By the time you get to ECT for depression you've tried else for your more intolerable depression.
> Most people diagnosed with depression are offered an oral antidepressant (in combination with psychotherapy) as a first-line treatment option. But _if oral antidepressants don’t help_, or _if the person is at imminent risk of hurting themselves_, there are other, more rapid treatment options: ECT, and more recently ketamine or esketamine.
> “ECT is consistently more successful than ketamine” at helping _patients with serious depression_
> “We need to improve public awareness of ECT for _treatment-resistant depression_.”
(emphasis mine)