Shock Therapy: Process, Preparation, Outcomes and More

Shock therapy, known medically as electroconvulsive therapy (ECT), is a treatment for major depressive disorder (MDD), bipolar disorder, and other psychiatric conditions. ECT is generally offered when other treatments are ineffective or there is a need for rapid response.

ECT has a stigma attached to it from the early days of shock therapy, but the ECT that is available today is very different from what it was like when first administered in 1938.

When ECT was first used, patients would be awake for the procedure and endure a full-body seizure created by an electrical current. In the decades since, scientists and researchers have used the knowledge they have gained about the brain to create a more therapeutic and less traumatic method for treating depression.

Here is an overview of how shock therapy is used today, including what to expect from an ECT session.

The Electroconvulsive Therapy Process

An ECT treatment regimen will typically include sessions two to three days a week for a total of six to 12 treatments. The schedule works out to about one month of treatment, although the course may continue for longer.

During ECT, you will be under general anesthesia. You will not be aware of what is going on while you are undergoing the treatment.

Once you are under anesthesia, electrodes will be attached to your scalp in specific locations. The brain is then stimulated with a brief amount of electricity to induce a seizure that will last less than a minute.

Your healthcare provider will closely monitor you to make sure that the anesthesia and a muscle relaxant are working and that you are not experiencing any complications.

When shock therapy was first used 80 years ago, patients needed to be strapped to the table to keep them from moving during the seizure. Today, an anesthesiologist will give you a muscle relaxant to keep your body from shaking uncontrollably, reducing the risk of injury.

The entire process lasts about one minute. When the procedure is finished, you will rest in a recovery room until you wake up from the anesthesia, which typically takes about five to 10 minutes. You should be able to go home within an hour.

For the most part, you can go about the rest of your day, although because you had anesthesia, you will need someone to accompany you home since you will be advised not to drive.

How to Prepare for Your Treatment

ECT sessions generally do not require much preparation, though you will need to go over the specifics with your doctor. Your doctor may give you orders to follow based on other health conditions you have or medications you take.

Since you will be put under anesthesia, your doctor will probably have you fast before the procedure, which typically means that you do not eat after midnight the night before your treatment.

If you smoke, you may be asked to refrain from smoking on the day of your treatment.

Potential Outcomes of Shock Therapy

Most people who undergo ECT will see a noticeable change in their symptoms. Some people will notice an immediate improvement after one session. However, it is more common to not see or feel a significant difference in symptoms for several sessions. 

Some people only need to undergo a series of shock therapy treatments once, while other people may need additional treatments to maintain the benefits.

ECT is much safer than it used to be, but it is still a medical procedure that can have side effects. You may go home feeling groggy from the anesthesia or have a headache, feel nauseated, or have general aches and pains.

It's also possible to experience some memory loss. For example, you might not remember what you had for dinner the night before or know which car you rode to your appointment in. While it can be disorienting, the memory loss after ECT is usually temporary.

Summary

Electroconvulsive therapy (ECT) can be used to treat major depressive disorder, bipolar disorder, and other psychiatric conditions. It is often considered when other treatments have not helped.

During ECT, electrodes are attached to the scalp, and the brain is briefly stimulated to induce a short seizure (lasting less than a minute). A person is under anesthesia and has been given medications to relax their muscles, so they do not feel any discomfort during the session.

A person might need just a few sessions of ECT to start feeling its effects, while others require more treatments to maintain the therapeutic benefits ECT can offer.

A Word From Verywell

If you are wondering if shock therapy might be a treatment option for you, discuss it with your psychiatrist. While ECT can provide lasting relief from the symptoms of MDD, bipolar disorder, and similar conditions, it's not the right choice for everyone. Your doctors will consider all the factors that are unique to your situation and make sure that the treatment they recommend meets your mental health needs.

Frequently Asked Questions

How does shock therapy work?

Even though ECT has been around for nearly 90 years, scientists still are not quite sure why or how it benefits some people with depression.

What researchers do know is what neurons do, which is send electrical signals back and forth. These signals tell the brain to release specific chemicals. When the brain undergoes ECT, an increase in beneficial neurochemicals like serotonin or dopamine may be released.

ECT may also impact the neurons in other ways, such as by stimulating the development of new brain cells or connections, or by affecting the electrical activity in the parts of the brain that are associated with mood regulation.

How much does shock therapy cost?

The cost of ECT varies. However, the price can be between $300 and $1,000 per treatment. If you have medical insurance that covers psychiatric treatments, your insurance may cover ECT.

What is shock therapy used to treat?

The most common reason for shock therapy is severe treatment-resistant depression. However, ECT is also considered a treatment option for bipolar disorder, catatonia, and schizophrenia. It is sometimes used to help reduce agitation in people with dementia.