The Truth about ECT

Picture if you will: an image of electroconvulsive (electroshock or shock treatment) therapy. For many people this image will involve an unwilling or drugged patient, strapped to a table (likely struggling) while a sadistic nurse administers dangerous shocks that result in dramatic screaming and thrashing. The result of this procedure usually leaves the patient in a worse state then they began in- for electroshock therapy is barbaric and obviously ineffective.

 

At least, that is the image Hollywood would like you to have, and one they have worked very hard on maintaining. Countless movies continue to present electroshock therapy as a treatment that is fundamentally abusive and ultimately useless. One Flew Over the Cuckoo’s Nest, Requiem for a Dream, and many others all present this portrayal. In Bollywood, the same is true- electroshock treatment are used a way to torture and hurt people. Unfortunately, it is one that is extraordinarily harmful and can create negative images and stigma towards a legitimate treatment.

https://www.youtube.com/watch?v=kHPdtWvL3Mk

 

There are a whole host of inaccuracies in Hollywood’s portrayal of electroshock treatments. The most important one, however, is that ECT actually works. ECT does cause a seizure- electrodes are attached to the head, and a current is passed between them, one which alters brain chemistry and activity. The fact is, between when ECT was first developed (1938) and until the 1950’s the treatment was dangerous. Broken bones and convulsions were not uncommon.

 

However, many advances have been made in the past decades. A muscle relaxant and general anesthetic is administered prior to the electroshock treatment to minimize muscle response during the seizure. Patient’s vitals are closely and carefully monitored. ECT has shown to be effective at easing symptoms of severe depression, bipolar disorder, and catatonia.

 

This is not to say that the treatment is perfect. In some countries (including 14 Asian countries) ECT is administered without appropriate muscles relaxants or anesthesia. In some cases, ECT has been known to cause retrograde amnesia, with some patients experiencing memory loss of events prior to the treatment. Partially because of these valid concerns ECT is usually only administered when other methods have failed. And even then patients are not unwilling, informed consent is always given before the procedure, another fact Hollywood prefers to gloss over.

 

Unfortunately the incorrect version of ECT Hollywood has propagated has a real and dangerous effect…and not just on the general populace. One third of medical students shown Hollywood’s version of ECT held less favorable opinions of the treatment and stated they were less likely to advise it to potential patients. In a 2012 survey 74% of undergraduate psychology students believed ECT to be physically harmful, with as few as 1.2% supporting its use.

 

Hollywood seems to have a fascination with science via electricity beginning with Frankenstein (1931) where Victor Frankenstein breathes life into his monster with electrical devices. Hollywood favors easy drama over scientific facts. The secret long ignored by films is that ECT can be performed safely and humanely and can be effective at alleviating depression and many other disorders that have been unresponsive to other treatments.

2 thoughts on “The Truth about ECT

  1. jfreud

    I’m so glad someone posted about this! I wrote a research paper about whether or not ECT should be used as a treatment for severe depression a couple years ago. I was struck by the amount of people who have the misconceptions you described in that they pictured it to be much more like it was when it was first developed and unaware of the advancements that have since been made. The fact that only 1.2% of undergrads support its use surprised me. I thought the number would be higher than that.

  2. mluning

    I’m not 100% sure what this has to do with cognitive psychology per say, but I’m still glad it’s being talked about! I remember learning that ECT was used pretty much only for the most severe depression in Wilson’s Abnormal Psych class and it totally astounded me that it was being used today, still, at all. It shocked me even more when I found out that people who get ECT for severe depression come back again and again and tend to swear by it. I think it’s also good to note that when they do administer ECT these days, people are put under and given a muscle relaxant so that they aren’t even conscious for the whole thing. The real thing is so far off from what the movies show, at least for today’s standards. It goes to show that to not repeat the past, we should only be using empirically validated treatments for things that they actually work on, such as not using ECT for treating Schizophrenia, which only makes matters worse.

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