What is Electroconvulsive Therapy (ECT)?

ECT is a safe and effective treatment for some severe mental illnesses. It is usually used for a severe illness when therapy and medications have not worked. ECT is done by trained medical professionals. They attach pads at specific points on the head and briefly send electricity to the brain. This triggers a short seizure that usually lasts less than one minute.

Since ECT was first used, the patient’s experience has much improved. ECT is now done under anaesthesia, which means the patient is asleep and does not feel any discomfort or pain. The patient is also given a muscle relaxant to prevent muscles from moving and the body from shaking. If you’ve seen ECT on television or in a movie, it probably looks very different than ECT in real life.

ECT can come with some risks and possible side effects. There is very low risk of complications from the anaesthesia and seizure during the procedure. If a number of ECT procedures are needed, memory problems are a common side effect. Almost all patients do not remember much of the ECT procedure itself (due to the seizure and anaesthesia).  Some patients have a hard time forming new memories during the ECT treatment period, but this goes back to normal after ECT is finished. A very small number of patients report severe on-going memory problems. ECT is rarely used in children and not often with youth and young adults. There has not been any increased risk found when ECT is used with these groups.

ECT can be a life-saving treatment. The risk from not treating severe mental illness can often be greater than the risks of ECT. It’s important to think about both the risk and benefits of non-treatment and the risk and benefits of ECT treatment for each patient.

What types of challenges are best suited for ECT?

ECT is most commonly used and effective for treating:

• severe bipolar disorder
• severe depression
• catatonia (a symptom of some mental disorders)

ECT may also be used for other conditions, including:

• severe suicidal ideation (thinking about and planning suicide)
• severe schizophrenia

How long will it take?

After a doctor recommends ECT as part of a treatment plan, another doctor will provide a second opinion. The patient and family should decide if ECT is the best option for them, and ask the doctor any questions they have. It is important to learn about the process and be able to give informed consent to go ahead with ECT treatment. To learn more about informed consent for ECT, see the video below.

An ECT procedure only takes about 5-10 minutes, but with preparation time and anaesthesia, it can take patients about an hour. Most patients recover quickly but, there will be some limits on their activity. For example, they should not drive or do anything that requires lots of energy in the first three weeks of the treatment period. The patient needs to rest and relax.

ECT is usually done 2-3 times a week for a few weeks. Most patients have 10-14 procedures, but the number depends on each person. Some patients will only need a few procedures before they notice an improvement. Others will need the full treatment period. Some people also need a procedure from time to time to keep them well.

ECT is often used with other treatments or support, such as medication and therapy.