Electroconvulsive therapy (ECT) is one of the most misunderstood treatments for depression. While it is generally used only in severe or life-threatening cases where medication and therapy haven’t worked, ECT can be effective.

ECT works by sending an electrical charge to the brain that causes a brief and controlled seizure. Although it may sound frightening, patients receive it while under general anesthesia, and awaken with no memory of the procedure. Typically, people receiving ECT will have 6 to 12 sessions over several weeks.

Immediate effect

Unlike medications and therapy, ECT tends to have an immediately positive effect on mood, which is why it can be so helpful for those at risk of suicide. Remember that—regardless of how it is sometimes shown in books and movies—ECT is never used on someone who doesn’t want it.

ECT has some side effects, including short-term memory loss. In some patients, the side effects of this treatment may be outweighed by the benefits.

Although ECT provides quick relief for most people, depression treated by ECT often returns. After treatment, doctors may suggest maintenance treatment with medication or further sessions of ECT.

Your doctor may be able to refer you to a qualified therapist. You also may ask for recommendations from clergy members, school counselors, the local health department, hospitals, crisis centers, and mental health organizations.

Interviewing counselors

When you first call a mental health professional, spend a few minutes learning about the counselor’s philosophy and treatment approach. Find out if he or she concentrates in a certain area, such as behavioral therapy or family counseling. If you feel comfortable talking with him or her, make an appointment.

The first time you meet with your therapist, you may be asked a number of questions, not only about your symptoms, but also your personal history, family, and friends. This information helps the therapist assess your situation and map out a treatment plan.

After a few visits, assess your progress. If you’re not comfortable with your therapist at this point, mention your feelings during a session and try to resolve the problem. If you can’t, don’t be afraid to contact another professional. You’re much more likely to benefit from treatment if you’re happy with your counselor.

Short-term therapy has become more common and may occur over a period of 10 to 20 weeks.

Types of therapy

Several kinds of therapy are used to treat depression:

Cognitive behavioral therapy (CBT) can help you identify and change the thought and behavior patterns that contribute to depression. People who are depressed tend to think negatively, and cognitive behavioral therapy teaches you how to identify and challenge the negative thoughts. This approach is usually done in short-term therapy, and has been found to be particularly helpful for depression.

Interpersonal therapy looks at how depression can be connected to troubled emotional relationships. Like cognitive-behavioral therapy, interpersonal therapy tends to be a short-term therapy, and has been proven to work well with depression.

Psychodynamic therapy links depression to traumas and conflicts that happened earlier in your life, especially during childhood. It can be a short-term treatment, although it is often a longer process.

Group therapy allows you and other people with depression—or people with the same issues that contributed to your depression—to meet together with a therapist and share experiences. The approach of the group may be any of the ones listed above.