Overcoming Anxiety Disorders-Research shows Neurofeedback treatment can provide relief from panic attacks and cure anxiety.

The following are brief excerpts from:

Neurofeedback with anxiety and affective disorders 

D. Corydon Hammond, PhD, ABEN/ECNS
Physical Medicine and Rehabilitation, University of Utah School of Medicine,
PM&R 30 No 1900 East, Salt Lake City, UT 84132-2119, USA

Strong research evidence also indicates that there are functional brain abnormalities associated with anxiety and panic disorder and posttraumatic stress disorder (PTSD). A particularly robust body of research, summarized by Davidson, has documented that depression is associated with an activation difference between the right and left prefrontal cortex. A large number of EEG studies, reviewed in earlier papers by Davidson, have established that the left frontal area is associated with more positive affect and  memories, whereas the right hemisphere is more involved in negative emotion. A biologic predisposition to depression exists when there is a frontal asymmetry in brain wave activity, with more left frontal alpha activity. This imbalance with more left frontal alpha means that the left frontal area is less activated. Such persons may be anticipated to be less aware of positive emotions while at the same time being more in touch with the negative emotions that are associated with the right hemisphere.

   The need for new treatments for depression, anxiety, and obsessive-compulsive disorder Responding to these well-established biologic predispositions, there has come to be a strong reliance in psychiatry on the use of medication for the treatment of depression and anxiety, although some evidence currently suggests that medication may not be as effective in treating these conditions as has often been believed.

   In light of this brief review and the fact that an increasing number of patients and parents seem interested in less invasive treatments, a need exists for nonmedication treatment alternatives that still address the underlying biologic factors associated with depression, anxiety, and OCD. We know that psychotherapy for depression compares favorably with medication in short-term follow-ups and seems to be superior in long-term follow-ups. With OCD, results from behavior therapy are clearly superior to those found with medication, although there is a significant drop-out rate and behavior therapy methods are not well liked by patients. It would be desirable to find a treatment that also would help address the biologic aspects of mental health disorders. Neurofeedback holds promise for offering such an alternative.

   Neurofeedback is EEG biofeedback or brain wave training. Neurofeedback training begins with a qEEG assessment. A tremendous body of research exists on the abnormal EEG and qEEG patterns associated with various medical and psychiatric disorders. The assessment for neurofeedback training may consist of anywhere from 2 to 19 electrodes being placed on the head at standardized electrode sites to gather EEG data. These data then may be compared statistically to a normative database, which provides scientifically objective information on how a patient’s brain activity differs from age-appropriate norms.  These data then guide the neurofeedback training process.

   During neurofeedback training, there usually are two electrodes placed on the scalp at locations where the EEG activity diverges most from norms. Reference and ground electrodes are placed on the earlobes. Nothing intrusive is introduced into the brain. The electrodes simply measure the ongoing brain wave activity. Ordinarily we are unable to reliably influence our brain wave activity because we lack awareness of it. When we are able to see representations of our brain wave activity on a computer screen a few thousandths of a second after it occurs, however, it allows us to modify our brain wave patterns through operant conditioning.

   The patient is placed in front of a computer screen. The computer display may be as complex as a computer/video game type of display. It also may be as simple as two bar graphs, one representing slow and inefficient brain wave activity and the other representing efficient, beta brain wave activity. The patient concentrates on the screen. When the inappropriate activity decreases slightly and the appropriate activity increases slightly, a pleasant tone is heard. At first, changes in brain wave activity are transient. As sessions are repeated, however, and the therapist gradually modifies the thresholds for inhibiting inappropriate activity and reinforcing healthier brain wave activity, enduring changes are gradually conditioned.

   As is seen in other articles in this issue, EEG biofeedback (neurofeedback) has been found to be effective in modifying brain function and producing significant improvements in clinical symptoms in children, adolescents, and adults who have several different biologic brain disorders. These conditions include such things as epilepsy, attention deficit disorder and attention deficit hyperactivity disorder (ADHD), and learning disabilities and have included up to 10-year follow-ups of patients. Neurofeedback treatment of depression, anxiety, and obsessive-compulsive disorder Neurofeedback for anxiety and obsessive-compulsive disorder.  A review of the literature on the neurofeedback treatment of anxiety disorders was conducted by Moore. He was able to identify eight studies of generalized anxiety disorder, three studies with phobic anxiety disorder, two studies of OCD, and one report of using neurofeedback with PTSD.

   The best studies of neurofeedback with anxiety were three outcome studies with phobic (test) anxiety. These studies included random assignment, four alternative treatment control groups, and a wait-list control group. In one study, the group that received alpha EEG enhancement training produced 33% more alpha after treatment, and all three feedback groups (who received alpha enhancement biofeedback, electromyography [EMG] [muscle] biofeedback, and alpha plus EMG biofeedback) demonstrated significant reductions in test anxiety. In comparison, the untreated control group and the relaxation training group experienced no significant reduction.

