With so-called neurofeedback, patients with depression or ADHD see on a screen what their thoughts are causing them. It can change your life – and our self-image.
Automatic ways of thinking have developed in our brains over years and decades and influence what we experience and feel. It’s not for nothing that we talk about the brain as a control center. But it also works the other way around. Experiencing the power of your own thoughts in real time is life-changing for some patients suffering from depression.
This is why some therapists also offer neurofeedback to their patients in addition to conventional therapy. The patient practices directly influencing the electrical activity of brain cells. It has not yet been scientifically proven that this can alleviate the symptoms of depression. However, the experience can be healing.
The activity of neurons is read directly from the brain
With neurofeedback, brain cell activity is measured through a brain-computer interface and reported to the patient in real time. For example, he observes a sinusoid on a screen that moves at different intensities. He then learns to control this curve – and thus influences his brain activity. Eight out of ten patients can do this well.
How this works varies from patient to patient. Many imagine everyday life experiences in which they indirectly control brain activity. If we focus on a newspaper article while reading on the train, the sensitivity of the auditory centers in the brain decreases. Only then can we ignore the conversation in the seats next to us. If we close our eyes and listen to calm music for a few minutes, our brain activity also changes. We only feel the consequences: our heartbeats slow down, we relax.
If measuring electrodes were attached to the surface of our head while listening to music, they would measure so-called alpha waves. The electrical activity of the brain, which oscillates at a frequency of 8 to 12 hearts, shows that the brain is relaxed but awake and alert.
Alpha waves show that inside the brain the cells just behind the forehead become quieter. At the same time, cells in the so-called “default mode network” exchange more electrical signals. The group of brain regions below the surface of the cerebral cortex are also activated when individuals perform mindful meditation during brain measurement.
Neural activity in the brain can be voluntarily controlled
Neurofeedback usually starts with these alpha waves and reflects them to the patient as sounds, images, or waves. First, alpha waves can be reliably measured using a simple device, the electroencephalogram. And second, therapy often consists of patients learning to relax again.
Generally, three to four hours of practice are enough and the patient can produce alpha waves on the screen almost by pressing a button. Theoretically, neurofeedback could be an effective alternative to weeks of meditation exercises in a monastery or other relaxation exercises.
Cats can also control their brain activity
The ability to control brain activity is not exclusive to us humans. Monkeys, cats and even rats can also do this. In the laboratory, animals hear a sound that shows the level of brain activity. If the animal manages to increase brain activity, it will be rewarded.
Once animals learn the procedure, they can control their brains better than many people. However, this is mainly due to the fact that the measuring electrodes are implanted directly into the animals’ brains. Brain electrical activity can therefore be measured much more directly.
Researchers develop app for patients
What rodents can apparently do surprises many people. For patients, the experience of neurofeedback can even be therapeutic. In a review article on the effectiveness of neurofeedback for depression, German researchers write that the experience of neurofeedback can strengthen self-efficacy, as psychologists call confidence in one’s abilities.
In the laboratory, scientists are now trying to use neurofeedback to specifically alter the activity of specific regions of the brain in order to alleviate depressive symptoms.
To do this, patients must lie down in an MRI scanner. During training, they observe the activity of the so-called amygdala. The region of the brain becomes active when experiences are emotionally evaluated in a positive way. Those who managed to increase amygdala activity felt less desolate and depressed in everyday life.
The research results of American scientists are so convincing that they have now managed to raise money for a large-scale clinical study with a few hundred patients for the first time.
However, it is unlikely that the procedure using a magnetic resonance tomograph will be established in treatment as it is complex and expensive. Israeli scientists are therefore already working on using artificial intelligence to detect a signal from the amygdala on the surface of the head. Chief scientist Talma Hendler is convinced that neurofeedback can help many patients in the future. She also works with people after a traumatic experience and children who suffer from attention deficit disorder.
Other neuroscientists are more cautious about using neurofeedback. Frank Scharnowski, who studies neurofeedback at the University of Vienna, has a decidedly different opinion: “It is still too early to establish neurofeedback as an evidence-based therapy.”
This evidence-based therapy would have to meet the highest scientific standards. For example, it would have to be clearly proven that training affects the region of the brain responsible for the symptoms of depression.
Researchers agree that this form of evidence will not be successful in the near future. To date, it remains unclear which neural mechanisms actually cause depression.
40 percent of patients are less depressed afterwards
Individual studies have already demonstrated that the mechanism of action of neurofeedback in depression is not necessarily based on controlling the emotional region of the brain: researchers in England had patients control the amygdala or another randomly selected region of the cerebral cortex. In both cases, 40% of patients felt better and less depressed after neurofeedback. Both groups seem to benefit equally from the self-efficacy experience mentioned at the beginning.
The medical mechanism of action of neurofeedback in depression is still unclear and the therapy cannot be considered scientifically validated. But the results of research around neurofeedback training clearly show that we can control our brain activity at will.
It remains to be seen whether in the future we will all sit in front of the computer with electrodes on our heads to relax. We can also simply listen to music at night – and thus relax our brain.