This
article briefly describes electroconvulsive therapy (ECT),
but
is
not intended as an authoritative guide. The
author is not a
doctor
and is certainly not your doctor, the person to whom you
should
first turn. The
description is based on worthwhile internet
sources
for which links are provided.
ECT
has a frightening image.
Graphically depicted in movies such as
One
Flew Over the Cuckoo's Nest , ECT is often portrayed as a
cruel,
dehumanizing
treatment from the stone age of psychiatry.
This
image is inaccurate and insidious.
ECT is still used to treat
depression
despite the improvement of drug therapies because it often
works
for certain individuals where alternatives do not.
The
procedure
is particularly useful for the severly depressed and
individuals
who can not tolerate drug treatment because of illness or
age.
It can literally save lives among the suicidal.
Like
its popular image, the very term electroconvulsive therapy
is
misleading.
"Electro" refers to the electrical
current used to
induce
a seizure. However,
the electricity is not responsible for
the
therpay's effectiveness, if anything it may cause or
aggravate
the
most common side effect of ECT, amnesia.
"Convulsive" describes
the
physical convulsions of the body during a seizures, a
rhythmic
motion
of the skeletal muscles, which again have no relevance to
treating
depression.
The
relationship between seizures and depression was first
observed
in
the early 1900's, when it was noted that patients with
both
epilepsy
and depression experienced a remission of the depression
after
a seizure. The
early efforts at artificially inducing seizures
to
treat other patients were crude and led to a host of
problems,
mostly
related to uncontrolled convulsions which could break
bones
and
poor understanding of how the therapy worked.
Although ECT is
now
far more refined, these images continue to haunt it and
stigmatize
those who have had it.
In
modern ECT, a muscle-relaxing drug is first administered
which
reduces
the physical convulsions to safe levels.
The patient is also
anesthetized,
and so is not conscious.
The seizure is induced by a
small
electrical current delivered through electrodes taped to
the
patient's
head.
ECT
is a significant procedure with risks and potential side
effects.
As
for ECT in bipolar patients, the particular risk is that
the
seizure
can ignite a manic episode.
This can be effectively
controlled
with fast-acting anti-mania drugs such as the old standby,
lithium.
As
with any medical treatment, the risks must be balanced
against the
benefits.
In doing so, it is important to remember that ECT
is often
a
treatment for patients in great need or who haven't
responded to
alternatives,
and who may be suicidal.
--
http://search.about.com/fullsearch.htm?terms=bipolar+ect&PM=59_0100_S
pendulum
Ah
yes, I forgot a cite you may want to look at for ...
completeness:
http://www.ect.org
thank
you Andrew!!
