what is electro shock therapy ?

Question

I am curious about electro shock therapy and wondered how it is performed and what are the effects. Does it really work?

Answer 1

Electroconvulsive therapy (ECT) is a controversial medical treatment involving the induction of a seizure in a patient by passing electricity through the brain. Patients with any of several conditions often show dramatic short-term improvement after the procedure. While the majority of psychiatrists believe that properly administered ECT is a safe and effective treatment for some conditions, a vocal minority of psychiatrists, former patients, antipsychiatry activists, and others strongly criticize the procedure as extremely harmful to patients' subsequent mental state.[1]

ECT was introduced as a treatment for schizophrenia in the 1930s, and soon became a common treatment for neurologically based disorders affecting mood. In the early days of use, ECT was administered without anaesthesia or muscle relaxants. Patients were frequently injured as a side effect of the induced seizure. ECT without anaesthesia is referred to as "unmodified ECT", or "direct ECT", and is illegal in most countries. Currently, in most countries, patients are first administered an anaesthetic agent as well as a paralytic agent, significantly reducing the chances of injury seen in unmodified ECT.

ECT was a common psychiatric treatment until the late 20th century, when it fell into disuse as better drug therapies became available for more conditions. It is now reserved for severe cases of refractory depression in such illnesses as clinical depression (unipolar depression) and the depression associated with bipolar disorder. When still in common use, ECT was sometimes abused by unethical mental health professionals as a means of punishing and controlling unruly or uncooperative patients. Many people came to view ECT unfavorably after negative depictions of it in several books and films, and the treatment is still controversial.

Techniques and Equipment
The original ECT machines used alternating sinusoidal mains current at a frequency of 50 or 60 Hz transformed down to 70-150 volts. Electrodes were applied bilaterally (one on either side of the head) and stimulus duration was usually 0.1 to 0.5 seconds. The machines were constant voltage and the amount of current delivered depended on the impedance of the patient's head. A current of 300 milliamps was typical. In the early 1940s, in an attempt to reduce the memory disturbance and confusion associated with treatment, two modifications were introduced: the use of unilateral electrode placement (with both electrodes on the non-dominant side of the head) and the replacement of sinusoidal current with brief pulse. It took many years for these modifications to be widely adopted and even today they are not universally used.[13] In the USA and the UK for example, bilateral electrode placement is still used more commonly than unilateral, with many psychiatrists finding bilateral more effective and easier to use although there is widespread agreement that it causes more memory loss than unilateral. A survey of psychiatric facilities in the New York City metropolitan area in 1997 found that approximately 11 per cent of ECT patients received sine-wave stimulation and approximately 75 per cent of patients were treated with bilateral electrode placement.[14] Typically, with modern brief-pulse constant current machines a patient may receive a stimulus of 750 milliamps lasting 1-6 seconds. Voltage depends on impedance up to a maximum of 225. Pulsewidth is 2.2 milliseconds, at a frequency of 30-70 Hz.[15]

Stimulus dosing, where the stimulus is adjusted to an individual patient's seizure threshold, is a more recent modification.[16] Although the research leading to its development dates back to Sweden in the 1950s and 1960s, its use has only been recommended since 1990 and some clinics still give all their patients the same dose.[17] Seizure threshold can only be determined by trial and error ("dose titration"). Some psychiatrists compromise between fixed dose and dose titration by roughly estimating a patient's threshold according to age and sex. The appropriate levels of stimulation are generally thought to be about one-and-a-half to twice threshold level for bilateral ECT and higher than this for unilateral. Below these levels treatment may not be effective in spite of a seizure, while doses massively above threshold level, especially with bilateral ECT, expose patients to the risk of more severe cognitive impairment without additional therapeutic gains.


[edit] Side effects and complications

[edit] Side-effect profile
Much of the accepted risk of ECT arises from the use of general anesthesia; there is considerable disagreement about other risks. The most common adverse effects are confusion and retrograde memory loss for events surrounding the period of ECT treatment, and generalised but mild muscle aches after waking. Some of the confusion and disorientation seen on awakening after ECT clears soon after.

