Posts

Can neurofeedback be a “Nudge” to a Stuck Nervous System Due to Early Life Stress?

Growing up in a single-mother household created a lot of stress and fear that stayed with me even as an adult.  Such a household dynamic brings a greater risk of poverty, which creates challenges in securing a safe place to live and putting food on the table on a consistent basis.  Fear in childhood from stressful experiences can change the trajectory of a person’s health over the entire life span if not addressed, specifically an elevated vulnerability to addiction in all of its forms.  Now, with the advent of the pandemic, we might need to add this to the long list of stressors that children struggle to adapt to as it might be years before the impact and lingering effects of the fear and isolation it has caused to be fully understood.  Is it possible that neurofeedback might be able to “nudge” the fearful nervous system back in the direction of health?

What we have learned about adverse childhood experiences and the traumatizing effects of such, is that talking about it may not be enough to move through the fear and calm the emotional centers of the brain.  More is needed and not everyone is willing to tolerate the side-effects of prescription medication, such as suicidal thoughts.  Therefore, research into alternative and complementary non-invasive, non-medication treatments, such as yoga and neurofeedback, has increased over the past couple of decades, with very promising results.

A recent review focused on neurofeedback to determine if it might help move the autonomic nervous system away from fear toward homeostatic equilibrium in people who experienced early life stress.  The researchers conclude that neurofeedback can increase the efficacy of other training protocols and more traditional talk therapy techniques.

Is direct neurofeedback a viable non-drug treatment option for ADHD?

As the most common neurodevelopmental disorder, Attention-deficit hyperactivity disorder impacts an estimated 11% of children in school, with symptoms of inattention, hyperactivity, impulsivity and various cognitive dysfunctions often persisting into adolescence and adulthood.  And thanks to modern neuroimaging technology, relatively distinct brain regions within the prefrontal cortex have been identified as having altered activity, accounting for the symptoms of ADHD.  These disturbances in the networks of the brain have begun to come under further study when considering therapeutic interventions.  Transcranial direct current stimulation (tDCS), aka direct neurofeedback, has shown promising effectiveness in both neuropsychological and neurodevelopmental disorders, especially ADHD.

Symptoms of inattention or being easily distracted is very common, as it is the mind’s natural tendency or default mode.  It is actually wired for continuous distraction and a culture that values multi-tasking reinforces this wiring.  Mindfulness, or the practice of narrowing our focus to a single-task or giving our undivided attention to the task at hand, is one way to train the mind to ‘pay attention’.  However, this is sometimes easier said than actually done.

Now add trauma to this default mode of distraction.  When the mind is overwhelmed by strong, and often uncomfortable emotions, the use of the natural, default distraction wiring of our brains can actually be of benefit as it provides relief from those emotions, albeit temporary, brief and fleeting.  In fact, using conscious distraction techniques can actually keep us be safe from harm in the moment by moving us away from more unhealthy reactions to such powerful emotions, such as self-harming thoughts and behaviors including substance use.

The go-to approach to ADHD has been medication and behavioral modification therapy, yet the lack of long-term effects for both has been disappointing to those who suffer from the symptoms of this neurodevelopmental disorder.  Such lack of long-term effects has generated renewed interest in neurofeedback in recent years as a promising method for improving neuropsychological and cognitive deficits in ADHD.  Although more research may be required to determine the length of initial treatment along with the need for ongoing intermittent treatment to assess how long the benefits last, this non-invasive brain wave modulation intervention may just be a better approach while eliminating any medication side-effects!

If you would like to read more about the current state of the research on using direct neurofeedback for ADHD, click the link below:

Might transcranial direct current stimulation (aka direct neurofeedback) be an additional tool to reduce symptoms of depression as a result of the impact of the pandemic?

If there is one silver lining to this pandemic it is the blossoming realization and acceptance of the fact that people need people!  It is shining a light on the cultural ideal of independence and reflecting the shadow side of such an ideal.  Human beings were designed to be interdependent, using relationships within their tribes and communities to grow and thrive.  If independence was truly the healthy ideal, why aren’t more people thriving during this pandemic?

Use this time to reflect on the lessons being brought forward to us.  If we embrace the fact that we need each other – and that it makes us feel good to help each other – than perhaps we can learn to be at ease with asking for help and support when we need it, knowing it will deepen our connections with others and make others feel good about themselves.  What brings hope during these unexpected – and let’s just own it – scary times is collaboration and comradery.  Knowing we are not alone – in our experiences, thoughts, and emotions – and that if we just have the courage to reach out, we will find relief.

