Therapists are using neurofeedback to treat ADHD, PTSD and other conditions

In the article “Therapists are using neurofeedback to treat ADHD, PTSD and other conditions,” Arlene Karidis  describes the life of Chris Gardner and how he got brain surgery to remove a tumor. However, this operation restricted the 58-year-old’s mobility and cognition until he tried a form of biofeedback, called neurofeedback, that is a brain exercise based on brain waves and immediate feedback on how the brain is functioning. For example, movies, video games, computers and other equipment can be used to monitor ones brave waves in a sense that when a number of one’s brain waves are displayed to be too fast or too slow, the movie is automatically paused in order to gain control of a steady number of brain waves once again and to test why this erratic change happened in the first place.

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Although there are other skeptics, such as Silver Spring psychologist Robb Mapou, who think there are other therapeutic ways to affect an individual’s outcome, many scientists and researchers believe that this stop-and-start feedback decreases the number of infrequent brain waves and yields them to a more-normal number which can improve an individual’s ability to focus and relax. Karidis affirms that “better focus and relaxation can seemingly help improve or eliminate such conditions as migraines and anxiety,” which could all an all improve one’s quality of life.

However, a common condition called Attention Deficit Hyperactivity Disorder (ADHD), has been on the minds of many. Here, an individual’s attention, focus, and organization skills are compromised from the time they developed this disorder in their childhood all the way through adulthood. A recent trial published in March in the Journal of Pediatrics states that “those who received neurofeedback had improvements in attention and impulse control, while those who did not receive the therapy did not.” Those who partake in neurofeedback may get better results and can even grow out of this disorder. In detail, according to Michael Sitar, a Bethesda psychologist certified in neurofeedback, “people with focus problems can switch tasks easier. Kids who repeat themselves and who are emotionally labile become calmer and don’t repeat as much and nonverbal people become verbal.”

Furthermore, Karidis cites Deborah Stokes, an Alexandria psychologist, who compared neurofeedback to riding a bike: “It’s non-conscious learning, based on the feedback, that, with repetition, can be long-lasting.” For example, there are many cases where this occurs such as...

  • Chris Gardener: he was projected to have a two-to-three-year recovery period, but by his ninth neurofeedback session, he was driving, taking power walks and working from home. He went from not feeling anything to being able to do almost everything he could do before.  Karidis elucidates upon Gardner’s case where he sat in a chair while tiny, pulsed signals were sent to his brain that would enable the brain to revive its communication channels (which can become impaired after a brain injury).

  • Thomas Nicklin: a teenager who was in boarding school, did 45 neurofeedback sessions over three months last year (Karidis).“Over time, Thomas went from three or four blinding migraines a week, vomiting and daily pain, to no symptoms,” said his mother, Pat Nicklin, because of the neurofeedback.

  • Mary Lee Esty, a Bethesda clinical social worker: who is starting up a study which would help treat veterans with PTSD. She has used neurofeedback to treat more than 2,500 people with the help from the Uniformed Services University of the Health Sciences (which gives participants in her program post-treatment evaluations).

  • Rex Cannon, past president of the International Society for Neurofeedback and Research, based in McLean, Va.: discovered that after neurofeedback treatments a significant reduction in seizures had occurred in a meta-analysis of 10 studies on epilepsy patients.

These are just a few examples of patients and experts that have experienced and seen the promising results of Neurofeedback. But if “about 1,850 professionals have been certified through the Biofeedback Certification International Alliance” (Karidis) than at least 1,850 patients can be helped with sessions two or three times a week, for a total of 10 to 40 in 1 to 4 months.

Do most people become totally normal? We don’t necessarily know. We also know that normal is vague and vastly different from one person to the next. But they can see an improvement on their symptoms by taking part in neurofeedback treatments.

Neurofeedback is able to help children, teenagers, and adults who have symptoms of ADHD, migraines, sleep issues and more. If your symptoms have not improved enough to meet your goals, your brain may need some training. Neurofeedback can train your brain to regulate, stabilize and focus itself so you're able to function at your optimal level, concentrate better on your tasks and follow directions that are given to you.

Contact us for more information on how Neurofeedback can help you and your family find the focus you need to function at your best.

