Photo: Supplied
Electroconvulsive therapy has had a bad rap in films and media for decades - in some cases, deservedly so. A specialist explains why the stigma is not warranted.
It has a dark history of misuse, a litany of ethical concerns and well-documented severe side effects.
Its portrayal on film - think Jack Nicholson in One Flew Over the Cuckoo's Nest - has not been kind.
But in the modern world, is this still a fair perception of electroconvulsive therapy (ECT)?
When The Detail late last year looked into upcoming changes in the Mental Health Act, advocates pleaded for the "brutal" treatment to stop.
We tried unsuccessfully then to get a specialist to talk about it, but there was a chorus of protest afterwards that ECT is not as bad as it is painted.
We are going back to look at it with Dr Hiran Thabrew, chair of the New Zealand National Committee and a child and adolescent psychiatrist and paediatrician.
He admits there is a lot of stigma about it and understands why the reluctance to talk about it - but says while there will likely be some backlash, the conversation is important.
The treatment is administered to between 200 and 300 patients with depression every year in New Zealand.
"It works pretty well, studies show that 70 to 90 percent of people with severe depression who receive ECT experience an improvement in symptoms, and it happens a lot faster than with medication," says Dr Thabrew.
He tells The Detail ECT is often recommended for people experiencing severe mental health conditions, especially treatment-resistant depression, profound bipolar disorder, and some cases of schizophrenia. It can be a game changer and lifesaver.
Modern ECT is administered under general anaesthesia with muscle relaxants to ensure the procedure is painless.
"There's a lot of stigma around ECT for a number of reasons but it's a very safe and effective medical procedure that involves the delivery of small pulsed electrical currents to the brain that is sufficient to induce a seizure for therapeutic purposes," he says.
"People who receive ECT will go to theatre, an operation room, like any normal surgical procedure, they will receive a general anaesthetic to put them to sleep and a muscle relaxant to stop any unwanted movements... so they are fully asleep while the procedure is undertaken... and then they are woken up at the end and they won't know anything about it, just how they feel afterwards."
But, he admits, there are side effects to inducing a controlled seizure, including short and long-term memory loss. Some patients, who underwent the treatment in America, have recorded total memory loss, which has never returned.
But Dr Thabrew says most side effects improve after treatment stops, and many patients find that the benefits - such as relief from severe depression or suicidal thoughts - outweigh the risks.
ECT is normally not a one-off treatment - 8 to 12 treatments, done two to three times a week, are usually required - and they are free through the public health system.
Some patients, says Dr Thabrew, are reluctant to access the treatment because of the historical and inaccurate depictions in film and television.
"One Flew Over the Cuckoo's Nest is a classic example - that leaves people with images and memories of people being strapped to beds and electrocuted. That is highly inaccurate. ECT looks nothing like that."
He says the use of ECT is continuously monitored and reviewed by medical professionals and mental health organisations to ensure best practices and patient safety.
Check out how to listen to and follow The Detail here.
You can also stay up-to-date by liking us on Facebook or following us on Twitter.
