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ECT - what no one is talking about

By Sam Westgarth - posted Wednesday, 2 April 2008


In Australia, as in the United States and the United Kingdom, statistics show that the number of patients receiving ECT, or electro-convulsive therapy, has risen drastically over the last ten years. Figures show the use has doubled in this time. In New South Wales, the number of patients receiving ECT has risen from 2093 in 1994-1995 to 5291 in 2005-2006 (“Australia; use of ECT has doubled in a decade”, The Daily Telegraph, November 18, 2006).

ECT is used for the treatment of a wide-range of psychiatric disorders, but is usually used as to treat depression. Even though doctors admit it is only used as a last resort, surveys show that one in four Australians suffer from some kind of depression: considering some of the contentious debate over the practice; the Australian public has cause for concern.

Supporters of ECT argue that, while the procedure is poorly understood and the mechanism for action unknown, as with various other somatic therapies in psychiatry, it is a remarkably effective treatment for intractable depression. A leading US expert, and vocal critic of ECT, Lawrence Stephens J.D., believes the “therapy” causes brain damage, memory loss and diminished intelligence.

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At present, there are movements like Mind Freedom which seek to ban the practice of ECT completely. Other groups are seeking to ensure that there is legislation which involves “informed consent”. Some of these groups acknowledge that there are some benefits to the procedure, but believe the practice should only be voluntary. Most agree that the voltage is too high and should be reduced.

The procedure itself has all the hallmarks of a serious operation. Electro-convulsive-therapy basically passes an electrical shock of between 70 to 400 volts, with an amperage of between 200 milliamperes to 1.6 amperes, through an already fragile brain. Sometimes the electrodes are placed on the temples - this is known as a bilateral treatment; and sometimes the electrodes are placed on the front and back of the side of the head (right or left depending on the natural stance of the person as a left or right handed person) - this is known as a unilateral treatment.

Uni-lateral treatments are seen by many critics as contemptible because there is still much research to do regarding how the two sides of the brain actually relate and function. As well as this there is little known about the brain mechanics during and after ECT.

Some psychiatrists falsely claim that the amount of electricity administered is actually very low. The electricity applied in ECT is, typically, as large as the amounts generated in your wall sockets at home. If the current were not limited to the head and were not in such short spells, it would kill you instantly. The electricity from ECT can be so abrasive that it burns the skin. Because of this psychiatrists use “electrode jelly”, also known as “conductive gel”, to prevent skin burns.

As reported with the use of the contestable “Tazor”, the electricity passing through the brain can cause powerful seizures that  have been known to shatter and break patients’ bones during procedures. To prevent this, a muscle relaxant/paralyser drug is administered before treatment. Currently, Lawrence Stephens J.D. believes that with the modern initiatives, the worst thing that can happen to you during a session of ECT is brain damage.

Earlier this year, Patricia, a patient at a hospital in Sydney, received ECT for the last two months of her 10-month admission. Distraught and anxious about the “treatment”, she worried that she would have no recourse to stop the procedure as she doesn’t have any family in Australia. After objecting to plans for further therapy she had become frightened of her doctor.

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I decided to help her seek some sort of third party. Initially, she had trouble getting the phone number for the mental health advocacy team. She wanted to complain about “… forgetting her memories”. She eventually got in contact with a doctor, a member, from the “advocacy” team, who tried to charge her $100 for an immediate consultation. After some probing, he said that unless there were “… drastic reasons for postponement …” there was nothing that could be done. In fact, the advocacy team and legal aid are exempt from the tribunals that make recommendations concerning the use of ECT. This, in effect, means that the advocacy team do not have any input into a doctor’s decision to “involuntarily” apply the use of ECT on a patient.

Without consultation with a lawyer, Patricia’s next ECT treatment went ahead. When I went to see her a few hours after her treatment she could not remember my name, or my age, even though I had discussed my age with her three times and she had used my name at least 15 times. She said that, other than severe exhaustion and the loss of memories (amnesia), she felt no different. Her nose was bleeding that day.

I went to see Patricia three days later. She still could not remember my name and her behaviour was as it was before - quite normal (except for some agitation in her mood).

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About the Author

Sam Westgarth is a freelance journalist who writes for the Bondi View.

Creative Commons LicenseThis work is licensed under a Creative Commons License.

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