Electroconvulsive Therapy Research Paper
December 5, 2013
Electroconvulsive Therapy
Electroconvulsive therapy, or ECT, is known for its therapeutic benefits and has been used as a psychiatric treatment in America since the early 1940s (Sabbatini, 2007). It uses electricity to induce seizures in patients suffering from mental illnesses in order to relieve them from their symptoms. ECT is most commonly known for the treatment of major depressive disorder and other depressive symptoms, but it is also widely beneficial in treating many other symptoms and diseases including bipolar disorder, schizophrenia, and it can even help people who are in a catatonic state. ECT is not a life-long treatment, unlike many other psychiatric medications, and does not have the harsh side effects that many of the medications have. The patient is usually administered multiple treatments until they are no longer feeling depressed or …show more content…
experiencing the other symptoms of their mental illness. ECT has a very negative reputation because of the inhumane ways it has been preformed in the past (Sabbatini, 2007). It was once a very painful procedure causing patients to be injured because they were often left conscious and not given muscle relaxants which are necessary to keep the patient from flailing around involuntarily during the treatment (Sabbatini, 2007). However, today the procedure is much safer and more effective because of the technological advancements and use of anesthetics and muscle relaxants to prevent the patient from being physically harmed (Abrams, 2002). There are many misconceptions about ECT and its effects because of the negative stories people hear about the way it was used in the past, but ECT has proven to be a very effective form of treatment of many mental illnesses.
In people with suicidal tendencies and depression, ECT may be a life saving treatment. This is especially true for those who have either no response, or have very harsh side effects from prescribed antidepressant medications. A large majority of people who receive ECT are outpatients, which means the people receive the treatment without ever being admitted to a hospital. During ECT, the patient is given an electric shock that induces a seizure causing their depression to decrease (Weiner, 2001). Despite many studies, it is still unknown how or why this treatment is so effective. The treatment is believed to work by stimulating a large part of the brain by releasing numerous neurotransmitters. It is thought that the electric shock somehow changes the brain’s chemistry and helps to release the chemicals that are being trapped, thus causing the patient to feel less depressed. (Weiner, 2001). Gary Kennedy, the director of geriatric psychiatry in Montefiore Medical Center states, “It reboots the system… Like turning a computer off and when it comes back on they are not as depressed” (Weiner, 2001).
Although it is most commonly used for depression, ECT can also be used to treat bipolar disorder and schizophrenia (Abrams, 2002). It is used to stabilize the patient’s mood and can also be effective in stopping psychotic episodes. Once the patient is stabilized, they are better able to respond to medications and treatment (Abrams, 2002). In some cases, patients with these mental illnesses are not mentally stable enough to think clearly or make the right decisions in choosing their treatment and do not have enough understanding of what is wrong in order to talk to a psychiatrist. After ECT treatment, they can become much more competent in understanding their circumstance.
Different agents have been used to induce seizures in order to treat psychiatric conditions as early as the sixteenth century (Sabbatini, 2007). In the late 1930’s, ECT was discovered to be a very effective process in treating depression and many other mental illnesses and became popular in many psychiatric facilities in the early 1940’s. After psychiatric medications had been developed, and ECT got a bad reputation around the 1960’s, the therapy began losing popularity (Sabbatini, 2007).
In the 1970’s doctors began finding ways to improve the treatment by increasing safety and comfort, and monitoring the anesthesia given to the patients during treatment (Abrams, 2002). Today, ECT has become one of the most effective treatments and a very safe method for treating severe mental illnesses. It is most commonly used to treat patients with major depressive disorder who have not responded well to any other forms of treatment such as medications. It was also shown to be very helpful in treating people who need quick treatment if they are at risk for suicide, delusional, or in a catatonic state. The documentary, Shock therapy: the last resort, shows multiple examples of patients who went through the ECT treatment and their different outcomes. A family with a young daughter decided ECT was the last chance they had to save their daughter who was slowly becoming catatonic. After multiple shock treatments, the girl began moving, talking, and eating again. As she slowly progressed, she was finally cured of her catatonic state (Freedman, 2001). In some cases, no other treatments and medications work. ECT was the last chance this family had in order to help their daughter, and it ended up saving her quality of life.
