Flow Neuroscience

Aug. 28, 2025

When it comes to brain stimulation for depression, two very different options often come up: Electroconvulsive Therapy (ECT) and Transcranial Direct Current Stimulation (tDCS). Both aim to improve brain activity linked to mood, but they work in very different ways and are usually recommended for very different situations.

Read more about ECT here and explore tDCS here.

What They Are

  • ECT: A hospital-based treatment where a brief electrical current is delivered under general anaesthesia to trigger a controlled seizure. It’s one of the most effective options for severe or treatment-resistant depression.

  • tDCS: A gentle, non-invasive current delivered through electrodes placed on the scalp. It doesn’t require anaesthesia and can be used at home with a medically approved device.

When They’re Used

  • ECT: Reserved for severe depression, treatment-resistant depression, or when rapid relief is needed (for example, high suicide risk).

  • tDCS: Recommended for all severities of depression, but not suitable for high risk, rapid relief because it can take a few weeks to see improvements

Effectiveness

  • ECT: Research shows high remission rates, with many patients experiencing significant improvement after a short course of 6–12 sessions. It often works faster than antidepressants or psychotherapy.

  • tDCS: Clinical studies show tDCS can be as effective as medication or therapy for all severity of depression, especially when used consistently over several weeks.

Side Effects

  • ECT: Temporary confusion after sessions is common. Some people experience memory loss — occasionally long-term — which is its most significant side effect.

  • tDCS: Side effects are mild, usually limited to tingling under the electrodes or slight headaches that pass quickly.

Setting and Convenience

  • ECT: Always delivered in a hospital or psychiatric clinic under the care of doctors, anaesthetists, and nurses. Sessions take planning and recovery time.
  • tDCS: Portable, discreet, and done at home. Sessions last about 30 minutes and can easily fit into a daily routine.

The Bottom Line

Both ECT and tDCS can play a role in treating depression — but they sit at very different points on the treatment ladder. ECT is powerful and often life-saving when other approaches have failed, while tDCS offers a gentler, more convenient option.

Always discuss your options with a qualified healthcare professional before starting any brain stimulation treatment.