Do I need electroconvulsive therapy?

Your doctor may discuss electroconvulsive therapy, or ECT, previously known as electroshock therapy, if you have severe depression that has not responded to other treatments. ECT is one of the most effective treatments for people with severe depression. It has been given a bad reputation by Hollywood movies.

What it is. ECT involves passing a current of electricity through the brain, resulting in something like a controlled seizure. Of people who receive ECT, 80% to 90% find that they get better.

How it works. Doctors aren't sure how ECT works. They know the procedure affects many of the same neurotransmitters that antidepressants affect. See How Do Antidepressants Work? It also affects the brain's metabolism and blood flow.

Who needs it. Your doctor may recommend ECT if your depression is severe and if any of the following statements are also true for you.

  • My depression symptoms aren't helped by medication or psychotherapy.
  • My risk for suicide is high.
  • I can't take medication due to other health conditions.
  • I need to get better quickly.
  • I also have other types of symptoms, such as hallucinations, that have not responded to medication.

How long you need it. People who are receiving ECT as therapy usually have 6 to 12 treatments every other day. Because half of the people who receive ECT have a relapse within 6 months, maintenance treatment with medication or follow-up ECT treatments, or both, may be needed.

If you and your doctor decide ECT is best for you, see What to Expect During ECT to learn more.