The Functioning of Electroconvulsive Therapy … Research Paper
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¶ … Electroconvulsive Work?
Electroconvulsive therapy is one of the oldest surviving biological treatments in the psychiatric field that entered the new millennium. Actually, this treatment approach has existed for more than 60 years and is still commonly used. The increased use of this therapy is influenced by the lack of medication that equals it with regards to antidepressant potency even after the introduction of the first antidepressant drug, imipramine. However, in the past few years, electroconvulsive therapy has attracted considerable attention with regards to its potency and efficacy. This attention has emerged because of the numerous advances in drug development that necessitates the improvement of existing therapies and medication. Despite these attempts, it is increasingly evident this therapy cannot be improved except through improvements in patient selection, knowledge dissemination, and prediction of response. Electroconvulsive therapy has usually appeared as a barbaric treatment but it's the most effective treatment for severe depression.
Overview of Electroconvulsive Treatment
Electroconvulsive therapy has a long history that dates back to more than 60 years ago when it was introduced as a treatment approach in psychiatry. The first use of this treatment approach was on a patient who was delusional, gesticulating, and hallucinating (Abrams, p.6). The patient fully recovered following electroconvulsive therapy, which indicated that this treatment approach could be utilized in patients with psychiatric conditions. Generally, electroconvulsive therapy emerged during a period of unprecedented therapeutic optimism in the psychiatric field. This was following numerous efforts made towards discovering and developing malarial fever therapy and other treatments. While other treatments flourished during this period, electroconvulsive therapy is the only one that is widely used today largely because of its safety, efficacy, and ease of administration. Electroconvulsive therapy will continue being used in psychiatric treatment because of its numerous advantages over other treatments. The increased use of this therapy will also be influenced by the fact that economic realities make it difficult to enhance instrumentation and stimulation.
Electroconvulsive therapy is a treatment for a minimal number of severe psychiatric or mental illnesses. While this therapy was developed for a variety of conditions, it is currently used for fewer, more severe conditions. Currently, the therapy entails passing an electrical current through the brain in order to generate an epileptic fit (Weiner & Krystal, p.275). The use of an electric current in this treatment has contributed to the term "electro-convulsive." The nature of the therapeutic process in this treatment sounds odd given that it was developed a time before effective medication was discovered. The therapy was developed after doctors noticed that some patients diagnosed with schizophrenia or depression and epilepsy show better response and outcomes after having an epileptic fit.
In today's healthcare setting, the therapy is administered under general anesthesia in a healthcare facility attended by a psychiatrist, a nurse, and an anesthesiologist (Dukakis & Tye, p.15). During this process, the patient is given a muscle relaxant in order for contortions and spasms associated with generalized convulsions not to occur. The anesthesiologist then gives the patient oxygen and help in controlling his/her breathing. The administration of the electric current in electroconvulsive therapy is quite different in today's healthcare setting as compared to the initial years of the treatment's discovery. In the early days of the treatment, the electrical current was administered while the patient was awake and was largely unregulated. This process was characterized by several side effects such as broken bones and teeth. Currently, the electrical current is administered using a machine that is calibrated to release the lowest effective dose via electrodes placed on the patient in areas that lessen side effects (Dukakis & Tye, p.17).
Given its effectiveness, electroconvulsive treatment is the only treatment in mainstream medicine that is receiving increased attention and research, increased use, and providing hope to psychiatric patients. Despite its controversial history, electroconvulsive therapy currently represents the only feasible treatment for severe psychiatric illnesses (Fink, p.3). While numerous efforts have been made to improve the therapy, especially patient selection and treatment measures, electroconvulsive therapy is still not perfect. This is primarily because of its side effects such as loss of some past memories and difficulties in retaining new or current memories in some cases. As research on this treatment method continues, more emphasis should be given to creating techniques of brain electrical stimulation and treatment of some severe psychiatric illnesses like depression with minimal side effects.
