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Many critics have portrayed ECT as a form of medical abuse, and depictions in film and television are usually scary. Yet many psychiatrists, and more importantly, patients, consider it to be a safe and effective treatment for severe depression and bipolar disorder.
Few medical treatments have such disparate images. I am a historian of psychiatry, and I have published a book on the history of ECT. I had, like many people, been exposed only to the frightening images of ECT, and I grew interested in the history of the treatment after learning how many clinicians and patients consider it a valuable treatment.
My book asks the question: Why has this treatment been so controversial? ECT works by using electricity to induce seizures. This is certainly a counterintuitive way of treating illness. But many medical treatments, such as chemotherapy for cancer, require us to undergo terrible physical experiences for therapeutic purposes.
The conflicts over ECT have other sources. ECT was invented in Italy in the late s. Psychiatrists had already discovered that inducing seizures could relieve symptoms of mental illness. Before ECT, this was done with the use of chemicals, usually one called Metrazol. By many reports, patients experienced a feeling of terror after taking Metrazol , just before the seizure started.
A Cleveland psychiatrist who was active then once told me that the doctors and nurses used to chase the patients around the room to get them to take Metrazol. Ironically, given that ECT would become iconic as a frightening treatment, the Italian researchers who proposed using electricity instead were searching for a safer, more humane and less fearsome method of inducing the seizures. In , there were no effective medications for the treatment of mental illness; the modern era of psychopharmacology was still more than 15 years away.
However, in insulin had been used to create a comatose state and chemicals had been used to induce epileptic seizures, both as novel forms of treatment for people with schizophrenia; these treatments rapidly became popular around the Western world as an antidote to therapeutic hopelessness. But they also carried risks, and Professor Ugo Cerletti, the head of the University of Rome psychiatric clinic, working with his junior colleague Lucio Bini, developed an electrical alternative for inducing brief seizures in people with psychiatric illness.
The benefits of ECT led to its rapid spread around the world. It rapidly became clear that it was a potent treatment for people with severe depression or catatonia. Despite the excitement surrounding ECT as an effective remedy, there was — understandably — something terrifying about the idea of electrical current being passed through the brain, even if the goal was to relieve illness. Perhaps this emanates from ghoulish perceptions suggested by the popular film Frankenstein , in which the monster is brought to life by electric currents.
By contrast, cardiac defibrillation with an electrical stimulus is commonly shown on TV as a lifesaving treatment — and so simple it can be used by non-professionals in hockey arenas and movie theatres. At CAMH, where each weekday 20 to 25 people receive ECT as part of their acute or ongoing treatment, most are outpatients who go home an hour after they have been treated. Arch Womens Ment Health. ECT in schizophrenia: a review of the evidence.
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Luchini, F, et al. A review of electroconvulsive therapy in suicidality. Mental Health Clinician. Electroconvulsive therapy. Updated July 8, Cleveland Clinic.
Reviewed May 13, Understanding electroconvulsive therapy ECT. American Psychiatric Association. What is electroconvulsive therapy ECT? Updated July Your Privacy Rights. To change or withdraw your consent choices for VerywellMind. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page. These choices will be signaled globally to our partners and will not affect browsing data.
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