Electroconvulsive therapy:

1
Electroconvulsive therapy Closing the gap
between myth and reality Ashley Frith-Pridham,
Angela Kermack, and Annamaria Langellotti Departme
nt of Nursing, Mount Royal University, Calgary,
Alberta
INTRODUCTION
ECT DEFINED
The Department of Health (as cited in Bray, 2009)
defines ECT as a treatment involving the passage
of an electric current across the brain. The
treatment is only administered to an
anaesthetized patient who has also been
administered a muscle relaxant. The electric
current induces seizure activity in the brain
which is necessary for the therapeutic effect of
treatment (p. 561).
Significant stigma exists surrounding the use of
electroconvulsive therapy (ECT) in treating
severe depression. When all other therapies have
been exhausted, ECT can be an effective way to
manage treatment-resistant depression however,
misconception, stigma and fear can dissuade
individuals from accessing this treatment. This
poster aims to bring some clarity to the
misconceptions and stigma associated with ECT
use, and illuminates the importance of empowering
individuals to make evidence-informed decisions
regarding their care and treatment plans. Current
literature, research and expert interviews will
be explored to provide a realistic analysis of
the risks and benefits associated with the use of
ECT.
HISTORY OF ECT
REPRESENTATION
ECT, representing all that was brutal and
inhumane in the past, began to acquire a massive
stigma during present time. Kevin Carver,
Registered Nurse, notes that, there is a huge
stigma surrounding ECT. Society portrays it as a
barbaric procedure (personal communication,
March 5, 2012). Media depictions of ECT and
anti-ECT coalitions play a role in the stigma
surrounding this treatment. Distorted information
is provided through the internet, movies,
television, and press. Negative public reaction
due to the history of ECT treatment is also a
factor in stigmatization. Anti-ECT
Legislation In the 1970s, lobbying against ECT
was initiated by ECT survivors, who had undergone
unmodified ECT or who had suffered severe
cognitive impairment after receiving ECT.
Psychiatrist, Peter Breggin was an active voice
in lobbying for anti-ECT legislation. Peter
Breggins view on mental health focused around
the negative iatrogenic effects of conventional
psychiatry and treatments such as ECT.   Media
Portrayal of ECT Ken Keseys movie, One Flew Over
The Cuckoos Nest, shows an unrealistic depiction
of ECT as an inhumane treatment. In this movie,
ECT was characterized with elements of
electrodes, mouth guards, and thrashing limbs.
Actor Jack Nicholson was shocked with a high dose
of electricity and was administered without
anesthesia. In 1971, Joan Didion wrote a review
in the New York Times on Doris Lessings novel,
Briefing for a Descent into Hell. The review
noted that ECT had obliterated the protagonists
memory (Shorter Healy, 2007, p.156). In
contrast to the barbaric portrayal of ECT in the
past, recently the Dr. Oz Show featured a special
episode on treating depression with
Electroconvulsive therapy in January 2012. The
show answered pressing questions that the public
posed. Dr. Oz specifically spoke about how
medical advances have dramatically modernized
ECT, which improves its safety. These advances
include general anesthesia and the switch to
safer types of electrical stimulation.  
CONCLUSION
Procedural modifications as well as the
advancement of biomedical ethics have shaped ECT
into a safe and effective treatment.
Unfortunately, many patients may not access this
potentially life-saving treatment due to stigma
and negative portrayal of treatment. It is
crucial for mental health care professionals to
provide an evidence informed, accurate portrayal
of ECT to patients as well as the general public.
The use of ECT as well as other treatment options
should continue to be explored to improve safety
in the treatment of mental illness and ensure
positive patient outcomes.
One patient who received ECT for depression
commented that no one thinks twice when
electricity is delivered to a heart that has
stalled but when electricity is delivered to the
brain, it is viewed as torturous rather than a
miracle (Payne Prudic, 2009a as cited in ECT,
Alberta Health Services, 2011)
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