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Electroconvulsive therapy (ECT), which has been around since 1938, has undergone a transformation of sorts—it is delivered more precisely and humanely today than in earlier decades.
ECT currently helps many people find relief from symptoms of mental illness, especially clinical depression.
However, ECT (or shock therapy) is considered by many doctors and mental health professionals a treatment of last resort—something to try when all else fails—because a side effect can be problems with memory.
During the 1930s, Italian neurologists Ugo Cerletti and Lucio Bini introduced the concept of attaching electrodes to a person’s head and passing a current between them to alter brain chemistry and activity. It is said that Cerletti came up with the idea after observing that when cows were shocked before slaughter, it sedated them.
Early ECT treatments must have been a terrifying affair. Patients were awake during the procedure and the electric current caused convulsive thrashing that sometimes resulted in broken bones. It is no wonder the public’s perception of ECT resembled a B-list horror movie.
Today, in modern treatment facilities, ECT is given with a muscle relaxant and general anesthesia. This lessens discomfort and minimizes muscle activity during the procedure. Patients are unconscious and do not notice any involuntary muscle movements or experience pain. Professionals closely monitor the patient’s vital signs and brain waves.
Many individuals who have undergone ECT report it is no more frightening than a dental appointment, or that it is scarier than going to a dentist but not painful.
Memory hiccups from ECT are reduced when the electrodes are placed on one side of the head instead of both. Also, new brief-pulse machines deliver precisely calibrated, intermittent doses of electricity to the brain, minimizing the side effect. However, many ECT patients experience some annoying memory problems.
A number of doctors and scientists warn of possible permanent cognitive damage (other than memory loss) from repeated exposures to ECT, but there is no definitive research evidence behind this claim.
After using ECT for more than 75 years, doctors still do not know why it helps. The controlled seizures may stimulate the growth of new neurons, reset brain activity to be more effective, or trigger the release of hormones than defeat depressive symptoms. Another theory is that ECT enhances the sensitivity of the brain’s receptors for neurotransmitters such as dopamine and serotonin.
If scientists can figure out why ECT helps it may also allow them refine the procedure even more, and maybe eliminate the side effect of memory loss. Still, even with its present imperfections, many individuals find that getting relief from stubborn mental health symptoms is worth putting up with ECT’s drawbacks.
Source: Scientific American
Photo credit: Life Mental Health (flickr)
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