Neurofeedback: Brainwave Training for Anxiety & More

Last updated January 3, 2024.
Edited and medically reviewed by Patrick Alban, DC. Written by Deane Alban.

Neurofeedback allows you to create healthy brainwave states on demand. It’s used to treat a host of mental and physical disorders like anxiety, ADHD & more.

It enables you to monitor what your body is doing by tracking functions like heart rate, blood pressure, skin temperature, or muscle tension in real time.

With this information and some practice, you can then influence these functions to improve your ability to achieve and maintain homeostasis.

There are several types of biofeedback which differ according to the body metric being monitored.

Scientists have found five main patterns of brain waves: alpha, beta, delta, gamma, and theta.

Each brainwave state corresponds to a different state of awareness as shown in the chart below.

Normally, we cycle in and out of these different brainwave states throughout the day and night.

All brainwave states are essential but should be experienced appropriately — at certain times of day and for particular durations of time.

Best Uses for Neurofeedback

Now let’s take a deeper look at the most common, evidence-based uses for neurofeedback.

1. Neurofeedback for Stress and Anxiety

If there is one specific area where neurofeedback shines, it’s stress reduction.

It’s useful for literally any condition with a stress-related component.

Learning how to manage stress is one of the best things you can do for your overall health, brain function, and mental well-being.

The typical stress-induced flight-or-fight response initiates a cascade of physiological changes you normally have no control over.

Your heart rate and blood pressure increase, your breathing becomes fast and shallow, and blood gets directed away from your brain and into your muscles.

In a meta-analysis of studies on ADHD, researchers concluded that neurofeedback effectively reduces the symptoms of inattention, impulsiveness, and hyperactivity. 

One review of large-scale clinical trials found that neurofeedback therapy induces a state of relaxed attention, modulates both over and under-arousal, and works comparably to the typical stimulant medications prescribed for ADHD. 

3. Neurofeedback and Depression

Psychologist D. Corydon Hammond, PhD, is a recognized authority in the field of neurofeedback.

He has nearly 200 scientific publications to his credit and is the primary author of the recommended standards of practice for the clinical use of neurofeedback. 

In a review of the current body of literature on neurofeedback for depression, he states that significant, enduring improvements occur approximately 80% of the time in patients who have a biological predisposition to depression. 

Most patients notice a difference after three to six sessions, feel a very significant improvement after ten to twelve sessions, and usually complete their treatment within 20 to 22 sessions.

One study on depression found that the use of neurofeedback decreased depressive symptoms by 50%. 

4. Neurofeedback for Peak Performance

Neurofeedback is also an effective technique to enhance overall performance.

It is used by Olympians, professional athletes, NASA astronauts, entrepreneurs, biohackers, and others who seek peak physical or mental performance.

The US military uses neurofeedback to treat soldiers with PTSD and brain injuries and for general performance enhancement. 

You too can use it to improve any area of your life — work, studies, relationships, health, and happiness.

Professional Neurofeedback Therapy

For serious therapeutic use, it’s recommended that you enlist the services of a certified neurofeedback professional.

They can help you determine the best type of neurofeedback for your situation since this therapy is not a “one size fits all” solution.

Treatment should be customized for your particular needs. 

What Happens in a Neurotherapy Session

So what goes on during a typical neurotherapy session?

First, a clinician will place electrodes on your head to measure the electrical activity of your brain.

Don’t worry, it won’t hurt a bit.

You’ll be able to see your brain activity presented in the form of a video game on a monitor.

Here is an image of an actual neurotherapy session.

You’ll be instructed on how to interpret what you see on the screen.

With a little practice, you’ll learn to control your brain activity to produce the brainwave state most helpful for your current needs.

Neurofeedback has been compared to playing a video game with your mind. (How cool is that!?)

But what you are really doing is harnessing your brain’s ability to change, known as neuroplasticity, by modifying your brainwave patterns for your benefit.

Significant changes in brain plasticity have been observed after just a single neurofeedback session. 

Neurofeedback Side Effects

As with any treatment modality, there is the possibility of side effects.

This is especially true if you have a history of mental illness or enlist the services of someone who is not qualified to perform neurofeedback.

The Association for Applied Psychophysiology and Biofeedback published a special report, Negative Effects and the Need for Standards of Practice in Neurofeedback.

This is clearly an off-putting list.

But the authors, who include world-renowned neurofeedback authority Dr. Hammond (see above), attribute side effects largely to the increasing number of unqualified lay people who are inappropriately and illegally obtaining neurofeedback equipment and setting up shop.

