Electroconvulsive Therapy (ECT)
When depression or another serious mental health condition doesn't improve with medication or therapy, it can feel like nothing will help. Electroconvulsive therapy (ECT) is an evidence-based treatment that offers another path forward. For many people, it brings relief when other treatments have not, and it often works faster than medication.
Penn Highlands Mon Valley Hospital offers ECT evaluation and treatment for adults age 18 and older, in both inpatient and outpatient settings. Our behavioral health team works closely with each patient, their family and their referring provider to decide whether ECT is the right choice and to guide every step of care.
What Is Electroconvulsive Therapy?
ECT is a safe, well-studied treatment for serious mental health conditions. While the patient is asleep under general anesthesia, a psychiatrist sends a small, controlled electric current through the brain. This causes a brief seizure, usually lasting less than a minute, that helps reset brain chemistry and ease symptoms.
The patient is asleep and feels nothing during treatment. A muscle relaxant keeps the body still, so there is no visible convulsion. ECT is given as a series of treatments, given 3 mornings a week (Monday, Wednesday and Friday). A typical course includes 6 to 12 treatments, depending on each person's needs and response.
Who Can ECT Help?
ECT is usually not the first treatment a person tries. Your care team may recommend it when:
- Depression is severe or has not improved with medication or talk therapy
- Depression includes psychotic features, such as hallucinations or delusions
- Symptoms of bipolar disorder (depression or mania) are severe or hard to control
- A person has catatonia
- Symptoms are so serious that a fast response is needed, including risk of suicide or serious harm
- Medications cause side effects a person can't tolerate, or a medical condition limits which medications are safe
- ECT has worked well for the person in the past ECT may also help people with schizophrenia or schizoaffective disorder when other treatments haven't worked.
It can also be an option during pregnancy or other medical situations that limit which medications are safe. Whether ECT is right for you is decided through a full evaluation with the Penn Highlands ECT team.
What to Expect Before, During and After ECT
Before treatment: You'll meet with the ECT team for a psychiatric and medical evaluation. This may include a physical exam, bloodwork and heart testing to make sure anesthesia is safe for you. The team will walk you through the consent process, review your medications and give you instructions for fasting and what to do on treatment days.
During treatment: Treatments take place in the recovery unit (PACU) at Penn Highlands Mon Valley Hospital. You'll receive anesthesia through an IV and a muscle relaxant. Once you're asleep, electrodes placed on your head deliver the electrical pulses for a few seconds. Your care team monitors your heart, breathing, blood pressure and brain activity the entire time. The procedure itself takes only a few minutes.
After treatment: You'll wake up 5 to 10 minutes later and rest in a recovery area while the team checks your vital signs. Inpatients then return to the inpatient unit. Outpatients go home with a responsible adult and should not drive for 24 hours after each treatment.
Possible Side Effects of ECT
Like any medical treatment, ECT has possible side effects. Most are mild and short-lived. On treatment days, some people have:
- Headache
- Nausea
- Jaw or muscle soreness
- Brief confusion after waking
Some people also have trouble with memory, especially remembering events from around the time of treatment or forming new memories during the treatment course. Memory usually improves in the weeks and months after treatment ends, though some gaps can remain. Your care team will talk with you about the benefits and risks for your situation and check in on how you're feeling throughout your care.
How Effective Is ECT?
ECT is one of the most effective treatments available for severe depression. Many people notice improvement within a few treatments, and some find relief when other treatments have not helped. Results vary from person to person, so your care team will talk with you about what to expect and adjust your plan as you respond.
Care That Continues After ECT
The goal of ECT is to help you feel well enough to return to your daily life. After a course of treatment, the Penn Highlands team helps plan the next step, which may include medication, therapy, finishing the course as an outpatient or continuation (maintenance) ECT. Our ECT team works closely with Penn Highlands Adult Behavioral Health and outpatient behavioral health services, including telehealth appointments, so care stays connected close to home.
For patients and loved ones in crisis: If you or someone you love is thinking about suicide or self-harm, call or text 988, call 9-1-1 or go to the nearest emergency department. ECT referrals are not managed as emergencies.
Frequently Asked Questions About Electroconvulsive Therapy
Modern ECT is very different from how it was shown in older movies and TV. Today, patients are asleep under general anesthesia and receive a muscle relaxant, so they feel nothing and their bodies stay still. The electrical current is carefully controlled, and the care team monitors the patient throughout.
No. You are asleep during the procedure and won't feel the treatment. Some people have a headache, jaw soreness or muscle aches afterward, which usually go away within a few hours.
ECT is provided at Penn Highlands Mon Valley Hospital in Monongahela for adults age 18 and older. Treatments are given Monday, Wednesday and Friday mornings.
A typical course includes 6 to 12 treatments, given Monday, Wednesday and Friday mornings. The exact number depends on how you respond and how well you tolerate treatment. Some people continue with less frequent maintenance treatments to help prevent symptoms from returning.
Some people have memory problems during and after a course of ECT, especially for events around the time of treatment. For most people, memory improves in the weeks and months after treatment ends, though some gaps may remain. Your team will talk with you about this before you begin and check in throughout your care.
Yes, if you are medically and psychiatrically stable enough to live at home during treatment. Outpatient ECT can be a new course, the completion of a course that began in the hospital or ongoing maintenance treatment. You'll need a responsible adult to drive you home and stay with you afterward, and an outpatient psychiatric clinician involved in your care. You can't drive for 24 hours after each treatment.
Talk with your psychiatrist or primary care provider, who can make a referral to the Penn Highlands ECT team. You can also email [email protected] with questions.
Send the referral and available records by secure encrypted email to [email protected]. See How to Refer a Patient for ECT above for what to include; the team will gather anything missing. Providers may also contact the team to discuss a potential referral first.
ECT is covered by many insurance plans, including Medicare and Medical Assistance, when it is medically necessary. Check with your insurance company about your specific coverage, or see our Accepted Healthcare Plans page.
