History of Electroshock Therapy: Does It Even Work?

Electroshock therapy, now known as electroconvulsive therapy (ECT) consists of a finely controlled electric current being transmitted through the brain, intentionally triggering a brief seizure. The procedure is done under general anesthesia and a muscle relaxer to minimize effects of the seizure. ECT is believed to cause changes in brain chemistry and is, currently, one of the fastest ways to relieve symptoms in the most severely depressed or suicidal patients.

Because of careful monitoring and the muscles being relaxed during treatment, the visible effects of the seizure are usually slight movements of the hands and feet. The entire procedure only lasts a few minutes, and, when the patient awakens from the anesthesia, there is usually some confusion and no memory of the treatment or events surrounding it. The confusion is typically short-lived.

Does Electroshock Therapy Work?

ECT often works when other treatments are unsuccessful and are generally prescribed when severe depression is unresponsive to other forms of therapy or when patients pose an immediate threat to themselves or others. Today, ECT is routinely covered by insurance companies because it is believed to provide the “biggest bang for the buck” when it comes to cases for which nothing else seems to work.

ECT has struggled to gain validation from the medical community and, perhaps even more so, the acceptance of the general public. There is still a great deal of stigma, as well as outright fear, attached to any method that employs electrically shocking the brain. This fear is not unearned. Electroshock therapy has some dark chapters in its history. Early treatments involved dangerously high doses of electricity given without their consent to patients who were strapped down and totally without the benefit of any sort of anesthesia. More often than not, these early treatments led to serious side effects, including memory loss and fractured bones.

Another prominent reason for a reluctance to embrace electroshock therapy is that it was often used to control or discipline patients in institutions rather than as a means of trying to help them. This sort of abuse was a complete contradiction of the original intent of those who first pioneered this treatment method. Like depression, the condition it was meant to alleviate, electroshock therapy has gone through a number of manifestations through the years.  

History of Depression

According to the World Health Organization, depression is the leading cause of disability. Initially called “melancholia”, the earliest accounts of depression appeared sometime in the second millennium B.C. The ancient Greeks and Romans were convinced that mental illness was brought on by spirits or demons, although the famous Greek physician, Hippocrates, thought there might be some connection to body fluids which he called humorous. From the Middle Ages into the Renaissance, many sufferers of mental illness were branded witches, and we all know the form of treatment that led to. By the beginning of the Age of Enlightenment, the consensus had become that depression was an inherited mental weakness that could not be cured, leading to the vast majority of patients ending up homeless or committed to institutions.

Prior to the use of an electrical current, malaria, metrazol, camphor, strychnine and other substances were used to created seizures in mentally ill patients. The first use of electroshock shock therapy was by Ugo Cerletti and Lucio Bini in Rome, in 1937, and it began to gain popularity in the US in the 1940s. Psychiatric hospitals and institutions were overrun with patients that doctors were unable to treat. Up until then, lobotomies were used to make patients more manageable, but electroshock shock therapy seemed to actually help those with severe depression to improve.

Is Electroshock Therapy Used Today?

ECT still has a lot to overcome. It is not totally understood how it works and is being constantly refined. There is also a lingering negative perception in the minds of the public. Some of that has to do with works of fiction based on bits of true experiences. The most well-known are Sylvia Plath’s autobiographical novel, The Bell Jar, and the novel, One Flew Over the Cuckoo’s Nest, by Ken Kesey. Both of these were, to say the least, frightening. There are also true life accounts, like the suicide of one of America’s favorite authors, Ernest Hemingway, shortly after ECT at the Mayo Clinic in 1961. According to his biographer, one of the last things Hemingway said was “Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient….”