More persistent memory problems are variable and difficult to quantify. Most typical with standard, bilateral ECT has been a loss of memories for the time of the ECT series and extending back for an average of 6 months, combined with impairment in learning new information, which continues for perhaps 2 months after ECT.[18] No long-term (six months post-ECT or more) studies of cognition, memory ability, and memory loss have been done in the past two decades, but some long-term studies before this reported permanent amnesia,[19][20] although others found problems were gone by seven months after ECT.[21] Calev (1994) surveyed the literature and concluded that patients must be warned of possible non-memory cognitive deficits, as "they are not going to function well on more tasks than they anticipate".[22] At least a third of ECT patients have some permanent memory loss, according to a systematic review in 2003.[23] Formal neuropsychological testing has documented permanent neuropsychological deficits in ECT patients,[24] including an IQ loss of more than 30 points in one.[25] The degree of impairment and resulting impact on functioning vary between individuals.[26] Critics of ECT believe that there is enough evidence that patients' memories can be permanently and severely damaged to justify a moratorium, at least until more research has been done into its effects on the brain.

Many early studies from the 1940s, 1950s, and early 1960s indicated that ECT was associated with brain abnormalities.[27] However, other authors such as Sackeim (1994) and Weiner (1984)[28] dismiss the work done in the 1940s and 1950s, pointing out that today's ECT is different. This is supported by the changes in procedure in the 1960s, by the far more effective imaging techniques used today to assess brain damage, by the fact that very few of the earlier studies were prospective, and by the fact that many were post hoc accounts of single patients rather than clinical trials.[29] Of the case studies which have not found brain changes after ECT, perhaps the most persuasive is a patient who had received more than 1250 bilateral ECT treatments and whose brain was in perfectly good health when she died at 89.[30] The recent work assessing the consequences of seizures has found no evidence that they cause brain damage,[31] with prospective studies appearing to confirm this.[32]

However, critics argue that the differences might make the procedure more damaging, not less. Anesthesia and muscle-paralyzing drugs increase the risks of the procedure and thus its mortality rate.[33] The claim that oxygenation prevents brain damage and thus makes some earlier studies irrelevant is disputed, for example, Sackheim[34] does not always oxygenate his patients: "They don't turn blue", so earlier studies in which animals are not oxygenated might still be relevant. Against this is evidence from more sensitive modern imaging studies, and the evidence from those suffering from epileptic fits of comparable duration to those provoked by ECT, who do not suffer hypoxic brain injury. In addition, while early ECT devices were less powerful than those of today,[35] causing opponents of ECT to suggest that today's machines might be more likely to cause brain damage than those used in the early studies, research has shown that the amount of electricity which reaches the brain tissue is significantly below the intensity and duration which would cause damage.[36]

There is more recent work noting brain abnormalities in those who have had ECT. Colon & Notermans found changes in nuclear volume in the cortex, but without loss of neurons.[37] Calloway et al. found an association with frontal lobe atrophy and ECT on a retrospective review of scans[38] , and accordingly did not claim these were caused by ECT (many schizophrenics, for instance, have abnormal brain anatomy as part of their condition,[39][40][41][42] and brain changes have also been found in depressive patients[43] ). Diehl et al. in a study of six patients found significant post-ECT T2 increases in the right and left thalamus consistent with a post-ECT increase in brain water content.[44] Dolan et al. found that a past history of treatment by electroconvulsive therapy was associated with greater sulcal widening in the parietal and occipital areas, although again they did not suggest this was due to ECT.[43] Accordingly, while some practitioners may fail to adhere to accepted guidelines for administering ECT, no studies since anesthesia and oxygenation were introduced as standard practice have shown that they cause any damage, despite the much better imaging currently available.

In addition to the physiological effects, ECT may also have adverse psychological effects, counterproductive to its commonly stated goal. These effects may include post-traumatic stress disorder. Instances of such a case have been recorded by David Armstrong.[45]

Psychologist John Breeding has highlighted what he regards as the psychological effects of ECT, particularly:

1) Suppression of emerging distress material
2) Suppression of ability to heal by emotional release;
3) Creation of emotional distress, including deep feelings of terror and powerlessness;
4) Promotion of human beings in the roles of victims and passive dependents of medical professionals;
5) Confirmation of patients' belief that there is something really wrong with them (shame)."[46]
Breeding regards psychiatric illness as the product of unresolved psychic conflict, often due to abuse, and feels that the correct treatment for such problems is to bring out this underlying conflict, and has compared the experience of those who have undergone ECT to that of Holocaust survivors.

