Today, many have heard about such a treatment method as electroshock, or electroconvulsive therapy. This procedure, thanks to the films, is notorious. But how are things really, is this kind of therapy really dangerous and as intimidating as they say?
What is this procedure?
When electroshock therapy is carried out, a current of various strengths is passed through the patient’s brain - from 200 to 1600 milliamps. Its voltage ranges from 70 volts to 400. The duration of exposure does not exceed a few seconds, often limited to fractions of a second. These impulses provoke convulsions. But it is worth noting that the applied dose of voltage is individual, depending on the susceptibility of the patient. A session is considered successful if the seizure itself has a duration of 25 seconds. To conduct this therapy, electrodes are installed on the sides of the temples on both sides. Sometimes they are attached in front and behind the head. Electrical impulses are usually triggered only through one side of the brain. The location of the electrodes will depend on the person’s disease, because with different diagnoses the area of ​​influence on the brain changes.
Before the procedure itself, the patient may be given a medicine that temporarily paralyzes the entire muscle system. These measures are necessary so that the patient does not break his bones at the time of passage of electricity through the brain. This indicates that electroshock therapy causes a strong shake of the whole body. In addition, the session must be carried out under general anesthesia.
But to cause such a shock, experts use not only electricity. For therapeutic purposes, gas inhalants are used (the composition is inhaled through a mask) and chemicals (administered subcutaneously with a needle). The effect of these drugs is equal to the electrical effect. Experts say that treatment occurs due to the shock state at the time of convulsive attacks, and it does not matter what methods they are caused (through a mask, needle or current).
What is this therapy for?
In 1938, electroshock therapy was proposed as a method of getting rid of schizophrenia. This procedure is also aimed at helping patients who suffer from some other mental illnesses. But years later it turned out that this method of treatment is not effective in case of schizophrenia, but at the same time it gives good results in a depressed state. Some doctors claim that this method of getting rid of such mental disorders is most effective, since approximately 75% of patients received the desired healing from the symptoms of their illness.
Indications for therapy
There are many conditions in which it is proposed to conduct a course of this treatment. But only four types of mental disorders are prescribed , in which the procedure of electroshock therapy is prescribed on an emergency basis. These include:
- Depression, during which revealed an irrepressible desire for suicide and the desire to inflict harm on oneself.
- Febrile catatonia.
- Conditions in which the patient stubbornly refuses to take water or food.
- Malignant antipsychotic syndrome.
But there are other indications in which electroshock therapy may be recommended, but in these cases the procedures will be carried out as planned. In addition, this treatment method is used not only in psychiatry, but also in narcological and neurological fields (for example, with epilepsy, pain syndromes).
Depression Treatment
Most commonly used is electroshock therapy for depression. It was established that this disease occurs due to hyperactive signal exchange between different parts of the brain. Therefore, the goal of the attending doctor should be to disrupt these connections and restore normal metabolism. It is believed that it is convulsions caused by electrical impulses that reduce the number of hyperactive connections between brain regions that are responsible for mood, concentration and thinking.
Preparation for therapy
To begin this treatment method, you will need to perform the following steps:
- A complete study of the neurological and somatic state of the patient.
- A general blood and urine test is done. In some cases, a biochemical blood test is performed in more detail.
- An assessment of cognitive functions is given.
- The cardiovascular system is checked and an electrocardiogram is examined.
- The musculoskeletal functions of the patient are evaluated.
A number of other measures are also being taken, for example, stopping food intake and certain medications that the patient has taken for treatment.
In addition, contrary to popular belief that electroshock therapy in psychiatry is carried out forcefully, the procedure is started only with the consent of the treating party. The patient must personally make such a decision and sign a special form. But sometimes a person’s mental state is extremely difficult, and he is not able to give his answer. In this case, a close relative or guardian may agree to the procedure. But in order for the decision to be legal, a consultation of doctors is going to give their opinion.
Frequency of procedures
It is known that electroshock therapy in psychiatry is carried out as a whole course, which includes several sessions. Their frequency varies depending on the country and the clinic in which the treatment is carried out. Usually, a patient is given two or three sessions per week. The duration of the course is on average four weeks. In some patients, improvement occurs much earlier, and sometimes it takes only two weeks. Sometimes improvement does not occur even after 20 times of therapy. But it is noted that if the first 12 sessions did not move the condition off the ground, then further treatment with this method will be unsuccessful.
Effects
This method of therapy is cardinal, and, of course, it has side effects that are early and late. In the first case, violations occur immediately after the session or during the session. This includes an unnaturally prolonged seizure, which requires an immediate interruption of the process by the introduction of special drugs. Also during the session, tachycardia may appear. In addition, a reaction may occur to anesthesia or another drug that is used for therapy. It manifests itself in the form of apnea (respiratory arrest).
In addition, early effects include headaches after the procedure, which can be eliminated with mild painkillers. After the seizure itself, overexcitation, nausea, a change in pressure, a painful condition, as well as confusion, which gradually subside, may appear. But they can be amplified with each regular session. The worst consequences include a heart attack and death.
Late side effects occur after a while after several procedures. They can increase throughout the course, while electroshock therapy is carried out. The consequences, as already mentioned, can manifest themselves in the form of a prolonged confusion of consciousness. It may also be partial amnesia or problems with thinking.
Memory disorder
For a long time there was an opinion that this procedure inevitably damages the brain. Therefore, studies have been conducted to find out what kind of memory is erased during electroshock therapy, and what disorders occur in this case. It was found that violations begin to appear after about the sixth session. In this case, amnesia can be of a different nature. Sometimes the patient simply did not remember that he was undergoing treatment with this method, and in other cases, selective memory loss was noticed . For example, a person was not able to remember names or other details. But all these disorders occurred only with those patients who, even before the start of therapy on MRI, foci of excessive intensity were recorded in the subcortical white matter. Usually, after a few weeks, the memory of these patients was fully restored, although some nevertheless noted that some of the events of their life had been permanently erased.
Are there any contraindications
In connection with a number of side effects, the question may arise in which cases electroconvulsive therapy is unacceptable. Oddly enough, doctors do not name absolute contraindications for this method of treatment. Although, at the same time, many doctors try to be careful, because there are conditions of the patient in which these procedures can lead to the death of the patient. This includes:
- Myocardial infarction (three months should pass).
- Intracranial hypertension.
- Gastrointestinal bleeding.
- Pheochromocytoma.
- The presence of brain tumors (genus of origin is taken into account).
- With problems associated with intolerance to anesthesia.
But, besides all this, there are conditions in which during the procedure it is necessary to take additional measures to minimize the risk of serious complications.