Although shock therapy has been performed for decades, researchers still don't know precisely how it works to combat depression.

"We've been looking for 50 years, but ECT causes many changes, and we haven't pinned down which one has the anti-depressant effect," says Charles Kellner, editor of Convulsive Therapy.

The major theories:

-- Neurotransmitter theory. Shock works like anti-depressant medication, changing the way brain receptors receive important mood-related chemicals, such as serotonin and dopamine and norepinephrine.

-- Anti-convulsant theory. Shock-induced seizures teach the brain to resist seizures. This effort to inhibit seizures dampens abnormally active brain circuits, stabilizing mood.

-- Neuroendocrine theory. The seizure causes the hypothalamus, part of the brain that regulates water balance and body temperature, to release chemicals that cause changes throughout the body. The seizure may release a neuropeptide that regulates mood.

-- Brain damage theory. Shock damages the brain, causing memory loss and disorientation that creates a temporary illusion that problems are gone. Shock supporters strongly dispute the theory, advanced by psychiatrist Peter Breggin and other shock critics. "Not only hasn't the Breggin brain damage theory been proven, it's been disproven," says shock researcher Harold Sackheim of Columbia University.

Famous patients

-- Lou Reed, rock musician. "Lou's conservative parents, Sidney and Toby Reed, sent their (17-year-old) son to a psychiatrist, requesting that he cure Lou of his homosexual feelings and alarming mood swings. . . . Lou suffered through eight weeks of shock treatments haunted by the fear that in an attempt to obliterate the abnormal from his personality, his parents had destroyed him," according to Transformer: The Lou Reed Story.

-- Thomas Eagleton, former Democratic senator. He lost the Democratic vice presidential nomination in 1972 when it was revealed that he received shock treatment for depression.

-- Ernest Hemingway, writer. He had shock therapy at the Mayo Clinic in 1961, shortly before committing suicide. He told biographer A.E. Hotchner, "What is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient."

-- Sylvia Plath, poet. She wrote a shock therapy scene in her autobiographical novel The Bell Jar: "I wondered what terrible thing it was that I had done" to get shock therapy.

Article Published by USA Today -- December 6, 1995
Copyright 1995 Gannett Co., Inc.

Further information about how ECT "works" can be found in the Informed Consent Statement.