In spite of having had a bad press in the past, electroconvulsive therapy (ECT) can be very effective at relieving symptoms for people with strong and persistent negative symptoms of depression.
Most doctors agree that severe symptoms are caused by problems with certain brain chemicals. Electroconvulsive therapy causes these chemicals to be released, making it more likely that they will play their part in healthy brain function, and so easing the severe symptoms.
Electroconvulsive therapy is offered at WLMHT if:
- Different medications have not helped
- Side effects from antidepressants are too severe
- ECT has been helpful in the past
- A person’s life is in danger due to the symptoms they are experiencing
- A person is suicidal.
Every person offered ECT is given information from their doctor and a leaflet explaining what it is and why it is used. The leaflet also explains a person’s rights when consenting to ECT.
Before ECT is started, a person must agree to the treatment. If they don’t want it, it can’t be given unless doctors decide the situation is an emergency. If a person is too ill to give their consent, WLMHT tells the Care Quality Commission and it arranges for an independent doctor to visit and give a second opinion. There must always be a second opinion from another doctor if a person is under the age of 18, even if they have consented to treatment.
If a situation is urgent and ECT will save a person’s life or stop their condition from becoming much worse, the rules about consent don’t apply. In this situation, The Mental Health Act allows ECT to be given without a person’s consent.
Electroconvulsive therapy is usually given three times a week. A person may need as few as three or four treatments, or as many as 12 to 15. Once a person starts to feel better, there may be one or two additional treatments to prevent a relapse.
WLMHT is audited and has been commended for the quality of its ECT treatment.
Treatment today is painless and safe because a person is put to sleep briefly so that muscles are relaxed and don’t contract. (In the past, people weren’t put to sleep, and muscles suddenly contracting could cause fractures). Once asleep, a very small current is passed through the person’s brain, activating it and producing a seizure. The effect on a person’s brain and heart is monitored carefully, and they wake up 10 to 15 minutes later.
On waking, a person may have a brief period of confusion, headache or muscle stiffness, but these symptoms usually wear off within 20 to 60 minutes. Short-term memory can be affected for a few days but most people find their memory returns to normal within a month. Some people find they have persistent memory problems for the period immediately surrounding the treatment but this, too, usually passes after some months.
Up to half of those having electroconvulsive therapy experience a relapse within six months. Consequently, the WLMHT care team may also prescribe antidepressants, lithium or further electroconvulsive therapy at monthly or six-weekly intervals. WLMHT is audited and has been commended for the quality of its ECT treatment.