Why is electroshock therapy still a mainstay of psychiatry?

She was in hospital in a near-catatonic state, which had been preceded by a several years of serious mental illness, eventually including psychosis.

The idea of her undergoing this kind of treatment was awful. However, she went from near-catatonia, IV fluids, and literal spoonfeeding to...being responsive, alert, and basically having the will to live again, over the course of intensive treatment (2-3 sessions/week for 2 months). Once she was able to eat and be aware of her surroundings, she was tapered off of ECT and began other interventions like talk therapy, medication, etc. All of this was 3 years ago, and she has not needed ECT again since. She is now in really good mental health.

I did a lot of research on ECT before I could come to terms with it. The turning point for me was calling a friend from high school whom I knew I could trust who had become a psychiatrist. She has administered ECT to her patients. I asked her what she would do if it were her own mother, and she said she'd do it.

It's not something to take lightly (the memory loss is real), but in this case it sure as hell beat the alternative. My mom credits it with saving her life as well.

PS If anyone reading this is struggling or has a loved one who is struggling, I don't have the right words but I'm thinking of you. None of these decisions are easy.

While waiting for the procedure I did get to know a lot of the patients and their families. There were a few people who seemed to be getting markedly better. There was also a woman with a brain injury and she claimed the ECT kept her mentally afloat for a few months, until she needed it again. The thing that helped my ex much more ended up being ketamine infusions, but even that has some risks.

This is just my experience. I don't know that there's a whole lot to learn from it, but I do know that for some patients it worked, though it's definitely not the permanent fix I've heard people claim it is.

"Electroconvulsive therapy gets a bad rap from old movies where we see people who “misbehave” in the mental institution getting what look like very painful electric shocks.

Modern electroconvulsive therapy is done with the patient sedated. You are pleasantly asleep, your limbs aren’t flailing about or anything, and it can be done on an outpatient basis with you going home as soon as you’re done.

There are a lot of worries about side effects. Some people experience some memory loss, especially of the couple of weeks before the treatment. Most of the time these memories come back. Sometimes they don’t. But how much do you want to remember the week when you were so depressed you needed ECT, anyway? Longer-term side effects are less well-known. Some people think a lot of ECT isn’t good for your brain, but if the effect exists it’s small enough that people are still debating whether or not they’ve really picked it up.

But the thing is, ECT really, really works. People get to the point where everything else has failed, and they’ve been on seven hundred different medications without feeling any better, and they’re ready to give up, and then they get ECT and start whistling happy songs and dancing the polka. I won’t say it works 100% of the time, because no medical treatment works 100% of the time. But in psychiatry, where expectations are always low, it’s the closest thing we’ve got to a miracle cure."

https://news.ycombinator.com/item?id=11238973

There are plenty of proponents of ECT, and overall the balance of evidence for most guidelines suggests it is useful in some situations. From my experience working in psychiatry in the UK at least, psychiatrists do just want to help treat patients, and use it as it seems to work in select situations. Its just another treatment option, why demonise it?