By Emily Cleveland-Job, ND
Medications for anxiety, depression, and attention difficulties are handed out like the gourmet cheese samples in the grocery store these days. Want to try some? Here’s some gouda. Certainly in some instances, these medications can be a good option. Yet I feel there needs to be more investigation into the potential causes of these symptoms and consideration of treatment options with fewer side effects and better outcomes. Don’t get me wrong…gourmet cheeses I am all for. Prescribing medications quickly without discussing or considering alternatives…not so much.
In my 4th year of naturopathic medical school, I decided to apply for an internship in neurofeedback because I wanted to work with Steven Sandberg-Lewis, ND, DHANP, and his wife Kayle Sandberg-Lewis, LMT, MA, BCN. As a Naturopathic Physician with a focus in functional gastroenterology, Dr. Sandberg-Lewis had inspired me with exceptional lectures and clinical insights for a couple of years before I was eligible to apply for the internship he and Kayle offered. Kayle, I had yet to meet, but I had heard she was one-in-a-million and an expert in the field of neurofeedback. At the National College of Natural Medicine, recently renamed National University of Natural Medicine, Dr. Sandberg-Lewis and Kayle oversee an internship called the Psy-Phy shift. Psy-Phy is short for Psychological Physiology. At the time I was applying, I knew nothing about neurofeedback, but I did the necessary research to appear somewhat knowledgeable about the subject in my application.
Fortunately, I was accepted and the ensuing year changed my life and my future practice. Throughout this one-year internship, we focused on individuals who had sustained traumatic brain injuries in their past. These injuries ranged from concussions, strokes, spinal cord injuries, soundwave injuries, and other head injuries that didn’t fall into these other categories. These individuals frequently suffered anxiety, depression, headaches, seizures, paralysis, and difficulties with problem -solving and communication. We saw amazing improvements in these peoples’ functioning and quality of life, all without prescription drugs. I also saw remarkable changes in myself as we were encouraged to experience the neurofeedback to help us understand what we were doing with patients.
What is neurofeedback?
The basics of neurofeedback lie in biofeedback. Biofeedback is a very broad term that describes the practice of learning to control some measurable bodily activity, like heartbeats, brainwaves, and muscle contraction. For example, it has been shown that by observing one’s heartbeat and focusing on breathing patterns, someone can slow their heart rate, lower their blood pressure, decrease anxiety, and improve focus. Neurofeedback specifically utilizes brainwaves to provide feedback information to the patient/user to help improve brain function.
Types of Neurofeedback
There are several types of neurofeedback. The two that I am most familiar with are traditional neurofeedback and Low Energy Neurofeedback (LENS). Traditional neurofeedback “trains” the user’s brain into a set range of frequencies, chosen by the provider based on the symptoms they are hoping to improve. The patient is connected to the neurofeedback machine which measures their brainwaves with an electroencephalogram (EEG). When the patient’s brainwaves get into this specific set of frequencies, the video game they are watching “rewards” them by playing. This is the feedback part of the traditional neurofeedback systems. In effect, the user learns to play a video game with their brain. Since they are rewarded when they get their brain into this specific range, their brain wants to try to stay in that range to keep the video game playing. This spills out into normal life, and the brain tries to stay in that set of frequencies even when they aren’t playing the video game. This therapy can help symptoms tremendously. The drawbacks, as I see them, are that these sessions generally take 45-60 minutes and work the best when the user can do them 2-3 times per week. Sitting still for so long can be very hard for kids, especially kids with attention difficulties. It is also very difficult as a time commitment and monetary investment to do 2-3 sessions per week. This form of neurofeedback is similar to exercise in that when you discontinue the therapy you can slowly loose the gained benefits.
The type of neurofeedback I use in the office is Low Energy Neurofeedback (LENS). LENS is a specific system of neurofeedback that does not require the patient to “play” a video game. The feedback aspect of LENS actually comes in the form of waves that are sent back through the EEG. The system measures the user’s brainwaves as they sit quietly with their eyes closed (or for some kids as they focus on a spot on the wall to keep their eyes still). As it measures the brainwaves, it calculates an “off-set” signal to send back in through the leads attached to the user’s head. This “off-set” signal basically sends a frequency back to the patient that is slightly different than what the patient’s brain is currently creating. The frequencies sent in have very low, micro volt amplitudes similar to the amplitudes the brain creates. Sessions last from a few seconds to several minutes. My translation of what happens with LENS is that the neurofeedback system sends a signal back to the patient that is speaking the same language but saying something different than what the brain is saying. It seems that this provides different enough information to the brain that the brain sees this as a way to move away from its set patterns. This generally makes things easier for the individual getting the neurofeedback. Easier to sleep, think, be positive, be calm and present in the moment, to be focused and flexible, and less reactive. Less reactivity in people with migraines and seizures generally means fewer of these events. Nice, right?
Oh yes, I didn’t mention side effects. Most commonly people report feeling very calm and focused after a neurofeedback session. Sometimes a little sleepy and occasionally people will feel they need a nap after their session. These symptoms usually start within about 20-30 minutes of the session.
Certainly, if the practitioner does more neurofeedback than the individual needs or can handle, there is the potential to aggravate symptoms for a period of time. In the case of migraines or seizures, you can understand why the practitioner should be very conservative with the amount of neurofeedback given to the patient. The term “less is more” is very true in the world of neurofeedback. Initially, it is not uncommon to “treat” only 1 or 2 sites for 2 seconds each as the practitioner and patient learn how many sites and which settings the patient will do best with.
LENS will frequently change the patient’s functioning to the point that they need less of any of the medications they are taking. This seems to be across the board for pharmaceuticals, not just antidepressant or antianxiety medications. Sometimes people will also need to lower their hypertensive medications, pain medications, thyroid medications, etc. Therefore, t is important to be aware of this as one goes through the therapy. They may start to feel “overdosed” due to the need for less medication.
LENS falls into a therapeutic category where generally when used correctly, the side-effects are positive outcomes we weren’t expecting. For example, I had one patient who started seeing me because of severe anxiety. A few sessions in, his anxiety had decreased significantly, and he admitted that he used to drink 2 bottles of wine each night just to get to sleep. He then found that he was no longer drinking in excess because his anxiety was so much better. These are side effects I’m happy to report! We don’t have to hide our side effect list for neurofeedback in 4 font type folded deep inside an informational insert.
Feel free to contact us if you have questions! We offer free phone consultations to answer questions. We have a variety of neurofeedback packages as well!
To learn more about LENS, go to www.ochslabs.com.