The Current - Could deep brain stimulation be a cure for depression?

Episode Date: November 28, 2025

Toronto journalist Anna Mehler Paperny had experimental surgery that placed electrodes in her brain in the exact location neurologists believe could be the source of her depression. She's part of a clinical study out of Sunnybrook Health Sciences Centre that uses deep brain stimulation to treat mood disorders. She speaks about the procedure and her hopes that the study, a first of its kind in Canada — will lead to a better understanding of the physiology of depression and its treatment.

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This is a CBC podcast. Hello, I'm Matt Galloway, and this is the current podcast. A warning, this next story talks about suicide. Anna Mailer Paperni can tell you what it feels like to have holes drilled into her head. Earlier this year, she had experimental surgery that placed electrodes in her brain in the exact location neurologist believe could be the source of her depression. Anna Mailer Paperni has written a lot about what it's like to live with depression. Her book, Hello, I Want to Die, Please Fix Me, Delves into the Agony of Living with

the Disease and her multiple suicide attempts. Now she's taking part in a clinical study, the first of its kind in Canada that uses something called deep brain stimulation to treat mood disorders. Anna Maylor-Paparney is a Toronto-based journalist, and she's with me in our Toronto studio. Good morning. Good morning. Thank you for having me. Thanks for being here. How are you doing? Really well, thanks. I want to talk about why you did this. We'll talk about what it was. But let's talk about why you did this. You wrote about this in the the Globe and Mail. And you said, I was in agony and I was sick of it. Describe what it is like to live with depression and what the agony that you were living with was like.

So there are a few things happening. There's the despondents, which I think is people's first association when you say you have depression. And the despondents that weight, that seeing everything through awful colored glasses takes over. That just like superates everywhere. The second was the desire to die, which wasn't constant, but was frequent enough to just destroy my day. It came, sometimes it felt like mosquitoes that weren't really menacing, but were just like invading your space and making it difficult for you to get on with your life. There are times when it felt like being hit by a subway train, and all of a sudden you just can't do. anything. You're taken over. Sometimes it feels like being stuck in a swamp where you're sinking into ooze and you can't get out. In all of those cases, all of those things really affected

my ability to function, which destroyed me because then you feel as though you're losing your reasons for living. I became enmeshed in this paralytic self-doubt. You question everything and find yourself unable to engage in really basic tasks that would give your life purpose or would express your life's purpose. So all those things together, and the fact that these weren't being adequately alleviated by the treatments I was trying made me think I had to try something new. And this went off for 14 years? You lived with this for?

Yes, on and off, yeah. And as you said, you were sick of it, And in your words, you were sick of waiting and wishing to die. Yeah. What do you want, and I want to get to, again, what you did, but part of this is about, and you've talked about this suicide attempts, you wrote this incredible book about it. What do you want people to know about, and to understand about that, to understand about suicide? I want people to understand how common it is, but also how genuinely debilitating.

I think sometimes the ubiquity of depression or the seeming ubiquity of depression allows people to minimize just how debilitating it is. And you're, as I said, a journalist, you've worked at all sorts of different places, writers and Globe and Mail and Global News, and I mean, you're accomplished in your field, and what did that mean in terms of what you weren't able to do?

I felt like I could have done so much more if I hadn't been shackled to this mood, what I came to understand as a mood disorder. I wish people understood the ways that it wrecks you, even as you struggle to function as a quote-unquote normal human being. And I wish people understood both how uncommon it is to get the treatments that exist and how inadequate those treatments are for so many people. What had you done to try to treat your depression in past?

I've tried dozens of drugs in hundreds of combinations, just about every psychotropic medication that has ever been believed to be affected for depression. I've had years of psychotherapy, which I should note has been enormously helpful, again, just in keeping me going. Psychotherapy is invaluable. I've tried electroconvulsive therapy. I've tried repetitive transcranial magnetic. stimulation. There are very few treatment, like proven treatment modalities for depression that I have not tried. And so when you heard about this, this is a clinical trial that's looking at deep brain

stimulation. When you heard about it, what was your immediate response? I first heard about this idea when I was writing my first book. I spoke with somebody who was doing this research and I spoke with somebody who had this procedure done on her, and for her, it was life-changing. But at the time, I didn't see it as something I might do. I felt there were still other options for me, and it just didn't occur to me to reach out. That changed a couple, a few years later, and I reached out to the study, we exchanged emails. I wasn't sure it was right, and there was a period.

