The Remote Control Brain What would it be like if you could control your mood with a hand held device? Literally turn the device to different settings and make yourself happier and sadder? Alix Spiegel talks to a woman who has that power. If you or somebody you know might need help, the National Suicide Prevention Lifeline is available 24/7 at 1-800-273-8255 or at suicidepreventionlifeline.org.
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The Remote Control Brain

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The Remote Control Brain

The Remote Control Brain

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ALIX SPIEGEL, HOST:

Hey there, it's Alix. And I wanted to let you know that INVISIBILIA creates all sorts of original content around each episode on npr.org. So follow us on Facebook or Twitter to see photo essays, read Q&A's with our experts and learn more about the topics we discuss each week. You can also sign up for our newsletter at npr.org/newsletter/invisibilia.

HANNA ROSIN, HOST:

A warning to our listeners, this story is about someone struggling with mental illness. And so parts of it could be difficult to hear.

SPIEGEL: Massachusetts General Hospital, May 7, 2018. Megan's (ph) obsessive-compulsive disorder has been really bad. So she's come to the doctor for some help. She sits in a chair as he fiddles with a handheld computer, the one that talks to the device that's been implanted in her brain. He's trying to find just the right amount of electricity to make her feel better.

(SOUNDBITE OF ELECTRICAL BUZZING)

ALIK WIDGE: While you were talking, I slowly ramped it up again. Anything different now?

MEGAN: A little bit.

WIDGE: Yeah? What's - what's happening?

MEGAN: Slightly more aware.

WIDGE: OK.

MEGAN: Like, I really - it's not, like, in the past, where it was, like, oh, I feel good. But it's, like, a different feeling.

WIDGE: A general just sharpening or it's like everything got, like, turned up a little bit.

MEGAN: Yeah.

WIDGE: Yeah, that's - OK, people say that. Let's try going up one more step.

(SOUNDBITE OF MUSIC)

WIDGE: Anything different there?

MEGAN: Yeah.

(SOUNDBITE OF MUSIC)

WIDGE: We should dial this one back a little bit. Now, if you notice me turning it down, then maybe I'll change my mind on that.

(SOUNDBITE OF ELECTRICAL CLICKING)

MEGAN: (Crying, unintelligible).

WIDGE: Did you just feel it?

MEGAN: (Crying) I don't feel very good at all right now.

WIDGE: Oh, so something just changed? That's why - because in the process of reconfiguring it, it just temporarily went off. So you really noticed that. Give me one second.

MEGAN: (Crying) Yeah.

WIDGE: OK, hang on a second. Let me get this back to a stable setting, and then let's go back to that left side and take a look. Tell me more. Like, what's...

MEGAN: (Crying) I'd rather talk about it in private...

WIDGE: OK.

MEGAN: (Crying) ...If that's OK.

SPIEGEL: Yeah, of course.

MEGAN: (Crying) I'm sorry.

SPIEGEL: No, no, no.

WIDGE: Yeah, let's take a break.

MEGAN: (Crying).

SPIEGEL: I'm so sorry.

WIDGE: It's fine.

ROSIN: This is INVISIBILIA. I'm Hanna Rosin. Today we have a story about a woman who was desperately unhappy. So she signed up for this sci-fi-sounding medical trial where she got an electrical device implanted in her brain. We look at her experience and the man she fell in love with, a love affair entwined with batteries and wires and electrodes, a technology which might have implications for us all. Stick around.

(SOUNDBITE OF MUSIC)

ROSIN: So Alix Spiegel is telling the story today. One note, there are references to suicide in this piece. And this is Megan's story, but that's not where we begin. We begin with part I - Megan's boyfriend.

SPIEGEL: Until he found Megan, Brian (ph) almost never had luck with girls. It had been a huge problem.

BRIAN: And I had a habit of meeting girls and then, kind of like job interviews, you leave thinking, wow, I think that went really well. And then, like, you don't hear back.

SPIEGEL: But even when Brian did hear back and things seemed to be headed in the right direction, it typically didn't last long. His rose always seemed to lose its bloom pretty quick.

BRIAN: I felt like they always wanted me to be different at some point. Like, there would be a point where they'd be like, why don't you - why aren't you more like this? Why don't you do this? And it was like they weren't accepting of who I was. Like, I felt like they didn't even really know who I was. I mean, I probably didn't really know who I was (laughter). So it didn't help.

SPIEGEL: So you wanted someone who accepted you?

BRIAN: Yeah, at least on some level. I got tired of people dating me but then wanting someone else.