Minimize Your Risk of Neurofeedback Side Effects

Fortunately, there are steps you can take to minimize your risk of side effects.

Personal Neurofeedback Devices You Can Use at Home

While there are many benefits to working with a trained neurofeedback professional, if your goal is general relaxation or performance enhancement, it’s not always feasible or even necessary.

For about the cost of one neurotherapy session, you can purchase a neurofeedback device that you can use at home.

These devices are worn as a headset or headband with small built-in sensors.

They interface with your computer or smartphone to create real-time data on your brainwave patterns.

There’s a lot of turnover in the expanding do-it-yourself neurofeedback market with companies rapidly coming and going, so this list is subject to change.

Prices range from $100 to $500 and, generally, you get what you pay for.

BioZen is a free app developed by the US Department of Defense.

Provided you buy the appropriate sensors, BioZen can be used to measure brain waves, skin temperature, respiratory rate, and more.

These products are in their infancy and will NOT deliver the same results you would get by going to a trained neurotherapist with professional-grade equipment.

But if your main interest is relaxation, general personal improvement, or even curiosity, at-home neurofeedback can be a reasonable option.

Personal Neurofeedback Devices as a Meditation Aid

Another promising use for your at-home neurofeedback device is to help you meditate.

A big roadblock with meditation that many people, especially beginners, have is that they don’t know when they are doing it “right.”

By using a neurofeedback device, you don’t have to guess whether you’ve reached the desired meditative brainwave state (usually the alpha or theta brainwave state).

A quality device can help you know for sure.

Once you’ve trained your brain to recognize what that brainwave state feels like, you can apply that knowledge to a traditional meditation practice.

Be aware that some companies selling binaural beats brainwave entrainment audios give the impression that they involve neurofeedback.

Listening to these audio files can alter your brainwave state, but it is a one-way street since there is no feedback involved.

Benefits of Personal Neurofeedback Devices

There are two big drawbacks to professional neurofeedback therapy — it’s expensive and time-consuming.

A typical session lasts 30-60 minutes.

Depending on your goals, you may need 10, 20, or possibly up to 50 sessions.

A course of treatment can easily run thousands of dollars.

And unless you have a serious medical condition, neurofeedback therapy will not be covered by insurance (and it may not be covered even then).

Personal neurofeedback can be done at your convenience for no cost beyond the initial investment of the device.

Most devices are portable so you can use them to relax anywhere, anytime.

You are totally in control and can use your device as much or as little as you feel is helpful.

And you can often share the device with friends and family.

Drawbacks of Personal Neurofeedback Devices

Keep in mind that if you have a physical or mental health condition, do-it-yourself neurofeedback is NOT a substitute for professional neurofeedback therapy.

This is nascent technology and these devices are not as reliable now as they may be in the future. 

Take a look at product review sites and you’ll see that technical problems are fairly common.

Also, it’s important to have a professional monitor your results under certain circumstances.

It’s extremely important to see a professional neurotherapist if you have a psychiatric disorder such as anxiety, depression, bipolar disorder, or schizophrenia as personal neurofeedback can exacerbate your symptoms.

Neurofeedback can also alter the effectiveness of prescription drugs.

For example, neurofeedback is very good at lowering high blood pressure, but it can cause your pressure to drop too low when used in conjunction with blood pressure medication.

So it’s important that you work closely with your healthcare professional even if you are doing neurofeedback on your own.

Handheld Options: HeartMath

One disadvantage of personal neurofeedback devices is that they generally require wearing a device on your head.

This is not always convenient or comfortable.

An excellent alternative is HeartMath emWave2, the granddaddy of personal biofeedback devices, or the newer Inner Balance Coherence Plus app that works with your smartphone. 

The emWave2 is small enough to fit in your hand and you need only clip a small sensor to your fingertip.

All the HeartMath options are based on heart rate variability, not brain waves, making them biofeedback rather than neurofeedback devices.

Heart rate variability (HRV) describes a naturally occurring fluctuation in heartbeats.

HRV devices work on the concept of coherence — the synchronization of your heart rate variability, breathing patterns, and other body rhythms — to achieve optimal function and performance.

The underlying concept is that, just as your car will ride smoother when your tires are properly aligned, your body will work better if all these rhythms are aligned.

You’ll find a comprehensive collection of research studies in the HeartMath Institute Research Library.

EmWave2 is an effective, affordable alternative if you’re looking for a small, unobtrusive device you can hold in your hand.