Electroshock therapy has been featured in many movies, usually as a total nightmare meted out by sadistic doctors on an innocent patient for no reason and with no benefit. And it's still used today. But why? Because, despite its depiction on film, it's painless and effective.
Electroshock therapy has a bad reputation, and in some ways it should. It involves passing an electric current through the brain cells of a living human being. If there's anything that doctors don't want people trying at home, it's that. Still, Hollywood may have gone overboard. Movies like The Snake Pit and The Butcher Boy portray the therapy as agonizing, and Requiem for a Dream makes it analogous to having an arm amputated. Many people today see the therapy as archaic as a lobotomy. Unlike lobotomy-like procedures, which have died out except in life-threatening cases of epilepsy, electroshock therapy is still commonly done.
The Origin of Electroshock Therapy
Perhaps the most curious part of electroshock therapy is that it was ever done at all. Anyone who has had any exposure to electricity knows that it doesn't feel good. It would seem to be inducing an injury for no reason. It turns out, though, that the point of electroshock therapy isn't the electricity, any more than the point of surgery is the cutting. Electricity is simply used as a means to induce a seizure. Temporary, mild seizures were observed throughout history to help those with mental illness. Hippocrates noticed that seizures brought on by malaria helped mentally ill patients. Later, physicians noticed that seizures during other illnesses like cholera and smallpox did the same. Once mental illness itself was studied, people found that there were very few epileptics who were also schizophrenics, and that epileptics often didn't have many other mental illnesses. It was in this way that a link between seizures and the prevention of severe mental illness was made.
Early doctors tried to induce seizures in their patients in various ways. They tried to induce high fevers, since illnesses like typhoid or tuberculosis often helped mentally ill patients improve. These were most often tried on patients with late-stage syphillis, before a cure for the disease was found. Next doctors gave patients too much insulin, which put them into comas or sent them into convulsions, but did manage to improve schizophrenics. Seventy percent of these patients showed improvement after being treated this way. Doctors then moved on to chemically-induced convulsions, but these proved risky. Then came the idea to use electricity as a way to stimulate seizures. Unlike drugs, which had to work through the system, electricity could be precisely placed at different parts of the body, and its level and length could be carefully controlled. It was the best, and most convenient, method.
The History of Electroshock Therapy
Which isn't to say that the movies have it all wrong when it came to portraying electroshock therapy as an inhumane treatment. Although it was effective, it caused retrograde amnesia. Patients were unable to remember their sessions, so they had no negative feelings toward the treatment. As the use of the treatment spread, so did its abuse. Throughout the sixties and seventies, patients in mental health facilities were often given this 'therapy' for being troublesome, instead of legitimately troubled. These patients were shocked several times a day, instead of once every week or so. What's more, they were shocked without being restrained. Since the treatment was meant to cause seizures, the patients would move violently, bruising themselves or breaking their bones. As more people looked at the often deplorable conditions in mental health facilities, shock therapy became part of the overall horror story.
There is still resistance to shock therapy. In the mid-1990s there was a movement to ban the practice in Texas. Patients complained that they were forced to sign consent forms for the therapy against their will in institutions. They also complained of ongoing seizures, extreme depression, and memory loss. Patients also claim that facilities use it, especially on older people, because it is quick, cheap, and covered by Medicare.
Electroconvulsive Therapy Today
Today, electroshock therapy has the slightly tweaked name of electroconvulsive therapy. Although there are still people who oppose it, it has shown remarkable success in treating depression, schizophrenia, mania, catatonia, and Parkinson's disease. Doctors are quick to point out that it's used when other treatment options have been exhausted.
The procedure is usually done as an outpatient process. The patient is put under anesthesia, and often a paralytic drug to keep them from moving too much and injuring themselves. If the drugs compromise their breathing, the patient is given oxygen through a mask. Doctors wrap a tourniquet or a blood pressure cuff around wrist or ankle to compromise blood flow to that area. This prevents the paralytic from seeping into that hand or foot.
Electrode pads are placed on the patients head in certain areas, and an electric current is applied. The hand or foot that has not received the drugs will seize at this time, showing the doctors that the process is working. The shock usually lasts for less than a second, and is followed by a seizure of 30 to 60 seconds. The entire procedure - minus the preparation and recovery - lasts about fifteen minutes. The most common side effect is a sense of confusion upon waking.