What type of depression is often treated with electroconvulsive therapy (ECT) instead of pharmacotherapy?

Electroconvulsive therapy (ECT) is primarily indicated for severe major depressive disorder, particularly when other treatment options, such as antidepressant medications, have proven ineffective or when rapid symptom relief is required due to the severity of the illness. Severe major depressive disorder may present with significant functional impairment, severe suicidal ideation, or life-threatening symptoms, which often necessitate immediate intervention. ECT has a fast-acting nature and can provide relief in these critical situations, making it a preferred choice for this level of severity.

In contrast, mild depressive disorders, moderate depressive disorders, and dysthymic disorder are usually managed with psychotherapy or pharmacotherapy. These conditions generally do not require the intense and immediate intervention that ECT provides, as they typically present with less severe symptoms that respond well to outpatient treatment modalities. Thus, the use of ECT is reserved for the most acute cases of major depression, emphasizing its role as an important option within the treatment arsenal for severe cases.