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An experimental pacemaker-like device that sends a steady stream of electric shocks to the brain offers a beacon of hope for millions of Americans with severe depression.

The device controls the amount of electrical stimulation sent to an area of the brain that regulates emotions called the subcallosal cingulate.

The electrical device helped Emily Hollenbeck of New York, who has lived in a black hole of depression for years, feel better immediately. 

Doctors believe that deep brain stimulation (DBS) works for depression because it communicates with the brain in a way it understands. Our brains use both electricity and chemicals to send messages between nerve cells, called neurons.

Emily Hollenbeck, a deep brain stimulation patient being treated for depression, said she felt better soon after the surgery to implant the pacemaker device and electrodes in her brain

Emily Hollenbeck is pictured wearing an EEG device that records brain activity as she reacts to short videos at Mount Sinai’s ‘Q-Lab’ in New York

Ms Hollenbeck suffered from depression symptoms as a child growing up in poverty and occasional homelessness. But her first major bout happened in college, after her father´s suicide in 2009.

Another hit during a Teach for America stint, leaving her almost immobilized and worried she´d lose her classroom job and sink into poverty again. She landed in the hospital.

She said: ‘I ended up having sort of an on-and-off pattern.’

After responding to medication for a while, she’d relapse.

She managed to earn a doctorate in psychology, even after losing her mom in her last year of grad school. But the black hole always returned to pull her in. At times, she said, she thought about ending her life.

She likened her depression to a black hole, where gravity felt so strong and her limbs so heavy she could barely move. Knowing the condition could kill her – both her parents died by suicide – she endeavored to try the innovative treatment not yet fully approved by the Food and Drug Administration. 

She said she’d exhausted all options, including electroconvulsive therapy when a doctor told her about DBS three years ago.

‘At first I was blown away because the concept of it seems so intense. Like, it´s brain surgery. You have wires embedded in your brain,’ said Ms Hollenbeck, who is part of ongoing research at Mount Sinai West in New York City.

She added: ‘But I also felt like at that point I tried everything, and I was desperate for an answer. Nothing else was working.’

She became one of only a few hundred treated with DBS for depression.

Ms Hollenbeck is one of more than three million Americans with treatment-resistant depression who could be eligible for DBS if it were approved for that purpose.

The innovative treatment has so far only been approved for Parkinson’s disease, but the FDA has agreed to speed up its review of Abbott Laboratories’ request to use its DBS devices for treatment-resistant depression.

Sedated but awake, Ms Hollenbeck underwent the surgery.

Emily Hollenbeck is pictured demonstarting how she makes circles in the air with her arms that are interpreted and projected as light on an interactive wall at the lab. She moves her arms faster now that she’s doing better

Pictured is a sample pacemaker-like device, used for deep brain stimulation therapy, and its electrodes which are implanted into a specific site in the brain involved in emotion regulation

Dr Brian Kopell, director of Mount Sinai’s Center for Neuromodulation, placed thin metal electrodes in a region of her brain called the subcallosal cingulate cortex.

The electrodes are connected by an internal wire to a device placed under the skin in her chest, which controls a steady flow of low-voltage pulses. Hollenbeck calls it ‘continous Prozac.’

In normal brains, Dr Kopell said, electrical activity reverberates unimpeded in all areas, in a sort of dance. In depression, the dancers get stuck within the brain´s emotional circuitry. DBS seems to ‘unstick the circuit,’ he said, allowing the brain to do what it normally would.

A growing body of recent research is promising, with more underway – although two large studies that showed no advantage to using DBS for depression temporarily halted progress, and some scientists continue to raise concerns. 

Hollenbeck felt better as soon as the surgery was over.

Dr Martijn Figee, her psychiatrist, said: ‘The first day after surgery, she started feeling a lifting of that negative mood, of the heaviness.

‘I remember her telling me that she was able to enjoy Vietnamese takeout for the first time in years and really taste the food. She started to decorate her home, which had been completely empty since she moved to New York.’

For Hollenbeck, the most profound change was finding pleasure in music again.

She said: ‘When I was depressed, I couldn´t listen to music. It sounded and felt like I was listening to radio static.

‘Then on a sunny day in the summer, LLEIDA PSICOLOGO I was walking down the street listening to a song. I just felt this buoyancy, this, “Oh, I want to walk more, I want to go and do things!” And I realized I´m getting better.’

She only wishes the therapy had been there for her parents.

Emily Hollenbeck stands for a portrait at the American Museum of Natural History’s Rose Center in New York on Jan. 12, 2024

This brain scan image provided by Mount Sinai in 2024 shows the targeted sites for electrodes implanted in patient Emily Hollenbeck for use with deep brain stimulation therapy

The road to this treatment stretches back two decades, when neurologist Dr. Helen Mayberg led promising early research.

But setbacks followed. Large studies launched over a dozen years ago showed no significant difference in response rates for treated and untreated groups.