Electroconvulsive therapy (also known as ECT) is a treatment for certain types of extremely severe mental illnesses that have not improved with all other treatment options. ECT is the process of passing an electrical current through the brain and stimulating a controlled seizure by placing an electrode on one side of the temple area of the head or an electrode on each side of the head. Before the electrical current that lasts between 6 - 12 seconds is delivered, the person is given a general anaesthetic and muscle relaxant. The treatment is normally done two times a week for a maximum of twelve times however it is stopped as soon as a response to the treatment is seen. How ECT works is not fully understood, but is thought that it changes the levels of certain chemicals in the brain.
ECT does have bad associations, partly due to its early use as a treatment that started in the 1930s. During this time it was performed without anaesthesia or muscle relaxants and was associated with occurrences of significant injury. It was also portrayed dramatically in some movies, such as 'One flew over the cuckoos nest'. There are still risks associated with undergoing ECT, including the risks of going under general anaesthetic, the risk of short term or long term memory loss and the small risk that the seizure could become prolonged or cause a blood pressure drop or an abnormal heart rhythm. The risk of death from ECT is the same as that for going under a general anaesthetic. Due to the risks, ECT is used as a last resort treatment and is only seen as a possible effective treatment option for severe or life-threatening depression, catatonia or for severe or prolonged mania.
Due to the potential risks of undergoing ECT, the decision to have ECT is only made by an experienced psychiatrist along with the patient if they are able to do so and the team involved in their care. It is only used when the risk of not treating with ECT, outweighs the risks associated with performing ECT.
Prior to ECT, the doctor will want to review the person’s medical and mental health history, current symptoms, diagnosis and the patients understanding of ECT and its risks. A physical health assessment will also need to be done such as blood pressure, ECG and some blood tests. If there is any history of heart problems a doctor specialising in heart problems may also be asked to do an assessment on the person prior to ECT. ECT takes a lot of planning, and will not be a decision made lightly or quickly.
You are not fit for work if you are undergoing electroconvulsive therapy treatment.