Myth Busting: Spreading the Truth About ECT
Facts help break down stigma against this important depression treatment
July 1, 2022
Electroconvulsive therapy (ECT) has been around since the late 1930s, and it has been clear from the beginning that it is an effective treatment for patients with certain types of mental illness, including severe depression, severe mania, and catatonia.
Despite this potential to provide dramatic relief for patients, stigma surrounding the procedure—partially fostered by misleading portrayals of ECT in Hollywood productions as well as discouragement from other sources—has influenced many who might benefit greatly from ECT to shy away from getting the treatment.
Once known as “electroshock therapy,” ECT has frequently been represented as barbaric and violent, a process that produces memory loss or leads to mind control. Many people remember the dramatic depiction of the therapy in the 1975 movie “One Flew Over the Cuckoo’s Nest.”
As a practitioner and advocate of ECT, McLean’s Stephen J. Seiner, MD, believes that it is important to spread the truth about ECT—including both its benefits and its risks. Below, Seiner addresses some of the most common questions he is asked about ECT.
Seiner is director of the Psychiatric Neurotherapeutics Program and the Electroconvulsive Therapy (ECT) Service at McLean Hospital.
Is ECT Painful?
ECT is done under general anesthesia—meaning that the patient is asleep—so the patient doesn’t feel any pain during the procedure and is also unaware while the procedure is taking place. Generally, the only potential discomforts for patients occur when they get a little pinprick before the procedure to insert the IV for the anesthesia, and after the first one or two treatments, when some patients experience mild headaches.
According to Seiner, many years ago, before ECT physicians started using general anesthesia and muscle relaxants, there was a risk of injuring bones, joints, or teeth because of the convulsions associated with the seizure induced by ECT. Now, however, by using anesthesia and a muscle relaxant, patients remain still throughout the procedure and significant complications are rare.
Does ECT Cause Seizures?
ECT does induce a seizure. This is intentional, as it is believed that this seizure helps to reset the brain and bring a patient back to their baseline—the person they used to be before they became sick. “However, it is important to note that this induced seizure doesn’t cause a seizure disorder (i.e., future seizures),” states Seiner.
In fact, there is evidence that this induced seizure can even be used to stop a prolonged seizure. It’s as though the induced seizure is acting as a vaccine, causing the brain to fix itself.
Does ECT Damage the Brain?
Numerous imaging studies over the years have consistently demonstrated that ECT doesn’t cause any structural damage to the brain. There is evidence that ECT causes growth in the hippocampus, and some people have postulated that this neurogenesis (new nerve growth) is an instrumental part of how ECT helps patients. It’s noteworthy that many antidepressant medications also cause some neurogenesis.
Does ECT Cause Memory Loss?
It can. There are two main types of memory loss that are seen in ECT patients. One is anterograde memory, which is the ability to remember new things. However, that is a very short-lived side effect of ECT. In fact, when people are tested two months or so after they have had ECT treatment, they typically test better on anterograde memory and cognitive function assessments than they did prior to having ECT treatment.