With ECT, you go under general anaesthetic in hospital and electricity is passed through your brain to cause a seizure. It is generally recommended for fast treatment of severe depression. ECT has side effects including memory loss. TMS is an outpatient procedure recommended before trialling ECT. TMS uses a magnet to stimulate the parts of your brain associated with positive mood. You are awake during the procedure, no drugs are administered, it is a walk-in-walk-out procedure. TMS has a benign side effect profile, the most common being a mild headache or fatigue that usually goes away after the first couple of sessions