Neurofeedback Therapy for Anxiety
Our society and technology have evolved very quickly – much more rapidly than the evolution of our bodies and brains. And that’s why sometimes our brain responds to stress as if a bear is chasing us. It goes into fight-or-flight mode with no actual danger present. You might have experienced it: your pulse races, your breathing speeds up, your pupils dilate – all in response to perceived danger.
While these symptoms serve an important purpose in some situations, they can be disruptive and uncomfortable in others. For example, if you have anxiety, you may have an overactive fight-or-flight response that can be triggered frequently, even when you're not in danger.
The good news is that, even if you experience these symptoms, there's a surprising amount of flexibility and potential for change in your brain. Research shows that the brain possesses the property of neuroplasticity, which is the capability to alter its structure or function in response to exposure to new stimuli or environments.
Rewiring the Brain With Neurofeedback Therapy
Neurofeedback is a form of biofeedback that uses EEG technology to read your brainwaves in real time and show visual or auditory feedback based on protocols determined by the neurofeedback provider. The training, or feedback, may be done using games or videos, and the main outcome is that over time, your brain learns to be in a healthier, more balanced state.
After consulting with your doctor, you may also try combining neurofeedback with treatments like CBT (cognitive behavioral therapy), lifestyle and home remedies, or medication. The type of therapy you choose depends on the nature of the anxiety disorder as well as your individual preferences.
The Different Faces of Anxiety
“Anxiety disorders” is an umbrella term that includes generalized anxiety disorder (GAD), panic disorder, phobias, social anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).
Feelings of fear and distress are normal physical responses when you are faced with severe stress or danger. However, it becomes a disorder if these feelings are prevalent almost all the time or if they become so intense that they interfere with your life. In many cases, the symptoms are frequent panic attacks, obsessive thoughts, a paralyzing phobia, or unrelenting worries.
What Part of the Brain Generates Anxiety?
Two separate pathways in the brain are involved in generating anxiety. One pathway begins in the cerebral cortex, the large, convoluted, gray part of the brain, and involves our perceptions and thoughts about situations.
The other pathway travels more directly through the amygdala (a brain structure associated with emotional processes), which triggers the fight-or-flight response. Both pathways play a role in anxiety, although some types of anxiety are more related to what is called the cortical pathway, while others may reflect greater involvement of the amygdala.
The cortical pathway is what most people think of when they consider the causes of anxiety. For example, suppose your thoughts are routinely filled with ideas or images that increase your anxiety, or that you obsess over doubts, become preoccupied with worries, or get stuck in trying to think of solutions to problems. In this case, you’re probably experiencing cortex-based anxiety.
On the other hand, the amygdala pathway doesn’t produce thoughts that you’re aware of and it operates more quickly than the cortex can. Therefore, it creates many aspects of an anxiety response without your conscious knowledge or control. In less than a tenth of a second, the amygdala can provide a surge of adrenaline, increase blood pressure and heart rate, create muscle tension, and more.
So if you feel like your anxiety has no apparent cause and doesn’t make logical sense, you’re probably experiencing the effects of anxiety arising from the amygdala pathway.
Anxiety and the Brainwave Connection
A healthy, well-balanced brain will generate appropriate brainwaves at the appropriate levels at the appropriate times.
The brain produces five types of brainwaves, which are repetitive patterns of neuronal activity: Delta, Theta, Alpha, Beta, and Gamma.
In many cases, anxiety is associated with decreased alpha waves and increased beta waves. Neurofeedback teaches you to modify your brainwaves to achieve the desired brainwave state.
For example, alpha waves occur when you are relaxed. Beta waves are associated with alertness, but they may lead to feelings of fear and anxiety when maintained for too long. So, if you are stressed and anxious, learning how to increase alpha waves while reducing beta wave activity might be your goal.
How Does Anxiety Affect the Brain?
Anxiety also changes the brain by weakening the connections between the amygdala and the ventrolateral prefrontal cortex. We’ve already discussed the amygdala and its association with emotional processes; the ventrolateral prefrontal cortex is a region of the frontal lobes associated with response inhibition and goal-appropriate response selection.
In healthy brains, the ventrolateral prefrontal cortex and the amygdala work together to analyze and respond to social and environmental cues. When you experience a potential threat the amygdala sends signals throughout the brain, activating the ventrolateral prefrontal cortex, which helps your brain respond to the situation appropriately. Anxiety weakens the connection between the ventrolateral prefrontal cortex and the amygdala, making you less likely to respond to the threat rationally.
Studies have shown that neurofeedback may help strengthen the connection between the ventrolateral prefrontal cortex and the amygdala. 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.
Visit our research overview article for a comprehensive summary of neurofeedback research in multiple conditions, with supporting scientific references.
What Kind of Neurofeedback Protocol is Used for Reducing Anxiety?
Alpha-theta neurofeedback training, which reduces arousal, has been applied to reduce anxiety and create a generally relaxed state of well-being. 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. SMR training also improves motoric precision and balance, as well as the ability to relax.
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.
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.
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.
Whether you were born with a brain naturally prone to anxiety or whether you developed your tendency for anxiety later in life, there are effective ways to reduce your anxiety.