Electroconvulsive therapy (ECT)
ECT is a medical intervention most commonly used in patients with severe major depression, bipolar disorder (BP) or catatonia who have not responded to other treatments or who are at risk for suicide. ECT involves a brief electrical stimulation of the brain while the patient is under anesthesia. Clinical evidence indicates that for individuals with severe major depression, ECT will produce substantial improvement in approximately 80 percent of patients.
Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses.
ECT often works when other treatments are unsuccessful and when the full course of treatment is completed, but it may not work for everyone. Much of the stigma attached to ECT is based on early treatments in which high doses of electricity were administered without anesthesia, leading to memory loss, fractured bones and other serious side effects. ECT is much safer today. Although ECT still causes some side effects, it now uses electric currents given in a controlled setting to achieve the most benefit with the fewest possible risks.
Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of several mental health conditions. ECT is used to treat:
Cognitive Behavioral Therapy
Cognitive-behavioral therapy (CBT) is a form of psychotherapy that treats problems and boosts happiness by modifying dysfunctional emotions, behaviors, and thoughts. Unlike traditional Freudian psychoanalysis, which probes childhood wounds to get at the root causes of conflict, CBT focuses on solutions, encouraging patients to challenge distorted cognitions and change destructive patterns of behavior.
Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment developed by Marsha Linehan, PhD, ABPP. It emphasizes individual psychotherapy and group skills training classes to help people learn and use new skills and strategies to develop a life that they experience as worth living. DBT skills include skills for mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
Deep Brain Stimulation (DBS)
Deep brain stimulation involves implanting electrodes within certain areas of your brain. These electrodes produce electrical impulses that regulate abnormal impulses. Or, the electrical impulses can affect certain cells and chemicals within the brain.
The amount of stimulation in deep brain stimulation is controlled by a pacemaker-like device placed under the skin in your upper chest. A wire that travels under your skin connects this device to the electrodes in your brain.
Deep brain stimulation is being studied as an experimental treatment for major depression, stroke recovery, addiction and dementia. Clinical trials may be available to candidates for deep brain stimulation.
Deep brain stimulation is an established treatment for movement disorders, such as essential tremor, Parkinson's disease and dystonia, and more recently, obsessive-compulsive disorder.
This treatment is reserved for people who aren't able to get control of their symptoms with medications.
Transcranial magnetic stimulation (TMS)
Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven't been effective.
During a TMS session, an electromagnetic coil is placed against your scalp near your forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of your brain involved in mood control and depression. And it may activate regions of the brain that have decreased activity in people with depression.
Though the biology of why rTMS works isn't completely understood, the stimulation appears to affect how this part of the brain is working, which in turn seems to ease depression symptoms and improve mood. Treatment for depression involves delivering repetitive magnetic pulses, so it's called repetitive TMS or rTMS.
Ketamine for Depression
Long used as an anaesthetic and analgesic, most people familiar with ketamine know of it for this purpose. Others know it as a party drug that can give users an out-of-body experience, leaving them completely disconnected from reality. Less well known is its growing off-label use in the USA for depression, in many cases when other options have been exhausted.
Compelling published study results and case reports exist of patients' depression—in some cases deeply entrenched depression that has lasted months or even years—alleviating within hours of use of ketamine.
BBC News: Ketamine has 'fast-acting benefits' for depression
Additional Alternatives Treatments include:
- Talk Therapy
- Good Sleep Habits
- Stress Management
- No Alcohol
- Supplements and Herbs - awareness of dangerous drug interactions
- Music and Art therapy
- Daily Routines and Structure
- Daily logs and Journaling