Happiness is a Warm Electrode

To some, acting on this rudimentary understanding of DBS and its effects on the brain recalls the notorious history of operating on the brain to treat mental disorders. One psychiatrist, Jeffrey Schwartz of the University of California at Los Angeles, has compared the procedure to a lobotomy. Swerdlow is more hopeful. He thinks DBS, or some future derivation of it, truly could help patients and advance neuroscience along the way. His main concern is that the trials are happening too fast.

But Malone can't imagine going much slower. Time is dangerous in depression, with suicide-the eleventh leading cause of death in the U.S.-claiming more than 32,400 lives every year. For Hire, DBS isn't about unlocking the mysteries of the brain; it's about being able to get out of bed in the morning.

Some Rare Good News

Depression started controlling Hire's life in her early 30s. At 36, after 12 years of service in the Navy, she was medically discharged because of the disease. She went back to school and became a physical therapist. She worked and worked, trying to ignore her growing unease and inability to relate to family and friends, let alone strangers. She tried various drugs and met frequently with therapists. Yet the depression only grew stronger.

In 1999 she stopped working for good. She started semi-regular courses of ECT. The treatment failed to improve her mood and affected her short-term memory, a common side effect. Then, in 2005, Hire heard about Malone's work with DBS and applied to be part of one of the first clinical trials of its use to treat depression. She and her therapist submitted a dictionary-thick stack of papers to Malone, documenting Hire's long battle with mental illness, but they got no reply.

By 2006, Hire rarely left her sofa, spent most days in sweatpants, and watched television from morning to night. It took her four weeks to work up the motivation to clean the house. That fall, she called her therapist and told her that she couldn't handle it anymore. "It was a really black, dismal existence," Hire recalls. "I just couldn't function."

As fate would have it, the very next day Malone called Hire's therapist with some excellent news: He wanted to meet Hire, if she was still interested, to begin the long process of determining whether she was a suitable candidate for the trial. The vetting could take months, but Hire didn't care. "I was at the end of my rope," she says.