If you have ever attended a session or heard of talk therapy, then you may already be aware that a psychologist provides this form of therapy.
A psychologist utilizes talk therapy, also known as psychotherapy, to treat various emotional difficulties and mental disorders. Using a variety of forms and techniques, a psychologist works to eliminate or control the symptoms that are disabling or troubling their patients so they can function better.
While psychology is an effective and proven method of treating a client’s symptoms and teaching ways of coping, psychologists cannot prescribe medications, which is where a psychiatrist’s help comes into play. A psychiatrist is a medical doctor that specializes in mental health, who can evaluate, diagnose, and treat mental illness with medication.
To prescribe medication for mental health disorders and problems requires years of training, from medical school to a residency program. Yet, the work of a physiatrist does just end with medication. While there is a critical distinction between these two types of mental health professionals, did you know that similar to a psychologist, a psychiatrist can provide other therapies as well? While less common than medication, one of the most commonly used of these therapies today is called Electroconvulsive therapy, or ECT.
If you struggle with severe depression and have not been successful with other treatments or medications, your psychiatrist may recommend ECT as the best course of treatment. Of course, that decision is ultimately up to you, but there is no need to shy away from it for the sole fact that the name sounds pretty terrifying. While it’s not for everyone, it could be successful for you, which is why we are breaking down the facts of ECT and breaking the stigma, so you can more confidently make a decision that you feel is best for you.
What is Electroconvulsive therapy (ECT)?
Performed under general anesthesia, Electroconvulsive therapy (ECT) is a medical treatment where small electrical currents are applied to the brain using an ECT machine. The currents that pass through the brain’s electrodes are intended to trigger a short seizure and can cause changes in your brain chemistry.
ECT can help reverse mental health symptoms and is generally only used for patients with severe depression for whom other treatments have not been successful. This procedure is also used to treat severe mania, catatonia, schizophrenia, and aggression in people living with dementia. Other situations where a psychiatrist might recommend ECT is for older adults or pregnant women who might experience harmful side effects of drugs.
How is an ECT procedure done, and what can I expect?
Before ECT, a full evaluation is performed to ensure it is safe for you. This includes an overview of your medical history, a physical exam along with necessary blood tests, a psychiatric assessment, and an Electrocardiogram (ECG) to determine if ECT will be safe for your heart.
A brief physical exam is performed just before the treatment as well, and you will be informed of anesthesia risks. A nurse will insert an IV (intravenous) line for the anesthetic, muscle relaxant, and fluids, and electrode pads will be placed on your head. During the procedure, a blood pressure cuff is used around one ankle to prevent the muscle relaxant from entering your foot, which is where your seizure activity can be monitored.
The electrode pads on your head are used to record electrical activity in your brain through an electroencephalogram (EEG) test. Your brain activity will increase considerably before the seizure, and the EEG will also signal once the seizure is over. The seizure will only last about one minute. While ECT’s effectiveness and success rate are still being studied, it is known that the chemical changes in the brain during and after a seizure can build upon one another and reduce symptoms of severe depression over time.
Is Electroconvulsive Therapy safe?
ECT is much safer than it used to be. Many of the earlier treatments were performed without anesthesia, which led to some severe side effects in patients, including fractured bones. Today, anesthesia is a requirement. You also may be given a mouth guard to protect your tongue and teeth from injury.
The anesthetic will make you aware of the procedure, while the relaxant helps prevent injury and minimize the seizure. ECT is not safe for people with serious heart problems. There is a slim chance that ECT can cause heart problems if your blood pressure and heart rate increase dramatically, but monitors will continually be assessing your oxygen levels, blood pressure, heart, and brain to prevent this risk.
ECT’s potential side effects include memory loss of the weeks leading up to your procedure, which can improve itself after a couple of months if this happens, immediate confusion that can last a few minutes or hours, along with muscle or jaw pain, headaches, and nausea.
What happens when treatment is over?
Once the procedure is over, you will be monitored in a recovery area. Should you experience any confusion, you may be monitored for a few hours. If the treatment goes well and is safe for you, your psychologist will have you return for more sessions, usually done three to four times a week, for three to four weeks in a row. You may not notice an improvement until you are through with at least six out of your twelve sessions.
Depending on how you respond to ECT, your psychologist may recommend ongoing treatments after your initial set, but less often and accompanied by counseling or other medications, such as antidepressants.
How do I know for sure if this treatment is right for me and where do I go for help?
If you are struggling with depression, no matter how severe, it is essential to seek help. If you have not yet worked with a psychologist or are unsure if you should seek out a psychiatrist, BetterHelp is an organization that can help get you started. Your counselor will help you decide if psychiatry is necessary to help improve your mental health, and from there, your psychiatrist can prescribe your best course of treatment.
With so many resources and treatments available like BetterHelp, there is no reason to wait any longer to reach out and ask for help.