ECT and TMS therapy have a considerable difference in terms of mechanism of action. ECT is the application of electric current directly to the patient's head while they are immobilized and sedated. It causes an intentional ‘therapeutic seizure’ with the aim to alter the firing function of neurons in the brain. ECT is often associated with short-term cognitive side effects. Likewise, potential adverse effects include nausea, headaches, muscle aches, brief changes in heart rate, transient arrhythmias, and changes in blood pressure. Long-term side effects are rare but memory deficits are a potential complication. With better alternatives available, currently, ECT has rarely been considered a first-line treatment except for sudden onset, rapidly deteriorating cases of depressive illnesses, or for patients with multiple complex psychotic illnesses. The risks involved and the invasiveness of the ECT procedure require patients to limit their activities, take leave from work, and in some cases hire a dedicated caregiver or get hospitalized for the period of recovery.  On the contrary, TMS does not involve the direct application of electric currents to a widespread region of the brain. TMS therapy targets a more focused anatomical location to activate the healing process of the brain more gently by magnetic currents while preventing cognitive dysfunction and generalized seizures. TMS therapy has much fewer adverse effects, thereby allowing patients to stay comfortable and awake during treatment sessions. TMS therapy also allows patients to live independently, resume routine activities and return back to work immediately, and continue other remission-promoting treatment modalities alongside such as psychotherapy and antidepressant medications. Performing routine activities during a course of ECT is extremely hard, and that is one reason why most patients would feel ECT being too extreme for their depressive symptoms.