Electroconvulsive Therapy

sim_eunjin
Mind Map by sim_eunjin, updated more than 1 year ago
sim_eunjin
Created by sim_eunjin about 5 years ago
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Mind Map on Electroconvulsive Therapy, created by sim_eunjin on 12/07/2014.

Resource summary

Electroconvulsive Therapy
1 PROS
1.1 Electroconvulsive Therapy (ECT) has successful, fast results.
1.1.1 Studies have found that the brain chemistry change after the procedure is almost instant as well as immediate relief of symptoms of some mental illnesses.
1.1.2 Typically, patients begin to see significant improvement after just 2 or 3 treatments while other medications sometimes take weeks to be effective.
1.1.2.1 Electroconvulsive therapy is an ideal option for those who struggle with suicidal thoughts or experience debilitating manic episodes.
1.1.3 Electroconvulsive therapy in known to succesfully treat cases that medication could not.
1.1.4 ECT is known to treat "hard-to-treat cases" such as depression, Schizophrenia, severe Mania, Catatonia, Tourette Syndrome and Obsessive Compulsive Disorder.
1.1.4.1 Studies found that ECT works on more than 80% of people with major depression
1.1.4.2 Studies states that "No treatment has ever been more effective for depression."
1.1.4.3 A nurse at a hospital reported "I have seen severely depressed people who were unable to dress or feed themselves; I had to change their diapers because they were so regressed and withdrawn. By the end of their ECT treatments they were smiling, eating and drinking on their own. It's as if they were brought back from the dead."
1.1.4.4 In one study, ECT was given for eight weeks to seventeen patients who had failed to respond to lithium. After the treatments, all patients recovered.
1.1.5 Star Wars actress, Carrie Fisher struggles with mental illness and explained on Oprah that she gets ECT every six weeks for her manic depression symptoms. She swears it’s saving her life.
1.1.6 Mind, a mental illness campaign, conducted a survey, in 2001, of mental health service users who had received ECT.
1.1.6.1 ‘If I had not received ECT I would be dead by now.’ (Woman, Staffordshire.)
1.1.7 “The effect of the treatment was amazing. All psychotic thoughts diminished, and I started to feel as if I was finally being lifted from the big, black hole I had been in. I honestly believe that, had I not received ECT, I would not be living the full, happy and healthy life that I am living today.” (Woman, Hertfordshire)
1.1.8 “It just seems to help me out of my depressed state of mind very quickly.” (Man, no area given)
1.2 Electroconvulsive Therapy (ECT) has been modified to be a safe treatment.
1.2.1 In the early years of ECT, the electrical currents were delivered in more powerful doses administered without anesthesia therapy. In the past, ECT was painful and had serious side effects such as broken bones.
1.2.1.1 Currently, ECT treatment lowed levels of electrical currents and uses muscle relaxants and anesthesia in order to reduce the severe spasms that generated injuries in the past.
1.2.2 ECT is ten times less likely to kill you than childbirth.
1.2.3 ECT is about 1000 times safer than untreated major depression.
1.2.4 80% of people who have had ECT report that the procedure was no more frightening than going to the dentist.
1.2.5 The public's concerns about ECT arise from the gruesome way in which the treatment has been portrayed by the popular media.
1.2.5.1 The film "One Flew Over the Cuckoo's Nest."
1.2.5.2 Stereotypes of Frankenstein, mad scientists and electrocution.
1.2.6 “The equipment is much improved — newer generations, easier to use, and more precise,” Dr. Furman, director of the ECT Program at Butler Hospital.
1.3 The risks of ECT often times outweigh the risks of not being treated.
1.3.1 “We always weigh out the risks and benefits of doing ECT as well as the risks of not doing ECT, most patients who turn to ECT have depression with physical manifestations, such as an inability to get out of bed for days at a time or eat or drink. If you are so depressed that you aren’t getting enough fluids, you run the risk of even more serious health complications” Dr. Furman, MD, director of the ECT Program at Butler Hospital.
