High-Powered Treatment

When Bill Russell tells people that his severe depression was relieved by shock therapy, the most common response he gets is: "They're still doing that?"

Most people might be quicker to associate electroshock therapy with torture rather than healing. But since the 1980s, the practice has been quietly making a comeback. The number of patients undergoing electroconvulsive therapy, as it's formally called, has tripled to 100,000 a year, according to the National Mental Health Association.

During an ECT treatment, doctors jolt the unconscious patient's brain with an electrical charge, which triggers a grand mal seizure. It's considered by many psychiatrists to be the most effective way to treat depression especially in patients who haven't responded to antidepressants. One 2006 study at Wake Forest University School of Medicine in North Carolina found that ECT improved the quality of life for nearly 80 percent of patients.

"It's the definitive treatment for depression," says Dr. Kenneth Melman, a psychiatrist at Swedish Medical Center in Seattle who practices ECT. "There aren't any other treatments for depression that have been found to be superior to ECT."

In fact, antidepressants — the most widely used method for treating depression — don't work at all for 30 percent of patients.

But some doctors and past patients say that the risks of shock therapy, such as memory loss, are too high a price to pay for the temporary benefits.

Despite convulsive therapy's 70-year history, doctors still aren't sure exactly how ECT works to ease depression. What they do know is that ECT works very quickly, with many patients reporting their depression lifting after just a few sessions — and in patients with severe depression, a fast-acting treatment is considered imperative to prevent a suicide attempt.

Russell, who lives in Mill Creek, Wash., has struggled with depression and obsessive-compulsive disorder since he was in high school. But his depression began to weigh on him like a lead coat in the spring of 2007, after the pace at his job as an electronics technician quickened, and he couldn't keep up and became overwhelmed. Every night that spring, he came home from work and went straight to bed. He was barely eating and dropped 40 pounds in three months. At his lowest point, he formed a plan to kill himself.

As his depression worsened, he was hospitalized, and at one point was on eight different antidepressants and anti-anxiety drugs, but none of them helped. It wasn't until he tried ECT as a desperate last resort that he was helped. His depression started to lift after the first week of treatments.

A crucial treatment — or brain damage?
But not everyone responds as well as Russell, say critics of the treatment who warn that the cognitive side effects, such as memory loss, are too severe, and that the fuzzy, foggy state of mind that ECT initially causes simply makes patients temporarily forget about their sadness. (Nearly every ECT patient experiences confusion, inability to concentrate and short-term memory loss during the treatment.)

"We talk about cognitive deficits and memory loss — really, that's brain damage," says John Breeding, a psychologist in private practice in Austin, Texas. Breeding has counseled several past ECT patients, who say they've suffered long-term cognitive damage as a result of electroshock. He's working to ban ECT in his state, and he runs the Web site endofshock.com.