How Electroconvulsive Therapy Works
Electroconvulsive therapy has always been regarded as a barbaric treatment approach because it involves the use of an electrical current to stimulate the brain. Actually, while the treatment procedure may be painless for patients, it entails literally shocking brain systems using an electrical current in order to generate seizures. The barbaric nature of this therapy emerges from the fact that the treatment procedure may generate painful muscle spasms and some memory difficulties. Despite these factors, electroconvulsive treatment is still the most effective treatment approach for psychiatric illnesses because of how it works. Some of the major ways through which electroconvulsive therapy works includes
I. Release of Brain Chemicals
Electroconvulsive releases important brain chemicals that help in recovery from severe psychiatric illnesses like depression. The therapy releases vital brain chemicals since the electrical current stimulates the brain for these chemicals in order to trigger an epileptic fit. While these chemicals do not emerge from the treatment procedure itself, electroconvulsive therapy helps in triggering the brain to release vital chemicals for an epileptic fit. The release of brain chemicals in this treatment procedure is linked to the fact that it is administered under general anesthetic and utilizes muscle relaxants. One of the most important aspects of release of brain chemicals is the fact that the therapy changes blood flow patterns via the brain as well as changes metabolism areas that could be affected by the psychiatric illness (Barnes par, 7).
Psychiatric illnesses are usually brought by problems with some brain chemicals, which contribute to ineffective or abnormal functioning of the brain. Electroconvulsive therapy provokes the release of these chemicals or makes them more likely to function properly and help in the recovery process. The role of electroconvulsive therapy in releasing important brain chemicals for normal functioning is supported by several subordinate ideas including
A. Electrical and Chemical Processes in the Brain
The brain works through complicated electrical and chemical processes that involve use of different brain chemicals, which is affected in case of a mental illness. Psychiatric or mental illnesses affect the normal functioning of the brain by hindering its effectiveness in releasing vital chemicals for various brain processes (Nairne, Smith & Lindsay, p.10). Similar to medication, electroconvulsive works to restore the normal functioning of these electrical and chemical processes through triggering the brain to release important chemicals. The therapy work on the brain's electrical and chemical processes in order for them to function normally and reduces symptoms of psychiatric or mental illnesses that interfere with normal functioning.
One of the important ways through which the treatment procedure works to restore normal functioning of the brain's electrical and chemical processes is by causing a change of chemical messengers. In essence, electroconvulsive therapy causes a change of the brain's chemical messengers i.e. neurotransmitters. The electrical current used in this treatment procedure excites brain cells and generates a seizure or causes them to work in unison. The resultant seizure activity cause changes in the chemical messengers in the brain that are commonly known as neurotransmitters. This helps in ensuring that electrical and chemical processes in the brain function normally.
The second way through which electroconvulsive therapy helps in normal functioning of electrical and chemical processes in the brain is through altering the regulation of stress hormones in the brain. One of the theories that support the effectiveness of electroconvulsive therapy is that its treatments change the regulation of stress hormones in the brain. These changes in turn affect a patient's mood, sleep, energy, and appetite. As a result, electroconvulsive therapy seems effective in treatment of severe depression (Reisner, p.199). Actually, this treatment procedure works to improve psychotic and depressive symptoms that are linked to severe depression as well as other psychiatric illnesses. The improvement of psychotic and depressive symptoms is associated with the fact that the treatment entails neuropsychological functioning during the maintenance stage of the treatment process. In a study conducted on a group of patients with psychiatric illnesses, neuropsychological test performance and depression ratings improved during maintenance electroconvulsive therapy (Vothknecht et al., p.151).
B. Increases Hyperconnectivity
Electroconvulsive therapy works to release important brain chemicals through increasing hyperconnectivity in brain processes, particularly in depressed subjects. According to researchers, the pathology of depression is considered to involve many connections in certain areas of the brain (Szalavitz par, 7). However, it is also assumed that depression may involve too little connectivity or wiring in the brain, which is characterized by low mood and low energy. In situations where there is too little connectivity in certain areas of the brain, electroconvulsive treatment increases connectivity. On the contrary, depressive symptoms that are characterized by hyperconnectivity are handled… [END OF PREVIEW]
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