Electro Convulsive Therapy (ECT) – Seizure in the Central Nervous System

Electro Convulsive Therapy or ECT is the brain child of two Italian neuropsychiatrists, Ugo Cerletti and Lucio Bini.

In 1938 Dr Cerletti became interested in the fact that pigs  were electro shocked through the temples to prepare them for slaughter.  The pigs were rendered unconscious but did not die.  They could survive the shock if allowed to recover.

Dr Cerletti decided to try it on his patients.  He found obsessive and difficult patients became meek and manageable after Electro Convulsive Therapy.

Back in l994 I was neither obsessive nor difficult.  I was trying my best to recover from an acute psychotic breakdown which came about after years of intolerable stress.  I was in a psychiatric unit and sectioned and so when the psychiatrist decided to treat me with ECT I had no say in the matter.

I had 6 treatments of ECT – two treatments a week, for three weeks.   Prior to the first treatment  I was weighed and had an Electroencephalogram (EEG) to find out if there were any problems with my brain.  Things were normal but a cerebral insult was found.  I was not told this at the time but discovered it some years later when I read my medical notes.    I asked the same psychiatrist if the insult was the result of concussion after I’d been knocked to the ground by my first, abusive husband, but the psychiatrist said it was more likely caused by stress, or by the medication I’d taken.  (A cerebral insult is a kind of lesion which heals in time.  It’s no longer in my brain as a subsequent MRI scan confirmed)

On six occasions I was woken early and taken to another ward where a needle was put into the back of my hand and a short acting anaesthetic and muscle relaxant were administered.  The muscle relaxant is to prevent a peripheral seizure that could carry the risk of bodily injury.  The goal of the ECT is to produce a seizure in the central nervous system.

I had to lie down on a table and electrodes were placed on either side of my head – bi lateral ECT.  These electrodes deliver an electrical stimulus.  The stimulus levels recommended for ECT are in excess of an individual’s seizure threshold.  For bi lateral ECT this is between one and one and a half times the seizure threshold.  The electrical stimulus is 800 milliamps and lasts between one and six seconds.

The headaches I suffered afterwards were relentless and the worst I’d ever experienced.  In every case of ECT there is brain damage.

Research is ongoing to find out how  ECT works.  Researchers from the Universities of Aberdeen and Dundee have recently carried out research using a small sample and concluded that following ECT  there is a reduction in the connections in an area of the brain previously linked to both depression and cognitive function.  But the research did not report on what happened to patients not given ECT

I will reluctantly agree that I did get better after the ECT and did return to reality.  Of course there can be spontaneous recovery from psychosis.  If the anti psychotic medication Olanzapine/Zyprexa had been available at that time then I am sure I could have avoided the  ECT.  I was to discover later that Olanzapine was very effective.

Do I resent having been forced to have ECT?  Yes.  Meditation and Psychotherapy  also change the brain and neither hurts.