Most people might be quicker to associate electroconvulsive therapy (ECT) with torture rather than healing. But since the 1980s, the practice has been quietly making a comeback.
The number of patients undergoing electroconvulsive therapy has tripled to 100,000 a year, according to the National Mental Health Association.
ECT - more colloquially known as shock treatment - is now accepted by growing numbers of psychiatrists as the preferred treatment for major depression and mania for patients who cannot take or do not respond to medicine.
The research on ECT boomed in the last decade. Most recently, scientists have been able to calibrate the amount of current a patient needs so that treatments can be individualized; one patient may require 10 times the amount of current as another before a seizure occurs.
Electroconvulsive therapy is a medical treatment for severe mental illness (especially severe depression) in which a small, carefully controlled amount of electricity is introduced into the brain.
During an ECT treatment, doctors jolt the unconscious patient's brain with an electrical charge, which triggers a grand mal seizure. It is considered by many psychiatrists to be the most effective way to treat depression especially in patients who haven't responded to antidepressants.
When it was first introduced, many people were frightened simply because it was called "shock treatment." Many assumed that the procedure would be painful; others thought it was a form of fatal electric shock, and still others believed it would cause brain damage. Unfortunately, unfavorable publicity in newspapers, magazines, and movies added to these fears.
Indeed, in those early years, patients and families were rarely educated by doctors and nurses regarding this or other forms of psychiatric treatment. In addition, no anesthesia or muscle relaxants were used. As a result, patients had violent seizures.
The way these treatments are given today is very different from the procedures used in the past. Currently, ECT is offered on both an inpatient and outpatient basis. Hospitals have specially equipped rooms with oxygen, suction, and cardiopulmonary resuscitation (an emergency medical procedure for a victim of cardiac arrest or, in some circumstances, respiratory arrest) in order to deal with the rare emergency.
ECT investigating the chemical basis of depression
The most compelling research is using ECT to investigate the chemical basis of depression. In 1984, National Institute of Mental Health (N.I.M.H.) researchers began to measure patients' body fluids before and after receiving a course of ECT to determine the levels of three neurotransmitter systems -serotonin, norepinephrine and dopamine - that have been associated with major depression.
Neurotransmitters are molecules in the brain that carry electrical messages and affect how information is communicated, processed and stored. Norepinephrine and serotonin affect mood, appetite and sleep patterns; dopamine coordinates movement, controls some hormonal release and, when properly balanced, keeps thoughts and feelings grounded in reality. The results of the research showed that whereas drugs strongly affect the norepinephrine and serotonin systems and do virtually nothing to dopamine, ECT has almost no effect on the first two systems and a striking influence on the third.
In spite of all this, ECT has been a hot topic for debates over medical ethics. The central dispute revolves around the risks of brain damage and memory loss. Critics of ECT, primarily former patients, say that no matter how much the procedure is modified and how carefully it is prescribed, it still causes irreversible brain damage and long-term memory loss.
Why is shock therapy given?
The purpose of ECT is to provide relief from the signs and symptoms of mental illnesses such as severe depression, mania, and schizophrenia. ECT is indicated when patients need rapid improvement because they are suicidal, self-injurious, refuse to eat or drink, cannot or will not take medication as prescribed, or present some other danger to themselves.
Risks associated with ECT
Advanced medical technology has substantially reduced the complications associated with ECT. These include slow heart beat (bradycardia), rapid heart beat (tachycardia), memory loss, and confusion. Persons at high risk for ECT include those with recent heart attack, uncontrolled blood pressure, brain tumors, and previous spinal injuries.
A crucial treatment — or brain damage?
Though most studies have found that ECT is effective for severe depression and several other conditions, opponents claim that the mechanism through which E
CT changes mental state is nothing more than the destruction of brain cells, and even proponents are unsure how it works. Many patients who have had ECT claim it caused their mental state to improve; many others think their ECT did more harm than good.
Critics warn that the cognitive side effects, such as memory loss, are too severe and that the fuzzy, foggy state of mind that ECT initially causes simply makes patients temporarily forget about their sadness. According to them, nearly every ECT patient experiences confusion, inability to concentrate and short-term memory loss during the treatment.
Actually, the stigma pushes people away from it, and it pushes some psychiatrists away from even recommending ECT. Psychiatrists readily admit that in the early days, ECT absolutely was a cruel procedure. And because the treatment has lingered in the shadows of psychiatry for decades, many people still associate it with its sketchy past.
Violation of human rights with ECT
"Unhealthy" dependence on computers is prevalent even in countries like China and there do seem to be more hardcore cases of lonely individuals spending all their free time online at the expense of their careers and social lives. At the Daxing clinic, these troubled teens are housed together, where they are subjected to hypnosis and even mild shock therapy in an attempt to rid them of their love of surfing. Thus, they are given treatment against their will or knowledge and consent is mostly obtained from parents.
A Massachusetts school in New York used electric shocks as a punishment for bad behavior, to some of its most challenging special education students. Many have severe types of dysfunction, including self-mutilation, head banging, eye gouging and biting, that can result from autism or mental retardation. Critics of the school say that applying shock as a punishment is not widely supported by the scientific community. Still, the parents defend use of shock therapy by saying that the shocks are making a difference in their children’s lives as nothing else has.
Thus, shock therapy is a procedure that seriously violates human rights and legal rights when done against the will of a person. Rights and Legislation WHO Resource Book on Mental Health," specifically states, "ECT should be administered only after obtaining informed consent."