I actually looked back at these emails the other day, and I wanted to confirm. There was a period where, like, I wasn't sure I was well enough to undergo this procedure. But we exchanged further emails. I circled back. Finally, late last year at the end of 2024, I was really serious about pursuing this because I felt as though I had no other options. What is the premise behind the procedure? I mean, what do researchers believe it's possible to do with this? So it's ingenious, but it's disdemeanious.

conceptively simple. Your brain activity is a series of electrical impulses. And they figure that because depression exists in the brain, something electrical is wonky. And they want to address that wonkiness. And so in this case, what they're doing is targeting a very small part of the brain that's believed to be both hyperactive and atrophied in depression. And by sort of zapping it with electricity, you stop this hyperactive firing. And suddenly it's not firing anymore. And that is believed to have downstream impacts on other parts of the brain. And they're still not sure how, but they hope that by zapping this misfiring region,

they're coaxing the brain or pushing the brain into a more adaptive form of functionality. And people will know, deep brain stimulation has been used for many years now to help treat people living with Parkinson's disease. What do we know about how successful it can be treating depression? We don't know much. It's still very experimental. But there have been experiments done for several years with varying degrees of success. There were a couple of large-scale randomized controlled trials that were actually halted prematurely several years ago because they didn't. think it was better, the intervention was better than a sham. And I was speaking the other day with one of the neuroscientists behind this. And I asked him, like, did that discourage you? Did you think

that this wouldn't work because of that? And he said, no. He said, we've seen it to be effective. We think they may have halted it too early. And we wanted to keep trying. And so you say yes, and you have a couple of different surgeries. Walk us through the first one. What was involved here? So the first one was, from my perspective, the major one. I wanted to be awake for it, because I wanted to see what was going on. They gave me drugs that would sort of make me dopey, and they gave me local anesthetic. They brought me into this operating room, and they shaved a small line on my head. They drilled holes through my skull, which sounds like a simple procedure, but was actually quite daunting from my perspective.

It sounds terrifying, but continue. It was a little terrifying. Yeah. There's this intense pressure. I wrote that it felt like a helicopter perched on my head. What does that mean? D-D-D-D-D-D-D-D-D-D. And just this intense pressure on these hyper-local points in your head.

You can't feel pain, but you can feel something. You can feel the pressure. Like something is pressing onto your skull. And then they sort of slice through your brain. brain's outer membrane and did you feel that I did it felt like this deep ache and they were joking they were lovely lovely people and they were joking they were like it's like an ice cream headache and I was like I've never had ice cream like that is that what they they kind of characterized it as an ice cream panic you say it's a deep ache I mean is there anything that would compare to that

I've not most people have not had a part of their brain sliced into so is there any kind of pain or ache that you felt that would be similar I can I can see their perspective it felt a little bit like all of a sudden going from cold to hot. So like when you, for example, it felt a little bit like when you've been out in the cold without adequate gloves for too long. And then all of a sudden you go into a heated room and your hands get that achy feeling. It felt a little bit like that. There was no pain, just that. Yeah. Yeah. So I was very lucky. And the weird, the weirdest thing was what there wasn't is when they were inserting these electrodes. And I desperately wanted to feel something because,

They're putting something into your brain. They're putting something into my brain. It was totally new for me. And I couldn't feel a thing. And it was so strange. But your brain has no pain sensors. Why did you, you said you wanted to be awake for it? Could you have been unconscious for it?

Yes. But you wanted to be awake. I wanted to see what it was like. I thought like, hopefully this is the only brain surgery I'll ever have. I want to know what it's like. Yeah. At Desjardin Insurance, we put the care in taking care of business. Your business, to be exact.