The decision to use ECT must be evaluated by each individual, weighing the potential benefits and known risks of all available, appropriate treatments in the context of informed consent,[47] free of coercion and veiled threats. Studies in 2004 and 2005 showed that half of ECT patients did not feel that they could refuse the treatment.[48]

Learn more:
http://en.wikipedia.org/wiki/Electroconvulsive_therapy

http://www.electroboy.com/electroshocktherapy.htm

Answer 2

I have had ECT twice and I swear by it.... Let me tell you what happens. First, you goto the hospital (if you are doing it outpatient) in the morning. The doctors put you to sleep. They then give you a muscle relaxant so that your body does not jerk and shake when you are shocked. In most cases they take the probe and put it on the right side of your head. If you are experiencing depression that does not get better, they may use two probes and put them on both sides of your head. Then the doctor administers the shock. It takes like 2-3 seconds. It takes longer to wake up then the shock itself. When you wake up you might have: a headache, nausea, memory loss, or feel tired. In the United States, people go Monday, Wednesday, and Friday. They usually have 8-12 sessions. When I had it done for depression, I had 10 sessions and experienced no memory loss. Mostly I had a bad headache and was sick in my stomach. I took a nap and felt better. You can't drive because you have been asleep and forget about doing anything for the rest of the day, because I think everyone feels really tired. It really help me when nothing else would...

Answer 3

Electr Shock Therapy, or ECT is actually a very SAFE and EFFECTIVE way to deal with depression (and mania).

It is not like it used to be.....I had it done twice in my life and it really helped me.

In general....in a hospital, they put you to sleep, give you a muscle relaxant and apply an electrode to one side of your head. (sometimes both sides) The electrode administers a shock to your brain. Then you are done. The prep time takes longer than the shock treatment.

The shock causes a convulsion. In the old days, this is what caused the body to jerk around (as shown in movies, etc). But because you are given a muscle relaxant, your body no longer jerks.

In most instances they only use an electrode on one side of the head, but if you are not improving, they may put electrodes on both sides. Doctors say that electrodes on both sides of the head are known to cause more memory loss, etc.

Usually when you wake up, you are tired and may feel nauseous, have a headache, and have a loss of memory. Most memory returns.

In the USA, they give treatments Monday, Wednesday, Friday. And most people have 8 to 10 sessions, but usually feel better after 4.

Answer 4

You are taken to a little room. Heart monitors are placed on you. You are put to sleep. They place a gag in your mouth for when you clamp your mouth down. They then shock you. The shock lasts from 2 to 6 seconds, depending on how long it takes for you to have grand Mal seizure which lasts about 25 seconds. Then you are taken to a recovery room until you wake up. You awaken with a huge headache and sore muscles. Most people due not recognize the people around them or what they have just been through. For many of us who have had the shock it has erased many years of memories such as who our family and friends are, who we are, how to do our jobs. Has caused other severe memory problems such as forgetfulness, changed our personalities, lowered our IQ's, caused problems with short term memory, henders our reasoning abilities and our judgement has been impaired, and relearning new tasks is very difficult (this list can go on and on).

Any positive effects for the treatment of depression does not last. Depression almost always comes back. For me it never did anything but make my depression worse as now I have all the cognitive disabilities to go with the depression.

This is still a barbaric and inhumane treatment. Most doctors are not turthful about the side effects of ECT. Make sure you really research this if you are considering it. Remember that when they flip that switch the doctors do not know where in the brain the electricity is going to go. They have no control over the premenate damage that will occur.

Answer 5

Electroshock therapy is where the doctors purposely give your brain a major seizure so that the electric pathways in your brain are changed. It is used for severe depression. The person loses some memory afterwards, but it can help the severely depressed. It is not a treatment entered into lightly or casually. It does work when needed.

Answer 6

Electroshock therapy is used for treatment of depression and manic depression. Electroshock therapy is usually administered to patients in a series of six to twelve treatments over a two week period.

It can be very dangerous because it can cause brain damage, memory loss or head trama

Answer 7

look it up on the net, there is a lot of argument as to its value, but its simply sticking electrodes on you and giving you a shock. like grabbing bare wires. no fun at all.

Answer 8

It is used to stop someone from doing something. Everytime they do it, they get shocked. Kind of like a shock collar for people.

Answer 9

electroconvulsive therapy is for people who are severely depressed or at risk to seriously kill themselves. I hear it works well on the elderly too. A common side effect is acute memory loss, but memory usually returns. I dunno if it works, i havent tried it!

Answer 10

there is diiferent kinds of EST, for muscle stimulation and
all kinds my brother has a TENS thing ,bout the size of cigs., and applys two patches and get massaged

fun little item