People against the use of ECT often stress possible risks of the procedure. Like any type of medication or treatment, ECT has side effects. After treatment, the most common and feared side effects are mental confusion and memory loss. The confusion normally fades away within a few hours after treatment. The memory loss varies depending on the person and the outcome of the treatment, but it is usually restored after a couple of weeks (Gelder, 2006). Other common risks and side effects of the therapy include alterations in blood pressure, which is typical, but often benign and harmless. Slight pain and discomfort after the treatment is also common, but can easily be treated with pain medication. Cardiovascular complications are severe, but very uncommon with ECT. Dental and oral trauma including dental fractures, dislocations, lacerations, and prosthetic damage are also very uncommon especially with today’s technology, which prevents the patient from moving and causing any injuries to their bodies. Also with newer technology, skin burns can be avoided, which commonly occurred when there was a fault in the electrical circuit of the machine administering the electric shocks. In the cases where the patient has died, the causes were most commonly from a reaction to the anesthesia, stroke, and cardiovascular or pulmonary complications. ECT however, has a very low death rate of about four out of every hundred thousand procedures resulting in death (Gelder, 2006). Overall, ECT is a very safe treatment. The most common side effects are very mild and often easily treatable, while the more serious ones are extremely rare.
Antidepressant medication has much harsher side effects than shock therapy. Antidepressant medications are the most commonly prescribed treatment for depression. Nearly eleven percent of people in the United States over the age of twelve use some sort of antidepressant medication. Antidepressants are the third most common type of prescribed medication (Andrews, 2012). All prescription drugs have side effects, but Paul Andrews, a professor of Psychology at McMaster University in Canada states that, “Antidepressant medications appear to do more harm than good as treatments for depression.” (Things Your Doctor Should Tell You About Antidepressants, para. 10) Antidepressants often kill neurons in the brain causing negative effects in brain cognition and affect the ability for someone to learn and react to situations. In one study, rodents were tested on their reaction time and learning capacity after being given an antidepressant medication. The drug effected their reaction time and also their ability to learn new skills. Research studies have also shown that antidepressants can increase the risk of cancer in the rest of the body (Andrews, 2012). There are millions of people who take antidepressants every day, but they do not realize that most of these drugs have harsher side effects and risks than ECT.
ECT treatment has few harsh side effects and is very helpful in treating multiple issues. The treatment can and has been used in treating people with a severe risk of suicide, people who have developed psychotic depression, psychotic mania, bipolar disorder, schizophrenia, and even people with eating disorders who have nutritional deficiencies.
ECT is also considered one of the least harmful treatment options available for depressed pregnant women (Abrams, 2002). It has been used to help women who need treatment during pregnancy without the harsh side effects that antidepressant medications may have on an unborn child. Women make up nearly seventy percent of the patients who receive ECT since they are two times more likely than men, to develop depression (Abrams, 2002). A large majority of the patients who receive ECT treatment are outpatients, but many psychiatrists and mental health professionals find it hard to decide when and if ECT should be used as a first choice treatment, or if it should be saved for the patients who have not responded to other types of treatment, such as medication or psychotherapy (Weiner, 2001).
ECT does not have the same effect on every patient. Some people react very well to the treatment while others may not be affected at all. In some rare occasions, the patient may have a negative experience with the treatment. For example, the American author, Ernest Hemingway, committed suicide shortly after receiving ECT treatment in 1971. His biographer reported him saying, “Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient” (Hotchner, 1966, p. 28). Like any type of treatment, ECT is not effective for all people. Furthermore, Hemingway received the treatment in the early 1960’s when the therapy was not as well developed as it is now. With today’s technology, the treatment is much more ethical.
There have been many people who have had very positive outcomes from the treatment as well. Lawyer, Curtis Hartmann, said,
ECT, a treatment of last resort for severe, debilitating depression, is all that has ever worked for me. I awaken about 20 minutes later, and although I am still groggy with anesthesia, much of the hellish depression is gone. It is a disease that for me literally steals me from myself; a disease that executes me and then forces me to stand and look down at my corpse. Thankfully, ECT has kept my monster at bay, and my hope intact. (Hartmann, 2002, p. 413)
This shows that in some cases, ECT can be the only real helpful treatment in curing depression in some people. Although electroconvulsive therapy had a bad reputation in the past, it is in fact a very helpful and effective form of treatment for many mental disorders. Major depressive disorder is the most common illness seen when using this shock therapy, but other illnesses such as schizophrenia and bipolar disorder can also be treated using this method.
