There is a lot of controversy about electro-convulsive therapy. There are those who claim that it causes brain damage, that it is a dangerous procedure that can cause heart attacks and that it is ineffective. Electroshock is known to cause at least temporary amnesia. Then there are testimonies about people who were frozen in severe depression who became well when given shock treatments after not responding to any other treatment. According to the University of Pennsylvania Health System's web site:
ECT is the most effective treatment of depression. While antidepressant medications are effective for more than 70% of all patients, efficacy rates for ECT approach 90%. It is the standard of care for refractory patients. When all else fails to relieve a severely ill patient, ECT usually come through dramatically. ECT remains the treatment of choice in severe depression, because of its excellent efficacy rate. Besides the fact that ECT is the most clinically effective treatment for depression, recent studies suggest that ECT may be more cost effective than other therapies, in the long-term treatment of depression. It is associated with less hospitalizations, shorter hospitalizations, and less money spent on health care.
Why does shock work? One cause of depression
may be abnormal levels of chemical messengers called neurotransmitters that regulate
emotion and mood - serotonin, dopamine, neurepinephrine and others. One theory is that
electroshock causes neurotransmitters to flood the brain, temporarily bringing their
levels back to normal, another theory speculates that it changes the way brain cells
receive the neurotransmitters. Just as neurotransmitters are believed to affect mood
and emotion, so do some hormones. One theory is that ECT affects the function of the
hypothalamus, a gland deep in the brain that, among other things, releases chemicals that
Gene Tierney a very beautiful actress who was given shock treatments for depression had her own theory as to why it worked.
She asked something to the effect of, "If you forget all your troubles, how can you be depressed about them?" It's possible that her reason is at least a partial reason for shocks efficacy. Since physicians often view depression as a medical problem they are unlike to accept that it is caused by one's personal troubles and so unlikely to accept her hypothesis. Although shock may be helpful in the short term, for long term results I think it should be combined with therapy such as cognitive therapy or the therapeutic methods described in the self help pages of this web site. Studies have shown how cognitive therapy has better long term results than medication alone and that probably applies to shock treatments as well. I am not saying that cognitive therapy alone should be used. There may be times when talk therapy by itself doesn't work but the combination of talk therapy with shock does.
John Breeding provides an online list of references to studies showing the negative side of shock treatment. There are studies that show that the brain changes in schizophrenics that have been electroshocked are more extensive than in patients that haven't. It isn't totally clear to me if these changes are a result of electroshock or of the patients needing electroshock having more severe illness to begin with. I haven't studied the literature enough to know.
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