Electroconvulsive Therapy (ECT)

Electroconvulsive therapy, or ECT, is one of the safest and most effective ways to treat mood disorders like severe depression and bipolar disorder when other therapies haven’t helped. It stimulates the brain with brief, mild electrical currents, believed to cause chemical changes in the brain that can help reverse symptoms. The treatment is pain-free and works quickly. About 70% of patients treated with ECT say they no longer feel depressed when their sessions are complete.

At Atrium Health, our interventional psychiatry team – including board-certified physicians, registered nurses and certified technicians – are experts in treating major depression and other mood disorders, and they are highly trained in ECT. Our team works closely with each patient’s mental health provider, tailoring care to meet your needs.

Understanding ECT therapy: How it works

ECT sends mild electrical pulses to a specific area of the brain, triggering a brief (about 30 seconds), controlled seizure. Experts believe this helps jumpstart the brain and improve mood symptoms by enhancing brain chemicals, regulating the hormone system and improving communication between different parts of the brain.

ECT techniques have improved greatly in recent years. The treatment is highly effective and tends to work faster than medications to relieve symptoms.

ECT treatments are grouped together over a short period of time – patients may undergo three treatments a week for several weeks. The procedure can be done on an inpatient or outpatient basis.

Conditions treated

ECT therapy can help with conditions such as:

• Depression
• Bipolar disorder
• Psychosis
• Catatonia
• Mania
• Parkinson’s disease

What to expect

Before ECT treatment

Your physician or mental health provider will refer you to us to see if ECT is right for you. During your visit, our team will evaluate you and explain how ECT works and what to expect. You may also need a series of tests, which could include bloodwork, a urine test, imaging scans, an electrocardiogram or an evaluation by a medical specialist.

During ECT treatment

Our ECT sessions take place in an operating room setting. An anesthesiologist will give you an IV of general anesthesia, followed by a medicine to relax your muscles. While you’re asleep, an electrical current is delivered to precise areas of the brain via 2 electrodes placed on your head. A physician monitors your brain waves, heart rate, breathing and blood pressure throughout the treatment.

We tailor ECT treatments so that you receive the smallest amount of electricity needed to improve your symptoms. The stimulation induces a brief, controlled seizure within the brain, but you will not feel anything.

The treatment only takes a few minutes. Patients are usually able to resume basic activities within an hour. You will need someone to drive you home, since you will have been under general anesthesia.

Patients typically receive between 6 to 18 ECT sessions in the first round of treatment.

Follow-up care

After your first round of ECT sessions is complete, you may benefit from additional sessions to keep symptoms from coming back. Sessions could vary from once a week to every few months, depending on your health care team’s recommendations.

Is ECT right for me?

You may benefit from ECT if:

• You have severe depression, psychosis, catatonia, mania, bipolar disorder or schizophrenia
• You have depression or motor symptoms related to Parkinson’s disease
• Medications have not worked
• You have a medical condition that prevents you from taking medications (for example, if you’re pregnant)
• You need quick and effective treatment (for example, if you are pregnant or have thoughts of suicide or hurting yourself)
• Your condition is accompanied by irrational thinking or unreal perceptions
• You have had previous success with ECT

You should avoid ECT if:

• You have a serious heart condition
• You have had a recent stroke or aneurysm
• You have severe lung disease

Most patients do well with ECT. The most common side effects are:

• Headache
• Nausea
• Muscle aches
• Short-term memory loss, which typically resolves within days or weeks after treatment