Over the last few decades, ECT has been revolutionized. It has become a primary choice therapy for many disorders, especially when prescription medications have no effect. However, ECT is still a very controversial treatment. Even though the techniques have been changed for the better and the treatment has become much safer, many opinions about the therapy have remained the same. Some people still claim that of shock treatment is useless, dangerous and not worth the risk, but many people, including psychiatrists, insist that the therapy is very effective and helpful now for many people. The technological advancements have changed this, once risky, form of treatment into a therapy that has improved many people’s lives, and in some cases, even saved them.
References
Abrams, R.
(2002). Efficacy of electroconvulsive therapy. Electroconvulsive Therapy, (17- 42) New York, NY: Oxford University Press. (357). 799-808
Weiner, R. D. (2001). The practice of ECT: Recommendations for treatment, training, and privileging. Washington, DC: American Psychiatric Publishing.
Andrews, P. W., Gott, L., & Thomson, J. A., Jr. (2012). Things Your Doctor Should Tell You About Antidepressants. Retrieved December 2, 2013, from: http://www.madinamerica.com
Freedman, B. (Producer). (2001). Shock Therapy: The Last Resort [Motion Picture]. United States: Film Garden Entertainment.
Gelder, M., Mayou, R., & Geddes, J. (2006). Psychiatry (3rd ed.). Oxford, UK: Oxford University Press.
Hartmann, C. E., (2002). Personal accounts: Life as death: Hope regained with ECT. Psychiatric Services, (53), 413.
Hotchner, A.E. (1966). Papa Hemingway: A personal memoir. Cambridge, MA: Da Capo Press.
Sabbatini, PhD, Renato M.E., (2007). The History of Shock Therapy in Psychiatry. Retrieved November 17, 2013, from History of Shock Therapy:
http://www.cerebromente.org
Electroconvulsive Therapy
Electroconvulsive therapy, or ECT, is known for its therapeutic benefits and has been used as a psychiatric treatment in America since the early 1940s (Sabbatini, 2007). It uses electricity to induce seizures in patients suffering from mental illnesses in order to relieve them from their symptoms. ECT is most commonly known for the treatment of major depressive disorder and other depressive symptoms, but it is also widely beneficial in treating many other symptoms and diseases including bipolar disorder, schizophrenia, and it can even help people who are in a catatonic state. ECT is not a life-long treatment, unlike many other psychiatric medications, and does not have the harsh side effects that many of the medications have. The patient is usually administered multiple treatments until they are no longer feeling depressed or …show more content…
experiencing the other symptoms of their mental illness. ECT has a very negative reputation because of the inhumane ways it has been preformed in the past (Sabbatini, 2007). It was once a very painful procedure causing patients to be injured because they were often left conscious and not given muscle relaxants which are necessary to keep the patient from flailing around involuntarily during the treatment (Sabbatini, 2007). However, today the procedure is much safer and more effective because of the technological advancements and use of anesthetics and muscle relaxants to prevent the patient from being physically harmed (Abrams, 2002). There are many misconceptions about ECT and its effects because of the negative stories people hear about the way it was used in the past, but ECT has proven to be a very effective form of treatment of many mental illnesses.
In people with suicidal tendencies and depression, ECT may be a life saving treatment. This is especially true for those who have either no response, or have very harsh side effects from prescribed antidepressant medications. A large majority of people who receive ECT are outpatients, which means the people receive the treatment without ever being admitted to a hospital. During ECT, the patient is given an electric shock that induces a seizure causing their depression to decrease (Weiner, 2001). Despite many studies, it is still unknown how or why this treatment is so effective. The treatment is believed to work by stimulating a large part of the brain by releasing numerous neurotransmitters. It is thought that the electric shock somehow changes the brain’s chemistry and helps to release the chemicals that are being trapped, thus causing the patient to feel less depressed. (Weiner, 2001). Gary Kennedy, the director of geriatric psychiatry in Montefiore Medical Center states, “It reboots the system… Like turning a computer off and when it comes back on they are not as depressed” (Weiner, 2001).
