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Medically reviewed by Kathleen Daly, MDMedically reviewed by Kathleen Daly, MD
Shock therapy, also called electroconvulsive therapy or ECT, is a treatment approach for mental health conditions. The treatment works by placing electrodes on your head to medically induce a seizure, which can help treat symptoms.
If your healthcare providers believe ECT can improve symptoms of a mental health condition you have, a team of nurses, psychiatrists, and anesthesiologists can help administer treatment.
Stigma Around “Shock Therapy”
Historically, electroconvulsive therapy was referred to as "shock therapy." However, to reduce the stigma associated with mental health conditions and their treatments, mental healthcare providers encourage people to use ECT (its abbreviation) now.
Purpose of ECT
Healthcare providers only recommend ECT when other mental health treatments (such as medications or therapy) haven't worked. If other treatments haven't been helpful for you, your healthcare team may recommend this therapy if you have:
- Catatonia (affects your ability to process the world around you)
- Schizophrenia (often causes delusions, hallucinations, and disorganized speech or behavior)
- Psychosis (when thoughts and perceptions become distorted, making it hard to understand what is real and what is not)
- Schizoaffective disorder (a combination of schizophrenia symptoms and mood disorder symptoms like depression or mania)
- Bipolar disorder (causes extreme shifts in your mood, energy levels, and ability to carry out everyday tasks)
- Severe depression
- Suicidal ideation
Research also shows that ECT is safe and effective for young people, those who are pregnant, and people who cannot take antidepressants. However, several other factors, such as the symptoms of your condition and your overall health history, can determine if ECT is specifically safe for your case.
If you are experiencing a crisis or know someone who is, call or text the National Suicide Prevention Lifeline at 988 for free and confidential support 24/7. You can also visit SpeakingOfSuicide.com/resources for a list of additional resources or call the number below to reach the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline.
How Does It Work?
During ECT, your healthcare team will cause a type of seizure called a tonic-clonic seizure. The tonic phase stiffens your muscles, and the clonic phase makes them twitch. They’ll give you medication so you won’t feel or remember the seizure. Your body won’t even look like it’s having a seizure. During this process, your providers will closely monitor you to ensure your safety.
The treatment is generally safe and effective for most people.
Before the Test
Before treatment starts, you will have to sign a form to give your consent to the treatment. Your healthcare provider will meet with you before treatment to review your medical history. They will also perform a physical exam to clear you for the therapy. If you have diabetes, they'll likely check your blood sugar levels.
Before treatment starts, your team will use equipment to monitor you while you lie on a bed. You will have a blood pressure and oxygen monitor attached to your body. You can also expect an electrocardiogram (EKG) monitor with electrodes attached to your chest and scalp.
Once you're prepped, your healthcare team will put you under general anesthesia. This helps you stay comfortable and motionless during the seizure. To help you breathe properly while you're asleep, your team may also wear a nasal cannula or a face mask. You can expect the treatment to be rather quick. Most therapy sessions last no longer than 15 minutes, and the seizure lasts 10-70 seconds.
During the Test
When you're under anesthesia, your healthcare team will monitor all the devices and electrodes attached to you. The electrodes on your scalp will deliver short bursts of electricity to specific areas of your brain. The electricity will cause a brief seizure, which your healthcare team will closely monitor to ensure your safety.
Your hands or feet may move slightly, but your entire body won’t convulse (shake) like a typical tonic-clonic seizure. After the seizure is complete, your anesthesiologist (a doctor who specializes in administering medicine) will slowly help you wake up.
After the Test
ECT is usually an outpatient procedure that doesn’t require staying overnight in a hospital. You will wake up a few minutes after the therapy ends without remembering the treatment.
Your healthcare team will move you to another room to recover from the anesthesia. Once you fully recover, you can leave. This can take a few hours, but it varies from person to person. After the treatment, you’ll need someone else to drive you home because you may still be a little disoriented.
While this therapy offers rapid treatment for some mental health conditions, it doesn't completely prevent symptoms from returning. You may have to return for additional treatment. Most people undergoing ECT usually receive 6-12 sessions, which can happen once every 2-5 days. However,, each case is individual, so some people may need more or fewer sessions.
Risks and Precautions
While ECT is generally considered safe, some people may experience confusion or memory problems that typically go away within two weeks. In rare cases, side effects may last six months or longer. If you're experiencing long-term symptoms, your provider may recommend taking cognitive-enhancing medications like Namenda (memantine) to reduce the side effects.
Other side effects of this therapy are often temporary and may include:
- Nausea
- Muscle soreness
- Headache
- Low or high blood pressure
More serious complications (such as a longer seizure or cardiac event) may be possible in people with a history of heart conditions. If you have a heart condition, you may still be able to receive ECT, but you'll likely need beta-blocker medications alongside treatment. However, these complications occur in less than 1% of people undergoing treatment.
How To Prepare for Therapy
Knowing how to prepare and what to bring before your appointment can help ease any worries about the treatment. Consider the following tips:
- Bring a form of identification and your insurance card
- Call your insurance company to understand your out-of-pocket costs
- Avoid wearing jewelry or other accessories to your appointment, as you'll need to take them off
- Wear loose-fitted and comfortable clothing
- Don't eat anything for eight hours before the therapy session
- Tell your healthcare team about any medications and supplements you're taking
- Ask your healthcare team if you can bring someone with you to your appointment for emotional support
- Arrange a loved one to take you to and from your appointment
Is ECT Effective?
Electroconvulsive therapy is effective for many people. For example:
- One study found that 81% of people with suicidal thoughts before starting therapy found complete relief after finishing all of their sessions.
- One study found that 80-100% of people with catatonia had improved symptoms after treatment.
- Some evidence also indicates that this therapy may be more effective than antidepressants in people with treatment-resistant depression.
If you think ECT may be effective for you, talk to your healthcare provider about your options. They can help you determine if this treatment is safe for you.
A Quick Review
Electroconvulsive therapy (previously known as shock therapy) is a safe and effective procedure for many people living with mental health conditions. This treatment attaches electrodes to your scalp to send small bursts of electricity to certain parts of your brain and provoke a painless seizure to alter brain activity.
Healthcare providers will only recommend this therapy if other treatments like medications and therapy haven't effectively improved your symptoms. If you're interested in this therapy, ask your provider if it's safe for you.
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