Electroconvulsive Therapy

At San Juan Capestrano Hospital, we use electroconvulsive therapy (ECT) to treat a wide range of mental health concerns. ECT is a mild procedure that is safe enough for at-risk patients such as pregnant women and those who have pacemakers. Endorsed by major psychiatric care providers nationwide, ECT has proved effective in helping patients who don’t tolerate medications well or have not had success with other therapies and services. We use ECT to treat depression, bipolar disorder, catatonia, and disorders that involve symptoms of psychosis, such as schizophrenia. Electroconvulsive therapy can:  

• Quickly relieve symptoms of mental health concerns such as depression and suicidal ideation 
• Increase the effectiveness of other interventions a patient may be receiving 
• Help patients who cannot take medications for health reasons 
• Continue to help a patient for months and even years after the end of a course of treatments 

While ECT can be effective after one or two treatments, optimal outcomes typically result after a patient has completed a course of multiple treatments.  

Electroconvulsive therapy is a procedure that helps neurons in the brain chemically reconnect, altering the patient’s brain chemistry. While ECT is sometimes thought of as most appropriate as a treatment for severe symptoms of mental health concerns, we have found that it can be beneficial for patients whose symptoms vary in severity and type.

At San Juan Capestrano Hospital, we offer ECT for adults age 18 and older who wish to supplement the mental health treatment they are already receiving or have been unsuccessful in healing from mental health concerns through other interventions and medications. ECT can be used to treat patients who have mental health concerns including: 

• Bipolar disorder 
• Catatonia 
• Mania 
• Schizophrenia 
• Dementia 
• Schizoaffective disorder 
• Depression 
• Psychosis  
• Suicidal ideation 

Many behavioral health professionals have identified ECT as a beneficial therapy for those who are experiencing severe symptoms of mental health concerns, but we have also found that it can help those who have mild to moderate symptoms of mental health concerns and wish to see faster results. Receiving electroconvulsive therapy can lead to the following benefits, depending on the person: 

• Effective treatment for people like pregnant women and those who have pacemakers and cannot tolerate strong medications used to treat mental health concerns 
• Faster results when used in combination with other treatment modalities 
• Optimal outcomes for patients who have not had success with other interventions 
• Easing of severe symptoms of mental health concerns  

At San Juan Capestrano Hospital, we have a designated ECT unit that includes a team of professionals who specialize in electroconvulsive therapy. Our well-trained staff performs ECT using state-of-the-art equipment and standardized procedures designed to keep our patients safe and comfortable. We go through the following steps when we provide ECT for our patients: 

• We help each patient complete an evaluation that gives us an understanding of their background, symptoms, and needs. Using the information we gather in the evaluation, our team determines whether the patient is a good candidate for ECT.  
• One of our staff goes over the procedure, explaining the potential risks and benefits the patient can expect. They also give the patient the chance to ask any questions. 
• On the day of an ECT procedure, patients should fast up to the time of the treatment. 
• Before the ECT procedure, we give the patient a muscle relaxant, and our anesthesiologist administers general anesthesia. 
• At San Juan Capestrano Hospital, our team of specialists provides ECT for our patients. This team includes psychiatrists, an anesthesiologist, and nurses who ensure the patient’s safety and comfort while they are receiving treatment.  
• We place electrodes on each side of the patient’s head, though placement will vary depending on the patient’s needs. 
• During ECT, we send a mild electrical current through the patient’s brain for a few seconds. This electrical current induces a minor seizure as it stimulates the brain’s neurons. The procedure itself lasts only a few minutes. 
• As a patient is receiving ECT, our expert team monitors their vital signs and brain activity to ensure that the seizure stays mild and lasts the correct amount of time. 
• When patients wake from the procedure, they typically do not remember the procedure and do not feel any pain or discomfort as a result of ECT. While the procedure itself lasts only a few minutes, a patient can expect to be in our ECT unit for around an hour, including prep and follow-up procedures. 
• Because the patient has been under anesthesia, we ask that they arrange for a loved one to drive them home after the ECT procedure. When a patient wakes from anesthesia, one of our staff determines whether they are experiencing any negative side effects before they release the patient to their loved one. 

While many patients notice results after the first ECT sessions, at San Juan Capestrano Hospital, we recommend that they complete a series of 10 sessions in a year to achieve ideal results. Typically, we suggest an accelerated number of sessions at the beginning of treatment, with a tapered schedule from there on out. For example, we recommend that patients complete three sessions every other day at first. Then they can participate in three sessions once per week, and finally, they can do the remaining sessions every month after that. 

When electroconvulsive therapy was first developed in the 1930s, there was less understanding about and fewer regulations for administering the treatment. As a result, the general population has many misunderstandings about how the therapy works and what outcomes to expect. Here are some common questions patients ask: 

• Does ECT cause permanent memory loss? While ECT can cause temporary memory-related side effects that commonly result from receiving anesthesia, permanent memory loss is uncommon. A patient’s temporary memory-related side effects typically resolve shortly after treatment. 
• Is ECT only used for patients who have tried everything else? ECT is often helpful for patients who have not had success with other treatment interventions. However, ECT can also be helpful for patients who are looking to supplement their existing treatment plans to see faster, more effective results. 
• Will ECT cause pain or trauma? ECT is a short procedure patients receive under general anesthesia. The patient does not feel pain or distress during the procedure and often has no memory of the treatment. 
• Will my personality change as a result of ECT? ECT does not affect a person’s personality. The treatment helps ease symptoms of mental health concerns and does not change a person’s identity, tastes, or thought processes. 
• Is ECT only beneficial for people who have severe symptoms of a mental health concern? While ECT can be helpful for those who have severe symptoms of mental health concerns, it can also be helpful for people whose symptoms range in type and severity. 
• Is ECT an outdated treatment option? ECT is better understood today than it was when it was developed in the 1930s, and the medical industry has made important technical advances when it comes to equipment and procedures. Likewise, today, those who perform ECT must follow strict, regulated guidelines. 

When ECT was developed in the 1930s, there were no standardized guidelines in place for its delivery. As a result, the media represented it poorly, and many people have developed misunderstandings and stigmas around ECT. Today, ECT is highly regulated, better researched, and much milder than popular culture portrays it. Over the years, researchers, scientists, and behavioral health professionals have made the following improvements to electroconvulsive therapy: 

• Today, ECT involves shorter electric pulses that are more targeted to reduce short-term memory-related side effects. 
• Providers who deliver ECT must receive specialized education through training programs and residencies. 
• Hospitals that offer ECT include evaluations and education that can help patients understand the risks and benefits of the treatment. 
• Specialized ECT units include medical professionals who can ensure the safety and comfort of their patients. 
• The use of anesthesia and muscle relaxants improves the patient’s experience during ECT. 

Currently, each year, around 100,000 people receive electroconvulsive therapy. ECT can be a fast, safe, and effective treatment for people who are looking to supplement their existing treatment or for those who have not had success with other therapies and medications.  

This content was written on behalf of and reviewed by the clinical staff at San Juan Capestrano Hospital.