Although it is most commonly used for depression, ECT can also be used to treat bipolar disorder and schizophrenia (Abrams, 2002). It is used to stabilize the patient’s mood and can also be effective in stopping psychotic episodes. Once the patient is stabilized, they are better able to respond to medications and treatment (Abrams, 2002). In some cases, patients with these mental illnesses are not mentally stable enough to think clearly or make the right decisions in choosing their treatment and do not have enough understanding of what is wrong in order to talk to a psychiatrist. After ECT treatment, they can become much more competent in understanding their circumstance.
Different agents have been used to induce seizures in order to treat psychiatric conditions as early as the sixteenth century (Sabbatini, 2007). In the late 1930’s, ECT was discovered to be a very effective process in treating depression and many other mental illnesses and became popular in many psychiatric facilities in the early 1940’s. After psychiatric medications had been developed, and ECT got a bad reputation around the 1960’s, the therapy began losing popularity (Sabbatini, 2007).
In the 1970’s doctors began finding ways to improve the treatment by increasing safety and comfort, and monitoring the anesthesia given to the patients during treatment (Abrams, 2002). Today, ECT has become one of the most effective treatments and a very safe method for treating severe mental illnesses. It is most commonly used to treat patients with major depressive disorder who have not responded well to any other forms of treatment such as medications. It was also shown to be very helpful in treating people who need quick treatment if they are at risk for suicide, delusional, or in a catatonic state. The documentary, Shock therapy: the last resort, shows multiple examples of patients who went through the ECT treatment and their different outcomes. A family with a young daughter decided ECT was the last chance they had to save their daughter who was slowly becoming catatonic. After multiple shock treatments, the girl began moving, talking, and eating again. As she slowly progressed, she was finally cured of her catatonic state (Freedman, 2001). In some cases, no other treatments and medications work. ECT was the last chance this family had in order to help their daughter, and it ended up saving her quality of life.
People against the use of ECT often stress possible risks of the procedure. Like any type of medication or treatment, ECT has side effects. After treatment, the most common and feared side effects are mental confusion and memory loss. The confusion normally fades away within a few hours after treatment. The memory loss varies depending on the person and the outcome of the treatment, but it is usually restored after a couple of weeks (Gelder, 2006). Other common risks and side effects of the therapy include alterations in blood pressure, which is typical, but often benign and harmless. Slight pain and discomfort after the treatment is also common, but can easily be treated with pain medication. Cardiovascular complications are severe, but very uncommon with ECT. Dental and oral trauma including dental fractures, dislocations, lacerations, and prosthetic damage are also very uncommon especially with today’s technology, which prevents the patient from moving and causing any injuries to their bodies. Also with newer technology, skin burns can be avoided, which commonly occurred when there was a fault in the electrical circuit of the machine administering the electric shocks. In the cases where the patient has died, the causes were most commonly from a reaction to the anesthesia, stroke, and cardiovascular or pulmonary complications. ECT however, has a very low death rate of about four out of every hundred thousand procedures resulting in death (Gelder, 2006). Overall, ECT is a very safe treatment. The most common side effects are very mild and often easily treatable, while the more serious ones are extremely rare.
Antidepressant medication has much harsher side effects than shock therapy. Antidepressant medications are the most commonly prescribed treatment for depression. Nearly eleven percent of people in the United States over the age of twelve use some sort of antidepressant medication. Antidepressants are the third most common type of prescribed medication (Andrews, 2012). All prescription drugs have side effects, but Paul Andrews, a professor of Psychology at McMaster University in Canada states that, “Antidepressant medications appear to do more harm than good as treatments for depression.” (Things Your Doctor Should Tell You About Antidepressants, para. 10) Antidepressants often kill neurons in the brain causing negative effects in brain cognition and affect the ability for someone to learn and react to situations. In one study, rodents were tested on their reaction time and learning capacity after being given an antidepressant medication. The drug effected their reaction time and also their ability to learn new skills. Research studies have also shown that antidepressants can increase the risk of cancer in the rest of the body (Andrews, 2012). There are millions of people who take antidepressants every day, but they do not realize that most of these drugs have harsher side effects and risks than ECT.