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Discover prevention tips that can help you be climate ready at keep it intact.ca. How risky is something like this? And it seems like a dumb question. They're cutting into your brain, drilling holes into your head. But how risky is something like that? Is the concern that something else could be touched that would impact another part? of your life? See, that's what scared me is I was scared that they were going to, like, accidentally

cut through some other fiber I needed to function. They said that's not a concern. What are concerns are issues around a bleed, which, again, they avoid because they can see, like, are there any blood vessels here where we're going through? So there's a potential for a bleed. There's a potential for infection. I believe there's a potential. albeit a small one, that your body, either in the brain surgery or in the subsequent chest

surgery, simply rejects this foreign object. I was told the risk of those were very small. Were you scared? Terrified. But it was important to do. I mean, part of this, you write in the paper, over the past 14 years I've often fantasized, but some scan revealing finally the locus of my mood disorder, the neural source of all my angst. Is that why you went through it despite the fact that you're terrified?

It was a big part of it. I wanted to find that locust, and I desperately wanted a change. I needed to jolt myself into a better place. So that's the first surgery, cutting you open, putting the electrodes in your brain. The second surgery connects those electrodes to what's kind of like a pacemaker, right? Like it's somewhere in you. It's right here. Barred. You just touched your, that's your left side. Right side. Right side. Just under your, under your clavicle. How does that work? That was dental anesthetics. I wasn't awake for it. But they effectively snake the electrodes down underneath the skin of your neck. I can still feel them here. You can feel them the back of your ear. It's the weirdest thing. For a while, actually, after the surgery, there was a tightness while they sort of got used to being or my body got used to being in that.

with those inside. So the tightness has dissipated now, but I can still feel them under my skin. They're sort of snaked under my skin and connected to this device, is sort of a pacemaker that's implanted here. There's still a scar. And a couple of weeks after that surgery,

they turned it on. And you say that this thing allows doctors to eavesdrop on your brain? That's the coolest part, I think. I mean, obviously, I want this to make me better, But the coolest part, I think, and then perhaps the most terrifying, is the eavesdropping because not only are they jolting this bit of brain, but they're recording brain activity. And they can create this wealth of information that they're still trying to understand.

So in turning it on, the jolting is, I mean, recording it is one thing, but the jolting, that's what the pacemaker is meant to do, right? Yes. We explain how those pulses were. work. So right now it's set to about seven, it started at two million amps. Now it's about seven million amps. And so it's programmed here in my chest. And it creates this sort of this electrical signal in this one part of my brain. And it creates what neurosurgeon near Lipsman calls an informational lesion. So effectively, you send zaps of electricity to this piece of a brain that's sending too many zaps and all of a sudden this jolt cuts off the hyperactive

zapping like it's kind of an interrupter or something like that exactly can you feel it can you feel no i wish i could i mean it'd probably be distracting yeah and then they track you as well and you mentioned that they they'd they'd adjusted it so it started at a certain level and then they've moved it up yes do they how do they how do they know how to turn the dial so they connect they use an ipad to connect to the device when I see them in person. And that allows them to adjust the voltage or the amperage, up or down. The weird thing is that I have a device that I take home. I'm able to turn it down, like if I feel off, if I feel it's too high for whatever reason.

I'm not sure what that would feel like, but they say I would know it would if I felt it. I'm allowed to turn it down, but I can't turn it up above a certain level. It's been what? How long since the surgery? about half year? Yeah, a little over six months, yeah. So is it working? I wish I could say yes.

I don't know yet. Do you feel different? In some ways, and I'm not sure how much of that is wishful thinking, but there are days when I feel like I have a floor of resilience where, like, my mood can fall, like, have disappointments, I have setbacks, but it doesn't fall to a point that's where I'm lost. And that's invaluable. I try really hard to hang on to that.

There are days when I feel like I'm able to derive joy from small things, which sounds so minor, but it's massive when you have an hedonia, when you have this inability to experience joy. So I don't want to make too much of it. It's still, I keep having to remind myself it's still early. But I'm hoping I'm starting to see the sign that it's working. I've talked to you about the depression that you've lived through before, and to hear you talk about it in that way is really emotional. Like it feels like, as you said, those are small things, but they're incredibly meaningful, right?

They really, really are. And I apologize, it's hard, it gets much harder for me to talk about it, the closer to the present that it gets, because it feels much more raw and much more vulnerable to do so. What do you mean? I think a couple of things. I think things feel safer to discuss when they're in the past. When it's in the present and I'm in the throes of it, it feels, I'm not sure if riskier is the right word, but it scares me to talk about things that I'm going through in the present.

