Electroconvulsive Therapy

At Providence, we are expanding mental health service needs for our patients. Many people struggle every day with common symptoms of depression which may include feelings of sadness, lack of pleasure in activities, changes in appetite or sleep, concentration difficulties, hopelessness and thoughts of suicide. Patients are typically referred when medications and psychotherapy are not providing sufficient relief or if side-effects are intolerable. We strive to provide for all patients, especially those in need.

We accept most commercial insurance plans as well as traditional Medicare, replacement and supplemental Medicare insurance plans.

No one is sure how ECT helps certain psychiatric disorders. It may promote changes in how brain cells communicate with each other at nerve synapses, and it may stimulate the development of new brain cells. ECT may flood the brain with neurotransmitters such as serotonin and dopamine, which are known to be involved in conditions like depression and schizophrenia.

If you have major depression, you typically receive antidepressant medication and psychotherapy. These treatments, though often effective, take time to work. This delay can be dangerous if your depression is accompanied by delusions or intense suicidal thoughts. ECT can work more quickly than antidepressants and is useful when you are at immediate risk for self-injury or suicide.

ECT can be prescribed when antidepressant medications have not worked. It can be useful for older patients who are unable to tolerate antidepressants and for pregnant women because medication might damage the fetus. People with bipolar disorder, schizoaffective disorder, catatonic disorder, schizophrenia and other functional psychoses can benefit from ECT. 

Before ECT, you are asked to avoid food and drink starting at midnight the night before treatment. During the procedure, you receive a short-acting anesthesia which puts you to sleep for 5-10 minutes. You also take a muscle relaxant during the procedure to stop your muscles from moving during the seizure. Cardiac monitoring pads are placed on your chest to check on your heart status during and after the procedure. Four electrodes are placed on specific areas of your head. Two of these electrodes monitor your brain waves. The other two deliver a short, controlled set of electrical pulses for a few seconds. The electrical pulses must produce a generalized seizure to be effective. Because you are under anesthesia and took muscle relaxants, you do not convulse or feel the current. 

You awaken about five to 10 minutes after the end of the treatment. You go to a recovery room and stay there until your blood pressure, pulse and breathing return to their pre-treatment levels. Usually this takes about 20 to 25 minutes. 

Someone else must drive you home after the procedure and stay with you until you go to sleep at night. You should not drive in the 24 hours following ECT. 

A single ECT session usually lasts one hour. This includes the time you are in the treatment room (15-20 minutes) and the time spent in the recovery room (20-30 minutes). Typically, ECT (whether inpatient or outpatient) is given two to three times a week for a total of six to 12 sessions. You may need more or fewer treatments. These sessions improve depression in 70- 90% of patients, a response rate much higher than that of antidepressant drugs. Although ECT is effective, its benefits are short-lived. For this reason, you will take antidepressant medication after ECT or may continue receiving ECT periodically to prevent a relapse.

The immediate side effects of ECT can last for about an hour and include: 

• Headaches 
• Nausea 
• Muscle aches and soreness 
• Disorientation and confusion 

You may also develop memory problems. Memories formed closer to the time of ECT are at greater risk of being lost while those formed long before ECT are at less risk of being lost. The ability to form new memories is also impaired after a course of ECT treatments, but this ability usually makes a full recovery in the weeks and months after treatment. 

Studies have demonstrated that ECT does not cause brain damage or cause permanent brain dysfunction. In fact, ECT often improves the brain functioning of patients with severe depression. By treating the depression, patients often report they can concentrate better and think more clearly. During your ECT treatment, we recommend that you don’t make important decisions until after recovery. If any important decisions must be made while receiving ECT, we suggest you consult with family, friends and your treatment team.