Electroconvulsive therapy: cruel torture or an effective method?


One Flew Over the Cuckoo’s Nest and other films and books portray electroconvulsive therapy as barbaric and cruel. However, a practicing psychiatrist believes that the situation is different and sometimes this method is indispensable.

Electroconvulsive therapy (ECT) is a very effective method for the treatment of severe mental illness. And they use it not “in third world countries where there are problems with medicines”, but in the USA, Austria, Canada, Germany and other prosperous states.

This method is widely known in psychiatric circles and in Russia. But true information about him does not always reach patients. There are so many prejudices and myths around ECT that people are not particularly willing to explore other points of view.

Who invented this?

In 1938, Italian psychiatrists Lucio Bini and Hugo Cerletti tried to treat catatonia (a psychopathological syndrome) with electricity. And we got good results. Then there were many different experiments, the attitude towards electroshock therapy changed. At first, great hopes were placed on the method. Then, since the 1960s, interest in it has decreased, and psychopharmacology began to develop actively. And by the 1980s, ECT was «rehabilitated» and continued to be researched for its effectiveness.

When it is necessary?

Now indications for ECT can be many diseases.

For example, schizophrenia. Of course, immediately after the diagnosis is made, no one will shock a person. This is unethical to say the least. To begin with, a course of medication is prescribed. But if the pills do not help, then it is quite possible and even necessary to try this method. But, of course, in a strictly defined way and under the supervision of specialists. In world practice, this requires obtaining the informed consent of the patient. Exceptions are made only in particularly severe and urgent cases.

Most often, ECT helps with hallucinations and delusions. What are hallucinations, I think you know. In schizophrenia, they usually appear as voices. But not always. There may be sensations of touch, and taste hallucinations, and even visual ones, when a person sees something that is not really there (not to be confused with illusions, when we mistake a bush for a demonic dog in the dark).

Delirium is a disorder of thought. For example, a person begins to feel that he is a member of a secret department of the government and spies are following him. His whole life is gradually subordinated to such thinking. And then he usually ends up in the hospital. With these symptoms, ECT works very effectively. But, I repeat, you can usually get into the procedure only if the pills did not have the desired effect.

Electroconvulsive therapy is performed under anesthesia. The person doesn’t feel anything.

Electroconvulsive therapy is also sometimes used for bipolar affective disorder. In short, this is a disease with different phases. A person is immersed in depressive experiences all day long, nothing pleases him or interests him. On the contrary, he has a lot of strength and energy, with which it is almost impossible to cope.

People endlessly change sex partners, take out loans for unnecessary purchases, or leave for Bali without telling anyone or leaving a note. And just the manic phases are not always easy to treat with medications. In this case, ECT can again come to the rescue.

Some citizens romanticize these conditions that accompany bipolar disorder, but in fact they are very difficult. And they always end in a severe depression, in which there is certainly nothing good.

ECT is also used if mania has developed during pregnancy. Because the standard drugs for such therapy are almost always completely contraindicated.

For severe depression, ECT can also be used, but is not done as often.

How does this happen

Electroconvulsive therapy is performed under anesthesia. The person does not feel anything. At the same time, muscle relaxants are always applied so that the patient does not dislocate the legs or arms. They connect the electrodes, start the current several times — and that’s it. The person wakes up, and after 3 days the procedure is repeated. The course usually includes 10 sessions.

Not everyone is prescribed ECT, for some patients there are contraindications. Usually these are severe heart problems, some neurological diseases, and even some mental illnesses (for example, obsessive-compulsive disorder). But the doctor will definitely tell everyone about this and, for starters, send them for tests.

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