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Depression

Feeling SAD? Neurofeedback May Help

Neurofeedback is training of brainwaves to optimize brain functioning.

Key points

  • Roughly 10 million Americans struggle with seasonal affective disorder (SAD) each year.
  • Traditional treatment options for SAD include light therapy, medications, supplements, and psychotherapy.
  • Numerous studies have shown neurofeedback to be an effective treatment modality for SAD.

It’s that time of year again: cold weather, less sunlight, shorter days. For many people, roughly 10 million, mood fluctuations also begin occurring more frequently. SAD, otherwise known as seasonal affective disorder, is a condition that refers to mood changes according to the time or season of the year. Typically, this occurs in the winter months, November through February. Symptoms include low mood, low energy levels, difficulties waking up, increased appetite, social withdrawal (feeling like “hibernating”), and difficulties concentrating, to name a few. Women are four times more likely than men to struggle with SAD (National Institute of Mental Health, 2018).

 Conner Flecks/Alamy Stock Photo
Source: Conner Flecks/Alamy Stock Photo

How to Differentiate SAD From Depression

For those individuals who struggle with depression, there is a higher probability of struggling with SAD in the fall and winter months. SAD is a “cyclic disorder,” meaning that there is a clear pattern related to specific times of the year. In the winter months, triggers for SAD include shorter days and less sunlight, but also spending more time indoors, the stress from the holidays, and end-of-year work deadlines. Depression, on the other hand, can be classified as episodic or recurrent. Individuals may struggle with periods of low mood followed by an ease in symptoms. This can occur year-round or be a singular event.

Traditional Treatment Options

Traditional treatment options for managing SAD mood symptoms include light therapy, medication, vitamin D therapies, psychotherapy, and movement and exercise. Because SAD has strong ties to lack of sunlight, light therapy, or bright light therapy (BLT) is often used as a first-line therapy (Campbell et al., 2017). BLT is often administered early in the morning with a light box. Individuals are exposed to 1,000 to 2,000 lux for about 30 minutes and typically see improvements in mood in a few weeks.

Treatment With Neurofeedback

A treatment option some may not have heard of is neurofeedback. Neurofeedback is the direct training of brainwaves to optimize brain functioning. The relationship between depression and brainwave functioning has been studied for some time. Individuals who struggle with depression typically show EEG patterns consistent with lower-than-typical beta functioning, higher-than-typical theta functioning, and overall low neural power (Volf et al., 2002). Low neural power equates to lower levels of serotonin and dopamine, resulting in cyclic symptoms of depression. The same pattern is seen with individuals struggling with SAD.

Training with neurofeedback involves training the “less-than-optimal” brainwaves to perform more efficiently and optimally. This is done through a reward circuit. Electrodes are placed on the scalp that measure brainwave activity. Once a “less-an-optimal” brainwave is detected, the client will be taught to "train their brain" to produce the desired brainwaves.

How is this done? When the brain naturally produces the desired brainwave, the client will be offered a "reward" such as a pleasing sound, playing a videogame, or pleasant visual. Over time, this teaches the brain that, to receive the reward, brainwave “X” must be produced. The more sessions a client goes through, the more the brain learns to produce the specific brainwave being trained. Over numerous training sessions, the brain learns to create the desired brainwave faster and maintain it longer. When the brain is performing at peak optimization, negative symptomology such as low mood, low energy, fatigue, and social withdrawal may improve.

Long-Term Efficacy

In my own neurofeedback practice, the question I get asked most frequently is whether the results from neurofeedback last. Data and research suggest that they do. Cannon and Lubar (2011) followed up with before and after psychometric scores from participants completing 30 sessions of training in the anterior cingulate gyrus. Analysis of variance procedures show significant differences between before and after baseline: “LORETA neurofeedback in the anterior cingulate gyrus appears to induce long-term cortical changes and produces significant positive increases in working memory and processing speed.” (Cannon & Lubar, 2011).

Research by Kouijzer et al. (2009) demonstrated significant improvement in executive functioning and social behavior in children with autism spectrum disorders (ASDs) treated with 40 sessions of neurofeedback. They also extended the findings by reporting long-term results of neurofeedback after 12 months of training. In addition, Van Doren et al. (2019) demonstrated the efficacy of neurofeedback training on individuals struggling with attention-deficit/hyperactivity disorder (ADHD) and further supported results indicating lasting effects for at least 6 months after training.

To conclude, seasonal affective disorder is a common struggle of many individuals in the winter months. Along with the traditional treatments options of light therapy, psychotherapy, supplements, and medications, neurofeedback is considered an alternative treatment modality. Promising research supports the efficacy of long-term positive results, and with more and more individuals looking for no-medication, noninvasive alternatives, neurofeedback is not to be overlooked.

References

Campbell, P. D., Miller, A. M., & Woesner, M. E. (2017). Bright light therapy: seasonal affective disorder and beyond. The Einstein Journal of Biology and Medicine : EJBM, 32, E13–E25.

Kouijzer M. E. J., de Moor, J. M. H., Gerrits, B. J. .L., Buitelaar, J. K., van Schie, H. T. (2009). Long-term effects of neurofeedback treatment in autism. Research in Autism Spectrum Disorders, 3 (2):496–501, ISSN 1750-9467, https://doi.org/10.1016/j.rasd.2008.10.003

Cannon R., Lubar J. (2011). Long-term effects of neurofeedback training in anterior cingulate cortex: a short follow-up report, Journal of Neurotherapy, 15:2, 130–150, DOI: 10.1080/10874208.2011.570688

Van Doren, J., Arns, M., Heinrich, H. et al. (2019). Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 28, 293–305. https://doi.org/10.1007/s00787-018-1121-4

Volf, V. V., Passynkova, N. R. (2002). EEG mapping in seasonal affective disorder. Journal of Affective Disorder. 72(1).

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