How I’ve Learned to Manage My Anxiety Around ECT Treatments for Depression

Electroconvulsive therapy can be nerve-wracking. Throughout my treatments, I’ve discovered ways to feel more at ease and improve the process from beginning to end.

I remember the first time I had electroconvulsive therapy (ECT) — I was scared to death.

Even now, after having had it so many times, I can still feel my heart rate accelerating as the nurses get me ready and the anesthesiologist comes around with the syringes full of the medications to put me under.

I can tell you that it’s completely expected to feel anxious when you’re about to have ECT. I’ve been having it on and off since 2006, so I’ve developed some tricks and tips to make for an easier and more comfortable ECT experience.

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1. Tell the doctors and nurses if you’re anxious

When you tell the staff that you’re feeling uneasy about the procedure, they usually take extra care in preparing you for it.

I’ve found that things go much more smoothly when I tell the psychiatrist, nurses, and anesthesiologist that I’m nervous. It also helps if you ask them to tell you exactly what they’re doing throughout the procedure.

For example, I prefer that the anesthesiologist tell me what medication he’s putting in my IV. And I request that the doctor tell me when he’s giving me the medication that will put me to sleep.

One time, they didn’t tell me when they were putting me under, and it made me feel even more anxious. If you tend to get more nervous when you don’t know what’s going on, asking to be walked through the procedure is a good way to reduce anxiety.

2. Practice self-talk

It helps me to talk to myself while I’m waiting for the treatment team to come and put me under.

I’ll usually say something like, “I know that I’m nervous, but it’ll all be over soon and I’ll feel so much better. I’m doing the right thing now and I can trust my psychiatrist for recommending this treatment.”

Self-talk is a powerful tool for getting through the moment and acknowledging that while you may be anxious, you’ll come through this better — you’ll feel relief from your symptoms and you’ll be able to continue living your life. 

3. Ask for anxiety medication

There are certain medications that can help calm down your ECT anxiety, but this is something that you’ll need to speak with your treatment team about.

My team had to adjust my dosage until they found the right cocktail that helped me, but I can say that the anxiety medication has helped me immensely.

I get an injection of my anti-anxiety medication shortly after I arrive at the ECT suite for my outpatient treatment, and it really helps me relax. Because it’s an injection, it works much quicker than if I took a pill.

4. Turn the heart monitor around

The ECT nurses noticed that when I look at the heart monitor, my heart rate and blood pressure increase because I’m so nervous about the procedure.

They turn the heart monitor around so I can’t see this happening. When it gets closer to ECT time and the doctors need to see the heart monitor, I’ve found that turning my head also helps.

The nurse who usually takes care of me tells me that if there were a problem with my heart, all the doctors and nurses would rush over to me.

It’s completely natural to feel anxious to the point where you feel like your heart is beating out of your chest. Again, this is another time to tell the nurses that you’re feeling nervous. They can talk you through it and see if the doctors have ordered a medication to help with your anxiety.

5. Listen to music

I bring my phone to my treatments and listen to my favorite songs or music that relaxes me. I know other patients who do this, too — one of my friends listens to the Beatles while she’s waiting to have her ECT procedure.

It might also help to make an ECT playlist of songs that especially work to calm you down.

6. Avoid thinking about ECT in between treatments

When I leave the hospital where I have my outpatient treatments, I promise myself that I won’t even think about ECT until I’m back at the hospital having my next treatment. This helps me live my life on my own terms and reduces my anxiety.

It’s very important that I try to have a “normal” life as much as possible and avoid thinking about how anxious I am about being put under for my treatment, the headaches I’ll have, or the prick of the needle when the anesthesiologist puts in my IV.

This means that I’ll go about life as usual. I’ll read my favorite books and watch feel-good TV shows and movies that I enjoy. To me, there’s no point thinking about ECT treatments between the times I show up at the hospital.

Another good idea is doing something fun on the day after your procedure — something you can look forward to when you’re on the hospital bed getting ready to have your ECT.

7. Remember that the doctors know what they’re doing

ECT is a very controlled procedure that doctors and nurses do several times a week on many people.

They know exactly what medication to use and how to help you get through the procedure.

ECT is so safe that they even provide it to pregnant people and older adults. Plus, before receiving ECT, you’ll have a medical evaluation to make sure you can handle the treatment and anesthesia.

8. Put a warm pack on your hand

At my hospital, the nurses put a warm pack on my hand to make my veins pop out more easily when the anesthesiologists are ready to come around and insert an IV needle.

This makes for an easier stick and a quicker, smoother process.

9. Ask for a pain reliever after ECT

When I’m done with the procedure, my head and jaw ache. This is to be expected. Your muscles may also hurt too. I always ask for Tylenol when I’m coming to and recovering from ECT.

Tylenol might not be the right pain reliever for you, but the doctors and nurses will hopefully have something in mind that will help you manage the pain. This over-the-counter medication helps me as I leave the hospital and go home to sleep, relax, and take care of myself.

10. Take on a positive mentality

For so many of my treatments, I dreaded it. I told my psychiatrist that I was sick of doing it. I complained. But then, I realized that whether I complain or not, I’m still going to have ECT.

There’s no way out of it, I’m on the schedule, and I know I’m going to do it regardless.

Plus, it always helps my depression. I always do feel better in a way that antidepressants and mood stabilizers simply don’t do for me. So, I have a choice: I can dread it and complain about how it’s not fair that I have to do it, or I can do it with grace.

I can change into my hospital gown and stretch out on the hospital bed with a positive attitude. This shift in attitude has helped me get through it, and even the nurses have noticed that my anxiety has decreased.

11. Manage expectations

I’ve realized that I can’t jump off the stretcher and immediately feel better. I don’t even feel less depressed the moment I come out of anesthesia.

At first, this scared the hell out of me: going through all of this and not even feeling better? And, physically, I felt terrible. You could say that all around, I felt shitty.

But the second day and the day after that, my mood started to improve and I noticed that ECT was a very essential component of my treatment.

Having realistic expectations about the process may also help reduce your anxiety before and after the procedure.

The takeaway

ECT can make you feel anxious and it’s not the most fun experience.

But according to the 2021 research, 80% of patients with severe depression will experience significant improvement. According to Mental Health America, 100,000 people have ECT treatments every year.

These statistics are encouraging when you’re deciding whether to have ECT and to keep having treatments.

For more details about what to expect during and after ECT, you can read about my ECT experience here.