That's why I asked how you were doing when you came in. I just wanted to know, like, do you feel, you talked about that paralytic self-doubt that you were living with. Has that felt in the past that you've been able to kind of put some of that to the side because of what you've gone through? It hasn't disappeared, but I'm hoping that it's starting to dissipate. This is a clinical trial. I mean, what you have done is the first of its kind in Canada. This trial that's happening right now, you're part of that.

You were, what, patient 19 at Sonnybrook Health Sciences Center in Toronto? a few hundred people, maybe a thousand people have had the surgery globally. They are recording the information from your brain through these devices and the iPad and what have you. What do you hope that leads to, not for yourself, but what do you hope that leads to broadly? A few things. I'm hoping it leads to improvements in this treatment, in DBS for Depression. I hope they can better understand it and better finesse it for future patients. and I'm hoping it leads to improvements in diagnosis because depression has become sort of a catch-all illness.

It is often unhelpfully heterogeneous to the point that, like, you could have very different symptoms and be classified with the same illness. I'm hoping that better understanding depression can help us better diagnose it. But I'm also hoping that this helps develop better treatments and potential biomarkers to ask, ascertain whether somebody will respond to treatments because there are so many people who are so ill-served by what we have now. And while I hope if this treatment is effective that more people can access it, not everybody who has treatment resistant depression wants holes in their head. But they all need a better option. Why do you think, and I mean, part of it is as you said, this is part of a solution perhaps or part of a treatment. But why do you think the treatments

that exist right now haven't helped more people and haven't helped people like you? I mean, there are many people living with depression who have been assisted by the treatments that are available. But we, talk to you, talk to other people who say that they are still suffering because the treatments aren't matching up. Why is that the case? Do you think? We continue societally to minimize the damage depression does. And in minimizing it, we inadequately fund and inadequately research options for treatment. What do you mean that we're minimizing? We talk a lot about depression, it feels like.

We're getting better, I think. But I think we still don't fully, we haven't fully reconciled just how much of a kick in the teeth it is. And I don't think our talk has yet translated to better treatment options or better investments in treatment options. I certainly don't think it's translated into access to existing treatments. This drives me nuts. I mean, I've been so lucky.

I've been able to access pharmacotherapy and psychotherapy. And while it hasn't been enough for me, it's certainly been better than nothing. And so many people I've spoken with have not been able to access the treatments that we do have. So this tells me there's something that's not matching up. We're, even though you're right, it feels like we're talking about it more. We're not acting on that talk. It says something that, I mean, despite everything that you've said in terms of what we're doing, you would still be willing to have holes drilled in your head because the treatments aren't matching up with what you need.

It says we have to do better. How hopeful are you? And again, I understand that you don't want to talk a lot about how you're living through the present, but how hopeful are you that this will be a way forward for you? It depends on the day. I'm hopeful though I think I have to be hopeful You have to be cautious in investing in that hope

I mean you worry again it's experimental You don't want to give Too much to it And have hopes dashed But it is something that you're living in That hope? Yes Yes very much so Yeah

What happens now with it I mean they keep fine tuning the They keep fine tuning I go back every few weeks The six month mark was big I had to have two EEGs in two weeks Which always feels like a lot

They take two hours, like, coating your head in a cap, and then they put your head in a cap, and then they coat it with gunk to, like, as conductant. It takes forever to get out of your hair. So they're still following me. I'm still recording, like, every time I have a strong mood state or one of four strong mood states, I record it in my device, and they take a snapshot. So they're still recording my brain waves, which is so scary to say. But, yeah, we're moving forward. Is there part of you that's kind of freaked out that they're recording you? I'm so freaked out.

I'm so freaked out by it. But it's for good. It's for good. I hope so. Yeah. It's an amazing story. The way that you wrote about this in the globe, but just how you described step by step kind of what you went through and why you decided

to do this is really quite something. I wish you the very best and it's really great to see you. Thank you very much. Thank you so much. Anna Maylor-Paparney as a journalist in Toronto, the author of Hello, I Want to Die, Please Fix Me. She's part of a clinical study out of Sunnybrook Health Sciences Center in Toronto that uses deep brain stimulation in the treatment of depression.

You've been listening to the current podcast. My name is Matt Galloway. Thanks for listening. I'll talk to you soon. For more CBC podcasts, go to cbc.ca.ca slash podcasts.