We would like to see the federal government, through the FDA, or states through their Offices of Mental Health, adopt this statement.

What ECT does is to produce profound emotional relaxation. The patient sleeps and eats well and her or his body has an opportunity for rest and repair. When the relaxing effect wears off, which is in a few days or weeks, the patient may remain well or she may relapse.

The essence of a grand mal epileptic seizure is the intensely rapid "firing" of every brain cell. In a natural seizure this activity of the brain causes the body to thrash about wildly, but when a seizure is induced in ECT the movements of the body are largely suppressed by a drug. In either case, if a complete grand mal seizure is occurring in the brain, the person is unconscious.

An ECT treatment is usually given in the morning before breakfast. First the patient receives an injection to reduce secretions in the mouth. Then she is taken to the treatment room, where she is given a general anesthetic through a vein in the arm. This takes effect quickly and is followed by another drug through the same needle, this being the one that suppresses muscle movement. The anesthetic is not necessary for the shock treatment as such, for the shock would produce unconsciousness, but it is given to spare the patient the feeling of becoming paralyzed. Next, two electrodes are applied to the head and a current passed briefly between them. (Most commonly, the electrodes are on the temples and the shock is about 140 volts for half a second, but these particulars may vary.) The brain seizure that is triggered by the shock lasts about a minute.

Throughout the treatment procedure the patient does not experience pain or discomfort, but she awakens soon afterward in a state of confusion. When the confusion subsides, she can resume her daily routine. Headache, mild muscle soreness, or nausea sometimes occur, but these usually respond to simple medication.

Treatments are usually given three times a week, and a typical course of ECT consists of from six to ten treatments.

During a course of treatment the patient experiences a cumulative eradication of memory, which begins with recent events and learning and thoughts (including worries), and gradually extends to the distant past. Once the course is ended, memory gradually returns in the opposite time order until, in about a month, the patient has regained the main outlines of her personal history and also knowledge and skills acquired early in life. After this length of time there is little further automatic return of memory, although a good deal more has become strong enough that it can later be revived by reminders or efforts at relearning.

The extent of the permanent memory loss varies with the number of treatments, age of patient, placement of electrodes, and other factors, but the pattern of loss is the same for all patients. The loss is total or near total for the period of the ECT course and tapers back over previous years with smoothly diminishing severity and no precise cut-off point. The patient's remaining memory appears "spotty" in that the smooth amnesic blanket has merely dimmed some memories but submerged others, depending upon their original relative clarity.

In addition to this erasure of pre-shock memory, which is certain to occur, there may also be a permanent adverse effect upon memory function after the shocking. That is, the patient's memory for new experiences and new learning may fade rapidly.

Some patients do not mind their memory changes and seldom have occasion to notice them. At the opposite extreme are persons whose work or way of life is made impossible by them. In between are persons who gradually adjust to various degrees of handicap.

Aside from adverse effects on memory, ECT contains also, like other major medical and surgical procedures, some element of ordinary risk. Fatalities are very rare, but there is a slight possibility that a stroke or heart attack could occur during a treatment. There is also the possibility that a particular individual may experience one or more untoward after-effects in addition to the expected deleterious effect on memory.