The truth about ECT and severe depression

Severe depression and other mental health conditions can disrupt the way the brain functions, and ECT is thought to help restore healthier activity.

"We compare it to a reboot on your phone or computer," says Pfister. "It helps with brain chemistry and neural networks, and we've even seen new neurons grow."

One of the most common misconceptions is that the electricity itself causes the healing. The machine delivers only a tiny pulse, which Pfister likens to the jolt from a 9-volt battery. Its single job is to spark the therapeutic seizure that follows.

During ECT, patients are fully asleep under general anesthesia for the entire procedure, which lasts only about five to eight minutes, while a team of nurses and psychiatrists supervise the treatment. It is not painful. Medications relax the muscles, so the seizure, which lasts just 30 to 60 seconds, registers as little more than a small twitch.

Most people wake up feeling fine, while some may notice mild soreness after their first session.

"It's like going to the gym after a long time off," Pfister says. "You might feel a little general soreness."

Patients may experience headaches or nausea, which are can be eased with over-the-counter medicine.

Pfister hears concerns about memory loss as a side effect most often, and he's quick to put it in perspective. While long-term memory loss may occur, it is very rare, and most patients fully recover within a few weeks to a few months.

During treatment, short-term memory can feel fuzzy — like struggling to recall what you had for dinner last night. As the sessions taper off, that fog typically lifts.

"It doesn't change who you are,” he says. “It's not a personality changer.”

Pfister also points out that severe depression itself clouds memory. As the depression eases, many people find that forming and recalling memories actually gets easier.

ECT has a response rate of over 60%, making it one of the most effective treatments for severe, treatment-resistant depression, helping the large majority of patients who try it. Improvement often shows up in small, everyday moments, and loved ones tend to notice it first.

"If I had a nickel for every time a family member said, 'He did something he hasn't done in years,'" Pfister says. "Something as simple as walking out to get the newspaper."

A typical course of ECT includes eight to 12 sessions, scheduled three times a week. Because the relief builds over time, most patients gradually step down to less frequent visits. Some people continue occasional maintenance treatments to stay well.

However, patients can't drive during the acute series, so they'll need a family member or friend to bring them home after each session. Taking time off work is also encouraged to focus on healing.

ECT usually begins with a referral from a psychiatrist, who helps determine whether it's an appropriate fit for each individual. It's considered remarkably safe across a wide range of ages — Sharp Mesa Vista's patients currently range from age 13 to 97 — and it can even be used during pregnancy, when many psychiatric medications aren't recommended.