Six days after receiving electric shock therapy for depression, renowned writer Ernest Hemingway killed himself. He'd suffered severe memory loss after the treatment. Although mental health professionals are well aware of the severe side effects associated with this electric shock therapy, some regard it as one of the best treatments for severe depression, especially when antidepressants and counseling are not effective.

The change of heart may be due to progress in how electric shock therapy is administered. Mental Health America (MHA, formerly the National Mental Health Association) explains that while images of draconian shock treatment (think One Flew Over the Cuckoo's Nest) linger, advances have occurred that make electroconvulsive therapy--the more PC term these days--safer and less likely to cause serious cognitive damage. Their stance is that many of the severe side effects occur when a practitioner does not administer the treatment according to clinical guidelines.

What Is Electric Shock Therapy?

The MHA describes electroconvulsive therapy (ECT) as a type of electrical stimulation of the brain, usually overseen by a psychiatrist, anesthesiologist and other medical staff. The two main types of stimulation currently used are bilateral pulse stimulation and unilateral pulse stimulation (which causes fewer side effects).

Before the treatment you'll be given an anaesthetic, or muscle relaxant, or both. Afterwards, a practitioner applies electrodes just above your temples or in the middle of the forehead, and an electrical current passes through your brain. The practitioner can individualized your treatment to your specific needs by adjusting the charge dose, pulse length, and duration.

The goal is to stimulate a grand mal seizure for 30 seconds to about a minute. Unlike popular depictions of electric shock therapy (and treatments in the early part of the last century), patients do not convulse and should feel no pain.

According to the American Academy of Family Physicians (AAFP), the theory is that the seizure triggers the release of neurotransmitters in the brain to make the brain work better and improve mood.

What Are the Side Effects of Electric Shock Therapy?

Following a treatment you may have a headache or muscle aches, feel nauseated or confused, or have an allergic reaction to the anesthesia. Short-term memory loss is a common side effect, but in some cases, the memory loss may be permanent - this could range from forgetting where you live to forgetting how to perform certain tasks, including hobbies. You may also experience heart rhythm or blood pressure changes, states the AAFP.

Who Is Most Suitable for Electroconvulsive Therapy?

Your doctor might recommend this treatment if you fall into any of these categories:

  • you have severe clinical depression and antidepressants and counselling have not been effective
  • you cannot take medications
  • you are mentally aware enough to give informed consent
  • you experience depression with other symptoms such as delusions or hallucinations
  • you are suicidal
  • you are pregnant while battling severe depression

What to Expect after Electric Shock Therapy

To treat depression you will receive 12 sessions of electric shock therapy (three to four a week).  However, it will not cure your depression. The MHA reports that about 50 percent of people will experience a relapse between six and 12 months after treatment. But, there's evidence showing that continuing electric shock therapy is more effective at preventing relapses than not continuing it.

You'll need to stay in hospital or the facility so medical staff can monitor you until you recover. If you were on antidepressants before, your doctor may recommend that you continue to take them after your treatment.

If your doctor recommends electroconvulsive therapy for depression, make sure you ask about the side effects, how it will be administered (bilateral or unilateral stimulation), how to prepare for a treatment, and the types of improvements you should see in your condition.

Sources: Mental Health America, the American Association of Family Physicians, the National Institutes of Health