SPIEGEL: The problem, as far as Brian could tell, was his depression. He'd struggled with it since he was 7. Brian's biological father had left a month after he was born, and his single mother did her best. But he came to wonder if she sometimes saw his father's face in his own when she looked at him. He wasn't sure.

But in any case, he'd resigned himself to a loveless fate - until one day, while perusing Facebook, he happened across a picture of Megan. Years before, she'd dated this guy he knew. But apparently, she had recently moved to his hometown. In her Facebook picture, she had a friendly smile. So Brian went for it.

BRIAN: At the risk of being too random, I was just browsing the old F-book - very hip - and saw you live in Farmingdale. How'd that happen? Maybe we should hang out at Adventure Land together.

SPIEGEL: Megan replied right away. She'd dropped out of college because of her OCD and depression and moved in with her parents. So sure, she'd love to hang out. She was looking for friends in the area too. Brian was glad to hear it, but he didn't allow himself to get too excited.

BRIAN: I remember thinking, if she just wants to be friends, that's cool.

SPIEGEL: So on the night of the date, he played it low-key. It was summer, so he suggested that they take a walk down Main Street. Then after, they went back to his apartment to hang out. Fortunately for Brian, things went much better than expected.

BRIAN: When we got back, we started watching a movie. And she took my arm and put it around her. And I was like, OK, she doesn't want to just be friends. And that was - that was the beginning, there.

SPIEGEL: From that moment on, Brian and Megan were thick as thieves.

BRIAN: We would just make weird jokes. And just everything was funny. Like, one of the earliest memories was, like, I - (in funny voice) I'd do, like, voices like this. And we were watching the 2012 debate, and one of the questions was about deductions. And I was, like, (in funny voice) the deductions. And she - that became a running joke for years (laughter). So it was just, like, a lot of just hanging out and being silly. And it worked for us (laughter). So...

SPIEGEL: Well, that's beautiful.

BRIAN: Yeah.

(SOUNDBITE OF MUSIC)

SPIEGEL: The only issue - though it wasn't a big one - was that Megan wanted to get this operation for her OCD. Megan had a bad case of obsessive-compulsive disorder and depression, which meant that she had to do elaborate mental rituals that ate up hours of her time. For example, Megan was always, always late to dates by at least an hour because before she left her parents' house she had to check and recheck so many things.

BRIAN: I mean, sometimes it would be really bad. Like, if it was, like, 6 - and, like, I think once I was doing St. Patrick's Day dinner. And I think she was a good three hours late. Like, I think she was going to come at 6. She didn't get there until after - after 9. And I was hungry, so I was really annoyed (laughter).

SPIEGEL: There were other ways it expressed itself. Several times a week, she would make him stop talking and stand perfectly still so she could review a particularly taxing mental list. And then there was the way that her OCD made it so hard for her to read, which Brian could tell really bothered her.

BRIAN: She would get depressed sometimes, like, I can't read. Like, I - as soon as she started reading, she would just feel like what she read wasn't right or she missed something. So she'd have to go back and read it again. And, you know, it's not an enjoyable way to read a book, like, constantly reading every paragraph, like, 20 times.

SPIEGEL: But none of this was a real problem for Brian. In fact, Brian felt like her OCD made Megan less judgmental of his depression. So the idea that she was going to get this part of her changed, it worried Brian a little.

Like, were you worried that it would change her personality?

BRIAN: (Laughter). Actually, now that you mention it, my one worry was that she'd realize she was too good for me (laughter), and she would break up with me. (Laughter). I'd be like, oh, she's going to be like, wow, I can do all kinds of great things, and I don't need this jerk - find someone better. But I guess I'm pragmatic enough that I was like, well, if it happens, it happens. You know, if - because I felt like that would be more the real her, if it's taking away the mental illness. So if she doesn't love me without OCD, then she doesn't really love me.

(SOUNDBITE OF MUSIC)

SPIEGEL: Brian wanted Megan to love him. He loved Megan - loved her just as she was, the whole of her. But if she had a chance at greater happiness, of course he would help her do it, whatever was needed. So their relationship and what would happen to that, he'd just have to wait, see whether the Megan who came out on the other side of the operation was so different from the Megan that went in that she no longer saw or wanted him.

(SOUNDBITE OF MUSIC)

ROSIN: Part II - Megan.

SPIEGEL: Before Brian, Megan had a geographically small life. There was her bed and also the floor beside her bed, but that was pretty much it.

MEGAN: Before I dated him, that was pretty much where I lived, my bedroom. But we went out. And that's - that helped a lot.

