Electroconvulsive therapy (ECT) is a medical treatment for severe mental health conditions. It works by helping reset certain brain circuits that affect mood, thinking and movement.
Doctors use a small, carefully controlled electrical current to induce a mild seizure. The seizure alters brain activity, stimulates nerve cell growth and affects other things that help to improve brain functioning.
During the procedure, the child is asleep under general anesthesia in a safe, controlled setting. Being asleep keeps their muscles from contracting during the seizure and keeps them comfortable. The electric current comes from an electrode placed on the head. The electrode looks like a round self-adhesive pad about the size of a silver dollar. A trained medical team closely monitors the child the entire time. The team includes a psychiatrist, anesthesiologist and nurses.
ECT for teens and children is used only when there are severe safety concerns and profound functional impairment. Doctors consider it when other treatments have not helped enough, or rapid improvement is needed. For families facing severe symptoms, it can offer a path toward greater stability and healing.
ECT is not a first-line treatment. Doctors consider it when symptoms are severe, life-threatening and have not improved with other treatments. Conditions that may be treated with ECT include:
ECT may be used to treat severe depression in teens or children when:
Catatonia is a serious condition that affects movement and speech. A child may stop talking, stop moving or become very rigid. Severe catatonia that goes untreated can lead to death. ECT is one of the most effective treatments for catatonia and can be lifesaving. This includes catatonia linked to psychosis, autism or mood disorders like depression.
ECT may also help with bipolar disorder with severe mania that is not controlled by medications. Mania means the child has high energy for days on end, racing thoughts, rapid speech and less need for sleep.
ECT can also help with mixed episodes, where the child has symptoms of mania and depression at the same time. This can look like high energy or agitation combined with low mood, sadness and thoughts of suicide lasting days to weeks. The combination can be very dangerous because it gives the child the energy and drive to act on thoughts of self-harm and other risky behaviors.
In selected cases, ECT may help severe psychosis that has not responded to medication. Psychosis is a set of symptoms that show that the child has lost contact with reality. This includes:
Schizophrenia is a brain disorder that causes psychosis.
ECT has been used as a treatment for over 50 years. The Food and Drug Administration classifies it a Class II device (moderate risk), like infusion pumps, for patients age 13 and older. Research shows it can be safe and effective for children and teens when carefully monitored by a trained team.
ECT for children is less common and is used only in highly selected cases after careful review by a specialized team. The decision is made thoughtfully, with a focus on the child’s safety and well-being. The possible risks are weighed against potential benefits. Caregivers are involved in the decision-making process, and their consent is needed to move forward.
ECT does not cause brain damage. Patients are asleep and do not feel pain. The treatment today is very different from what is shown in older movies.
ECT does not change who a child is. The goal is to reduce severe symptoms so they can feel and function more like themselves.
Some children have short-term memory problems. These usually improve after treatment ends. The care team watches closely and talks with you about any changes they notice.
Your child’s safety is the top priority. A dedicated ECT team, including doctors and nurses, follows clear steps to protect and monitor your child throughout the procedure. Safety guidelines include:
To understand why ECT can help, it is useful to know what it does in the brain. ECT affects brain chemicals such as serotonin, dopamine and norepinephrine. These chemicals help control mood and behavior. ECT may also improve how brain cells connect and communicate. This process is called neuroplasticity. Healthier brain circuits can lead to better mood and thinking.
An electrode is a small, soft, conductive pad similar to a sticker. It safely delivers a very brief, mild electric current to the brain. There are different ways to give ECT. These include:
Electrode placement depends on clinical severity and other medical conditions. For example, if a patient has a shunt or cochlear implants, that will affect where doctors put the electrodes.
Pulses of electric stimulation can be given as “brief pulse” or “ultrabrief pulse.” This refers to how long the electrical stimulus lasts. Ultrabrief pulse uses lower electrical charges, which can reduce side effects but may take longer to work than brief pulse. Doctors adjust the dose for each child. The team chooses the approach based on safety and treatment goals.
ECT is often started during a hospital stay so the child can be closely observed. Outpatient treatment is possible for stable patients. Stable means they don’t need 24-hour medical care, and they don’t present a risk to themselves or others. The decision to use an inpatient or outpatient approach depends on your child’s illness and severity.
Here is what to expect before, during and after the procedure.
Before starting ECT:
ECT is done at a hospital. Your child starts in same-day surgery and gets an IV placed. Your child’s psychiatrist checks in and answers any questions. At their treatment time, your child is taken to the OR (operating room). They will be there for less than 30 minutes.
During the procedure:
The electrical stimulation itself lasts only a few seconds. Most of the visit is spent preparing for the procedure and allowing your child to recover safely afterward, so the total visit may take a few hours.
After the procedure, your child is taken to the post-anesthesia care unit (PACU) for recovery. Once they start to wake up, the parent or guardian can join them. If the procedure is outpatient, the child can go home the same day.
Short-term side effects may include headaches or muscle aches. Long-term side effects can include persistent memory loss, forgetting events before treatment and difficulty forming new memories. Many side effects improve within months, but some memory impairment may last for several years. Despite potential side effects, the benefits of ECT in treating severe mental health symptoms can outweigh the risk of side effects for many children.
The number of treatments depends on your child’s diagnosis and how they respond. There is no fixed number that is recommended.
Many children receive up to 12 treatments, given two or three times per week in the early phase of treatment. Some may need more. Many factors influence how long these more frequent treatments are needed. Factors include the type, severity and timing of illness.
Improvement can happen quickly. Some children feel better after one to three treatments, and most show clear progress within several sessions. For severe symptoms, ECT often works faster than medication.
After the early course, some children need tapered and maintenance ECT. These treatments are spaced farther apart to help prevent relapse and support long-term stability.
ECT can be safe for teenagers when done by an experienced team with careful monitoring. Doctors recommend it only after a thoughtful review of risks and benefits.
Yes. ECT can be used in children, but it is rare. It is usually considered only when symptoms are severe and other treatments have not helped.
Some children improve within the first few treatments. Most show clear improvement within a few weeks.
ECT is one of the most effective treatments for severe catatonia, including autism-related catatonia.
A doctor may recommend ECT when symptoms are severe, life-threatening or have not improved with other treatments. The goal is to help your child feel safer and more stable as quickly as possible.
In the US, ECT is legal. Rules about age, consent and extra safeguards can vary by state. Your care team can explain what is required where you live. The American Academy of Child and Adolescent Psychiatry released a policy statement in 2025 supporting access to ECT for appropriately selected youth. It emphasized the need to reduce barriers and improve availability.
Our pediatric psychiatry experts use the most advanced, effective, and evidence-based approaches to treat the full spectrum of child and adolescent mental and behavioral health problems. The collaborative care team includes psychiatrists, psychologists, advanced practice registered nurses, social workers, and clinical counselors.
Last Updated 04/2026
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