I'm sure this varies by person and situation, bipcyclist.

Speaking only for my own experience, I had once rejected the idea when first suggested to me, but then about a year or so later, I agreed to the ECT. The first time suggested, I was in a manic state with mixed features and it was proposed by an inpatient mental health practitioner that I didn't know. I knew very little about ECT at that time, and didn't trust the woman. Plus, being manic, I rejected all kinds of things. It was only after I had gone through the ringer of over 4 years of various manic type episodes, and then crashed into a months long pure depression, that I agreed. And that time it was suggested by my trusted long-time outpatient psychiatrist. The fact was, that I had been trialed on several bipolar medication cocktails, and had suffered some terrible side effects and poor results. ECT did seem like a last resort when I finally agreed, but I don't think it need be for everyone.

I imagine that ECT can seem appealing in cases where people just can't wait to find a good medication cocktail. I mean, what if you had to move somewhere or your employer was threatening that you get better quick or "get lost". The speed of possible ECT results can be appealing.

I have read that people who can't tolerate many medications or maybe women who are pregnant (in severe episodes) may choose ECT. Believe it or not, ECT is generally safe for pregnant women.

I imagine that if you've had a good experience with ECT in the past, you may feel quicker to try it again in the future.

Like many decisions in life, they become easier when we are at the end of our rope. Becoming very educated about a type of treatment (like ECT) can assist in such a decision.

Daonnachd is correct that the movie "One Flew Over the Cukoo's Nest" is a much dramatized and inaccurate presentation. ECT, though obviously scary before the first treatment, is usually regarded as less uncomfortable than a dental cleaning, though of course any procedure with general anesthesia is a serious one.