Anthony Luciano had always had a tendency to get depressed, but a family crisis nearly 30 years ago sent him over the edge.

A dispute with his daughter temporarily broke up his family, and Mr. Luciano, of Altoona, Blair County, began to suffer from chronic, debilitating depression.

Over the next three decades, the bakery manager took a raft of antidepressant medications, was admitted to mental hospitals five or six times and underwent 30 to 40 electroshock treatments.

Nothing the doctors did gave him any feeling of hope or energy until last summer when surgeons at UPMC drilled two holes in his skull, inserted a pair of electrodes, and turned on the current.

The experimental surgery, known as deep brain stimulation, operates on the premise that a small, steady voltage applied to the electrodes can quiet the "sadness center" that is hyperactive in people with chronic depression.

"I noticed a difference the first time they tested it" a month after the surgery, Mr. Luciano, now 65, recalled last week. "I felt on top of the world, and everybody saw it. Everybody at home noticed the difference, too."

While the surgery may sound excruciating, it is actually relatively painless. Patients are lightly sedated while doctors inject local anesthetic before making incisions in the scalp and drilling dime-sized holes in the skull.

Because the brain has no pain sensors, the insertion of electrodes to a spot roughly behind the eyebrows, and their ongoing presence in the brain, don't cause distress. From the skull, wires snake down beneath the scalp and neck to twin battery packs under the skin on either side of the chest. Doctors can adjust the settings by remote control.

Five months after the operation, Mr. Luciano said he didn't really notice the equipment.

Led by neurosurgeon Douglas Kondziolka and psychiatrist Robert Howland, UPMC has done the DBS surgery on four patients, with a fifth scheduled soon, as part of a multicenter trial of the procedure in about 30 depressed patients. Half of them will have their devices turned on for four months, while the other half will not have theirs turned on until after that period.

The trial is designed to test whether the procedure is safe and has a measurable benefit for those whose devices are activated. If the federal Food and Drug Administration approves, the experiment, using equipment manufactured by Medtronic Inc., will be expanded to hundreds of patients nationally, Dr. Kondziolka said.

A parallel trial is under way at other hospitals using equipment made by Advanced Neuromodulation Systems and aiming at a slightly different target in the brain.

The DBS equipment has a proven track record. It has been used on more than 30,000 American patients with Parkinson's disease or other movement disorders, quieting areas in their brains that cause the tremors, rigidity and jerking that are part of those conditions.

Even though the electrodes are providing extra current to small zones in the brain, it seems that they are actually dampening or evening out brain activity in those areas.

"In some of the depression studies that have been done, they have found these cells are overactive," Dr. Kondziolka said, "and it's thought that the DBS is calming them down, preventing them from firing."

Both Dr. Kondziolka and Dr. Howland acknowledged they have a public relations challenge in doing brain surgery on people with mental illness because of the sordid history of lobotomies, a crude operation in which an ice pick or other instrument was used to separate the frontal lobes from the rest of the brain. There are at least three major differences between those early surgeries and DBS, the two said.

First, the patients are volunteers and often eager ones. As Mr. Luciano put it, "Some people have told me, 'Boy, you must be crazy to try something like this,' but I say I've been suffering from depression for 30 years, and I've got to try something to get better because I can't live like this the rest of my life."

Of the estimated 15 million American adults with major depression, nearly 3 million of them are resistant to any standard therapy.

"When people have failed three or four types of treatment," Dr. Kondziolka added, "the chances that they will improve become extremely low, so their lives are severely compromised by depression."

The second difference with DBS, the doctors said, is that it's much more precise, aimed at small areas of the brain that previous research has shown are involved in the disorders.

Finally, it is reversible. The current can be adjusted or even turned off, they said.

Still, doctors don't understand how DBS works at the biomolecular level, and that makes even its proponents cautious about how fast to move in using it for mental illnesses.

Mahlon DeLong, a DBS pioneer at Emory University School of Medicine in Atlanta, wrote last year that even though the surgery is well proven for treating movement disorders, when it comes to psychiatric ailments, all need to ask, "how can scientists, medical professionals and the public balance the desire for scientific progress and the need to protect patients from undue risks? In spite of intense pressure for widespread use of DBS, pilot studies and subsequent well planned, large clinical trials must take place first."

Dr. Howland agreed. "I think historically, brain surgery in psychiatry has had a very bad reputation and deservedly so," he said. "So we exercise a lot of caution to avoid a lot of the controversy and problems that occurred with prior surgeries."

To make sure the electrodes are being put in the right place and not causing such unwanted side effects as changing the sense of smell and taste, patients must be awakened during surgery so they can report their reactions.

During one operation in late September, a patient from rural Pennsylvania was brought back to full consciousness after each electrode was inserted and asked to rate his mood, energy level and how anxious he was.

The patient, who asked not to be identified, said he didn't feel much change when doctors tried different settings on each electrode. Often spacing his answers out over several seconds, the man typically said, "No ... uh ... I feel about the same."

But a month later, when both electrodes were activated simultaneously during an office visit, the patient became much more talkative. Dr. Kondziolka said. "I've never seen him that animated."

In some cases, the doctors said, they've even had to turn down the voltage to keep patients from becoming too manic.

Once doctors individualize the settings for each person, the patients come back in for one more office visit, where they are put in either the active or the "sham" group. To keep the patients from knowing which group they're in, the doctor does the same testing on each person, but the voltage is never switched on for those in the sham group.

DBS is being tried on people with two other disorders: Tourette syndrome, which causes involuntary movements and vocalizations; and obsessive-compulsive disorder, or OCD, which leads to anxious, repetitive behaviors like hand washing or constantly checking whether doors are locked.

There has even been some early work on using DBS for people with morbid obesity, threading the electrodes into the part of the hypothalamus that helps control appetite.

Mr. Luciano won't know until next month which group of patients he has been in. But he doesn't feel as upbeat as he did when the device was tested last year, so he is eager to get past the study period, when he knows for sure that the voltage will be on.

His goal: ending years of lethargy, negative thoughts and trips to psychiatric wards, which eventually forced him onto the disability rolls.

"I have hope I can do stuff around the house more frequently and take care of the family a little better and pay attention to my wife a little more -- and she'll be glad about that."

But the change he has already felt is much more profound than those statements might suggest.

The mood change he felt after his device was tested meant "I wasn't thinking about suicide anymore. I wasn't telling myself there isn't any sense in living anymore."

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