By Simon Kitchen, CEO of Bipolar UK

The article describing Electroconvulsive Therapy (ECT) as ‘dangerous’ in The Independent in June 2022 triggered a passionate debate on our eCommunity. Many voices said ECT has been lifechanging, often lifesaving.

When people with bipolar are at their most unwell they, and their doctors, often have to make difficult decisions about treatment, weighing up the benefits with potential side effects.

Listen to our Director of Research, Dr Tania Gergel, describing ECT as the only treatment that can bring her back to health after episodes of severe depression, psychosis and mania in this Radio 4 documentary 'Shocking'

ECT can save lives

As CEO of Bipolar UK, I have personally met many people with bipolar who’ve told me they wouldn’t still be here if it wasn’t for ECT. The suicide rate is 20 times higher[1] for people with bipolar, so our position as a charity and a collective voice for those with the condition is that they need as many treatment options as possible. 

There is substantial evidence to prove the benefits of ECT[2], and a recent review found that it is the ‘most effective treatment[3] for severe, psychotic or treatment-resistant depression’.

It’s time to let go of the old myths

It’s a common belief that ECT is straight out of One Flew Over The Cuckoo’s Nest where the staff use force and out-dated equipment to control the patients. These misconceptions create fear and stigmatise people using ECT.

The article doesn’t describe the reality of modern ECT, not explaining that patients are given a muscle relaxant or that ECT[4] is given under a general anaesthetic. This means many clinicians - psychiatrists, anaesthetists and mental health nurses – need to work together to improve the patient experience. Instead of the steady stream of electricity that used to be given, modern ECT[5] uses a series of brief electrical pulses, which stimulates the brain. ECT is given as a course of treatments, typically twice a week for 3–8 weeks. 

It’s not fully understand how or why ECT works, but it’s thought that the effects of ECT gradually build with each treatment and that it causes the release of certain brain chemicals,[6] which seem to stimulate the growth of some areas in the brain that tend to shrink with depression.

Evidence shows that the benefits can outweigh the risks

The article states that there are concerns ECT can cause ‘irreparable’ and ‘severe’ brain damage. There is no evidence[7] to support this. Some degree of autobiographical memory loss, especially from the time period during which ECT is administered, can be a common and difficult side effect[8] although the experiences vary widely for every individual. Even so, many patients[9] who have received ECT themselves say that it is an effective and necessary treatment.

Dr Tania Gergel[10], Bipolar UK’s Director of Research, who has a diagnosis of bipolar and who has had multiple courses of ECT, including during a pregnancy, says: ‘Having ECT wasn’t frightening. I have noticed no deterioration of intellectual ability or capacity to build new memories, and have been able successfully to resume my academic career’.

Richard Hopkins, who has a diagnosis of bipolar, says: ‘Four lots of ECT treatment pulled me out of depression after only one week. There’s a lot of misunderstanding around but it really helped me. The only thing is that you get buzzy for about two minutes when you come round. And the only memory loss I had was about what happened in hospital – but that wasn’t a bad thing. There were no headaches, no significant memory loss and no other side effects at all. My consultant psychiatrist told me that it’s saved many lives, I think it’s saved mine.’

Perhaps most harmfully of all, the article states that 67% of people who have ECT are women and implies there’s a sinister reason behind this gender difference. Yet this is mainly because depression is much more common in women[11], and is even safe and effective during pregnancy[12] when certain medications might harm the foetus. 

We support patient choice

As a charity we welcome a conversation. ECT is not the answer for everyone. But it is essential – a matter of life and death even – that everyone with bipolar should have the choice. 

Bipolar UK’s moderated eCommunity is open 24/7 to anyone affected by bipolar. Join here: www.bipolaruk.org/ecommunity

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[1] https://pubmed.ncbi.nlm.nih.gov/30173059/

[2] https://pubmed.ncbi.nlm.nih.gov/30098649/

[3] https://pubmed.ncbi.nlm.nih.gov/35048827/

[4] https://www.nice.org.uk/guidance/ta59

[5] https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/ect

[6] https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/ect

[7] https://pubmed.ncbi.nlm.nih.gov/34265274/

[8] https://pubmed.ncbi.nlm.nih.gov/18379329/

[9] https://pubmed.ncbi.nlm.nih.gov/30694874/

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7612414/

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478054/

[12] https://pubmed.ncbi.nlm.nih.gov/29796968/

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Last updated: 27 February 2023