A doctor may recommend electroconvulsive therapy (ECT) if you do not respond well to talk therapy and medication.

Depression often causes intense feelings of sadness, irritability, hopelessness, and indifference. You may find it’s challenging to live with, even when undergoing traditional treatments like medications and talk therapy.

This is where ECT may come in. ECT stimulates your brain with electrical currents. It may provide help where other treatments have failed.

ECT is rarely a first-line therapy, but doctors may consider it if you’re not making progress with your current treatments.

ECT involves the use of electrical currents to stimulate a seizure in the brain.

During ECT, you will be under general anesthesia and receive muscle relaxants to help prevent injury. Once under, technicians will hook you up to a machine and deliver short electrical pulses directly to the brain, stimulating a seizure that typically lasts about 15 to 70 seconds.

The entire procedure lasts about 5 to 10 minutes. You may notice improvements in about 6 sessions. You can typically go home shortly following the completion of the procedure.

Some evidence suggests that a person will often develop tolerance to the procedure over the course of treatment. This can result in changes in seizure length.

ECT is a generally safe and effective treatment method for severe depression, but it’s rarely used and may have decreased in use since the 1970s.

For more information on ECT, you can check out this article.

ECT works for depression. Experts generally consider it safe and effective, but it’s often reserved for severe cases of depression where a person is at risk of suicide or other severe impairment.

A 2021 analysis found sufficient evidence to suggest that ECT is safe and effective in treating major depression and other mental health conditions. They noted that side effects were often mild and transient (clear on their own).

Reasons a doctor may suggest ECT for depression treatment include:

  • not responding to standard medications and talk therapy
  • severe major depressive disorder that interferes with daily living activities
  • refusal to eat
  • severe psychosis
  • inability to move normally, which can include rigid posturing in place or abnormal movement

Despite its potential to help, it remains a rare treatment choice. Worldwide, doctors have only used it to treat about 0.02% of people with severe major depressive disorder.

Other conditions treated with ECT

In addition to depression, doctors may recommend ECT for treating:

Though generally safe and effective for treating severe major depression, like all procedures, it can cause some unwanted side effects.

Side effects can range from mild to severe, but they tend to be transient and do not interfere with treatment completion.

A common issue with ECT involves cognitive impairments, including reduced attention span, diminished executive function, and reduced learning and memory capacity. These effects may last for several weeks following treatment.

Some other commonly reported side effects include:

  • headache
  • nausea/vomiting
  • constipation
  • muscle pain
  • dizziness
  • insomnia
  • temporary increased blood pressure
  • thirst or dry mouth
  • drowsiness
  • dysuria with geriatric patients
  • cardiac arrhythmias

Side effects that may occur due to being put under include:

  • temporary, slight memory loss
  • fatigue
  • nausea
  • headache
  • confusion

Due to the severity of the depression doctors may use ECT to treat it, the benefit of treatment often outweighs the risk of side effects.

If a doctor recommends ECT for you or a family member, you should discuss the risks versus the benefits to help determine if the treatment will work best for you.

ECT is an effective, generally safe, and last resort treatment option for severe depression. A doctor may only recommend it if your depression does not respond to first-line treatments, like medications and talk therapy.

A doctor may recommend it if you exhibit potentially life threatening behaviors, such as suicidal actions or refusing to eat. The procedure is relatively short and often involves several sessions. When you’re under general anesthesia, electrical pulses will stimulate a seizure in your brain.

Like some other treatments, it can take some time before you start to notice the effects of ECT, but many people who undergo the treatment eventually see positive results.

Side effects are possible, but they often go away following treatment. They can include memory loss and impaired thinking capabilities. It may also include some physical symptoms, such as nausea or vomiting.

If a doctor suggests ECT, you should consider discussing the risks versus the benefits. Often, the benefits of the procedure will outweigh the potential risks.