seizure.
- The seizure typically lasts from 15 seconds to two minutes.
- The surge of activity and the therapeutic seizure contribute to an easing of the mental health symptoms the patient had been experiencing.
Because the patient receives a muscle relaxant and general anesthesia before they begin the ECT session, they experience no pain from this seizure, nor do they retain any memory of it when they are awakened.
Is ECT Safe?
When ECT is provided by experienced professionals at a reputable hospital such as CenterPointe Hospital, it is an extremely safe procedure.
Unfortunately, certain myths about ECT contribute to the stigma that continues to be associated with this procedure. Fears about the safety of ECT are often related to incorrect portrayals in books, television shows, and films. These portrayals often focus on problematic features of ECT that were addressed and successfully resolved decades ago.
ECT was first used in the 1930s. Over the next few decades, some so-called professionals used ECT for what we now recognize to be unethical purposes (such as a punishment or means of control for particularly difficult patients in mental health facilities). Thankfully, practices such as these were eradicated long ago.
It is also important to understand that the safety and effectiveness of ECT have been improved considerably through the years due to factors such as technological advances, increased understanding of how ECT affects the patient, and the incorporation of certain prescription medications into the procedure. For example, when ECT was first used, patients were not anesthetized. Today, anesthesia and muscle relaxants are integral elements of ECT sessions.
If you receive ECT at CenterPointe Hospital, you can rest assured that you will be taking part in a safe and comfortable procedure that can have a significant positive effect on your mental health and quality of life.
What Happens During an ECT Session?
Because ECT involves general anesthesia, you will be asked to refrain from eating or drinking for several hours prior to the session. One of the professionals who provide your care will explain how long you need to fast, and they will answer any other questions you have about preparing for your first ECT session.
When you arrive at the room where the ECT session will take place, here’s what will typically happen:
- You will recline on a comfortable bed.
- Cardiac monitoring pads will be placed on your chest. These pads will allow your team to observe your heart rate during and after the procedure.
- Four electrodes will be placed on your head. Two of these electrodes will deliver the electrical pulse, and the other two will allow your team to monitor your brain activity.
- You will have a blood pressure cuff placed on one of your arms. As with the cardiac pads and two of the electrodes, this will be done for monitoring purposes to ensure your continued safety.
- You will be given a mouthguard to prevent you from biting your tongue during the session.
- You will receive an anesthetic that will put you to sleep for about seven to 10 minutes.
- You will also be given a muscle relaxant. This prevents your muscles from reacting during the brief seizure that occurs after the electric current is applied.
- Once you are asleep and the muscle relaxant has had time to take effect, a very brief electrical pulse will pass from the electrodes on your forehead into your brain.
- This electrical impulse will trigger a brief seizure. The seizure lasts no more than a few minutes. You will be asleep, so you will not experience any discomfort. You will also be under the direct care of a team of skilled professionals throughout the entire process.
- A few minutes after the seizure ends, you will awaken. You will have no memory of anything that occurred while you were under the effects of the anesthesia.
- You will remain under the supervision of the professionals who provided the ECT session for 20-30 minutes. This will allow you to return to full alertness and make sure that your blood pressure and heart rate are steady.
A full ECT session usually takes about 60 minutes. This includes the prep time after you arrive at the ECT room and your recovery time after the procedure. As noted above, the actual ECT procedure lasts just a few minutes.
Most people who receive ECT participate in six to 12 sessions over the course of two to four weeks. A member of your care team at CenterPointe Hospital will review your ECT schedule with you before you take part in your first session. Throughout your time in our care, your team will be available to discuss your experiences with ECT and answer any questions you have.
How Can I Learn More About ECT?
To learn more about ECT at CenterPointe Hospital, or for help determining if you are a good candidate for this service, please contact us directly at your convenience. A member of our team can provide you with the details you are seeking and help you make the most informed decisions about your care.
This content was written on behalf of and reviewed by the clinical staff at CenterPointe Hospital.
“I am so thankful to the ECT staff who were incredibly reassuring and understanding during my treatment. My depression has lifted and I am back to being myself again. I’m so glad I made the decision to ask for help.”