WALNUT CREEK, Calif. — Recently, actress and writer Carrie Fisher told Oprah Winfrey that she receives electroconvulsive therapy regularly to treat depression caused by her bipolar disorder. Taken aback, Winfrey asked, “They still do that?”

Yes, they do. About 100,000 people in the United States receive electroconvulsive therapy, better known as electric shock treatment, every year for severe mental illness, but that number may be surprising to those who thought ECT went out of favor with the advent of better psychotropic drugs.

Robert K. Dolgoff, a psychiatrist and medical director for mental health services at Alta Bates Medical Center in Berkeley, Calif., said Winfrey’s surprise is understandable. Unlike the 1960s and ’70s, when the “One Flew Over the Cuckoo’s Nest” novel and film offered a dramatic portrayal of mental illness and barbaric treatments like the lobotomy, there is hardly anything in popular culture today that depicts the treatment. That’s because, Dolgoff said, the procedure is simply boring.

“The people just lie there. There’s no convulsing or twitching. They’re asleep,” he said. “No one makes movies about that.”

ECT has a long history as a treatment for people with mental illness. It is also arguably one of the most controversial medical procedures performed today. There are no shortage of ECT critics, including some Bay Area activists who rallied in the 1980s to ban the practice in Berkeley through the voter-approved 1982 Measure T, which was eventually overturned in the courts.

For some former ECT patients, who call themselves survivors, ECT is a brutal treatment that wipes out important parts of memory. For others, the treatment is one of last resort, a lifesaver when medications and therapy fail to lift often lethal depression.

David (not his real name), a 40-year-old small-business owner in San Francisco, spent about 10 years working to lift what he called “bone-shattering depression” with 50 to 55 combinations of up to 10 different psychiatric drugs.

“At times, my depression got to the point where it was almost a psychopathic level,” he said. He was diagnosed with chronic major depression.

He sought out ECT in 2006, saying he was desperate for relief. After four sessions, David reported he had positive results. The chronic depression lifted. He felt content and, for the first time, had peace of mind.

“It was black and white before and after,” he said. “I felt like a person. It was a resounding success. I do believe it restructured my brain for the better.”

David reported slight memory loss, which is not uncommon Dolgoff said. Usually, the doctor said, the memory loss is minimal and almost always temporary. Actress Fisher joked about her memory loss in her blog, saying that her outgoing telephone message asks callers to clearly identify themselves in case she forgets who they are in between treatments.

ECT was developed in 1938, and its use became widespread in the 1940s and 1950s. Today the procedure is regulated more strictly than in decades past by a set of patients’ rights laws. In California, patients are rarely given ECT without their consent. Forced ECT has to be approved by a judge and it takes several weeks, if not months, to get in front of a judge. Minors in this state are not allowed to have ECT.

ECT basically uses bursts of electricity in the brain to produce a mild seizure. Dolgoff said it is not known why it works, but doctors believe it releases neurotransmitters in the brain and stimulates parts of the brain that are underactive. It is most effective, Dolgoff said, on patients who are severely depressed or catatonic.

“ECT is not a good treatment for mild depression. They don’t need it. There is some risk in ECT. Why would you take a risk if you had other treatments that you could do instead?” he said, adding that interest in the treatment has increased in the past 10 years, partly because of less stigma associated with mental illness and partly because patients are reporting that it works.

“It’s been a long time since ‘One Flew Over the Cuckoo’s Nest’ so people have gotten over the fear of ECT,” he said.

Dolgoff noted that although slight and temporary memory loss is associated with ECT, memory loss is also a side effect of depression. Cognitive function actually improves in some people after ECT, he said.

Assurances that memory loss is temporary is not good enough for San Francisco’s Leonard Roy Frank, the nation’s most vocal opponent of ECT. Frank has been working for nearly four decades to raise awareness of the ill effects of ECT, compiling facts and quotes about the treatment in his free online book “The Electroshock Quotationary” found at www.endofshock.com.

Frank, 78, was in his 20s when he was committed to a Bay Area mental hospital in 1962. His parents were concerned that he unemployed, had become a vegetarian and had grown a beard. He said he was labeled schizophrenic.

Frank received several ECT treatments against his will and suffered severe, permanent memory loss.

“Permanent memory loss is the surest indicator of brain damage,” Frank said. “That’s the heart of our critique of ECT. Psychiatrists deny brain damage, but if it’s permanent memory loss, short term or long term, that’s an indication of brain damage.”

South Carolina certified psychiatrist and neurologist Mark George, honored by U.S. News & World Report in 2009 as one of 14 “pioneers of medical progress,” said ECT is the most effective treatment for major depression.

But, he said, it’s wrong that the psychiatric community has denied that ECT has no adverse effects, and it is wrong that people like Frank were forced into treatment.

“That’s a bad thing that psychiatry did,” he said.