1.3.2 ‘It was a life-saver to me, as I was very depressed and highly suicidal.’ (Woman, Wiltshire)
2 CONS
2.1 Electroconvulsive Therapy comes with side effects after treatments.
2.1.1 Confusion
2.1.2 Memory Loss
2.1.2.1 Many patients have trouble remembering events that occurred a bit prior to treatment trouble as well as events that happened after the treatment ended.
2.1.2.2 “Permanent loss of reading and numeracy skills.” (Man, West Midlands.)
2.1.2.3 “I don’t play the piano, organ or violin any more, as I can’t remember how to. It seems my long-term memory has gone forever. Memories from my past five years, and more, have become either vague or have gone.” (Man, Berkshire.)
2.1.2.4 “I qualified as a maths teacher. Following all this ECT, I have no understanding of the maths concepts used in my further education courses, or even O-level standard.” (Woman, Cleveland.)
2.1.2.5 In one study, 55% of patients felt that they had not regained normal memory function, three years after receiving ECT.
2.1.2.6 An American psychologist conducted detailed autobiographical interviews with 19 people who were about to have ECT, and with a control group who did not have ECT. He then questioned both groups about the same information afterwards He found that all the 19 patients showed a number of instances of forgetting their former memories the control group whose memories were unchanged He followed up half of the ECT patients a year later, and there had been no return of the lost memories
2.1.3 Physical Side Effects
2.1.3.1 Typically, patients experience headaches, jaw and muscle pain and nausea right after their treatment.
2.1.4 Cognitive Impairment
2.1.4.1 ECT typically causes trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life.
2.2 The benefits of ECT aren’t always permanent.
2.2.1 ECT can be very effective in the short-term but it often needs regular treatment to keep symptoms at bay to reduce the risk of relapse.
2.2.2 The relapse rates in the year following ECT are likely to be high unless antidepressant medications are subsequently prescribed.
2.3 Many feel that ECT is useless and damaging.
2.3.1 Mind conducted a survey, in 2001, of mental health service users who had received ECT.
2.3.1.1 ‘I would happily die rather than have ECT again.’ (Woman, Yorkshire.)
2.3.1.2 27% found it unhelpful/damaging in the short term while 43% felt that it was unhelpful or damaging in the long term.
2.3.1.3 Two-thirds would not agree to have it again.
2.3.1.4 “Under no circumstances would I choose to have ECT. I would rather go down fighting than submit to that abomination.” (Woman, no area given)
2.3.1.5 ‘It was hell on earth.’ (Woman, Dorset, ECT three to five years ago.)
2.4 The ECT Handbook has many recommendations that hospitals do not follow.
2.4.1 Handbook Recommendations
2.4.1.1 ECT treatment centre should consist of at least 3 rooms: a waiting, a treatment room and a recovery area.
2.4.1.2 An anaesthetist and a psychiatrist must be present for a treatment session to take place.
2.4.1.3 ECT procedure must have a nurse, who the patient knows and trusts, to escort the patient.
2.4.1.4 In the treatment room, there must be an electrocardiogram machine to measure blood pressure, a defibrillator to restart the heart and a standard box of drugs in case of cardiac arrest.
2.4.1.5 All staff working in the ECT unit need regular training updating and practice in basic advanced life support techniques.
2.4.2 A survey of the 230 sites in England and Wales that provide ECT found that:
2.4.2.1 32% of sites did not have a dedicated ECT procedure area of three rooms.
2.4.2.2 36% of sites did not have a nurse in the recovery room trained in basic life support and resuscitation techniques.
2.4.2.3 5% of sites did not have either copies of The ECT Handbook or the hospital’s own policy for ECT.
2.5 Unethicality
2.5.1 Support Coalition International internet, an anti-ECT group gathered evidence that doctors are administering ECT by force to patients who in many cases have refused.
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