The US National Institute of Mental Health says ECT is the most effective treatment for major depression. I agree. My illness would be defined as neuro-psychiatric. Every neurological illness has a psych component, and vice versa. I tend to think my illness became serious when the neurological component reared its ugly head at age 17 when I had a powerful temporal lobe seizure with a couple dozen epileptic discharges that fried my temporal lobe and left me without positive emotions, libido and numerous other acute and chronic deficits. I was also agoraphobic. But I can't say that seizure wasn't precipitated by feelings of worthlessness, suicidal ideation and depression. I suffered major episodes on intervals of 8 years and each was an epic struggle for survival. Long story short (is it too late for that?) I had ECT in 2014. I was hospitalized for 2 weeks and had a grand mal induced every other day. It was a game changer and a life saver. I haven't had a panic attack since. I lost so many symptoms I can't remember them all. I didn't need any meds for over 6 years, and now take a maintenance dose of Escitalopram and that's it. I am a retired electronics technician and I like to say that ECT set all my firmware switches back to factory default.