WHEN IS ECT USED?

Your consultant may recommend you for ECT if one of the following applies to you:

• You may have had severe depressive illness for some time and a number of different drug treatments have been tried without success. Your illness may be making it impossible for you to function and/or be causing you serious distress
• You have tried several antidepressants of different types but have had to stop them all because of side effects
• You are currently severely depressed and have had one or more previous episodes of depressive illness in which you have not found any range of medicines helpful - but you have benefited from ECT before. (You might discuss with your doctor whether it is worth trying antidepressants again before using ECT.)
• A depressed patient who is not eating or drinking sufficiently and whose life is in danger may be recommended to have ECT
• Suicidal feelings - it is not unusual for people with clinical depression to have some thoughts of dying or suicide. But if you feel a strong inclination - remember this is a symptom of illness. It may be hard to believe just now - but people have been there before you, have got better and are now happily living their lives. Things can seem very different when you are ill - and depression that hasn't responded to other treatment and includes a suicidal urge could well be a reason for accepting a doctor's recommendation for ECT. It is important to try to talk to someone about it

It can be hard for the patient, but unless there is extreme urgency, antidepressants need to be given enough time to work before the decision is made to use ECT. On the other hand, you are entitled to question if you feel that the doctor is waiting too long for a result from one particular medication. Neither ECT nor medicines will solve underlying problems in your life - neither those that existed before you became ill nor any new difficulties that have been caused by your illness. But effective treatment with medication and/or ECT, perhaps used together with a 'talking treatment', like counselling or psychotherapy, could help you deal with problems.

The decision to recommend ECT should be made by a Consultant Psychiatrist or a Senior Registrar. If you are not sure whether your hospital doctor is a Consultant - ask, or get someone to ask for you. You are entitled to see - and spend some time with - the senior doctor concerned.

ECT should be used with care in those with heart conditions.

In the vast majority of cases where ECT is used, it is in order to treat a depressive illness. In rare cases, however, it is used:

• To treat schizophrenia, when a serious episode has not got better with other treatment
• To treat mania - again only in very severe cases when things have not improved with drug therapy. Mania is the "high" or "elation" phase of manic depressive illness (also known as bipolar disorder)