I had my first treatment out of no less than six (but possibly more, depending on how it goes) today, and i think it went really well. I haven't forgotten anything (yet), as far as I can tell, the nurses and doctors were all really great, and I had some idea of what was going on every step of the way.
I wasn't in any pain when I woke up, but I did have some motor control problems (terrible balance and coordination). I'd recovered a bit by the time I got home, and completely by the time I woke up from the nap I took to recover from the anesthesia.
I was a psychology student before I had to go on medical leave due to depression, and I do have some idea how it works. They put you under anesthesia so you don't feel any pain, and they attach these electrodes to your head and your chest; some for an EEG to measure your brain activity, two to induce the seizure and a few on your chest to measure your heart and make sure nothing bad happens when you're under. They give you IV muscle relaxants so you don't seize everywhere and bruise or break anything; I woke up aching like I'd spent a while working out or something, but nothing bad, and it's mostly gone now (I do have an ache in my arm like I got my flu shot today, though I didn't.). Then, once all the drugs are into you and you're hooked up, they run electricity through those two electrodes on your head for 5-10 minutes to induce a seizure.
When I woke up, I didn't even know that anything had happened. I was waiting for them to get it over with and was wondering why I was so drowsy, lol. I was tired and that was about it; I was also getting these really vivid sort of afterimages when I closed my eyes, and I think that was because they used ketamine (horse tranquilizer) as the anesthesia because it helps to prevent relapses.
My understanding is that the seizure-inducing electrical current resets how your brain deals with certain neurotransmitters -- it sort of sets the settings back to the default, making you less depressed. And it really works! 50% of patients last a year or more without needing further treatment -- more if you do certain things like take lithium paired with an antidepressant post-treatment.
I'm not sure how "x kills brain cells" is a clinical term.
The main risk is memory loss, if you're not a heart patient, and I haven't had much of that so far (that I can tell.). My mind is doing fine.
I'd hardly call it an enjoyable experience, but it's much better than being depressed for the rest of my life. This is my best chance (after 14 medications, cognitive behavioral therapy and dialectic behavioral therapy) to get an actual life that's worth living, and I'm taking it. I don't even care about the consequences, really -- it's not like things can get much worse (though ECT hasn't made anything worse and I hardly expect it to.).
I'm prepared to cope with the memory loss, but for now I'll take it day by day.