This month we have been celebrating the Queen’s golden jubilee and there has been a lot in the media about how life has changed over the past 60 years. The BBC for example told people that “Sixty years ago, when the Queen came to the throne, Britain was a very different place. Our lives today are a world away from those we would have led back then.” People were invited to transport themselves back to 1952 and see what they would have been eating, wearing, etc, at that time (the BBC scrupulously pointed out that the results were intended to reflect the spirit of their lives, rather than be a scientific calculation).
What would it have been like to have electroconvulsive therapy (ECT) 60 years ago? How has the treatment changed?
If you were having ECT about 60 years ago in Britain you would have been rather younger, and rather more male than nowadays. Nowadays about 70 per cent of ECT patients are women, and older people are more likely to be treated with ECT than younger people. This was not always the case. Nowadays most people undergoing ECT are being treated for depression, with a small minority being treated for schizophrenia and other disorders. Sixty years ago, a larger proportion of patients would have been receiving ECT for schizophrenia.
Sixty years ago you could well have been given unmodified ECT, that is, ECT without an anaesthetic or muscle relaxant. By 1957 however, most hospitals in England were routinely using anaesthesia when administering ECT. Electrode placement would have been bilateral, just like it usually is now (unilateral was introduced in the 1950s but never really caught on). You probably would have had about the same number of treatments (six or seven in a course) as nowadays although they were more likely to have been given three times a week, rather than twice a week which is current practice in the United Kingdom. Some people had longer courses, just as they do nowadays, and some people had multiple courses or were put on maintenance ECT, just as they are nowadays, and ended up having large numbers of treatments. The machine would probably have used a sine-wave current, whereas nowadays all ECT machines in use in the United Kingdom use brief-pulse current.
The machines look different today but ECT remains essentially the same – someone is given an electric shock that is strong enough to cause a seizure. Nowadays the shocks are, if anything, more powerful than they were sixty years ago.
And they still don’t know how it works.