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  • 10 months ago
In 1982, a young nurse was suffering from severe, unrelenting depression. She couldn’t work, socialize or concentrate. One controversial treatment changed everything: after two courses of electroconvulsive therapy (ECT) her symptoms lifted. So what exactly is electroconvulsive therapy and why is it so stigmatized? Helen M. Farrell details the history and evolution of ECT.

Lesson by Helen Farrell, directed by Artrake Studio.

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Transcript
00:00in 1982 a young nurse was suffering from severe unrelenting depression she
00:13couldn't work socialize or even concentrate well enough to read the
00:17newspaper one treatment changed everything after two courses of
00:23electroconvulsive therapy or ECT her symptoms lifted she went back to work
00:29then on to graduate school where she earned high grades at first she talked
00:35openly about her life-changing treatment but as she realized many people had an
00:39extremely negative impression of ECT she stopped sharing her experience ECT
00:46carried a deep stigma left over from a history that bears little resemblance to
00:50the modern procedure the therapy was first used in medicine in 1938 in its
00:56early years doctors administered a strong electrical current to the brain causing
01:01a whole body seizure during which patients might bite their tongues or even break
01:06bones modern ECT is very different while a patient is under general anesthesia
01:13electrodes deliver a series of mild electrical pulses to the brain this
01:19causes huge numbers of neurons to fire in unison a brief controlled seizure a
01:26muscle relaxant keeps spasms from spreading to the rest of the body the
01:31only physical indication of the electricity flooding the brain is a
01:35twitching foot the treatment lasts for about a minute and most patients are able
01:40to resume normal activities about an hour after each session ECT is commonly used to
01:47treat severe cases of major depression or bipolar disorder in patients who
01:52haven't responded to other therapies or who have had adverse reactions to
01:56medication half or more of those who undergo treatment experience an
02:01improvement in their symptoms most patients treated with ECT have two or
02:06three sessions per week for several weeks some begin to notice an improvement in
02:11their symptoms after just one session while others take longer to respond
02:16patients often continue less frequent treatments for several months to a year
02:21and some need occasional maintenance sessions for the rest of their lives
02:25modern ECT is much safer than it used to be but patients can still
02:30experience side effects they may feel achy fatigued or nauseated right after
02:35treatment some have trouble remembering what happened right before a
02:38recession for example what they had for dinner the previous evening rarely they
02:43might have trouble remembering up to weeks and months before for most patients
02:48this memory loss does improve over time what's fascinating is that despite its
02:53proven track record we still don't know exactly why ECT works neurons in the
02:59brain communicate via electrical signals which influence our brain chemistry
03:04contributing to mood and behavior the flood of electrical activity sparked by ECT
03:09alters that chemistry for example ECT triggers the release of certain
03:15neurotransmitters molecules that help carry signals between neurons and influence
03:20mental health ECT also stimulates the flow of hormones that may help reduce
03:25symptoms of depression interestingly ECT maintenance works better when
03:30paired with medication even in patients who were resistant to medication before as we
03:35come to a better understanding of the brain will likely be able to make ECT even
03:41more effective in 1995 more than a decade after her first course of ECT the nurse
03:48decided to publish an account of her experience because of the stigma
03:53surrounding the treatment she worried that doing so might negatively impact her
03:56personal and professional life but she knew ECT could make a difference for
04:01patients when all else failed though misperceptions about ECT persist accounts
04:07like hers have helped make doctors and patients alike aware of the treatments
04:11life-changing potential
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