Lisa Morrison was only 19 when she received her first dose of electroconvulsive therapy. She was in South Africa, restrained on a treatment table in what was then-called an asylum. 

Morrison, now 52, says she was over-medicated, frightened and felt “choiceless.” She’s now the co-author of a study published on Aug. 10 in Health Care for Women International that investigated the risks and aftermath of electroconvulsive therapy (ECT). 

The international study, involving 858 participants from 44 countries, found that women patients were less likely than men to report improved mood following ECT treatment, and reported worse outcomes than men across the board, including short- and long-term memory loss. 

After Morrison’s second course of ECT, administered alongside talk therapy and medications this time, her depression “temporarily lifted.” She moved to Northern Ireland and married her husband. But over the next seven years, from 2009 to 2016, she underwent six series of ECT treatments. She was experiencing severe depression after being raped at the age of 14, and says ECT was misused and her “significant history of childhood trauma” was not addressed by it. 

She also didn’t know the side effects that would continue to affect her after treatment had ended. When her son was 2, she took a break from work to look after him. But to this day, she has no memory of that year of her life. 

The published study shows that her experience was not uncommon – and celebrities like Paris Jackson have also opened up about the reality of receiving electroconvulsive therapy. 

What is electroconvulsive therapy? Paris Jackson has done it, too. 

Paris Jackson, daughter of Michael Jackson, opened up in a recent interview with Page Six about her “painful” experience receiving nine ECT treatments in three weeks after being “very, very close” to attempting suicide. 

“You go in, you get your hospital gown, they knock you out, strap you down, put a bite guard on your mouth (and) electrocute you,” Jackson said of the treatment. “The first time I woke up, and it was the most sharp pain I have ever experienced inside of my head. It’s soreness from getting electrocuted.”

ECT is a procedure that passes small electrical currents through the brain to cause a brief seizure to improve symptoms of mental health conditions like treatment-resistent depression, severe mania (associated with bipolar disorder) and aggression in people with dementia. ECT is safer today than decades ago, when early treatments used high doses of electricity without administering general anesthesia. 

It is still offered as a treatment for some cases because, according to Cleveland Clinic, it can provide relief when other treatments like medications or therapy haven’t worked and can work relatively quickly. Makesha Joyner, MD, a board-certified psychiatrist at Kaiser Permanente, wrote that many of her patients reported an improved mood and decreased symptom severity within just a couple of weeks.

However, the treatment can still cause significant side effects, per the Mayo Clinic, including confusion, which can last for a few minutes to several days; memory loss; nausea; headaches; jaw pain and medical complications like temporarily increased heart rate and blood pressure during the procedure.  

Jackson said friends visited her during this time, but she has no recollection of their conversations, citing amnesia as one of her side effects. Memory loss associated with ECT treatment can include retrograde amnesia, in which the patient forgets events in the weeks or months – sometimes, though rarely, even the years – prior to treatment. While the treatment “was working” for Jackson, she said that “getting shocked once a month” for the rest of her life was not a sustainable option.

Most treatments in the United States are given two to three times per week for three to four weeks. Patients who need “maintenance ECT” usually get treatment every two to four weeks, for a period of six months to a year. A lifetime schedule is rare. 

Women face the brunt of electroconvulsive therapy treatment and side effects

On average, studies show that women are at least twice as likely to receive ECT as men, and the August study found that 81% of psychiatrists administering treatment were men, despite women making up the slight majority of psychiatrists in the United States. 

Women also reported greater pressure of coercion to consent than men (36.8% vs 22.4%), and fewer women described their involvement as “voluntary” (49.9% vs. 63.5%). However, the differences were marginal for those who reported receiving ECT “without my consent/against my will” in their survey responses. Overall, fewer women (15%) than men (29%) said they would want to have ECT again. 

Sarah Hancock, a co-author of the study based in San Diego, says she lost the ability to read and type, lost her balance and could not form new memories for two years after she stopped treatment. 

“This survey demonstrates my experience wasn’t as rare an outlier as my doctors, counselors and mental health staff led me to believe,” Hancock says. 

Morrison says that being diagnosed with a series of mental illnesses – without an understanding of her trauma – led her to believe she would be ill her entire life. 

“The many diagnoses I received reinforced in me the devastating messages so many women internalize,” Morrison says. “I’m to blame. I’m bad. This is my shame.”

The study aimed to illuminate that disconnect, in which ECT is prescribed “without first addressing the real underlying causes of the symptoms in the first place… like being in a situation of abuse,” Hancock says. 

The authors of the study have mixed views on what they want their study to accomplish – some want ECT to be banned altogether, others want stronger FDA regulations. But across the board, they believe the research on ECT is outdated, and that the information given to patients is insufficient. 

“It was to highlight people’s actual experiences to bring more into the mainstream,” Morrison says. “When you’re deemed mentally ill, your testimony is not seen as valid, reliable, trustworthy. So often our voices aren’t heard (and) are marginalized.”