Action is actually an antidote to fear.  So, although the mind says withdraw, let the body lean in and reach out a hand – to call a friend, to pet an animal, to throw and catch a ball with a child and best of all to give and receive a hug with a loved one.  You might even try your hand at writing, perhaps a letter or poem, to someone you care about and are unable to see in person at this time.  Letting them know you are thinking about them and care about them might forever change their world in that immediate moment.

All of these acts of connection soothe the mind’s sense of disconnection.  As neuroscience is demonstrating, our brains are wired for connection and, when we begin to experience disconnection, symptoms like depression start to develop.  And the current pandemic conditions are only exacerbating any pre-existing sense of disconnection.  Therefore, we need more tools that support the brain’s innate ability to reorganize towards health, beyond medications that bring so many unwanted side-effects.  We need tools that reduce the fear signals in the brain so that action becomes more of an option when depressive symptoms loom.

Well, such a tool exists and a recent systematic review and meta-analysis of the research reflects that this tool is effective in the treatment of depression.  Prior to this review, the results were mixed.  However, now enough randomized clinical trials have been conducted and the cumulative data reflect that direct neurofeedback has achieved superior response and remission rates, warranting further large-scale clinical trials!

This information is vital as we continue to move through this pandemic and beyond.  The lasting effects of the physical distancing required for our immediate physical health are still unknown at this time, yet history informs us that the psychological wounds may be deep.  Acknowledging that symptoms of depression may be arising, whether within our own experience or witnessing it in others, helps to anticipate support might be needed along the healing path.  Knowing about the treatment options facilitates choice throughout the journey.

To read more about this research click on the link below:

Is direct neurofeedback safe and effective for depression when pregnant?

I believe most of us want to do what is best for our health, such as eating well, exercising, getting enough sleep and staying connected with friends and family and I imagine maintaining our health and wellbeing takes another step up on our list of priorities when we think about getting (or are) pregnant.  If we smoke, we might consider stopping.  If we drink alcohol, we again might consider stopping.  However, if we experience a mood imbalance (think anxious and/or depressive symptoms), do we consider stopping any medications we are taking that are currently supporting our experience of more balance in our moods?  And what happens if we begin to experience some of these symptoms for the first time during our pregnancy, do we consider taking medications while pregnant or try to tough it out?

It is not uncommon for physicians to encourage women to stop such mood management medications as the side effects can be premature birth and low birth weight, similar to the impacts of smoking and drinking during pregnancy.  Where does this leave moms-to-be that are either taking such medications or might experience antenatal anxiety and/or depression?  There is research that shows babies have higher levels of the stress hormone cortisol when moms experience untreated depression, which increases the risk of that baby developing anxiety, depression, and other mental and behavioral challenges later in life.  So it is well known that depression in pregnancy negatively affects both mom’s and her baby’s health, so is there any other option?

A recent pilot randomized controlled research trial shows hope for a non-invasive, non-medication brain stimulation treatment option, specifically transcranial direct current stimulation (tDCS), also referred to as direct neurofeedback.  The results of this trial reflect the feasibility and acceptability of such an option along with encouraging preliminary effectiveness and no serious adverse (i.e., side) effects in this under-treated population.  The effects even lasted a month after delivery!  The results of this pilot study supported the next step to a definitive random controlled trial to evaluate tDCS for antenatal depression.

If you might be interested in reading more about this treatment option, either for yourself or someone you know that is struggling with such a decision, please click on the link below to learn more:

Can Stimulating the Prefrontal Cortex Calm the Default Human Survival Flight/Fight Response?

When humans encounter situations that they perceive as threatening, the parts of the brain responsible for our survival (i.e., amygdala, hippocampus) kick in to determine if running away from the threat is possible, to fight if not, and if neither is possible to stand still, hold our breath to be quiet and ultimately faint.  This flight/fight/freeze/faint response is not only the default position of our brains, it can be so activated over time from trauma and stress that it stays turned on even when we are not in harm’s way.

As someone that grew up in a home that would now be described as chaotic, I found myself in a series of situations that I either ran away from or fought, with a few where I found myself frozen in fear.  As a young child we don’t understand how these experiences are effecting our development, we just do what we have to – anything to survive.  As a young adult, I began to sense the amount of pressure I held in my body and used that energy to drive myself forward, sometimes to the point of exhaustion.

Through several years of psychotherapy, I discovered that the survival response in my brain, when activated (which happened to be most of the time), reduced my access to the parts of my brain that helped me to focus and communicate.  I subsequently learned that this is referred to as ‘amygdala hijacking’ and I describe it as the amygdala literally turning off the light switch leaving it in the dark to fend for itself without being able to see that there is access to support, specifically the prefrontal cortex.  And when you can’t access this part of the brain on a consistent basis, it loses its ability to offer a more balanced perspective of life.  Remember that saying “If you don’t use it, you lose it”, well it applies here too.