SPIEGEL: Megan didn't want and hadn't always had such a limited existence. Until her first year of college, she'd been able to push past the constant demands of her OCD and her depression and live a reasonably active life. But then, during her freshman year, things fell apart. So she had to come home, live in the small circle by her bed.

It had all started when she was 10. That was when she started waking up in the morning with the overwhelming sense that something was not right and that she needed to mentally identify exactly what the not-right thing was before she could move on with her day.

MEGAN: It was mostly obsessions, obsessions about bad things I did in the past. And I was raised Catholic, so that didn't help. (Laughter).

SPIEGEL: There were just so many things to feel guilty about. She'd spend hours obsessing over the fact that she'd drunk part of her little brother's juice, then lied to her mother about it, or that she hadn't done her homework exactly right. And it wasn't just past behavior. She was also worried about all of the terrible things that would happen if, God forbid, she ever left her room.

MEGAN: I think a lot of people thought I was being lazy. But I was just avoiding a lot of pain that - it was painful to stay in my room. But it was more painful to leave because that's where I could affect the world. I could go - if I went for a drive, I could hit somebody, whereas if I stay in my room, I still have to do some compulsions. But at least I'm not going to hurt anybody. So...

SPIEGEL: So she stuck to her small patch of ground, stayed until she was so depressed that she had to go to a psychiatric ward, which didn't help, and another one, which also didn't help - and another. But nothing seemed to solve it.

MEGAN: Yeah, I was at my wit's end. I tried everything.

SPIEGEL: Which is why, at age 25, Megan decided it was time to cut out part of her brain. She'd happened across an article about this brain surgery called cingulotomy, where doctors removed just a small section - like a subtle facelift inside her skull. And she immediately called to get evaluated.

MEGAN: That's initially what I was - thought I was signing up for. And then when I went in, they said, well, we have this trial called deep brain stimulator.

SPIEGEL: The deep brain stimulation trial was for OCD. But changing the electrical patterns in her brain would probably also affect her depression, though the doctors couldn't promise it would work.

(SOUNDBITE OF MUSIC)

SPIEGEL: Still, the whole thing sounded really interesting. They'd insert the device deep in the pulp inside her head.

MEGAN: It's, like, these two chopstick-like things, and there's wires coming off them. And there's electrodes that stimulate the necessary parts of the brain.

SPIEGEL: To power the miniature chopstick things, they'd run a wire under her skin, down her neck, to some batteries which would be implanted near her collarbone. From the outside, you wouldn't be able to see a thing - no wires or protrusions, so no one would know. Plus, along with all of this invisible internal hardware, Megan would get a handheld device - kind of like a remote control for her brain that the doctors would program with different electrical settings.

MEGAN: I think three different ones to work from.

SPIEGEL: There's a higher level of electrical stimulation and a lower level. And then she could turn the whole thing off. So in a limited way, Megan would be able to adjust her moods, which seemed kind of cool.

MEGAN: It is cool (laughter).

SPIEGEL: As soon as Megan heard about all of this, she knew she wanted to do it. And since she was signing up for a medical trial, everything would be free. And so one day in 2013, she found herself sitting nervously in a thin hospital gown while a female nurse ran a buzzer over her scalp, and her hair fell like dead leaves around her.

MEGAN: I remember kind of wanting to cry a little bit.

(SOUNDBITE OF MUSIC)

SPIEGEL: After her head was bald as an egg, they wheeled her into the operating room and screwed her into position.

MEGAN: I remember sitting there with, like, a halo. They screw in this halo with screws in the side of your head. And it keeps your head in place. And you're kind of, like, sitting there - kind of like this, I think - forward.

SPIEGEL: Megan had to be awake during the procedure so they could test whether they'd found the exact right spot. But they pumped her full of drugs, so she didn't even mind when they took a saw to her skull. For a long time, she sat there as they worked - surrounded by people and yet far away.

(SOUNDBITE OF MUSIC)

UNIDENTIFIED PERSON #1: (Muffled voice) Wah, wah, wah, wah, wah (ph).

MEGAN: Most of the time, they sounded like the "Peanuts" adult - the teacher. Like, I didn't understand most of what they were saying.

(SOUNDBITE OF MUFFLED CROSSTALK)

MEGAN: And the next thing I remember was being asked questions like, how do you feel here?

(SOUNDBITE OF MUSIC)

MEGAN: I laughed involuntarily at some point. And they were, like, trying to get from me, like, why. And I'm like, I don't know, like (laughter).

UNIDENTIFIED PERSON #1: (Muffled voice) Wah, wah, wah, wah, wah, wah.

MEGAN: (Laughter).

