I'm not bipolar, but a quick google search says: "Yes, ECT (electroconvulsive therapy) is effective for treating mania, particularly in cases where medications are not sufficient or when the condition is severe. ECT can rapidly alleviate manic symptoms and is a valuable treatment option for individuals with severe bipolar disorder, especially when other treatments haven't worked " Notice the caveats appeasing the pharmaceutical industry. (when medications are not sufficient, severe bipolar disorder). Let me ask this...if ECT is the most effective treatment, (per the NIMH) why does it have to kowtow to medication? Why isn't it the first option? I think the answer is it makes psychiatrists look stupid because they don't know how or why it works. It just does. And, they don't like to look stupid.