When I discovered yoga, I found a way to keep these two parts of my brain connected and when I did, it reduced the level of anxiety in the moment and began to strengthen the bridge that allows space to response, instead of react.  One of the most powerful tools that I learned from my time on the yoga mat was deep belly breathing, which was the first tool that I took off of the mat and into my everyday experiences.

Research has shown that practicing such breath techniques has neurophysiological impacts through respiratory vagus nerve stimulation.  The vagus nerve is the main part of our parasympathetic autonomic nervous system that is responsible for rest and digest processes and when stimulated is closely associated with emotional balance, mental flexibility, empathy and attachment.  It does this through decreasing hippocampal activity among other things, reducing the reactivity in the fear center of our brain, making access to the prefrontal cortex easier.  Now, what I have to admit is that I practiced such breath techniques for years until I began to consistently experience the emotional balance I so craved.  So, from personal experience I know it works, yet it can take time.

So how excited was I when I read the recent research in the Journal of the American Medical Association (JAMA) Psychiatry that looked at this bridge from a different perspective – stimulating the prefrontal cortex in order to allow it to stay online and calm the fear center of the brain when experiencing threatening circumstances, reducing anxiety.  This research looked at the effects of transcranial direct current stimulation, such as used in direct neurofeedback, of the prefrontal cortex on amygdala threat activity in people who experience chronic anxiety.  Neuroimaging was used to assess the impact and the results reveal a direct connection between the ability of the prefrontal cortex to regulate the fear response in the amygdala.  These findings offer more support to the neurocognitive mechanism contributing to the positive effects of direct neurofeedback and offer much hope to more directly and quickly reduce anxiety through such a non-pharmaceutical treatment option.

The Stigma of Stuttering – Can Direct Neurofeedback Improve Speech Fluency?

If you know – or have ever known – someone that struggles or struggled with stuttering, then you most likely are aware of how physically and mentally exhausting it can be for them to communicate as they attempt to control the disruptions in their speech caused by this neurodevelopmental condition.  And when we realize that this condition typically begins before the age of 6 and impacts about 5% of preschool children, then I’m sure that most of us can imagine how children might develop additional mental and emotional challenges, such as anxiety, embarrassment, shame and low self-esteem, that most likely will have a significant impact on how they experience life as they grow up.

The good news is that many children outgrow this condition as their brains continue to develop.  With the help of speech therapy, many others will be able to learn how to slow down their speech enough to manage the disruptions.  However, some (approximately 1%) will continue to stutter for a lifetime.  Research focused on these adults is beginning to show changes in the actual structures of the brain when compared to adults without this neurodevelopmental condition.  This is great news as it allows for exploration of treatments known to impact those brain structures.

Once such treatment, direct neurostimulation is beginning to gain some traction in the realm of research on stuttering.  There may be variations in the neurostimulation technique; however, the treatment is non-invasive and includes the delivery of direct, low-intensity electrical currents to the scalp.  If the intensity of the electrical current is higher, it will work to change the neurons (stimulating or reducing neural firing), while lower intensity currents will work with the brainwaves, specifically disrupting dysfunctional brainwaves patterns and supporting the brain’s innate ability to organize and regulate itself.  Either way, these treatments that gently work to stimulate the brain directly are bringing hope to those who continue to be challenged by this condition into adulthood.

So, if you, a loved one or someone else you know is part of the 1% of the adult population still dealing with this neurodevelopmental condition, consider reading the recent research by clicking on the link below:

Might direct neurofeedback be worth a try?

I’m a big believer in our innate ability to heal ourselves, the power of the human body and mind to continually work together towards homeostasis and health.  I also have personally experienced the chaos created in both by trauma, challenging my body and mind to maintain that state of equilibrium and well-being.  Through my own healing journey, I have discovered tools along the way that have worked to reinforce that innate ability to heal and feel sense of encouragement when the research supports personal experience.  Direct neurofeedback is one of those tools.

Trauma comes in all shapes and sizes, whether you experienced abuse or neglect as a child, grew up on a home with one or both parents suffering from a mental illness or addiction, or were a witness to domestic violence while living with adults or going through a contentious divorce.  The enduring nature of the trauma from such interpersonally violent upbringings stems from the impact on the developing brain and nervous system.  When we embrace this fact, then we can also embrace the fact that sometimes the mind cannot talk itself out of such experiences when not involving the body in the process.

