What Is Electroconvulsive Therapy?
Electroconvulsive therapy (ECT) is a safe, effective treatment for certain mental health disorders. Most often, we use ECT to treat depression that hasn’t improved with other therapies, known as treatment-resistant depression.
Treatment-resistant depression may include major depressive disorder, a persistent feeling of sadness or apathy. It also may include bipolar disorder, a condition that causes periods of manic highs and depressive lows. Sometimes, we use ECT to treat catatonia, a condition involving irregular movements or behaviors.
How Does ECT Work for Depression?
Experts know that invoking a brief seizure is key to the effectiveness of ECT. But we don’t know exactly what aspect of the seizure makes ECT effective.
During this brief, safe seizure, your brain will release neurotransmitters, messengers that send chemical signals between your nerve cells. Your brain will also build new synapses, creating new connections and pathways for your neurotransmitters. Any of these aspects of brain activity could be what makes ECT work.
Who May Benefit Most from Electroconvulsive Therapy?
Electroconvulsive therapy is shown to be most effective for people who have certain mental health disorders such as major depressive disorder or bipolar disorder.
We usually offer ECT if the following situations apply to you:
- Medication and therapy haven’t reduced your mental health disorder symptoms.
- You require rapid symptom improvement (for example, if you are at risk of suicide).
- You’re an older adult who can’t tolerate medication side effects.
Electroconvulsive Therapy Preparation
ECT uses general anesthesia, so you need to fast for at least eight hours before your treatment session. You can drink water up until four hours before the treatment.
ECT can cause temporary confusion or memory challenges. You will need a trusted loved one or caregiver to stay with you at all times during the three to four weeks of your scheduled ECT treatments.
What to Expect During Electroconvulsive Therapy
We give ECT as either an inpatient (for patients in our psychiatric hospital) or outpatient (for patients in our clinic) treatment. Some people begin with inpatient treatment and continue their course of ECT through the clinic after they are discharged. Whether your treatment is inpatient or outpatient, the steps are the same:
- You will receive an intravenous (IV) line with anesthesia to minimize discomfort or pain.
- The treatment team will attach electrodes to your scalp.
- An electrical current will pass through the electrodes to trigger a brief, therapeutic seizure.
- The treatment team will move you to a recovery room, where you will be monitored for 20–40 minutes.
Each session of ECT takes about 15 minutes. You can return home the same day as your treatment if you receive ECT in the clinic. You will need someone to drive you home and stay with you afterward.
How Many ECT Treatments Are Needed to Feel Better?
Most people experience the benefits of ECT within about three weeks. Most patients receive about eight to 12 treatments—usually three treatments a week—over 3–4 weeks.
How Long Does ECT Last?
Some patients experience the full benefits of ECT with one round of treatments. Others find it helpful or necessary to have periodic maintenance treatments. Maintenance treatments may be offered anywhere from weekly to quarterly, depending on your needs. Your treatment team will discuss maintenance options with you, if needed.
Is ECT Safe?
Electroconvulsive therapy is a safe, effective treatment for select patients. Persistent misconceptions about ECT stem from treatments occurring several decades ago, which often used higher doses of electricity and no anesthesia. Many of ECT’s risks and side effects decreased due to improved practices over the past several decades.
Today, we perform ECT safely and more effectively. Some studies have shown that patients who benefit from ECT have improved brain functioning after treatment. Our anesthesiologists and psychiatrists use low doses of electricity in a controlled setting to achieve the most benefit with the fewest risks. Your care team will discuss the potential risks of ECT with you before treatment, so you can make an informed decision.
Electroconvulsive Therapy Side Effects
The most common side effects of ECT are muscle aches, headaches, and nausea. Our team will give you medications to reduce or eliminate these symptoms.
ECT also may cause cognitive side effects, including brief periods of memory loss or confusion. Confusion may last for a few hours or days after a treatment session. Memory problems usually resolve within a month or two of ending ECT treatment.
ECT Side Effects: Long-Term
ECT rarely causes long-term side effects. Our specialists will take every precaution to minimize side effects as much as possible.
Electroconvulsive Therapy Cost
Copays for ECT are typically higher than other office visits, but the cost may vary based on your insurance. Most insurance companies cover ECT based on medical necessity. Our team will help you understand what costs your insurance covers before starting treatment. We offer a self-pay rate for the treatment if your insurance plan does not cover ECT.
What If ECT Doesn’t Work?
Data shows that ECT is successful for about 3 in 4 patients with treatment-resistant depression If it isn’t effective for you, you may be a candidate for several other treatment options:
- Ketamine infusions
- Transcranial magnetic stimulation (TMS)
- Vagus nerve stimulators
- Clinical trial treatments
Why Choose Huntsman Mental Health Institute (HMHI)?
Our specialists are the only ones in Utah that offer the full range of neurostimulation treatments for treatment-resistant mood disorders. We lead one of the largest ECT programs in the country, providing around 7,000 treatments each year.
Experts at HMHI have decades of experience in neurostimulation and psychiatric treatments. We continually research ways to improve care and offer leading-edge therapies through clinical trials. The Treatment Resistant Mood Disorder Clinic is part of the National Network of Depression Centers, a large group of centers dedicated to evidence-based treatment for depression and bipolar disorder.
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Make a Referral
The Treatment-Resistant Mood Disorders Clinic specialists offer comprehensive, evidence-based therapies to decrease your mental health condition symptoms and improve your quality of life. Refer a patient by filling out our referral form, or learn more by calling 801-587-3297.
Meet Our Patients
Electroconvulsive Therapy Provides Hope for Husband and Father Struggling with Bipolar Disorder
Chris struggled with mixed bipolar disorder episodes—a dangerous mix of severe depression and mania that keeps him hyper-focused on thoughts of suicide. He tried numerous medications and lifestyle changes, but wasn't responding well to either. After his sixth attempted suicide, he was referred to the Treatment Resistant Mood Disorders Clinic and tried electroconvulsive therapy (ECT) to stabilize his moods. ECT gave him the chance to be a dad and husband again.
Watch Miranda's Story
Miranda Riley was hospitalized for suicidal thoughts in 2021. When medication and therapy wasn’t working, Miranda’s therapist suggested electroconvulsive therapy (ECT). The treatment ended up giving her the relief she needed. "Everybody has different results," Riley said. "But for me, it was absolutely life changing."