-Written by Lily Schmitt and Tanya L. Hilber, PsyD


Reference

Karidis, Arlene. “Therapists are using neurofeedback to treat ADHD, PTSD and other conditions.” The Washington Post. Health and Science. Web. 19 Jan. 2015. https://www.washingtonpost.com/national/health-science/therapists-are-using-neurofeedback-to-treat-adhd-ptsd-and-other-conditions/2015/01/16/b38e6cee-5ec3-11e4-91f7-5d89b5e8c251_story.html?noredirect=on&utm_term=.bf4b688f61b7

Have You Ever Been So Tired You Can't Sleep?

Truck driver Joe Diemand (76) feels that way all the time. Working long and late hours like Joe or working the night shift have even been called carcinogenic by the World Health Organization. U.S. Center for Disease Control recommends at least 7 hours of sleep a night and reports show that more than 80 million Americans are sleep deprived. Just look at the spike in fatal car accidents and heart attacks (increases 24%) the Monday after day light saving time!

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We have an internal molecular clock that is set to mirror and stay in sync with the sun. Because of technology and brain imaging, these three Nobel Prize (2017) winning scientists discovered this so called circadian cycle and it is now known that disruption to this cycle can lead to things like diabetes, heart disease, and dementia. 

Disruption to this sleep cycle is due to our eyes and their exposure to certain light at certain times. I can't help but feel guilty as I stare at my computer screen late at night while reading about the negative affects of reawakening my wake cycle through exposure to this type of light. According to the most recent National Geographic, Michael Finkel states light at night inhibits the production of melatonin, the hormone that helps regulate our daily biological rhythms.

Insomnia is the main reason 4% U.S. adults take sleeping pills each month. But there is research to show that people who generally take longer to fall asleep, wake up for prolonged periods during the night, or both do not need medicine. Neurofeedback has been shown to improve sleep . 

The engine of our brain, the prefrontal cortex, is the first to begin to deteriorate when we do not get enough sleep. Finkel reminds us that this is the home for our decision-making power and problem solving abilities. It's no wonder why we are cranky when we are tired. Chiara Cirelli (a neuroscientist at the Wisconsin Institute for Sleep and Consciousness) tells us, “Every cognitive function to some extent seems to be affected by sleep loss.” So, what better way to improve symptoms of sleepiness than by training your brain with Nuerofeedback which directly  addresses symptoms for each individual client by focusing on certain parts of the brain that need strengthening. Using certain electrode site placement on the head and frequency levels, people report improvements in falling asleep, staying asleep and quality of sleep after the recommended 20 sessions of Neurofeedback.  These sessions in turn improve a healthy lifestyle as lack of sleep can induce overproduction of ghrelin, the hunger hormone, and can lead to obesity. Even those who get 6 or less hours of sleep per night are at higher risk for depression, psychosis, and stroke. Neurofeedback has not only been reported to help with sleeplessness but also these exact diagnoses. 

A common symptom of ADHD is daytime sleepiness (Timimi & Leo, 2009). This symptom served as a predictor for homework problems and academic impairment in adolescents with ADHD (Langberg, Dvorsky, Marshall, & Evans, 2013). Those with Autism have also having difficulty falling asleep and experience disturbed sleep once they do. ASD has also been linked to anxiety and depression. Neurofeedback addresses any dysregulated state of the brain and research has shown it improves many symptoms of these disorders. 

In this case, if you snooze, you don't lose! Biofeedback is now a "Level 1 - Best Support" for Attention and Hyperactivity behaviors or ADD/ADHD interventions based on The American Academy of Pediatrics (AAP). Other treatments such as Behavioral Therapy and medications are considered "Level 1- Best Support" treatments as well. Based on the dysregulation model, neurofeedback addresses common symptoms of ADHD like inattentiveness and impulsiveness by "brain training" and helping to regulate brain activity. Not only can neurofeedback address behavioral, academic and emotional symptoms, it can help regulate our sleep to allow for the full potential of " playtime of the brain" (Finkel, 2018). Sleep Help guides and tips are a great place to start, and if you'd like more information on how neurofeedback can improve quality of sleep, contact us today. 

~ Written by Hannah Berry, M.Ed.

References: Finkel, Michael. (2018). "While we sleep, our mind goes on an amazing journey." National Geographic, Aug. 2018.

