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Exploring the History of Electroconvulsive Therapy as a Mental Health Treatment

written by: Daniel P. McGoldrick • edited by: Paul Arnold • updated: 8/17/2010

The history of electroconvulsive therapy is both intriguing and somewhat disturbing. Here, we’ll discuss the advent of this controversial method of treatment, its development through the years, and also the reception it has met in the medical community and beyond over time.

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    Stimulating the Brain to Produce Seizures

    Electroconvulsive therapy (ECT) is a medical procedure used to treat severe mental illness whereby (nowadays at least) a small, carefully monitored amount of electricity is used to stimulate the patient’s brain to induce a cerebral seizure. In carefully controlled conditions, ECT (also known as electroshock treatment) is usually administered while the patient is also given some sort of anesthesia and muscle relaxant. It has always been used primarily for the most severe cases of depression, acute mania, and schizophrenia.

    What are the Pros and Cons of ECT in Treating Mental Health Disorders will give you a good idea about how it is used today, and what to carefully consider if such a treatment is recommended for you or a loved one.

    It’s hard to believe that shocking a fellow human’s brain with a great deal of electronic juice, so to speak, seemed like a good idea to someone in the medical profession once upon a time. Even more intriguing is that this drastic measure was conceived as a means of treatment, not some sort of punishment for heinous crimes. Building upon the belief and practice of using respiratory stimulants such as cardizol and camphor to induce seizures (because seizures were thought to be incompatible and antagonistic to mental illnesses such as schizophrenia), doctors turned to electricity to produce the same affect.

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    Electroconvulsive Therapy History - The Shocking Beginning

    In 1938, electroconvulsive therapy history began when the Italian neurologist Ugo Cerletti and his assistant, Lucio Bini, used it on the first human as an alternative to other seizure-producing methods. That first patient hadn’t said anything rational or coherent in weeks, but after receiving 55 volts for two-tenths of a second, he sat right up and demanded to know what in the world they were trying to do to him (with much more colorful Italian phrases than that). The good doctors were encouraged, curiously enough, by this reaction.

    The New York State Psychiatric Institute was the first American state to use ECT on patients. Through the 1940s and 1950s, ECT was used widely throughout the world for the illnesses discussed above. It was controversial from the beginning, as patients being electrocuted was seen to be barbaric (doctors experimented with voltages that were way too high) by many in both the medical profession and the general public. Many patients received no anesthesia while shocked. In some instances, serious side effects like bone breakages, memory loss, brain damage, difficulty swallowing, pain where the shocks were administered, and even death (roughly 1 in 1000 died from ECT) occurred.

    Critics of the therapy often cite the damaging results from these early years when the procedure wasn’t practiced safely. Unfortunately, mental patients largely had no voice and so unscrupulous doctors were able to use them as guinea pigs.

    More recent studies show that very low dosages, together with careful administration and drugs that ease the procedure, do help patients reduce the severity of their illness symptoms. Technological advances greatly decreased the amount of harm it could otherwise cause.

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    The Ebbing Tide of ECT in the 60s and 70s and its Regeneration Later

    Another significant development in electroconvulsive therapy history coincided with a widely popular novel (published in 1962) which was made into a successful movie (in 1975). The main protagonist in Ken Keesey's One Flew Over the Cuckoo's Nest, Randle McMurphy (along with all the other mental patients), were constantly threatened by the specter of receiving grueling ECT treatments from the somewhat diabolical medical staff at the mental ward they were restricted to.

    Therefore, the novel and movie produced a disturbing reputation for ECT in two separate decades. Incidentally, Keesey was furious when the movie didn't follow the book in that the character Chief Bromden, wasn’t the narrator in the movie. Keesey proudly came up with the idea of Chief Bromden narrating the story while on an LSD trip, experimenting with his own brand of self-medicating procedures.

    Coincidentally, the popularity and practice of ECT in the 60s and 70s seriously diminished to near extinction, but came back on the mental health scene later as an alternative that does show positive results in extreme cases, albeit in low doses.

    Curiously, science still doesn't really know why it works. But it is my layman’s belief that because we now know much more about the brain, and the necessary firing of synapses (electrical impulses) and the receptors which govern many functions of the brain, we get a clearer picture of how it helps.

    The foreign electrical currents jumpstart parts of the brain that are working improperly because of impairment. It is also believed that the procedure works a lot like drugs available now to combat depression or stabilize moods by changing the manner in which receptors receive chemicals like serotonin.

    NeuroStar TMS Therapy to Treat Depression is a very interesting, innovative method of treatment worth reading about. But if all other methods have been exhausted, ECT may be a procedure worth considering to relieve some of the painful symptoms of serious mental illnesses.

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    Sources

    National Institute of Mental Health @ http://www.nimh.nih.gov/index.shtml

    Sciencemuseum.org.uk

    ELECTROBOY: Fighting Depression and Bipolar Disorder @ http://www.electroboy.com/electroshocktherapy.htm