Electroconvulsive therapy most rapid, effective cure for ‘severe depression’ – Psychiatrist

Electroconvulsive therapy (ECT) has been suggested as the most rapid and effective cure for severe depression even though it is considered ‘barbaric’ and archaic by patients.

“It might come as quite a surprise to learn that, as a psychiatrist, if I ever had the misfortune to develop severe depression, my treatment of choice would be electroconvulsive therapy (ECT),” says UK based psychiatrist, Mariam Alexander.

ECT is a medical procedure in which an anaesthetised patient has a small electrical current applied to their scalp in order to induce a seizure for the purposes of treating severe mental illnesses and occasionally neurological disorders too.

Each treatment takes just a few minutes and is usually administered two or three times a week. ECT course length varies depending on the needs of the patient, but on average eight to 12 treatments are given.

In her opinion article published by the Guardian UK on Wednesday, the psychiatrist explained that the procedure is meant for people suffering from “severe depression” and not for the “mild to moderate depression” which she said could be treated with improved sleep, diet and physical activity, a talking therapy and perhaps an antidepressant.

According to Ms Alexander, a consultant liaison psychiatrist for UK based NHS, ECT should be recommended for those suffering severe depression which she described as “the pointy end of the depression spectrum.

“When your mind and body spirals into shutdown, thinking becomes so overwhelmingly negative that you may feel totally hopeless. Nihilistic delusions may emerge, such as the unshakeable belief that your body is rotting away. Auditory hallucinations may say awful things to you. Suicidal thoughts can become constant and irresistible.

“In liaison psychiatry, we see individuals so severely depressed that they have become catatonic – a state that means they may be unable to move, speak or eat.”

It is in that extreme state of depression that she recommended ECT.

The psychiatrist said patients shy away from the method because of fear of the myth associated with it.

“When I raise the possibility of ECT with patients, their response is often one of fear, arising from outdated ideas.

“It’s almost impossible to discuss ECT without the word “barbaric” being used. For anyone who is familiar with the psychiatric era of One Flew Over the Cuckoo’s Nest, this is understandable. But things have moved on a great deal since then.”

She, however, noted that it is not yet clear how the ECT procedure works.

Spate of Depression

The World Health Organisation (WHO) has been raising concerns on the high rate of suicide among young people globally, as a result of depression.

Depression is the leading cause of disability globally, as well as the leading cause of about 800,000 suicide deaths in the world. It is also the second leading cause of death in 15 – 29-year-olds, globally.

WHO believes depression is one of the most ignored and misunderstood form of mental disorder, especially in developing countries such as in Nigeria.

In its 2017 World Mental Health Day message, the health body said over seven million Nigerians suffer from all forms of depression, a condition it said should be tackled head-on.

The suicide rate has increased in Nigeria with Sniper, an agro-chemical, among the agents popularly used.

This prompted the Nigerian government to direct a ban on the product.

Health experts believe the rising suicide trend in Nigeria can be drastically reduced by understanding depression, which they say is a preventable and treatable ailment.