Langberg, J. M., Dvorsky, M. R., Marshall, S. and Evans, S. W. (2013). Clinical implications of daytime sleepiness for the academic performance of middle school‐aged adolescents with attention deficit hyperactivity disorder. J Sleep Res, 22: 542-548. doi:10.1111/jsr.12049

Timimi, S., & Leo, J. (2009). Rethinking ADHD: From brain to culture. Palgrave Macmillan.

Consistent Use of ADHD Medication May Stunt Growth by 2 Inches

As previously seen on Hilber Psychological Services, there may be a relationship between consistent use of SDHD medication and height growth. According to the article, "Consistent Use of ADHD Medication May Stunt Growth by 2 Inches, Large Study Finds", written by Dr. David Rabiner, "although the benefits of medication treatment on ADHD symptoms dissipate, the impact on adult stature persists". The Multimodal Treatment Study of ADHD (MTA Study) tested 600 7–9-year-old children with ADHD. These children were randomly assigned into one of these four groups: 
1. Carefully monitored medication treatment
2. Intensive behavior therapy
3. Medication treatment combined with behavior therapy
4. Community care (parents obtained whatever treatment they want)

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After 14 months, the study showed that those children who received carefully monitored medication treatment or medication treatment combined with behavior therapy had lower levels of overall ADHD symptoms and better overall adjustment compared to those children who received intensive behavior therapy or community care. The results stayed the same after an evaluation 10 months later. However, evaluation after 1 year and again after several groups showed no group differences based on the initial group treatment assignments. Therefore, the initial benefits of the medication had disappeared. The study continued annually through age 18 and then reduced visits to age 25. Within this group, individuals were categorized based on their medication usage:
a. Consistent, i.e,. those who had met the minimum threshold during each year;
b. Inconsistent, i.e., those meeting the minimum threshold in some but not all years; and
c. Negligible, i.e., below the minimum threshold in all years. 

At the last evaluation, age 25, participants self- and parent-reported, and doctors measured the patient's height compared to other individuals around the area that had not been diagnosed with ADHD in their childhood. Based off of the medication categorized above, only 14.3% of participants consistently used medication through age 18. After comparing the other participants, participants with ADHD maintained substantially higher ADHD symptoms over time regardless of their initial treatment. It was clear that ADHD symptoms in young adulthood are not related to patterns of medication use through adolescence. 

There was thus no indication that consistent medication treatment over a number of years had any persistent impact. However, there was a relationship found between persistent medication use and adult height. According to Dr. Rabiner, "Students in the Consistent and Inconsistent medication treatment groups had average heights — combined across these groups — that were about an inch shorter than those in the Negligible treatment group. And, participants in the Consistent Group were nearly an inch shorter on average than those in the Inconsistent group, i.e., nearly 2 inches shorter than those in the Negligible group". 

Overall, the study concluded there was substantial persistence of ADHD symptoms into adulthood and although the benefits of medication treatment on ADHD symptoms dissipate, the impact on adult stature persists. However, it is possible that some other factor that contributed to some participants taking medication more consistently, e.g., more severe symptoms, also explains the reduced height attainment in this group.

There are many take home messages:
1. Relatively few youth with ADHD use medication consistently over their development.
2. Many individuals with ADHD will continue to struggle with ADHD symptoms into adulthood. 
3. Although medication helps control symptoms in the short-term, it is not a cure.
4. It is unknown whether optimal medication treatment maintained over many years would have a greater impact.
5. Parents and clinicians need to balance the need for persistent treatment in some children with the likely consequences of reduced adult height. 

Due to the symptoms that may occur from using persistent medication, an optimal solution would be to find the lowest effective dose of medication, or combine medication treatment with other behavior therapy and/or other approaches.

If your focus still has not improved enough to meet your goals, your brain may need some training. Neurofeedback can train your brain to regulate, stabilize and focus itself so you're able to concentrate better on your tasks or follow directions that are given to you.

 Contact us for more information on how Neurofeedback can help you and your family find the focus you need to function at your best.

~Written by Allison Parker and Tanya L. Hilber, PsyD

Reference: Rabiner, David. “Consistent Use of ADHD Medication May Stunt Growth by 2 Inches, Large Study Finds.” SharpBrains, SharpBrains, 28 Mar. 2018