17 September 2014

Depression: Retraining the Brain

Discussions of depression and suicide are typically saved for Depression Awareness events, such as Depression Awareness Month coming up in the United States in October, but the recent passing of a beloved comedic and drama film star has the public eye focusing itself on the matter a little early. 

Numerous experts and media personalities have been examining depression from different perspectives. One message we've heard repeatedly is "suicide is a permanent solution to a temporary problem" (ironically stated by the actor himself) as a reminder for those suffering from depression to seek help. The fact is, there are a lot of treatment approaches out there from antidepressants to a variety of counseling techniques. Lifestyle changes regarding exercise, nutrition and sleep are helpful,  as is maintaining a strong social support network. Often, "seeking help" means trying a number of approaches, or combinations thereof, to see which one works best.

We challenge mental health practitioners to do the same and take a look at another approach that is often overlooked  - neurofeedback. In an upcoming webinar,  Lindsay Hollmuller, MS, LPC, BCN will discuss the benefits of using neurofeedback and quantitative encephalographic analysis with clients suffering from depression. 

One of the more interesting aspects of depression is that genetic susceptibilities are part of the origins. Some individuals carry genetic markers for depression, meaning they have a predisposition to these mood states, not unlike how some families have higher incidents of heart attacks. Disregulation between activity in the frontal lobes has been demonstrated in numerous studies to correlate to depression. This research, pioneered by Richard Davidson's research group, has shown via quantitative encephalography (qEEG) and neuroimaging, that there is a neurophysiological basis for depression. The brain's neurons fire at a variety of speeds, producing different intensities of activity across different firing rates or bandwidths. The asymmetry in the brainwaves between the left and right hemispheres is linked to Alpha bandwidth (8-12Hz) amplitude, specifically the lack of Alpha amplitude in the left lobe compared to the right lobe.

Are the depressed therefore at the mercy of their own brain, without any possibility of respite?
Perhaps there was once a time when the answer was yes, but neurofeedback offers its own answer: no. Just as doctors encourage patients with a family history of diabetes to modify their eating habits in order to avoid the onset of diabetes, neurofeedback practitioners work with clients in order to modify brainwave patterns associated with a predisposition to depression. This training need not be only a preventative treatment, but an excellent adjunct treatment to help those who currently suffer from depression.

How Does Neurofeedback Therapy Work?
The markers for depression manifest themselves as disregularities in the activity levels of the frontal lobes, which through the use of neurofeedback can be retrained. Neurofeedback therapy (or neurotherapy) can correct the hypoactivity in the left hemisphere of an individual, by reinforcement through operant conditioning. An electrode is placed on the individual's left frontal lobe to measure the brainwave activity in the Alpha bandwidth. When the activity increases to a higher level, the individual is given visual and auditory feedback (hearing a tone or seeing an animation/movie play) to reward them. Over multiple sessions, the individual's brain can slowly increase activity in the Alpha range, such that the hypoactivity in the left frontal lobe is no longer apparent.

A case study presented by Lindsay Hollmuller, MS, LPC, BCN
When “Jane Doe” arrived to her first neurofeedback session to treat her symptoms of depression, she reported feelings of sadness, difficulty in concentration and a decrease in functional activity and motivation. Treatment for “Jane Doe” consisted of 2 sessions a week for 3 weeks, a total of 6 sessions of neurofeedback.  According to her self-report daily progress notes, “Jane Doe” reported improvements in mood and emotional outlook indicating more energy, an increase in motivation and concentration, as well as a more “calm” attitude.  She verbalized that it seems as if “the fog has been lifted” and indicated that she feels she is able to more easily make decisions. 

Does this make neurofeedback a miracle cure?
No, although it opens a whole new avenue of possibilities for treating depression.  Like with all therapies, progress with neurotherapy is only achieved when the clinician and the client wholeheartedly work together. Set-backs can sometimes occur. According to Lindsay, "Aside from the mood state disorder itself, there can be other complications in treating individuals for depression with neurofeedback. Neurofeedback requires consistent, regular sessions. If an individual’s lack of motivation is severe enough, they are more likely to be inconsistent with treatment. Missing or cancelling sessions frequently may result in a disruption in treatment can may affect progress in treatment. Many times, individuals will begin to experience the positive effects of the treatment, and be more motivated to attend regular, consistent sessions."

The BFE would like to thank Lindsay Hollmuller, MS, LPC, BCN, for her recent 1-hour webinar presentation on Depression: Retraining the Brain, where she will discussed the research that suggests a neurophysiological basis for depression, and through the use of quantitative encephalographic analysis (QEEG), how retraining the brain through neurofeedback can assist in modifying brain wave patterns associated with depression.

Depression: Retraining the Brain Webinar
Lindsay Hollmuller, MS, LPC, BCN
Recording now available.

The BFE offers a wide range of online classes and webinars ideal for mental health professionals who are interested in learning more about neurofeedback. For more information, visit the BFE Online Shop.

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