ECT treatment has few harsh side effects and is very helpful in treating multiple issues. The treatment can and has been used in treating people with a severe risk of suicide, people who have developed psychotic depression, psychotic mania, bipolar disorder, schizophrenia, and even people with eating disorders who have nutritional deficiencies.
ECT is also considered one of the least harmful treatment options available for depressed pregnant women (Abrams, 2002). It has been used to help women who need treatment during pregnancy without the harsh side effects that antidepressant medications may have on an unborn child. Women make up nearly seventy percent of the patients who receive ECT since they are two times more likely than men, to develop depression (Abrams, 2002). A large majority of the patients who receive ECT treatment are outpatients, but many psychiatrists and mental health professionals find it hard to decide when and if ECT should be used as a first choice treatment, or if it should be saved for the patients who have not responded to other types of treatment, such as medication or psychotherapy (Weiner, 2001).
ECT does not have the same effect on every patient. Some people react very well to the treatment while others may not be affected at all. In some rare occasions, the patient may have a negative experience with the treatment. For example, the American author, Ernest Hemingway, committed suicide shortly after receiving ECT treatment in 1971. His biographer reported him saying, “Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient” (Hotchner, 1966, p. 28). Like any type of treatment, ECT is not effective for all people. Furthermore, Hemingway received the treatment in the early 1960’s when the therapy was not as well developed as it is now. With today’s technology, the treatment is much more ethical.
There have been many people who have had very positive outcomes from the treatment as well. Lawyer, Curtis Hartmann, said,
ECT, a treatment of last resort for severe, debilitating depression, is all that has ever worked for me. I awaken about 20 minutes later, and although I am still groggy with anesthesia, much of the hellish depression is gone. It is a disease that for me literally steals me from myself; a disease that executes me and then forces me to stand and look down at my corpse. Thankfully, ECT has kept my monster at bay, and my hope intact. (Hartmann, 2002, p. 413)
This shows that in some cases, ECT can be the only real helpful treatment in curing depression in some people. Although electroconvulsive therapy had a bad reputation in the past, it is in fact a very helpful and effective form of treatment for many mental disorders. Major depressive disorder is the most common illness seen when using this shock therapy, but other illnesses such as schizophrenia and bipolar disorder can also be treated using this method.
Over the last few decades, ECT has been revolutionized. It has become a primary choice therapy for many disorders, especially when prescription medications have no effect. However, ECT is still a very controversial treatment. Even though the techniques have been changed for the better and the treatment has become much safer, many opinions about the therapy have remained the same. Some people still claim that of shock treatment is useless, dangerous and not worth the risk, but many people, including psychiatrists, insist that the therapy is very effective and helpful now for many people. The technological advancements have changed this, once risky, form of treatment into a therapy that has improved many people’s lives, and in some cases, even saved them.
References
Abrams, R.
(2002). Efficacy of electroconvulsive therapy. Electroconvulsive Therapy, (17- 42) New York, NY: Oxford University Press. (357). 799-808
Weiner, R. D. (2001). The practice of ECT: Recommendations for treatment, training, and privileging. Washington, DC: American Psychiatric Publishing.
Andrews, P. W., Gott, L., & Thomson, J. A., Jr. (2012). Things Your Doctor Should Tell You About Antidepressants. Retrieved December 2, 2013, from: http://www.madinamerica.com
Freedman, B. (Producer). (2001). Shock Therapy: The Last Resort [Motion Picture]. United States: Film Garden Entertainment.
Gelder, M., Mayou, R., & Geddes, J. (2006). Psychiatry (3rd ed.). Oxford, UK: Oxford University Press.
Hartmann, C. E., (2002). Personal accounts: Life as death: Hope regained with ECT. Psychiatric Services, (53), 413.
Hotchner, A.E. (1966). Papa Hemingway: A personal memoir. Cambridge, MA: Da Capo Press.
Sabbatini, PhD, Renato M.E., (2007). The History of Shock Therapy in Psychiatry. Retrieved November 17, 2013, from History of Shock Therapy:
http://www.cerebromente.org