Weird History

Everything You Need To Know About Electroconvulsive Therapy, And Why It's Still Used Today  

Mariel Loveland
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The mere idea of electroconvulsive therapy - or ECT, formerly known as electroshock therapy - is, well, shocking. Running electricity through a human body as a form of medical treatment sounds cruel. But modern electroconvulsive therapy is nothing like what occurred in the psychiatric hospitals of yesteryear. In fact, some consider it one of the safest and most effective treatments available for severe depression.

Hollywood's portrayal of ECT certainly hasn't helped the treatment's reputation. Many people blame films like the Academy Award-winning blockbuster One Flew Over the Cuckoo's Nest for ramping up the stigma in the public's perception of ECT. In the movie, Jack Nicholson's character writhes in pain, but modern ECT is mostly painless.

Today, electroconvulsive therapy helps an estimated 100,000 Americans a year whose severe depression doesn't respond to other forms of psychiatric treatment.

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Electroshock Therapy Started Thousands Of Years Ago With A Fish

The practice of electroshock therapy - now commonly referred to as electroconvulsive therapy - goes back thousands of years. Long before the lightbulb and modern electrical engineering came along, those hoping to ease their pain with electroshock therapy turned toward electricity-producing marine life. Originally, the shock came from a torpedo fish, AKA the electric ray. When fully rested, these little guys can administer a shock of up to 220 volts.

But electroshock therapy wasn't initially used as a treatment for psychological disorders. Aristotle mentioned it as a pain reliever. Ancient Roman doctor Scribonius Largus, who rose to prominence in 43 CE, claimed it helped with pain in the gut, while Dioscorides, a pharmacologist in ancient Greece, believed it relieved headaches.

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ECT Is Statistically Safer Than Childbirth

Though some typically view ECT as a last resort because of the perceived risks and lack of trained doctors to administer it, modern forms of the treatment are reportedly safer than childbirth. One study found that out of 10,000 ECT patients, only about 2.9 deaths occurred; a separate study of 100,000 treatments saw about 4.5 deaths.

According to the World Health Organization, the mortality rate is 239 maternal deaths per 100,000 live births in developing countries and 12 per 100,000 live births in developed nations. As another point of comparison, certain antidepressant medications can increase the risk of death by 33%.

Some experts believe ECT is a suitable first line of defense rather than the last, depending on the situation. Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York, told the treatment can "turn the depression around in a matter of days," and 85% of patients should make a full recovery. Antidepressants can take weeks or months to show results.

"It is likely one of the safest, if not the safest, and certainly the most rapid treatment for severe depression that exists," said Dr. Charles Stone, a California-based clinical and forensic psychiatrist.

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Effective In 80% Of Cases, It's Still An Uncommon Treatment

According to the BBC, ECT is effective in more than 80% of cases, alleviating "the most harmful symptoms of mania, catatonia... or severe depression." It's far from a perfect treatment, though. ECT does not provide a permanent cure, and patients need the treatment every few months or weeks to stave off symptoms.

The BBC likens the treatment to chemotherapy because it leaves a mental illness "in remission." Similarly, chemotherapy comes with a list of dangers and painful side effects, so it is sometimes the last resort for many cancer patients. Doctors only use ECT in extreme cases when a patient doesn't respond to medicine or psychotherapy.

Chemotherapy remains a widely used treatment despite its relatively low success rate. Though ECT has a high success rate, doctors do not implement it often.

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Photo:  Otis Historical Archives National Museum of Health and Medicine/Flickr/CC BY 2.0
A Doctor With Depression Discovered The Treatment By Accident

In the 1800s, a French doctor with depression inadvertently discovered ECT's mentally therapeutic properties by accident. Guillaume-Benjamin-Amand Duchenne de Boulogne was down on his luck. His wife had died; he was in a failing second marriage, had abandoned his child, and hated his job. The doctor was reportedly so depressed that he neglected his patients.

Duchenne de Boulogne was studying electroshock therapy in relation to muscle fiber contraction and experimented on himself rather than other willing participants. Through his experiments, he realized ECT had reduced his depression symptoms.