During Mental Health Week in May, I realized that even in 2015, many taboos and misconceptions continue to exist about mental illnesses and certain treatments, notably electroconvulsive therapy (ECT), better known as electroshock or shock therapy. I therefore feel it is important to clarify and demystify this treatment.

Firstly, ECT is a last resort solution for patients whose illness has not responded to any of the drugs that treat severe depression and other psychiatric problems. It is a treatment suited to only a limited number of individuals. ECT is an option in cases where the symptoms of depression could lead to the person refusing to eat or drink or even to consider suicide.

The aim of ECT is to stimulate the brain by applying brief electrical pulses of varying intensity in order to obtain an effect comparable to that provided by antidepressants. Contrary to how ECT is portrayed in some movies, its methods have changed considerably, with the regulatory framework now much better defined. Fortunately, references to the treatment in films like One Flew Over the Cuckoo’s Nest have become obsolete and in no way reflect the actual practice.

Research continues into increasing the effectiveness and reducing the side effects of ECT. Current methods are endorsed by the vast majority of the scientific community and are applied in basically the same way from one institution to the next. In all cases, written consent must be obtained from the patient, a family member or the courts, if need be. The patient is systematically put under general anesthesia for a short period of time. The anesthetist also administers a muscle relaxant to prevent the patient from moving and being injured, which was a risk in the past. Vital signs are monitored throughout the session (blood pressure, heart rate and blood oxygen level).

Dignity restored

Prior to scheduling the treatments, the doctor explains the risks and benefits associated with ECT. The patient is never viewed as the subject of an experiment! This procedure in no way undermines the person’s dignity; in fact, it aims to restore his or her autonomy, and patient testimonials bear out the benefits of the treatment.

There is no question that this therapy also has its share of adverse effects, particularly on a cognitive level. Some patients may experience confusion or memory problems after the treatment, but these difficulties rarely last more than six months. However, it’s important to keep in mind that depression itself can also spur memory problems, as can anesthesia.

It must be strongly emphasized that research has never found that ECT leads to learning problems, intellectual deficiencies or, worse, death. On the contrary, for people who are suicidal or in despair, ECT can considerably reduce and even eliminate the clinical symptoms of depression for a given period of time. This ray of light in the otherwise cloudy sky of mood disorders can be significant for patients who have become accustomed to living under a shroud of darkness.