Medical Advances and Breakthroughs
Mood-Lifting Implants continued...
At first, her mood was just off-kilter, though sometimes she experienced
mania — periods of wildly elevated emotion and extreme energy. "I'd stay up
half the night washing and ironing sheets," she says. She took the drug lithium
to regulate her moods, but eventually the swing tilted in the opposite
direction and stayed there.
Schaefer was so depressed she was barely able to leave the house. The
simplest tasks became overwhelming. "I had so little concentration, I'd get
lost going to the grocery store," she says. Once she wandered away from her
home and ended up in a nearby park, where her frantic family found her — hours
later — asleep on a bench.
Schaefer was hospitalized several times for her depression and, through the
years, tried everything — counseling, drugs, even electroshock therapy. "All
that did was destroy memories of my three daughters," she laments. She even
considered taking her own life.
Then, two years ago, Schaefer's doctor helped enroll her in a study of a
pioneering treatment called deep brain stimulation at Boston's Massachusetts
General Hospital. Already approved for treating patients with Parkinson's and
other neurological disorders, DBS is a kind of pacemaker for the brain. The
battery-powered unit is placed in the chest, where it sends electric signals to
receivers that have been implanted in specific brain regions, correcting
abnormal activity associated with depression.
In studies of DBS, half the patients have experienced at least a 50 percent
improvement in mood, and a third have had complete remission — unusual success
for treatment-resistant depression. "You just don't get these kinds of results
in these patients," says study coauthor Emad N. Eskander, M.D., associate
professor of surgery at Harvard Medical School. The procedure is still
experimental, though final trials for FDA approval are under way and it could
be available within a few years.
Schaefer was among the lucky ones. "I used to cry every day," she says. But
after her pacemaker was turned on, her sadness gradually lifted. She no longer
has trouble finding her way around town, and has returned to church, where she
cochairs the trustee committee. She is filling in her missing memories by
creating scrapbooks for her daughters and other family members.
Every six months or so, Schaefer has to have the batteries in the chest unit
replaced — surgery done under general anesthesia. But, weighing where she was
before and what her life offers her now, she says it's not a big deal: "For 34
years I was fighting just to stay alive." Even with the pain and inconvenience,
she says, "this is the best thing that's ever happened to me and my
When a person's heart stops beating, no blood — and no oxygen — is going to
the brain. Cooling the body a few degrees reduces the chance of damage,
increasing the odds that the patient will return to a normal life. That's why
accident victims who live through a plunge into a freezing river can survive
without neurological problems. But in a hospital, the processes that are used
to cool bodies — blowing cold air on patients, or packing them in ice — can
take hours, often too long to stop cell death and brain damage. It's no wonder
only a small fraction of cardiac arrest patients whose hearts are restarted
regain all their abilities.