It’s a pity that even over 70 years after the first successful demonstration of its efficacy in the treatment of acute mental illnesses like schizophrenia, there is still very little informed public opinion about Electroconvulsive Therapy or ECT. Although, it is a fact that ECT is one of the most effective method for treating severe mental disorders.
This clearly begs certain obvious questions: Why there is so much ignorance about ECT among common people? Is this ignorance induced by some misconceptions because ECT uses controlled electric current as a mode of treatment? If electricity is the cause of the fear and resultant reluctance to go for ECT then one better avoid going for X-ray sessions or to the operating theatre for diagnosis and treatment purposes, as well.
Why not ECT?
X-rays comprise of the harmful ultraviolet rays. But controlled exposure to these rays by an expert radiologist under a physician’s supervision makes it such a useful modern method of pinpointing anomalies in human body. By the same logic, an operation theatre if not manned by an expert anesthetist, attendant nurses and a qualified surgeon is also not at all a good place for you to come under the knife.
It seems, when it comes to ECT everything boils down to imaginary fears, some may have their genesis in the horrific depiction of ECT in both Hollywood and Bollywood movies. One can very well recall how such a useful and well-established mental treatment procedure was given a bad name in films like ‘Khamoshi’ and ‘Raat Our Din’ or in ‘One Flew Over the Cuckoo’s Nest’- a film from the Hollywood.
Cobwebs of Ignorance
To understand and appreciate the real worth of ECT as a comprehensive treatment procedure, it is important to first remove the cobwebs of ignorance surrounding it. Let’s begin with asking: What is ECT and how does it work?
Safest and Effective
Today ECT is considered among the safest and most effective system of treatment for mental illnesses like depression.
• Like any normal operating procedure, here too the patient is treated under general anesthesia.
• The patient is given a muscle relaxant to ensure that he is relaxed during the course of the treatment.
• To begin the treatment first electrodes are placed on the patient’s scalp.
• Thereafter, a finely controlled electric current is applied.
• The current causes a brief seizure in the brain.
• The patient is carefully monitored by specialist doctors during treatment.
Post ECT phase
• Minutes after the ECT treatment the patient wakes up.
• He or she is unlikely to remember the treatment or events surrounding it, and is often confused.
• But there is no need to worry as the confusion normally lasts for only a short period of time.
• ECT is usually given up to three times a week for a total of two to four weeks.
• According to doctors ECT reboots the system in the brain.
• The seizure is likely to restore some neuro-connections or reconnect nerves that are “short-circuited.”
• The procedure also may change the levels of norepinephrine, dopamine, and serotonin, which play a role in depression.
• Studies show that there were only 2.9 cases of deaths per 10,000 patients treated with ECT. As per another study the figure is only 4.5 deaths per 100,000 persons treated.
When is ECT most useful?
American Psychiatric Association maintains ECT can be safely used:
• If there is an urgent need for rapid treatment response. Example- Pregnancy
• If the patient refuses food leading to nutritional deficiencies
• If the patient does not respond to anti-depressant therapy
• If patient’s other ailments rules out use of antidepressant
• If the patient is in a catatonic stupor
• If the patient’s depression is accompanied by psychotic features
• In treating bipolar disorder, including both mania and depression
• In treating mania
• In treating patients with severe suicidal tendency
• If the patient has responded to a previous ECT treatment
• In treating schizophrenia
Experts Vote for ECT!
Dr Declan McLoughlin, Psychiatrist from Ireland
“Over 75% of the patients on ECT show very good improvement. It’s the most powerful anti-depressant that is largely used among adults. He says if 8% of treatment mode in Indian is ECT, its just 1 % in London. But that does not mean that mental health of British is better compared to that of Indians.”
Dr Pratima Murthy, Professor of psychiatry, NIMHANS.
“Over 20 patients undergo the ECT therapy every day at the Bangaluru based India’s premier mental health institute – NIMHANS.”
In the US it is not precisely known as to exact number of patients who undergo ECT annually as many states do not maintain any record of that. But according to an estimate by non-profit Mental Health America, every year about100, 000 persons undergo the ECT treatment for various types of mental disorders. In India, the number of people who undergo ECT is more than those who take the treatment in UK.