Emily Hollenbeck’s journey

NEW YORK. Emily Hollenbeck battled with a profound, persistent depression, describing it as akin to a black hole, where the weight of gravity made movement almost impossible. Aware of the potential lethality of her condition, Hollenbeck, who had lost both her parents to suicide, was open to an unconventional solution: undergoing brain surgery to implant electrodes as part of an experimental therapy.

Known as deep brain stimulation (DBS), this treatment holds promise for the nearly 3 million Americans grappling with treatment-resistant depression like Hollenbeck. While already approved for conditions such as Parkinson’s disease and epilepsy, many in the medical community envision broader applications for depression.

Administered via targeted electrical impulses, akin to a pacemaker for the brain, DBS has shown encouraging results in recent research. However, setbacks occurred with two significant studies showing no discernible advantage to DBS for depression, momentarily stalling progress. Nonetheless, the Food and Drug Administration has expedited its review of Abbott Laboratories’ request to utilize DBS devices for treatment-resistant depression.

“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 Hollenbeck, a participant in ongoing research at Mount Sinai West. “But I also felt like at that point I tried everything, and I was desperate for an answer.”

Hollenbeck’s struggles with depression began in childhood, exacerbated by her father’s suicide in 2009 and further compounded during her tenure with Teach for America. Despite responding to medication intermittently, she faced relentless relapses, even while pursuing a doctorate in psychology. DBS emerged as a last resort three years ago.

“I ended up having sort of an on-and-off pattern,” she recounted. “After responding to medication for a while, she’d relapse.”

Under the care of Dr. Brian Kopell at Mount Sinai’s Center for Neuromodulation, Hollenbeck underwent surgery to place electrodes in the subcallosal cingulate cortex, a brain region regulating emotional behavior. Connected to a device under her skin, this setup delivers controlled electrical stimulation, dubbed by Hollenbeck as “continuous Prozac.”

Reflecting on her post-surgery experience, Hollenbeck’s psychiatrist, Dr. Martijn Figee, noted immediate improvements. “The first day after surgery, she started feeling a lifting of that negative mood, of the heaviness,” he remarked.

For Hollenbeck, the effect was transformative. “When I was depressed, I couldn’t listen to music. It sounded and felt like I was listening to radio static,” she said. “Then on a sunny day in the summer, 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.”

Yet, Hollenbeck recognizes DBS as part of a multifaceted treatment regimen. While hopeful about her progress, she underscores the importance of ongoing care.

Her journey mirrors broader advancements in understanding and treating depression. Pioneering research by Dr. Helen Mayberg and others highlights the potential of personalized approaches to DBS, offering new hope for those grappling with this debilitating condition.

As the medical community continues its pursuit of effective therapies, Hollenbeck’s story stands as a testament to resilience and the transformative potential of cutting-edge treatments in mental health care.