Today, many have heard of such a treatment method as electroshock, or electroconvulsive therapy. This procedure, thanks to the films, has a bad reputation. But how is it really, is this type of therapy really as dangerous and scary as they say?
What is this procedure?
When electroshock therapy is performed, a current of varying strength 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. The session is considered successful if the seizure itself lasts 25 seconds. For this therapy, electrodes are placed in the temple area on both sides. Sometimes they are attached in front and behind the head. Electrical impulses usually only travel through one side of the brain. Location of the electrodeswill depend on the person’s disease, since the area of influence on the brain changes with different diagnoses.
Before the procedure itself, the patient may be given a drug that temporarily paralyzes the entire muscular system. These measures are necessary so that the patient does not break his bones at the time of the passage of electricity through the brain. This indicates that electroshock therapy causes a strong shake-up of the entire body. In addition, the session must be performed under general anesthesia.
But to cause such a shock, specialists use not only electricity. For therapeutic purposes, gas inhalants are used (the composition is inhaled through a mask) and chemicals (introduced subcutaneously with a needle). The effect of these drugs is equal to the electrical effect. Experts say that the treatment occurs due to the state of shock at the time of convulsive attacks, and it does not matter what methods they are caused by (through a mask, a needle or current).
What is this therapy for?
In 1938, electroshock therapy was proposed as a method of getting rid of schizophrenia. Also, this procedure is aimed at helping patients who suffer from certain other mental illnesses. But years later it turned out that this method of treatment is not effective in the case of schizophrenia, but at the same time it gives good results in a depressive state. Some doctors claim that this method of getting rid of such mental disorders is the most effective, since approximately 75%patients received the desired healing from the symptoms of their illness.
Indications for therapy
There are many conditions for which this treatment is offered. 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 an irrepressible desire for suicide and a desire to self-mutilate was revealed.
- Febrile catatonia.
- Conditions in which the patient stubbornly refuses to take water or food.
- Malignant neuroleptic syndrome.
But there are other indications for which electroshock therapy may be recommended, but in these cases, the procedures will be carried out as planned. In addition, this method of treatment is used not only in psychiatry, but also in narcological and neurological areas (for example, in epilepsy, pain syndromes).
Treatment for depression
Electroconvulsive therapy is most commonly used for depression. It has been established that this disease occurs due to hyperactive signaling between different parts of the brain. Therefore, the goal of the attending physician should be to disrupt these connections and restore normal metabolism. It is believed that it is the spasms caused by electrical impulses that reduce the number of hyperactive connections between brain regions that are responsible for mood,concentration and thinking.
Preparing for therapy
To proceed with this treatment method, you will need to complete the following steps:
- Full study of the patient's neurological and somatic condition.
- 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 being checked and the electrocardiogram is being examined.
- The patient's musculoskeletal functions are assessed.
A number of some other measures are also carried out, for example, stopping the intake of food and some medications that the patient took for treatment.
In addition, contrary to popular belief that electroshock therapy in psychiatry is mandatory, the procedure is started only with the consent of the treated party. The patient must personally make such a decision and sign a special form. But sometimes the mental state of a person 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 council 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 treatment is carried out. Usually a week to the patientthere are two or three sessions. The duration of the course is on average four weeks. In some patients, improvement occurs much earlier, and sometimes only two weeks is enough. Sometimes improvement does not occur even after 20 times of therapy. But it was noticed that if the first 12 sessions did not move the state off the ground, then further treatment in this way will be unsuccessful.
Consequences
This method of therapy is cardinal, and it naturally has side effects, which are early and late. In the first case, violations occur immediately after the end of the session or during its implementation. This includes an unnaturally prolonged seizure, which requires 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 (stopping breathing).
In addition, early effects include headaches after the procedure, which can be eliminated with mild painkillers. After the seizure itself, overexcitation, nausea, changes in pressure, a painful condition, as well as confusion may appear, which gradually subside. But they can intensify with each next session. The worst consequences include a heart attack and death.
Late side effects appear after a fewprocedures. They can increase during the entire course, while electroshock therapy is being carried out. The consequences, as already mentioned, can manifest themselves in the form of prolonged confusion. It could also be partial amnesia or thinking problems.
Memory disorder
For a long time there was an opinion that this procedure inevitably damages the brain. Therefore, studies have been carried out to find out what kind of memory is erased during electroshock therapy, and what disorders occur during this. It was found that the disturbances 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 being treated with this method, and in other cases selective memory loss was noticed. For example, the person was unable to remember names or other details. But all these disorders occurred only with those patients in whom, even before the start of therapy, MRI showed foci of excessive intensity in the subcortical white matter. Usually, after a few weeks, the memory of these patients was completely restored, although some nevertheless noted that some of the events of their lives were irretrievably erased.
Are there any contraindications
Due to a number of side effects, the question may arise as to when 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 showcaution, since there are patient conditions in which these procedures can lead to the death of the patient. These include:
- Posted myocardial infarction (due to pass three months).
- Intracranial hypertension.
- Gastrointestinal bleeding.
- Pheochromocytoma.
- Presence of brain tumors (gender of origin is taken into account).
- For anesthesia intolerance problems.
But besides all this, there are conditions in which additional measures must be taken during the procedure in order to minimize the risk of serious complications.
