A new international survey of 858 electroconvulsive therapy (ECT) recipients has delivered stark findings relating to women’s experiences of this controversial procedure. The paper explicitly demonstrates that the widespread use of ECT on women needs to be understood from a trauma-informed perspective.

Note from the author: It has been difficult to write this blog, which includes my own experiences, and I invite you to consider if now is a good time for you to read this.

I am a co-author of this paper, a woman who has received ECT multiple times and a survivor of abuse. It has been devastating to learn how other women have been harmed, but I am grateful that our voices are being heard. The survey reveals that 73% of participants who received ECT were women. We cannot hear these stories without being compelled to act. And while people also report positive, even life-saving experiences of ECT, psychiatry continues to ignore those harmed and fails to prevent future harms.

The Disproportionate Use on Women

Why this disproportionate use? While higher rates of depression in women are often cited as an explanation, the study found that women were more often given ECT across all diagnostic groupings, including bipolar disorder and psychosis/schizophrenia. The explanation that women have higher rates of depression may lie in long-established evidence about the root causes of women's distress often not addressed by traditional psychiatry:

• A major explanation for the sex difference in depression is that women are subjected to more stressors and depressing events and circumstances than men (Burton, 2025).

• Gender inequality and heightened exposure to severe adversity, particularly childhood sexual abuse and violence, are strongly linked to the gender gap in depression rates (Kuehner, 2017).

• Older women – the largest group of ECT recipients – are among the most marginalised in society. For example, people aged 60 to 65 in the UK have the highest poverty rates among adults of any age (2023, Centre for Ageing Better).

In this context, the study found a striking power dynamic, with 81% of psychiatrists giving ECT being men. A male psychiatrist treating a female patient was 13 times more likely than a female doctor treating a male patient (a figure that soared to 25 times more likely in the USA). The research paper provides further context for these figures. While there is no implication of conscious sexism on the part of prescribers, this finding raises uncomfortable questions about the replication of power imbalances and abuses.

As a survivor myself of both abuse and ECT, these women’s voices haunt me. I don’t want anyone else to feel this way.

One participant, aged 50 from the UK, said she felt “Retraumatised. Held down and body 'done to' against my will”. As a survivor myself of both abuse and ECT, these women’s voices haunt me. I don’t want anyone else to feel this way. More quotes describing participants’ actual experience of ECT are given in the following parts of this series.

This has been my experience. I could not have given informed consent because I wasn’t given accurate information. NICE (2003; 2022) guidelines stipulate various steps which must be taken if a person hasn’t responded well to ECT previously. And yet I had my fourth, fifth and sixth course (12 sessions each time) despite becoming increasingly unwell and continuing to be suicidal. When I was most vulnerable, my rights were not protected.

Thanks to Mad in The UK for allowing us to republish this blog.

References

American Psychiatric Association. (2025). The Practice of ECT: A Task Force Report (3rd edition). Washington, DC: A.P.A.

Beresford, P. (2020) PPI or User Involvement: Taking stock from a service user perspective in the twenty first century. Research Involvement and Engagement, 6 (36).

Brus, O., Nordanskog, P., Båve, U., Cao, Y., Hammar, Å., Landén, M., Lundberg, J., & Nordenskjöld, A. (2017). Subjective memory immediately following electroconvulsive therapy. Journal of ECT, 33, 96-103.

Burton, N. (2025) The 7 reasons why depression is more common in women. Psychology Today

Centre for Ageing Better (2023)

Chris Harrop’s Blog Post ECT: New Studies Detail Harms, Lack of Efficacy, Lack of Informed Consent - Mad in the UK

Ho, A. (2011) Trusting experts and epistemic humility in disability. International Journal of Feminist Approaches to Bioethics, 4 (2), 102-123.

Holland, S., Cook, L., Harris, C., Liennard, S.L., Malik, S., Price, Z., Rodrick, L., Speyer, E., Vaughan, R. and Williams, J. (2025) Critical reflections on public involvement in research: Involving involuntary recipients of social services to improve research quality. British Journal of Social Work, 00, 1–19.

Kuehner, C. (2017). Why is depression more common among women than among men? Lancet Psychiatry, 4, 146-158.

Martin, J., Strawbridge, R., Christmas, D., Fleming, M., Kelly, S., Varveris, D., & Martin, D. (2024a) Electroconvulsive therapy: A Scotland-wide naturalistic study of 4826 treatment episodes. Biological Psychiatry Global Open Science, 5, 100434.

NICE Guidelines on the use of ECT (2003)

NICE Guidelines on the use of ECT (2022)

Royal College of Psychiatrists UK Patient Information Leaflet

Sackeim, H., Prudic, J., Fuller R., Keilp, J., Lavori, P., & Olfson, M. (2007). The cognitive effects of ECT in community settings. Neuropyschopharmacology, 32, 244-254.

Sapouna, L. (2024) Critically unlearning about madness and distress: Reflections on social work education and activism in Ireland. International Mad Studies Journal, 2 (1).

Universal Declaration of Human Rights (Article 5)