If the NICE guidelines are being followed, you will only be offered ECT (in most cases) if you have tried other treatments and found them unsuccessful, unhelpful or unacceptable, or you are so unwell you are unable to engage with them.
These should have included
This doesn't mean you have to try ECT; you can choose to try other treatment again. There may be new drugs, or better access to different talking treatments, since you last tried a treatment.
Other physical treatments
Transcranial magnetic stimulation (TMS)
This is another physical treatment which can sometimes be used as an alternative to ECT or antidepressants. It stimulates the brain using magnetic fields.
NICE guidance says that there are no major safety concerns with TMS. Research has shown that it can be helpful in treating depression, but the benefits may vary for different people. TMS is now available on the NHS in some hospitals.
The advantages of TMS are that it does not require a general anaesthetic, and does not normally cause a seizure, so is much less likely than ECT to cause memory loss.
If nothing else has helped, including ECT, and you are still severely depressed, you may be offered neurosurgery for mental disorder, deep brain stimulation, or vagus nerve stimulation.
This information was published in June 2016. We will revise it in 2019.