During ECT, a brief electrical stimulus is given to the brain via electrodes placed on the temples. The electrical charge lasts between 1-4 seconds, and causes an epileptic-like seizure.
Before treatment, the patient is anaesthetised and given an injection of muscle relaxant which depresses the breathing, and oxygen is given until the patient is able to breathe naturally again. Most patients get a total of six to twelve ECTs at a rate of one a day, three times a week.
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ECT is usually given to people with severe depression which has not responded to other forms of treatment such as anti-depressants. However, it is sometimes used for those with a diagnosis of bi-polar affective disorder (manic depression) or schizophrenia. It is usually only given after the risks have been explained and with the person’s consent, or in the extreme case when the person’s life is at risk.
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This is not clear, but there are numerous theories including the following:
- Neurotransmitter theory: ECT works like anti-depressant medication, changing the way brain receptors receive important mood-related chemicals.
- Anti-convulsant theory: ECT-induced seizures teach the brain to resist seizures. This effort to inhibit seizures dampens abnormally active brain circuits, stabilising mood.
- Neuroendocrine theory: The seizure causes the hypothalamus to release chemicals that cause changes throughout the body. The seizure may release a neuropeptide that regulates mood.
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