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What to Expect During Electroconvulsive Therapy

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It seems archaic, treating someone’s mental illness by shocking their brain with electricity. Most people think it is a technique from a bygone era, something akin to a lobotomy or casting out demons. Many people are often surprised to learn that electroconvulsive therapy still takes place today.

I turned to electroconvulsive therapy (ECT) during a particularly difficult time in my life. My depression was unbearable, my anxiety was out of control, and I fought suicidal thoughts daily. My severe depression can often be my strongest enemy. It can impair every area of my life. Sometimes it is so debilitating, I am unable to function. I can’t work, I can’t have a social life, I can’t do much more than survive. It was after multiple inpatient psychiatric hospitalizations that I was presented with the option of trying ECT.

I was initially very skeptical. I had no idea it was a treatment still used today. Visions of insane asylums filled with chains ran through my head. I was in the psychiatric unit of a local hospital when I was offered the option of trying ECT. I learned that the hospital had many patients being treated with ECT multiple times every week. I was stuck in a cycle of hopelessness and despair, coupled with endless medication changes in a search for something that could finally help my depression. I was growing tired with no end in sight. I agreed to give ECT a try.

ECT works by administering a small electric shock to your brain which triggers a seizure. The seizure is thought to affect the neurotransmitters in your brain. There is still a lot that is unknown about why and how ECT works, but the change in brain chemistry has been found to potentially alleviate symptoms in someone with severe mental illness. ECT can be used to treat severe or treatment-resistant depression, severe mania, catatonia, and aggression in people with dementia.

I’ve done multiple rounds of electroconvulsive therapy (ECT) and I am very familiar with the process. Knowing what to expect can help dispel the fear and uncertainty associated with this therapy. I stayed in the hospital for my first round of treatments, but they can be performed outpatient as well. I would have treatments three times a week over the next month. I was very anxious before my first treatment, but I soon learned there was not much to be afraid of.

The procedure would always be performed in the morning as I would need to fast for 12 hours beforehand. In my hospital, ECT was performed in a room off to the side of the surgical recovery room. My psychiatrist and an anesthesiologist were both present. Earlier, a nurse had started an IV to give me fluids. I was brought into the room and made to feel comfortable on the bed. My doctor then placed a band around my head with two small metal electrodes that sat near my temples. A conductive gel was rubbed on my head to help the connection between my skin and the electrodes. The anesthesiologist placed an oxygen mask over my mouth and pushed some medications through my IV. One of the medications was a paralytic. This would prevent my body from convulsing during the seizure. A blood pressure cuff was inflated around my ankle. This would stop the paralytic from affecting my foot so that my doctor could monitor the seizure. My foot would be allowed to twitch, while the rest of my body would stay relaxed.

I would also be given anesthesia medications. I would feel a small rush when the medicine was pushed and then everything would fade to black. I was always unconscious during the procedure and never felt any pain. The doctor would then administer a small jolt of electricity through the electrodes attached to my head. I don’t remember any of this. The procedure only lasted 5 to 10 minutes.

Suddenly, I would be waking up in the recovery room next door. I would feel groggy, just like waking up from any other surgery. I would continue to receive fluids and oxygen while I woke up. Occasionally I would have a headache, but there was a nurse ready with some pain medication if I needed it. I would spend about 20 to 30 minutes waking up and then I was taken back to my unit. I would usually feel tired for the next hour or so, but then I felt ready to go about my day. For me, I always felt the most relief on the day of my treatments. I would have my procedure in the morning and would usually feel decent the rest of the day. My depression would certainly creep in at times, but I could tell that the ECT was helping.

Electroconvulsive therapy remains a controversial subject with many psychologists and other professionals on both sides of the issue. The effects of ECT are different for everyone. I’ve spoken to people who said that ECT was a miracle treatment for them. I know of a woman whose depression was nearly cured after she received treatment. I needed several rounds before I felt any benefits. For quite awhile, I felt that ECT was only temporarily effective with the benefits lasting for maybe a few days. The longer I received the treatments, the longer I would feel relief. It certainly wasn’t a cure for me, but I would say that the improvements I did feel were worth it.

There are side effects and risks involved with ECT and it is important to be aware of them. Confusion, memory loss and headaches occur most often. There are also risks associated with the anesthesia, but those are more rare. Toward the end of my treatments, I started to have some memory problems. There were a few times I would wake up in the recovery room and it took several minutes for me to remember why I was there. I would have a hard time hanging on to small details and I would struggle to remember past events. When the memory loss started to get worse, I made the decision to stop doing ECT. The side effects stopped progressing right away and my memory began to improve.

I have not had any ECT for a couple of years now. Luckily, my depression has improved. Finally, finding a good mix of medication has helped tremendously, but I definitely feel like this treatment has been a factor in helping me recover from depression. I hope that sharing my experience can potentially help others who might be considering ECT. I want to dispel some of the myths and help take the mystery out of electroconvulsive therapy. The treatment is not for everyone, but hopefully this information can help you make the right decision for your needs.

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Originally published: May 1, 2018
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