The Digest | New Jersey Magazine
Issue link: https://magazines.vuenj.com/i/1408472
T here is perhaps no medical treatment that has been more thoroughly vilified in movies and TV shows than electroconvulsive therapy (ECT). One need only reach back to the 2013 cycle of American Horror Story: Asylum to see a truly traumatizing depiction of ECT. After being trapped inside Briarcliff Asylum, protagonist Sister Jude is forced to undergo brutal sessions hooked up to a device that shoots electricity through her body, prompting violent convulsions. I was a high school senior when I watched this scene for the first time, and it colored my understanding of ECT. I thought it was a torturous, barbaric treatment that should forever be relegated to the first half of the 19th century. That was, however, until I spoke with Jason E. Estok, MD, a clinical psychiatrist, and the leader of the ECT program at Englewood Health. "People's understanding of ECT is informed by media and movies and entertainment. It's easily depicted in a negative light and people get this misconception that it's used as a punishment or to erase people's thoughts," Dr. Estok says. Colloquially referred to as "electro-shock therapy," it turns out this highly misunderstood technique is proven to successfully treat certain psychiatric and neurological illnesses. Dr. Estok says ECT is a useful, if not lifesaving, treatment for individuals with refractory depression—meaning they have tried various treatments and medications and seen no improvement in their symptoms. In fact, ECT has the highest rate of response and remission, compared to other depression treatments. It can also be used to treat mania, schizophrenia, and catatonia—which refers to when a person is extremely immobilized or extremely excited, both of which can be life threatening conditions—but is most commonly used to treat chronic and unresponsive cases of depression. "I've personally seen people with depression that have responded to ECT and felt better when all these other treatments haven't worked. Being able to offer that to people who have been suffering from depression is why I got into this line of work," Dr. Estok says. The reason ECT can be helpful for people who have not responded to medications is because the drugs typically used to treat depression are often aimed at rebalancing neurochemistry. (Think: medications that re-up serotonin inhibitors.) But not everyone's brain is the same and not everyone's depression is the same. Some cases of depression can't be easily solved with a simple V U E N J .C O M 127