Neurofeedback and Anxiety
Updated: Sep 5
“Anxiety disorders” is an umbrella term that includes generalized anxiety disorder (GAD), phobias, panic disorder, obsessive-compulsive disorder (OCD), social anxiety disorder, and post-traumatic stress disorder (PTSD).
Neurofeedback training that reduces arousal may be applied to reduce anxiety and create a generally relaxed state of well-being.
The Neural Imbalance
In many cases, anxiety is associated with decreased alpha waves and increased beta waves. Anxiety also changes the brain by weakening the connections between the amygdala and the ventrolateral prefrontal cortex. Studies have shown that neurofeedback may help strengthen the connection between the ventrolateral prefrontal cortex and the amygdala (Zhao et al., 2019). With the connection restored, the ventrolateral prefrontal cortex can effectively provide an appropriate response to potential threats, reducing the impulsive, hyperactive reactions commonly associated with anxiety.
Alpha-theta neurofeedback training, which reduces arousal, has been applied to reduce anxiety and create a generally relaxed state of well-being (Moore, 2000; Gruzelier, 2009). Training is typically done with eyes closed while listening to auditory feedback.
Another neurofeedback protocol that is used for reducing anxiety symptoms is the SMR protocol. SMR training is a common protocol used to improve attention and focus. The SMR frequency band is associated with an alert, attentive state coupled with calm or silent motor activities. SMR training commonly improves focus and attention by decreasing drowsy, mind-wandering theta waves and anxious or racing high beta waves while increasing the calm, focused SMR waves. It also improves motoric precision and balance, as well as the ability to relax.
Evidence from single randomized controlled trials suggests that compared with no treatment, there is a statistically significant improvement in symptoms with neurofeedback treatment in patients with post-traumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) (Banerjee et al., 2017)
In a study of highly talented musicians performing under stressful conditions, only musicians who received alpha-theta neurofeedback training had enhanced musical performance under stress (Egner & Gruzelier, 2003).
In another study, adolescents with self-reported attention and anxiety symptoms had enhanced alpha and SMR along with improved symptoms (by visual analog scales) after neurofeedback training of alpha, theta, and SMR twice a week for five weeks (Tsatali et al., 2019).
In one RCT of test anxiety, neurofeedback participants generated 33% more alpha and showed a significant anxiety reduction; by comparison, untreated participants and those receiving relaxation training experienced no significant symptom reduction (Garrett & Silver, 1976).
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