ECT: The Procedure (with video)

Representations of ECT are a dime a dozen. And some paint a picture of torture and madness. So what does ECT look like? Take a peak…

We began a series yesterday on electroconvulsive therapy (ECT). Click here to read Part 1. Today we’re going to get into the procedure itself. I’ve included a video, which some may find disturbing.

My use of the video is to show what an ECT procedure looks like. Though the discussion is interesting, my intent is purely to provide a visual.

ECT Prep

You, your family, significant other(s), and your psychiatrist have decided to go with ECT. Well, it’s not something you just walk-in and have done. Here’s some of the before-procedure-day preparation…

  • A physical exam, including a thorough medical history
  • Basic blood work
  • An electrocardiogram (ECG) – remember, having a history of heart disease is a major consideration

Here are some of the goings-on prior to the procedure – the day of…

  • No food or drink coming in
  • A quick check of vitals, heart, lungs
  • An I.V. is inserted
  • Assorted monitors hooked-up
  • An oxygen mask may be applied
  • Application of electrode pads to the head

Having worked in a psychiatric facility, I can tell you some patients are admitted the night before the procedure. The same may apply to a general hospital. ECT is also performed on an outpatient basis.

The Procedure

In addition to prep and recovery time, an ECT procedure takes 10-15 minutes. The administration of ECT can be unilateral or bilateral.

In a unilateral procedure, both electrodes may be placed on the same side of the head. Unilateral ECT is used to minimize memory loss and other potential cognitive side effects.

In bilateral ECT, the electrodes are placed on both sides of the head. Though it holds the potential to cause more side effects than a unilateral procedure, it’s believed to be more effective.

In the U.S. and the U.K., most ECT procedures are bilateral.

Well, the general anesthetic is administered and you’re on your way. While you’re zonked, a muscle relaxant is injected into your IV to prevent an over-the-top seizure.

Depending on your specific circumstances, other meds may be administered. A mouth guard may also be inserted to protect your teeth and tongue.

Everything looks good, so your doc pushes the magical button on the ECT machine. A very small amount of electrical current hits the electrode(s) and is delivered to your brain. The result is a 30-60 seizure.

As you may imagine, your brain lights-up like a Christmas tree. And the happenings are recorded by an electroencephalogram (EEG). The beginning and end of the seizure is easily noted.

But even if you weren’t hooked-up to an EEG, the doc can observe your seizure at a hand or foot.

So the procedure’s over and the short-acting anesthetic and muscle relaxant are wearing-off. You’re taken into a recovery area and monitored.

Do not be distressed if you experience confusion upon awakening. It’s normal. And the fact of the matter is, it may last for several hours. Frankly, it may last for days – even months.

Be sure to read yesterday’s piece for more details on side effects and risks. Click here.

Treatment Regimen

Naturally, an ECT treatment regimen is going to be a per-case-basis kind of thing. But as a rule of thumb – in the U.S., an average course of ECT runs three times a week for two to four weeks. A total of six to twelve procedures is typical.

The Video

Okay, let’s have a look at the video. Again, my only purpose is to provide a look-see, not an opinion (you’ll have to come back for Part 3 for that). Some may find the video a bit disturbing.

Let’s tie a bow on Part 2 in the series. Nice job! Ah, but be sure to come back tomorrow for the third and final piece. It’s then I’ll wax controversy and opinion.

Thanks to for the resource material…