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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 family."

Code Cool

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.

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