Should I Consider Electroconvulsive Therapy for My Depression?

Millions of Americans suffer from major depressive disorder, a mood disorder that causes persistent and pervasive feelings of sadness, hopelessness, and low self-worth. While there’s no cure for depression, it can be managed — as long as you find the right therapy.

For many people, therapy includes antidepressant medications. But unfortunately, those medicines don’t “work” for everyone. Electroconvulsive therapy (ECT) provides an alternative treatment that offers meaningful, long-term relief.

At Conduit Behavioral Health, Temika Heyward, PhD, FNP, CRNP, PMH, and her team specialize in helping people break the stranglehold of depression, offering therapies designed to address even the most stubborn symptoms. Here, learn how ECT works and when to consider it for your care.

The ABCs of ECT

Electroconvulsive therapy uses small electrical currents to trigger biochemical changes in your brain and optimize nerve pathways involved in mood regulation. The electrical currents trigger a brief, controlled seizure that lasts less than a minute. 

Although ECT has been used for a long time, many people need to be more informed about how it works or what it does, perhaps because in its early days, ECT was performed using chemical agents (like camphor). Without anesthesia, while patients were awake—the idea of intentionally triggering a seizure while awake is, understandably, problematic to most people.

Today, ECT is performed under anesthesia using muscle relaxants and other medications so you sleep and stay comfortable throughout treatment. We monitor your brain’s electrical activity during treatment using an electroencephalogram (EEG). The EEG reflects increased activity in your brain during the seizure, with activity “leveling off” as the seizure subsides.

ECT for depression

ECT has a long history of successful use in people with treatment-resistant or severe mental health disorders, including some types of depression, bipolar disorder, post-traumatic stress disorder (PTSD), and schizophrenia. Research indicates ECT can provide rapid improvement in about 70%-90% of people who receive therapy.

Still, it’s not a good choice for all people with depression. Specifically, ECT is considered when other types of therapy, like medication and psychotherapy, have failed to provide long-term, meaningful symptom relief. This type of depression is called treatment-resistant because it doesn’t respond — or doesn’t respond enough — to the “regular” treatment routes.

ECT may also be a good choice for people with severe forms of depression or other mental health issues, like catatonia or depressive psychosis. It’s also considered for people who need rapid intervention, including some people with suicidal thoughts or actions.

What happens during treatment

ECT can be performed on an outpatient basis and during a hospital stay. Most patients benefit from a series of treatments based on their specific symptoms and how quickly they respond to treatment.

During treatment, you’ll lie back or recline while we place electrodes on your scalp to administer therapy and monitor your brain activity. Next, we administer an anesthetic to put you to sleep. Muscle relaxants prevent contractions that typically occur during seizures.

Once the anesthetic takes effect, we initiate the seizure activity by delivering a small electrical current via the electrodes. This part of the treatment takes less than a minute. 

Once your treatment is complete, you’re moved to a recovery area where you’ll relax while the anesthetic wears off. It’s common to feel groggy after treatment, so while you’ll be discharged shortly afterward (for outpatient treatment), you should plan to take the day off and relax.

Find relief from your depression symptoms

ECT can provide meaningful relief from persistent or severe depression symptoms, but generally, it’s a therapy that’s only recommended when other options don’t work. To find a therapy option that works for your depression symptoms, request an appointment online or over the phone with Dr. Heyward and the team at Conduit Behavioral Health in Baltimore, Maryland, today.