Electroconvulsive therapy (ECT) has been around since the early 20th century. It’s considered a very effective treatment for controlling and preventing episodes of mania and depression, but it’s usually used only as a last resort. Therapy, medication, and lifestyle choices are commonly used for longer periods.
ECT has been known for decades to be able to improve mood. While the misuse of ECT in the past gave it a bad reputation, it’s now considered a safe and effective treatment for bipolar disorder.
ECT is mainly used to treat the depressive phase of bipolar disorder, but can also be used during the manic phase. It has also been shown to be effective in preventing future episodes.
Despite evidence of its effectiveness in treating bipolar disorder, ECT is considered more of a treatment of last resort rather than a first-line treatment. It’s often used when drugs are ineffective or when an episode must be treated immediately as in very severe or emergent cases.
During the procedure, you’ll receive a muscle relaxant to prevent injury. You’ll also receive an anesthetic that will leave you temporarily unconscious. A nurse will then place electrode pads on your head. The electrode pads are connected to a 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 seizure. The seizure activity improves the symptoms through mechanisms of action which are still largely unknown. But some experts have explained it as a process that “reboots or restarts your brain,” leading to more normal function.
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 that include:
- jaw pain
- muscle ache
- muscle spasms
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 adults. However, it may be risky for people with certain medical issues. And it must be done by a trained doctor and isn’t available for home use.