How ECT Works for Severe Depression

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Antipsychotics and SSRIs are first-line treatments for minimizing depression symptoms, but they don’t come without adverse side effects. Many of these drugs cause weight gain, low sex drive, nausea, dry mouth, and even insomnia. If prescribed in the wrong dosages, certain medications can make depression symptoms even worse. Adverse side effects aside, some people suffer from depression that is resistant to medication and other common forms of treatment.

For patients who experience no relief when using antidepressants or other depression treatments, doctors may suggest Electroconvulsive therapy (ECT). ECT therapy has proven to be effective in treating the most severe cases of depression.

Here’s everything you need to know about this treatment option.

What is ECT?

ECT is a procedure that is used to treat severe forms of depression, though the treatment is often reserved for patients who haven’t found success with other treatment options. The procedure uses an electric current which produces a controlled seizure. The seizure, which creates a burst of synchronized brain wave activity, lasts for 30 seconds. To make treatment as relaxing as possible, patients receive a dosage of a muscle relaxant as well as anesthesia. This prevents the physical aspects that occur during a seizure. With these medications, there are no physical side effects of the treatment.

With ECT, there are changes made to the brain wave pattern that help to minimize depression symptoms. Most patients undergo treatment three days a week for 2-4 weeks. On the Hamilton Depression Rating Scale, ECT patients experienced at least a 50% improvement.

Preparing for ECT

Before undergoing your first ECT treatment, you’ll have to undergo a full health evaluation. This includes basic blood tests, a physical exam, medical history review, an ECG, as well as a psychiatric assessment. You will also be required to meet with an anesthesiologist to discuss the risks of anesthesia as well as any issues you’ve had in the past.

ECT Sessions: What to Expect

Before an ECT session begins, you may have a brief physical exam. Afterwards, you will be given general anesthesia to put you to sleep during the procedure. Be sure to follow all of your doctor’s instructions in preparing for anesthesia, such as not eating the day of an ECT session. You will also reserve a muscle relaxant to minimize convulsions.

Once the IV has been inserted to deliver the anesthesia, electrode pads will be placed on your head. Some patients require unilateral electric currents while others require bilateral. When you have fallen completely asleep and your muscles are relaxed, the ECT machine will deliver a small electric current through the electrodes which then passes into the brain. This triggers a small seizure. During this time brain activity will dramatically increase. An EEG machine will be used to monitor activity in your brain.

Soon after the anesthesia and muscle relaxant will wear off, allowing you to wake up. Be sure to have someone to drive you home after an ECT session as you may be confused or still drowsy from anesthesia.


Patients who haven’t found success in other forms of depression treatment can start to quickly lose hope. For patients with severe depression, ECT may improve symptoms after just a few sessions. Results are also long-lasting. Unlike antidepressants, patients don’t have to undergo ETC sessions for the rest of their life. Most patients start with a few sessions each week and then gradually move to a session a month.

Another benefit of ECT therapy is that it’s relatively safe. While there are some side effects, they are usually minimal and can be treated with over-the-counter medicine. While antidepressants can impact various parts of the body, ECT side effects tend to be localized to the head and face region.


While ECT is generally extremely safe, there are side effects to be aware of. Common risks include:

  • Confusion
  • Headache
  • Muscle ache
  • Jaw pain
  • Increased heart rate and blood pressure

Since ECT impacts the heart, it’s important to discuss any heart issues with your doctor. Underlying heart conditions can be worsened because of ECT.

The most serious side effect of ECT is the risk of memory loss. After an ECT session, patients mayhave a hard time remembering events that happened weeks or months before treatment. Memory loss is temporary and tends to return to normal a few months after treatment is over.


As the benefits of ECT continue to be understood by a greater number of doctors and patients, a growing number of people have turned to using ECT. If you’re dealing with depression and have yet to find a treatment that produces results, discuss the possibility of ECT therapy with your doctor.

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