However, page one of the advertising pages of the Journal has an ad for an advanced ECT machine by the named vendor. Some readers will know I am a strong supporter of ECT for carefully selected patients. It therefore seems odd indeed that ECT treatment appears not to be included in that January 2019 mood disorders-themed issue. Taken with the content cover of ECT in the top two paragraphs on this page raises a strong sense of curiosity about the density of so much focus on ECT. In the context of severe mental illness, the severity of the suffering, so often prolonged before effective ECT treatment commences is indeed lamentable.