The brain, along with the spinal cord, forms the body’s main control center of our central nervous system.  This control center is where incoming stimulus is evaluated and decisions about what action to take are made.  It is the neurons in the brain that support the mind’s awareness of sensations, emotions, thoughts and ultimately behaviors when they communicate with each other.  When our neurons communicate, they produce electrical pulses referred to as brain waves.  These brain waves can be compared to the radio waves and the various stations that we tune into to listen to the radio.  AM stations work on a lower bandwidth, while FM stations have a higher bandwidth.  Our brain waves change according to what we are “tuned into”, with our slower brain waves being the AM stations and our faster ones being the FM stations.  Therefore, the brain is the main body part that is driving our beliefs, perceptions and reactions.

Understanding this very complex organ has taken some time as we waited for science to catch up with the personal experience of many.  With the advent of the electroencephalogram (EEG for short), we are able to see the various brain wave activity and now research has been able to identify the brain wave patterns associated with various neurological and emotional conditions, including ADHD, anxiety and depression.  This information created the opportunity to identify and work with tools to change or modify those brain waves, supporting the brains natural tendency towards balance and health.

Therefore, we are now better able to understand that when our brain waves are out of balance we will experience dis-ease in our minds and bodies, creating an unnatural, unhealthy environment that jeopardizes our overall well-being and health.  This understanding allows a more specific focus on tools that change or balance our brain waves to return the brain to its natural healthy state and thus creating an atmosphere for peace of mind and strength of body.  It helps us to appreciate the past experience with psychotherapy (or “talk” therapy), where it has been shown that changing our perceptions changes our experience of the world.  It also better explains the use of drugs (prescription or otherwise) to alter the brain’s ability to function and alleviate symptoms of dis-ease in the mind and body.

A newer approach to what ails many in the Western world is the use of more traditional Eastern practices such as yoga, meditation and deep breathing, which research is now able to show that these practices support the brain’s natural balance by modifying the brain wave patterns that create the imbalance.  In addition to these techniques, which work best when implemented as daily practices over the long haul, direct neurofeedback is showing success in altering brain waves more quickly that underlie the symptoms of a wide range of conditions, offering more immediate relief.

If you would like to read more about the research to determine for yourself if this tool might be worth a try, click on the button below:

Neurofeedback – Promising non-pharmaceutical intervention strategies for anxiety and depression!

Many people that I connect with express a desire to try other approaches to address symptoms of anxiety and depression before turning to medications, especially when it is their children that are suffering from such symptoms, as all prescription medications come with undesired side-effects.  As a psychotherapist and yoga teacher, I share the research with them that shows the effectiveness of integrating these two (yoga and talk therapy) healing arts to support the shift in focus toward health promotion for those who prefer to take a more natural, holistic approach to healing. Now I am excited to share recent research that demonstrates combining neurofeedback with heart rate variability training (e.g., deep slow abdominal yogic breathing) provides another viable non-pharmaceutical approach to address the symptoms of anxiety and depression.  And the research showed a reduction in symptoms for both children and adults!

Neurofeedback is not new and is a form of biofeedback, where instruments are attached to the body to provide information to the individual on the functioning of their body.  Biofeedback, including neurofeedback, as a field of study has been growing since the 1960s.  Neurofeedback (or EEG biofeedback) is the form of biofeedback that enables people to change the brain’s electrical activity.  An EEG (electroencephalography) is the device that captures the real-time brain wave activity so it can be displayed and assessed for any unhealthy patterns that might be contributing to symptoms, such as anxiety and depression.  Being able to offer a way to change unhealthy brain wave patterns through neurofeedback is of special interest to those of us working with clients to relieve such distressing symptoms because the brain is a central contributor to the emotions, physical symptoms, thoughts and behaviors that define many problems for which people reach out for support.

Yoga and it’s slow, controlled deep abdominal breathing is also not new.  What is new is the research that is showing how this yogic breathing impacts heart rate variability (HRV).  HRV has been shown to be linked with an increase in cardiovascular disease, specifically when the variability is low.  (Please refer to last month’s Reflection to learn more about HRV.)  Stress and anxiety increases the activity of the sympathetic nervous system, the system responsible for the flight-fight response in the body, leading to increases in heart rate and a lowering of heart rate variability. On the other hand, activation of the parasympathetic nervous system, the system responsible for the rest-digest response in the body, has been shown to decrease heart rate and increase heart rate variability, specifically through the stimulation of the vagus (Cranial X) nerve that controls the heart, lung and digestion.  It is the controlled breathing found in a regular yoga practice that stimulates the vagus nerve, bringing balance to the activity of the sympathetic nervous system activity.

Even more recent research has brought these two healing modalities together to assess the impact of stimulating both the brain with neurofeedback and the vagus nerve with deep abdominal breathing on symptoms of anxiety and depressing in both children and adults.  The results showed evidence that such training may provide an effective, non-pharmaceutical approach to reducing such symptoms, with some additional benefits such as improving blood pressure!

To read the full research article, click on the link below: