Modern ECT
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NARRATOR: The preparations are being made for an electroconvulsive therapy treatment, ECT for short. It's used when all other treatments have failed. Applying an electrical current can sometimes work wonders against depression.
ANETTE-YVONNE REICHERL: [SPEAKING GERMAN]
INTERPRETER 1: I remember how it was after the third or fourth ECT. It was like a switch clicking on, and my life returned again.
MALEK BAJBOUJ: [SPEAKING GERMAN]
INTERPRETER 2: We know that depression is usually a recurring condition. There are often new episodes, and we want to prevent them. And ECT is a procedure that can snap people out of a depressive episode quickly and extremely effectively.
NARRATOR: Anette-Yvonne Reicherl is familiar with major depressive episodes. In 2005, she had an especially bad one. Nothing and no one could convince her to get out of bed.
ANETTE-YVONNE REICHERL: [SPEAKING GERMAN]
INTERPRETER 1: When the depression is very severe, there was just one thought in the foreground, to put an end to my life.
NARRATOR: Anette-Yvonne was in different hospitals and tried all kinds of new medications. But nothing helped until a doctor suggested electroconvulsive therapy.
This is how it works. First, the patient is hooked up. Electrodes on her forehead will monitor her brainwaves. She doesn't notice the treatment because she's fully anesthetized.
First, the team gives her a short-acting hypnotic drug to put her to sleep.
OLAF KNIESEL: [SPEAKING GERMAN]
INTERPRETER 3: After that, she's given a muscle relaxant because the treatment causes very strong muscle contractions that could lead to broken bones or other injuries. So the muscles have to be relaxed.
NARRATOR: The actual treatment is carried out by this current producing device and an electrode on her temple.
OLAF KNIESEL: [SPEAKING GERMAN]
NARRATOR: For a few seconds, a weak current runs through the patient's brain. The doctors watch her right foot to monitor her motor reactions. Thanks to the medication, there's only a slight twitching. The convulsion lasts about half a minute, but the printout shows the brain continues to react to the electrical stimulus.
There are a number of different theories about what happens in the brain during electroconvulsive therapy. The current affects the hippocampus in the limbic system. The current causes increased blood flow in the brain and boosts the release of certain neurotransmitters.
Studies have shown that the treatment modifies synaptic connections in the brain, as well as altering levels of the brain chemicals that are responsible for mood. All this has an antidepressive effect. Despite that, the procedure is rarely carried out.
MALEK BAJBOUJ: [SPEAKING GERMAN]
INTERPRETER 2: One of the reasons is that performing it is very complicated. Each treatment requires the presence of two doctors, an anesthetic nurse, and a psychiatric nurse, always four people, which is quite elaborate.
ANETTE-YVONNE REICHERL: [SPEAKING GERMAN]
INTERPRETER 1: It brings me back to life. Since then, I've been much better. I can deal with daily life again, and I have even discovered lots of new sides to myself.
NARRATOR: Anette-Yvonne has now had about 100 treatments. She's a familiar face here. After a first series of 16 treatments in 2006, she now comes every four weeks for a maintenance ECT. Except for a few headaches, she's never had any side effects.
MALEK BAJBOUJ: [SPEAKING GERMAN]
INTERPRETER 2: With ECT, we also know that having a great number of treatments doesn't damage the brain. On the contrary, there are signs that nerve growth factors are stimulated by ECT. So there is no upper limit to the number of ECT treatments that can be administered.
NARRATOR: Electroconvulsive therapy may sound daunting, but for some people, it's the only way out of depression.
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