Electroconvulsive Therapy for Depression: A Treatment Option to Support Mental Health
Electroconvulsive Therapy for Depression: A Treatment Option to Support Mental Health
When you think of electroconvulsive therapy (ECT), it may bring to mind exaggerated portrayals in movies like An Angel at My Table and Don’t Worry Darling. Such depictions make the procedure seem painful and risky. In reality, research indicates that ECT is a safe and highly effective medical treatment option for people with severe mental illnesses.
“ECT has a 70–90% improvement rate for severe depression—higher than almost any medication,” says Jeremy Kendrick, MD, a psychiatrist at Huntsman Mental Health Institute at the University of Utah.
If you’re considering ECT, here’s what to know about how it works, who it may help, and how U of U Health experts support patients throughout treatment.
How Does Electroconvulsive Therapy Work?
ECT is performed under general anesthesia. During the procedure:
- Small electric pulses are passed through the brain to intentionally trigger a brief, controlled seizure.
- This stimulation activates areas of the brain involved in depressive illness, which can lead to improvements in symptoms.
ECT is effective for about three out of four patients, making it a highly desirable option for mental illness. ECT produces measurable changes in the brain that lead to mood regulation. Researchers continue to study exactly why ECT works so well.
“Given the complexity of the brain, it is difficult to know exactly why and how ECT works so well,” Kendrick says. “But evidence supports that the treatment involves changes in neuroplasticity, neurotransmitter regulation, and even remodeling of the circuitry of the brain.”
Who Is Electroconvulsive Therapy for?
ECT is typically used for the treatment of mental health conditions that aren’t responding to other types of therapy, such as:
- Major depressive disorder (MDD), especially when there is a high risk of suicide or treatment resistance.
- Bipolar disorder, for both severe mania and deep depression.
- Catatonia, a condition that causes unresponsive or abnormal movements and can occur with depression or schizophrenia.
What to Expect During Electroconvulsive Therapy
At Huntsman Mental Health Institute, patients are asked to not eat or drink for at least eight hours before their appointment. Feeling nervous is completely normal.
“Remember that you’re in a controlled medical environment with an anesthesiologist, a psychiatrist, and nurses whose sole job is your safety and comfort,” Kendrick says.
The procedure itself takes about 5–10 minutes. At the clinic, patients will:
- Check in and have an IV placed
- Be taken into a treatment room where monitoring and blood pressure cuffs are placed
- Meet with the health care team to discuss their care plan and ask any questions
Once a patient is asleep, they will:
- Receive a brief electric stimulus lasting seconds
- Experience a brain seizure lasting less than a minute while their body remains still
As the body metabolizes the anesthetic, the patient will start to wake up. Because the anesthesia takes time to wear off, the patient is taken to a recovery room where they will be monitored by nursing staff for 20–40 minutes. It’s important for patients to plan for someone to drive them home and stay with them for 24 hours after the procedure.
Understanding the Risks
ECT is considered safe, but like any procedure involving anesthesia, it has potential side effects, such as:
- Short-term confusion, often feeling "foggy" for an hour or two after treatment
- Physical effects, like mild headaches, muscle soreness, or nausea
- Memory loss, most often difficulty remembering events right before or around treatment—also called retrograde amnesia
Support Before, During, and After Treatment
At Huntsman Mental Health Institute, patients receive care through the Treatment-Resistant Mood Disorders (TRMD) Clinic. The process begins with a comprehensive evaluation to ensure ECT is safe and appropriate.
“We want to ensure the patient is a safe candidate both physically and psychiatrically,” Kendrick says.
ECT isn’t a one-time treatment. It’s usually given two to three times weekly for three to four weeks, depending on symptoms and response. Most people begin to notice improvement within three to four weeks.
A care team meets with the patient before and after each session to monitor side effects and determine whether any medication adjustments are needed. Electrode placement might be adjusted to minimize memory problems while maximizing mood improvement.
Choosing the right mental health treatment is deeply personal. For many people, ECT can be life-changing.
“ECT is not a punishment or a ‘last resort’ of failure,” Kendrick says. “It is a highly effective, biological intervention that can help people reclaim their lives.”
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