   In most cases, anxiety and insomnia are readily treated with neurofeedback. Many children with ADHD are treated by inhibiting slow brain wave activity (eg, theta) while reinforcing the sensorimotor rhythm (12–15 Hz) the sensorimotor strip. In these cases, one of the first improvements that parents often notice is that the child falls asleep more easily and remains asleep. The reason may be that the sensorimotor rhythm overlaps in frequency with beta spindles, and when the sensorimotor rhythm is increased in a waking state, it also increases beta spindles that occur as one begins trying to go to sleep, which facilitates improvement in insomnia. Although anxiety often involves excess right frontal beta brain wave activity, clinical experience has shown that a qEEG assessment is often invaluable because the excess of fast beta activity may be in other locations. Someone who obsessively worries may have this beta excess along the midline or in the center of the top of the head at an electrode location known as Cz.

To read the full report click here.  The following are references supporting the above excerpts.

– Heller W, Etienne MA, Miller GA. Patterns of perceptual asymmetry in depression and anxiety: implications for neuropsychological models of emotion and psychopathology. J Abnorm Psychol 1995;104:327–33.

– Heller W, Nitschke JB, Etienne MA, Miller GA. Patterns of regional brain activity differentiate types of anxiety. J Abnorm Psychol 1997;106(3):376– 85.

– Wiedemann G, Pauli P, Dengler W, Lutzenberger W, Birbaumer N, Buckkremer G. Frontal brain asymmetry as a biological substrate of   motions in patients with panic disorders. Arch Gen Psychiatry 1999;56:78 – 84.

– Brown D, Scheflin AW, Hammond DC. Memory, trauma treatment, and the law. New York7 WW Norton; 1998.

– Davidson RJ. Affective style and affective disorders: perspectives from affective neuroscience. Cognition and Emotion 1998;12:307– 30. 120 D.C. Hammond / Child Adolesc Psychiatric Clin N Am 14 (2005) 105–123

– Davidson RJ. Emotion and affective style: hemispheric substrates. Psychol Sci 1992;3:39– 43. [34] Davidson RJ. Cerebral asymmetry, emotion and affective style. In: Davidson RJ, Hugdahl K, editors. Brain asymmetry. Boston7 MIT Press; 1995. p. 361– 87.

– Goodman WK, McDougle CJ, Price LH. Pharmacotherapy of obsessive compulsive disorder. J Clin Psychiatry 1992;53(Suppl):29– 37.

– Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. The Yale-Brown obsessive ompulsive scale. I. Development, use, and reliability. Arch Gen Psychiatry 1989;46:1006– 11.

– Goodman WK, Pricee LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, et al. The Yale-Brown obsessive compulsive scale. II. Validity. Arch Gen Psychiatry 1989;46:1012– 6.

– Jenike MA, Baer L, Ballantine T, Martuza RL, Tynes S, Giriunas I, et al. Cingulotomy for refractory obsessive-compulsive disorder: a long-term follow-up of 33 patients. Arch Gen Psychiatry 1991;48:548–55.

– Hughes JR, John ER. Conventional and quantitative electroencephalography in psychiatry. J Neuropsychiatr Clin Neurosci 1999;11(2):190 – 208.

– DeRubeis RJ, Gelfand LA, Tang TZ, Simons AD. Medications versus cognitive behavior therapy for severely depressed outpatients: mega-analysis of four randomized comparisons. Am J Psychiatry 1999;156:1007 – 13.

– Antonuccio DO, Danton WG, DeNelsky G. Psychotherapy vs. medication for depression: challenging the conventional wisdom with data. Professional Psychology: Research and Practice 1995;26:574– 85.

– Hollon SD, Shelton RC, Loosen PT. Cognitive therapy and pharmacotherapy for depression. J Consult Clin Psychol 1991;59:88 –99.

– Foa EB, Franklin ME. Obsessive-compulsive disorder. In: Barlow DH, editor. Clinical handbook of psychological disorders. 3rd edition. New York7 Guilford Press; 2001. p. 209– 63.

– Lubar JF. Neurofeedback for the management of attention deficit/hyperactivity disorders. In: Schwartz MS, editor. Biofeedback: a practitioner’s guide. New York7 Guilford Press; 1995. p. 493– 522.

– Moore NC. A review of EEG biofeedback treatment of anxiety disorders. Clin Electroencephalogr 2000;31(1):1– 6. [59] Garrett BL, Silver MP. The use of EMG and alpha biofeedback to relieve test anxiety in college students. In: Wickramasekera I, editor. Biofeedback, behavior therapy, and hypnosis. Chicago7 Nelson-Hall; 1976.

– Hardt JV, Kamiya J. Anxiety change through electroencephalographic alpha feedback seen only in high anxiety subjects. Science 1978;201:79– 81.

– Feinstein B, Sterman MB, MacDonald LR. Effects of sensorimotor rhythm training on sleep. Sleep Research 1974;3:134.

– Sterman MB. Effects of sensorimotor EEG feedback on sleep and clinical manifestations of epilepsy. In: Beatty J, Legewie H, editors. Biofeedback and behavior. New York7 Plenum Press; 1977. p. 167– 200.

– Sterman MB, Howe RD, Macdonald LR. Facilitation of spindle-burst sleep by conditioning of electroencephalographic activity while awake. Science 1970;167:1146– 8.

      Like us on Facebook