UNIDENTIFIED PERSON #2: (Muffled voice) Wah, wah, wah, wah.

MEGAN: (Laughter).

(SOUNDBITE OF MUSIC)

ROSIN: Part III - Megan's doctor.

SPIEGEL: When Dr. Dougherty told people about his job, they invariably asked if he felt like a god. This was not at all how he thought about himself. But he had to admit it was amazing how the procedure could change people, the instant way electricity, carefully inserted into the brain through a thin piece of metal, could flip a whole mood.

DARIN DOUGHERTY: I remember one of our early patients - it might have been our first patient - I turned it on and started to stimulate. And the person was like, oh, my gosh, I feel so good. I don't feel depressed anymore. This is fantastic.

SPIEGEL: Standing over the man's open skull, looking down at the shining surface of his brain, Dr. Dougherty was just gobsmacked.

DOUGHERTY: Never seen such a thing (laughter). So it was pretty astounding, almost feels like a light switch.

SPIEGEL: It was the kind of impact that he'd hoped to have when he first studied neuroscience in medical school - an awe-inspiring power. It felt like he, Darin Dougherty, could erase emotional pain.

DOUGHERTY: I've had a patient who sat in her basement for 10 years, really couldn't get out of the house - mostly crying, feeling terrible. Her depression score on a scale called the MADRS was 44, which - you just have to take my word for it - is very high, and subsequently, went down to a two. She was completely asymptomatic. She goes out to the mall with her daughter, goes to family events and goes out to dinner. I mean, it's just been life-changing.

(SOUNDBITE OF MUSIC)

SPIEGEL: Of course, he didn't want to get ahead of himself. About a third of the OCD patients they'd implanted with the device had experienced no effect at all. And one of the biggest DBS depression trials in the U.S. was discontinued because they were having trouble demonstrating success and, also, two of the patients committed suicide. Still, the potential wasn't exactly hard to see. He believed deep in his heart that one day, people like him would be able to tinker with the brain with incredible specificity and, in the process, they'd relieve so many people, treat OCD, maybe depression. The idea was thrilling.

DOUGHERTY: But you also have to be careful because even though it is neurobiology, the brain is also the seat of who we are.

SPIEGEL: Who we are. The more he increased the electrical stimulation, the more he altered the person sitting in front of him, changed their brains electrical patterns and, therefore, their mood.

DOUGHERTY: What's your mood is like over a day-to-day basis - kind of your mood climate, as it were - would affect your entire experience of what - what life is like. So I think over time it has to impact how you perceive life, how you feel, how you enjoy it or don't.

SPIEGEL: But it wasn't just that. There were other real concerns. He didn't think about it all that much, but in the back of his mind, Dr. Dougherty knew that one day, DBS technology might be used not just on people like his patient Megan, who are very seriously ill, but other people.

DOUGHERTY: If you can move these things, what about enhancement?

SPIEGEL: Would doctors one day just dial in greater extroversion for people who felt too inhibited?

(SOUNDBITE OF ELECTRICAL CLICKING)

SPIEGEL: Better facility for art?

(SOUNDBITE OF ELECTRICAL CLICKING)

SPIEGEL: Would they set an electrical floor which meant that a person could never feel desperate unhappiness? There was no way to know. So do you think that one day people will just - this will be kind of metabolized by everyone, and it will seem perfectly normal in the same way that antidepressants now seem perfectly normal?

DOUGHERTY: I think so, yeah.

(SOUNDBITE OF MUSIC)

ROSIN: INVISIBILIA will be back in a minute.

(SOUNDBITE OF MUSIC)

ROSIN: Part IV - it's electric.

SPIEGEL: Everything seemed fine. After surgery, Megan slept for a bit then woke in her hospital room. She remembers going to the mirror to check herself out.

MEGAN: My head looked like a baseball (laughter) - a bloody baseball is what it looked like.

SPIEGEL: During the surgery, they tested the electricity some. But they hadn't left it on. They couldn't until she was fully healed. And she wasn't scheduled for activation until several months later. That was when she traveled to Boston so the doctors at Mass General could finally flip her switch and figure out the best level of electricity to give her.

She didn't think it was going to be a big deal. So she went by herself, and there wasn't much hubbub during the actual level setting. She just sat in a chair as the doctor dialed her electricity up and down. He started out really low. But when he got to 3 volts, Megan began to really respond.

MEGAN: It was a feeling of euphoria - like, not just an emotional sensation of, I feel so unburdened, but just a physical sensation, like, after, like, a really great massage and maybe a shot of bourbon, you know? Like, it was like a massage, a shot of bourbon and someone telling you you won a million bucks all wrapped in this one moment. And I was like, oh - it felt great. And remember I felt - I smelled - I had a - I smelled something that the only way I can describe it is chalk and chocolate mixed together.

SPIEGEL: Megan could barely contain her excitement.

MEGAN: Oh my gosh, leave it here because this is heaven.

SPIEGEL: So 3 volts is where the doctors left her, 3 out of a possible 10.5. The doctors explained that they still needed to watch her. They had no idea how the setting would affect her over time. So they asked her to stay at a hotel near the hospital and check in after a couple of days. Megan remembers walking out of the hospital feeling like a completely new person, like everything about her had suddenly changed.

MEGAN: Because, like, I - I'm a very shy person. So I found myself feeling more comfortable talking to strangers. Like, if I went to the store, you know, checking out with the cashier - you know, like, making little conversations wasn't hard for me anymore, and - which was an amazing thing because normally, I was so caught up in my own obsessions, I just didn't have the ability to do that.

But I just felt so much freer, like someone spring-cleaned out my brain and took out all the unnecessary thoughts. And it's so spacious in there. And I wanted to fill it up with all this good stuff, you know? I really thought that day that OCD was in the past. Like, I was never going to have to deal with it again.

(SOUNDBITE OF MUSIC)

SPIEGEL: And the first day was great, but...

MEGAN: But I couldn't sleep that night. And then the next day, I was up all day. I was like, wow. That's weird. I like my sleep.

SPIEGEL: Still, the day was pleasant. It felt incredible simply being in her hotel room.

And what did you do in your hotel - read?

MEGAN: Read, watch TV, dance, even. Like - (laughter) yeah. I was...

SPIEGEL: Really?

MEGAN: Yeah, I danced to music. I was - felt really energetic. And I was kind of frustrated that I was stuck in this place where I didn't know anyone. It was, like, the first time in a very long time I actually wanted to go out and do something.

SPIEGEL: But then the next night, she didn't sleep again. And the following morning, things started to go downhill.

MEGAN: It was an awful - that's when it started to, like, become a bad thing. I - my mind started to race a lot. And...

SPIEGEL: And for some reason, she suddenly felt the need to constantly push at the world around her - physically push at it, using the weight of her body to move it away from herself.

MEGAN: Pushing my hands and legs against the floor and the wall. Like, I just need to get some tension out.

(SOUNDBITE OF MUSIC)

SPIEGEL: When she got to the hospital the next day, her doctors told her she'd had a submanic episode. And they had to turn her off, like, completely and totally off.

MEGAN: So I, actually, left with nothing because they - I had - they had to settle - because they - I had such a intense reaction. They wanted to kind of let me kind of go back to normal and then start lower, you know? And I remember feeling very deflated because I was like - they took something so wonderful away from me. And I thought this was just a fluke. I'm never going to feel like that again.

(SOUNDBITE OF MUSIC)

ROSIN: Part V - failure.

SPIEGEL: It was about a month before they could turn Megan back on. And when they did, they set it so low - .5 - that Megan couldn't feel a thing. It was incredibly frustrating, but the doctors counseled her to be patient. They just needed to get her brain acclimated so she wouldn't go manic again. A few months later, they raised her electricity but just a tiny bit - 1.5. So it was still too low to make much of a difference. And Brian started to get worried. He could tell Megan was descending into depression. Everything about her slowed down. She was like a zombie.

BRIAN: Very flat affect, you know? - saying as much as I have to. And it's not even like, get out of here. It's more of just, like, silence.

SPIEGEL: Since Brian was intimate with depression himself, he knew he shouldn't take it too personally. But he couldn't help it.

BRIAN: It's almost - it made me anxious, like, being around her because, like, I couldn't be myself because I just feel like I'm annoying her.

SPIEGEL: For Megan, though, the problem wasn't Brian. The problem was her. It felt like she would be trapped in OCD forever. And she just couldn't take it. In her lowest moments, she says she started thinking about suicide.

MEGAN: Just thinking about, what's the point of all this struggle, you know?

SPIEGEL: A month passed and then another and another. And so about half a year after her original operation, with her settings still at the low level of 1.5, Megan decided that it wasn't fair to Brian. She told him she wanted to break up.

BRIAN: Like she was holding me down, like her problems, like, was going to ruin me. And she felt bad that I had to put up with her, and she was - she talked about, like, fear, like fear of not being good enough for me. So...

(SOUNDBITE OF MUSIC)

SPIEGEL: Brian was devastated. They seemed so right for each other. But on another level, it felt familiar. This, after all, was the way his romantic relationships always ended. So Brian decided to try to suppress thoughts of Megan - all the memories of them sitting together on the couch, watching random things on the Internet, talking nonsense and laughing too hard at stuff that didn't matter.

(SOUNDBITE OF MUSIC)

ROSIN: INVISIBILIA will be back in a moment.

(SOUNDBITE OF MUSIC)

ROSIN: Part VI - success.

SPIEGEL: Brian's mother died. That's how they started talking again. He and Megan had hardly spoken at all since the breakup. It was complete radio silence for three months. But then his mother died, and Megan saw a notification about it on Facebook. So while he was back in Florida making funeral arrangements, Megan let herself into his apartment and left him a present. She didn't like the thought of the hurt he was feeling, of him totally alone.

But Megan's levels were still so low that even though it was on, the device was having no real effect. And in the fall, she was hit with a devastating depression. So she decided it was best for them just to remain friends. Brian would still help with some things, stuff like doctors' visits, like the one Megan had in the winter of 2015 at Mount Sinai in New York.

MEGAN: I remember it was really, really cold, like to the point of, like, your skin feels like it's peeling off. And that did not make it any better because I remember my OCD was really bad. The depression was bad. And, you know, you're standing in the subway. It was freezing.

SPIEGEL: Brian, as usual, was trying to be funny to lighten the mood. But they got really lost trying to find the right hospital building.

MEGAN: So when - by the time we get in the building, I am just in a bad, bad mood. And I just burst out crying in the psychiatrist's office, saying, I have thoughts of suicide. I wish I was dead.

SPIEGEL: The psychiatrist, naturally, seemed alarmed and told Megan that in light of her condition, they'd definitely give her a substantial increase.

MEGAN: We just want you to stop feeling this bad.

SPIEGEL: Megan remembers sitting quietly as he dialed her up.

MEGAN: Up to two, 2.5, three, four.

(SOUNDBITE OF MUSIC)

SPIEGEL: The instant Megan walked back into the waiting room, Brian knew something was up. The Megan who came out was just a million miles away from the Megan who'd walked in.

BRIAN: The way she walked, her face - she was like a new person.

SPIEGEL: There was a confidence and excitement about Megan that was obvious. She was a bright-eyed woman, comfortable in her own skin and full of good cheer.

BRIAN: And I remember being like, wow. Like, (laughter) that's great. Like, she went from, like, completely like a zombie to, like, hey. What's up? And I was like, oh.

MEGAN: I remember thinking in the back my head, you know - I'm like, if this was off, I'd be horrified at this. The idea that something like this could - that something like this is inside me - like, part of me is like, this is kind of creepy. This - I should be kind of creeped out that I went from feeling suicidal to not because someone's fiddling with a button and controlling electrodes in my brain. Like - but at the same time, I'm like, well, thank God I live in this day and age. Like, that was the best day.

(SOUNDBITE OF MUSIC)

SPIEGEL: Megan had been instantly transformed. And in the weeks and months that followed, it became clear to Brian that this Megan really was different from the old Megan. For example, old Megan's routine extreme lateness...

BRIAN: That hasn't really happened that I can remember that she'd be late.

SPIEGEL: Same with her need to have Brian stop and stand silent for minutes at a time.

BRIAN: Yeah. No, she doesn't do that anymore. That - it stopped that.

SPIEGEL: Also, Megan was finally able to read again with ease. In fact, she'd started work on a novel.

So now she's not just reading, she's writing.

BRIAN: Yeah. It's a big change.

(SOUNDBITE OF MUSIC)

SPIEGEL: It was amazing. But best of all, even after four volts gave Megan a new freedom, she still seemed to love Brian, which is why, in the spring of 2017, Brian gave her a ring - the culmination of their love affair. He'd first popped the question at the home of Megan's favorite writer - Louisa May Alcott.

BRIAN: And I know I put on a funny voice because that's what I do when I'm nervous is act silly. So I think I was like (imitating Southern accent) ma'am, will you do me the honor of being my wife?

(SOUNDBITE OF MUSIC)

SPIEGEL: Megan, of course, said yes.

(SOUNDBITE OF MUSIC)

BRIAN: OK.

MEGAN: Hey, Brian.

BRIAN: Hello.

(SOUNDBITE OF DOG BARKING)

MEGAN: So that's my dog, Koko - Koko with two Ks. We named her after Koko the gorilla, who passed away on the day that we decided to get her.

SPIEGEL: So let's start with the good news. Brian and Megan live in a small apartment in the back of a house outside Boston. Because they have Koko, Megan keeps the remote control to her brain in the top drawer of her bureau. Once, Koko got a hold of one of the remote's battery chargers and chewed it into oblivion. That was a mess.

MEGAN: Hey, Koko, what do you think about the DBS? What do you think?

(SOUNDBITE OF DOG BARKING)

MEGAN: It's good?

(SOUNDBITE OF DOG BARKING)

MEGAN: Good. I'm glad to hear that.

(SOUNDBITE OF MUSIC)

SPIEGEL: It's a very sweet scene, but it took them a long time to get here - five years, from 2013 to 2018, of struggle with the technology, struggle like the moment that you heard at the very top of our story. But right now, anyway, Megan feels a million miles away from those difficulties. She has a job. She works at an environmental startup, and she loves it. They even give a yearly bonus. And the idea of a bonus fills her with joy. She never thought she would live a bonused life.

MEGAN: I like to say I'm cured just because of where I was. It was awful. Like - and even though I still have OCD, it's just not - it's nothing to complain about.

SPIEGEL: And the device in her brain didn't just help her OCD. It substantially changed her mood. As long as the device is on, Megan isn't capable of being depressed in the same way that she was before. Some people might be bothered by that idea, feel an unease on some existential level. But Megan doesn't. She's never found herself asking, who am I now? From the very first day that she was dialed up to four, that was clear to her.

MEGAN: My answer was, this is me - the happy me. This is me. And the other - before this was on, this - that was me being sick 'cause depression is an illness. And so it's like, are you still you after you don't have a cold anymore? Yes. You're not yourself, are you? So I think of it that way.

SPIEGEL: So you didn't have, like, a kind of broader crisis.

MEGAN: No, I felt too happy for one of those (laughter). I was just too excited about not having OCD. I was like, I don't care what's doing it. I don't care (laughter).

(SOUNDBITE OF MUSIC)

SPIEGEL: But then there's the less good news, which is that this life that Megan and Brian have built for themselves, it may or may not last. This has to do with Megan's levels. The highest amount of electricity that you can feed from the device to the brain before it begins to damage tissue is 10.5 volts. And since 2013, when Megan first got her implant, the doctors have been slowly pushing her levels up from 0.5 to 4 and onward. She's now at 6 on one side and 7 on the other.

So in the space of roughly six years, she's more than halfway to the maximum. And since she's only in her 30s, that's something she worries about and why Megan tries to make each setting last as long as she possibly can.

MEGAN: 'Cause you don't want to waste it. You don't want to, like, go higher than you need to in order to feel like you're getting the therapy, otherwise - 'cause it only goes so high. And you don't want to acclimate to a level when you don't have to.

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SPIEGEL: In other words, the clock is ticking. Megan knows it. And Brian knows that Megan knows it.

BRIAN: I think there's that fear in her that she's going to hit the limit where it's like, we can't turn you up anymore. So I think maybe there's part of her that's like, I better take my time. Like, I was just turned up this year, maybe I should give it more time.

SPIEGEL: Of course, doctors can't be sure how this will all work out. If Megan runs out of electricity, she could regress. According to one expert, she could even end up feeling worse than she was before because her brain will need a higher level of electricity just to function. But that's not absolutely certain.

It's possible that they'll invent their way out of this problem. But for now, Megan is just going about her life - a woman married to a man who loves her, who has a job and an existence that's gotten so busy that the fact that she has an implant has started to fade into the background.

MEGAN: Kind of so used to it now, it doesn't seem as amazing as it did then. Now it's, like, just a part of me.

SPIEGEL: It's interesting even that for you, it doesn't feel that interesting.

MEGAN: Yeah, it's amazing what you get used to. I mean, I never thought I could get used to some - these batteries in my chest. But after a few weeks, I kind of forgot they're there. And yeah, I don't think - I hardly ever think about it. It's not even a weird thing to me anymore. But I guess it is 'cause you're doing the interview (laughter).

(SOUNDBITE OF MUSIC)

SPIEGEL: I'm doing this interview because Megan's experience is interesting but also because ultimately, the device in her head isn't just about her. That's just where this story starts. It's about all of us because the device, it could change a lot of things, like how we think about happiness and mood.

The military is aggressively pursuing these technologies. And in fact, DARPA - the arm of the Defense Department that developed the prototype for the Internet - has funded advances even since Megan's stimulator was put in six years ago. There are no more chopsticks. They've been replaced by something called the Octopus - a network of neural implants that snake around the brain. The Octopus has a bunch of new features, like now the electrodes both stimulate and record. The military is looking to use it on veterans, maybe to eliminate PTSD, maybe some other stuff.

And I've been told that it's possible - in fact, very, very likely - that one day, this technology will be more broadly available, and ultimately, will be used to enhance people not just treat them. What isn't clear is whether these kinds of enhancements will ultimately create inequity between people who can afford implants and people who can't. I've talked to scientists who are absolutely sure that it will. So there are still a lot of questions.

How would you feel if they said - like, if they said, no, we're not going to give this to you anymore and you can't - like, how would that affect...

MEGAN: I don't know what I'd do. I - I'd hit even - a worse depression than ever 'cause it's - I know - 'cause, like, I've been on this for a while now. So it would be even worse than before 'cause before I didn't even know what I was missing. I didn't know that this was going to work. So just knowing that there's something out there that could make it go away and they're not giving it to me, that would be terrible. Like, I don't know what I'd do.

(SOUNDBITE OF MUSIC)

SPIEGEL: When I was talking to Megan, this thing happened. She was showing me her remote. And by mistake, it got turned off.

MEGAN: Oh, I'm off now. And I feel it.

SPIEGEL: Really, like, as soon as you turn it off?

MEGAN: Yeah, I mean, it might be the fact that - yeah, I just feel icky. It's all - a sudden feeling of dread. It's hard to describe 'cause it's - I know it's not - nothing's changed around here. It's not like, all of a sudden, there's a fire or anything. So it's hard to pinpoint why I feel that way because nothing's changed. And now all of a sudden, I just feel like I've committed murder, you know? That's what it feels like.

SPIEGEL: The walls were closing in, so Megan pushed a button on her device and the electricity flooded back. She could feel the muscles in her neck relax. It felt good.

(SOUNDBITE OF JONATHAN BARLOW'S "I REMEMBER THIS PLACE")

ROSIN: That's Alix Spiegel.

(SOUNDBITE OF JONATHAN BARLOW'S "I REMEMBER THIS PLACE")

ROSIN: Stick around for a preview of next week's INVISIBILIA.

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ROSIN: Next week on INVISIBILIA, Elle (ph) dated mostly white guys and never thought much about it until one day, when someone on the Internet took her to task.

ELLE: I was just like, oh, like, I think you're mistaken. Like, oh, no - like, I'm not racist. I said, I'm open-minded to dating other people.

ROSIN: But the comment got her thinking, watching her own behavior - like how she navigated Tinder.

ELLE: I was literally giving white faces a chance that I was not giving black and Latinx faces.

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ROSIN: Next week on INVISIBILIA, one woman's quest to get rid of her racial preferences. Can you change who you're attracted to? And should you even try?

(SOUNDBITE OF JONATHAN BARLOW'S "OVER OCEANS")

SPIEGEL: INVISIBILIA is hosted by me, Alix Spiegel.

ROSIN: And me, Hanna Rosin.

SPIEGEL: Our show is edited by Anne Gudenkauf. Our executive producer is Cara Tallo. INVISIBILIA is produced by Yowei Shaw and Abby Wendle.

ROSIN: With help from B.A. Parker and Liza Yeager. Our project manager is Liana Simstrom.

SPIEGEL: We had help from Jake Arlow, Julie Carli, David Guthertz, Taylor Haney.

ROSIN: And Leena Sanzgiri.

SPIEGEL: Fact-checking by Sarah Knight and William Brennan (ph). Our technical director is Andy Huether. And our vice president of programming is Anya Grundmann.

ROSIN: Special thanks to Mark Memmott, Michael Ratner (ph), Emily Bogle, Chris Benderev, Daniella Cheslow, Jon Hamilton, Jacqueline Haber (ph), J.C. Howard, Damon Lindelof, Lawrence Carter-Long, Joe Shapiro, and Jennifer Weaver (ph).

SPIEGEL: And to Jonathan Barlow for his songs "Fadeless," "I Remember This Place," and "Over Oceans," and Gary Grundei for his song, "Pain" (ph). Additional music for this episode provided by Ramtin Arablouei and Blue Dot Sessions.

ROSIN: And now for a moment of non-Zen.

SPIEGEL: Hey. Hey there - all right, wait a second - hey. Just kidding.

(SOUNDBITE OF JONATHAN BARLOW'S "OVER OCEANS")

ROSIN: To see an original illustration for this episode by Christina Chung, visit npr.org/invisibilia.

(SOUNDBITE OF JONATHAN BARLOW'S "OVER OCEANS")

SPIEGEL: If you or anybody you know might need help, the National Suicide Prevention Lifeline is available 24/7 at 1-800-273-8255 or at suicidepreventionlifeline.org.

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