Electroconvulsive therapy (ECT) has been known for decades to be able to improve mood. While ECT’s use, or rather misuse, gave it a bad reputation, it’s now considered a safe and effective treatment for bipolar disorder.

ECT is mainly used against the depressive phase, but can be used during the manic phase as well. It has also been shown to be effective in preventing future episodes.

How does ECT fit into your treatment?

Despite evidence of its effectiveness against bipolar disorder, ECT is considered more of an emergency or backup treatment rather than a first-line treatment. It’s often used when drugs are ineffective or when an episode must be treated immediately.

How does ECT work?

During the procedure, you’ll receive a muscle relaxant to prevent injury. You’ll also receive an anesthetic to make you unconscious. A nurse will then place electrode pads on your head. The electrode pads are connected to an ECT machine that can generate electricity. When you’re asleep and your muscles are relaxed, a doctor will send a small amount of electricity through your brain. This causes a minor seizure. The seizure reboots or restarts your brain, leading to more normal function.

Who can take ECT?

Although effective, ECT is usually reserved as a last resort or for special circumstances. ECT is often an option for people whose bipolar disorder has proven resistant to drug treatment or is causing severe episodes.

It’s considered safe enough to be used on pregnant women and older patients. However, it may be risky for people with heart problems. It must be done by a trained professional and isn’t available for home use.

What are the side effects?

A notable side effect of modern ECT is memory loss, but it’s usually limited to the time around the therapy session. It can also cause temporary confusion.

You may also have some temporary physical side effects, including:

  • nausea
  • vomiting
  • headache
  • jaw pain
  • muscle ache
  • muscle spasms


ECT has been around since the early 20th century. It’s considered a very effective treatment for controlling and preventing bipolar episodes, but it’s usually used only as a last resort. Therapy, medication, and lifestyle choices are commonly used for longer periods.