Electroconvulsive Therapy began in the early 1930’s, when researchers injected chemicals in people to induce seizures. The chemicals were soon replaced with electrical currents. Today, ECT is a highly refined procedure, with precisely calculated electrical currents administered in a controlled medical setting.
ECT is most commonly indicated for people with severe depression, bipolar disorder and schizophrenia that haven’t improved with medications or other treatment modalities. Patients with these illnesses may experience sadness, despair, difficulty concentrating, loss of appetite and inability to sleep. They may also have suicidal tendencies. Today, as many as 100,000 people in the U.S. receive ECT each year to treat these mental illnesses.
A small intravenous (IV) catheter is inserted in the patient’s arm or hand by a registered nurse or anesthesiologist. An anesthetic is given through the IV, along with a strong muscle relaxant. These general anesthetic agents allow the patient to drift gently off to sleep. A mouth guard is used to protect one’s teeth and tongue. While asleep, a small, precisely calculated dose of electricity is delivered between two electrodes to induce a closely monitored seizure. The patient wakes up after approximately ten to fifteen minutes without discomfort or memory of the treatment. The patient is then carefully observed in the recovery room until discharge. Under normal circumstances, the entire procedure, from admission to discharge lasts about 2-2 ½ hours.
It is common for patients to experience some confusion immediately after an ECT treatment. A patient may wake up and not remember where he or she is or why he or she is receiving ECT. This generally lasts from a few minutes to several hours. Often patient’s describe their thinking as “feeling hazy” or “clouded”. This typically goes away when the course of treatment is completed.
A patient usually receives an ECT treatment two to three times a week for a total of six to twelve treatments. ECT is an exceptionally effective medical treatment, helping 90% of patients who receive it. Most patients remain well for many months after a treatment course; however, monthly or bimonthly maintenance treatments are also an option to maintain disease remission.
It is still not completely understood how ECT helps treatment mental illnesses. It is known, however, that many neurochemical changes occur during and after seizure activity. It is theorized that when ECT is administered on a regular basis, these neurochemical changes build upon one another and reduce the symptoms of the mental illness.
Despite its unpopular past, electroconvulsive therapy is now a safe and effective treatment for serve depression, bipolar disorder and schizophrenia. ECT can work faster than psychiatric medications or psychotherapy can, and it can help when other treatments have failed. It is also safe for elderly patients and pregnant patients.
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