Modern Brain Treatments Offer Hope for Mental Health Sufferers
Electroconvulsive Therapy (ECT) Might Surprise You With Its Unconventional Methods
With tales of shock therapy still looming in people's minds, it's easy to be skeptical about treatments that employ electricity to alter brain function. However, the stigmatized image of electroconvulsive therapy (ECT) and other neuromodulation therapies is far from the reality of these modern treatments.
Advances in neuromodulation have led to minimally-invasive psychiatric treatments with the potential to revolutionize care for those whose brains do not respond to traditional approaches like medications or talk therapy.
How does neuromodulation work?
Neuromodulation involves adjusting or rebalancing the nervous system, often focusing on the brain. This wide range of therapeutic options spans from cochlear implants for deafness to deep brain stimulation for epilepsy and Parkinson's disease. At the heart of these methods is the ability to modulate or change abnormal connections to restore normal communication and function between neurons, as explained by Dr. Randall Espinoza, a geriatric neuropsychiatrist at the UW Medicine Center for Behavioral Health and Learning.
Two recognized, safe, and effective neuromodulation therapies are ECT and transcranial magnetic stimulation (TMS), offering hope to individuals struggling with severe mental health disorders.
ECT: A Fresh Start for the Brain
ECT is approved for severe depression, bipolar depression, and catatonia, regardless of cause. Its benefits extend to other disorders like schizophrenia when used appropriately. Contrary to popular belief, ECT does not involve full-body convulsions as it only triggers seizures in specific locations on the scalp.
The mild electrical current used during ECT creates a controlled, short seizure lasting between 30 to 60 seconds. The electricity's application is minuscule, mild enough to support the jaw and face during ECT without feeling electrical stimulation. According to psychiatrist Dr. Brandon Thomas, should the machine reach its highest setting, it would light a regular light bulb for less than a second.
While ECT's mechanism is not fully understood, research suggests it alters the levels of certain neurotransmitters, hormones, and neurotrophic factors in the brain, encouraging the formation of new connections.
Doctors monitor a patient's brain activity, heart rate, rhythm, blood pressure, and oxygenation levels during ECT, ensuring its safety and effectiveness. The Food and Drug Administration (FDA) regulates ECT devices, and its endorsement is joined by numerous professional and scientific organizations worldwide.
How long does someone need ECT?
Initial ECT treatment usually occurs a few times a week for a couple of weeks to a month, totaling six to 12 sessions for most patients. Afterward, additional ECT sessions or medications may be necessary to prevent mental illness symptoms from resurfacing.
Side Effects of ECT
Memory loss is the most significant potential side effect of ECT, primarily involving short-term memory loss of events leading up to treatment but poor recall of distant or remote memories. Fortunately, short-term memory loss usually resolves within a few weeks after the treatment is completed.
TMS: A Gentle Brain Boost
TMS is used to treat major or chronic depression, obsessive-compulsive disorder (OCD), anxious depression, and smoking cessation. Similar to ECT, TMS offers a noninvasive approach, requiring no incisions or implants.
Unlike ECT, TMS employs a magnetic field to stimulate neurons, allowing the patient to remain conscious and even engage in activities like reading or listening to music. After an initial hour-long session, subsequent sessions last approximately 20 minutes, five days a week, for four to six weeks.
Much like its counterpart, TMS does not cause a brain seizure, and its side effects are minimal, often limited to lightheadedness, mild headaches, and twitchy face muscles, which typically subside quickly with continued treatment.
Who can receive ECT and TMS?
Neuromodulation therapies are offered only with informed consent and appropriate diagnosis, following a thorough medical evaluation. Unlike in rare cases where court mandates or patient incapacity allow forced treatment, these modalities are never administered without a patient's consent.
For those seeking effective mental health treatment, neuromodulation presents a valuable option. Future applications of these therapies may include vagus nerve stimulation, magnetic seizure therapy, and deep brain stimulation. In Washington state, ECT and TMS treatments are available at the Garvey Institute Center for Neuromodulation in the UW Medicine Center for Behavioral Health and Learning.
As Espinoza emphasizes, stigma surrounding brain health conditions and treatment must fade to allow for broader acceptance and improved psychiatric treatment options. For anyone struggling with mental health issues, compassionate support and resources are available. A brighter future awaits.
- Despite the stereotypes associated with electroconvulsive therapy (ECT) and other neuromodulation therapies, these modern treatments have the potential to revolutionize mental health care for those whose brains do not respond to traditional treatments like medications or talk therapy.
- Two recognized, safe, and effective neuromodulation therapies are ECT and transcranial magnetic stimulation (TMS), offering hope for individuals dealing with severe mental health disorders.
- ECT, used for severe depression, bipolar depression, catatonia, and other disorders like schizophrenia, employs a mild electrical current to create a controlled, short seizure to alter the levels of certain neurotransmitters, encouraging the formation of new connections in the brain.
- TMS, used for major or chronic depression, obsessive-compulsive disorder (OCD), anxious depression, and smoking cessation, uses a magnetic field to stimulate neurons, offering a noninvasive, minimal-side-effect approach for patients.
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