ECT, or electro-convulsive therapy, is highly effective in treating severe Major Depression, as well as in some forms of recurrent Major Depression with one big caveat — nearly everyone who receives this treatment has some sort of memory loss. During ECT, a person is placed under general anesthesia so that they will not feel anything from the procedure. Electrodes are then place on the person’s head and an electrical current is applied to the brain. This results in the creation of a brief seizure that lasts for several seconds. The number of ECT sessions necessary for a therapeutic effect varies by person and severity of the depression. However, most people undergo between six and 12 sessions.

ECT is considered as an initial treatment when a person’s depression has resulted in psychosis (example: hallucinations), catatonic stupor (example: severe reduction in movement and speech), suicidality, or food refusal. Also, it is offered to depressed patients who do not respond to adequate trials of medication. An alternative to ECT in the psychotically depressed patient is a combination of an antidepressant with an antipsychotic medication.

There is considerable confusion about ECT, resulting in many patients being frightened of the procedure. Part of this is based on portrayals of ECT, including in the movie “One Flew Over the Cuckoo’s Nest,” as inhumane. Actually, ECT is a fairly safe treatment for depression. Because of the anesthesia, patients do not experience any pain associated with the procedure. Also, ECT provides the quickest treatment of depression.

Just as with medication, ECT does have some side effects. The most prominent is an impairment in memory functioning, or memory loss. Persons undergoing ECT frequently do not remember the procedures. Additionally, they may become confused, and not remember events surrounding their hospitalization. Others have more serious memory problems, losing significant portions of their memory of the past. While this memory impairment can be quite dramatic, it is generally transient, with many people having full memory functioning several weeks after the last session. However, some people never fully recover from this memory loss. At this time, professionals cannot tell a person ahead of time what kind of memory impairment they will suffer from this procedure, how severe it will be, and whether it will be temporary or permanent in nature.

Following ECT, many patients are given an antidepressant to help prevent a relapse of depression. Other patients receive maintenance ECT. This treatment consists of periodic ECT sessions. Because of the limited number of sessions in maintenance therapy, it is usually conducted on an outpatient basis.

Other physical treatments that have been employed in the treatment of depression, include bright light therapy, sleep deprivation, and rTMS (repetitive transcranial magnetic stimulation). Bright light therapy has an important role in Seasonal Affective Disorder (SAD). The technique referred to as rTMS should still be considered experimental.

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• Betty’s Story with Depression
• An Overview of Depression Treatment Options
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• About Group Therapy
• What is a Manic Episode?
• An Overview of Treatments for Bipolar Disorder
• How Much Therapy Is Enough?
• About Family Therapy