Anxiety: Can Neurofeedback Make a Difference?



Anxiety, can perhaps be connoted as an emotion that everyone feels and that which is healthy to express. However, when it becomes excessive and disproportionate, maybe even irrational, it can stem from an underlying mental health disorder. These disorders can also seriously affect day-to-day living and cause physical symptoms. Up to 40 million people are affected by an anxiety disorder in the United States, but only about 36% receive treatments.

Humanity has evolved with the concept of anxiety. The idea of which stems from predators’ approaching, and alarms going off in the body, such as an increased heartbeat, sweating, a rush of adrenaline – amongst other hormonal and chemical reactions, such the fight-or-flight response being set off. These are all essential to survival to avoid potential danger.

The APA describes a person with anxiety disorder as “having recurring intrusive thoughts or concerns.” While a number of different diagnoses constitute anxiety disorders, the symptoms of generalized anxiety disorder (GAD) will often include the following:

  • restlessness, and a feeling of being “on-edge”
  • uncontrollable feelings of worry
  • increased irritability
  • concentration difficulties
  • sleep difficulties, such as problems in falling or staying asleep

Other anxiety disorders also include panic disorders and specific phobias.

Research has found that possible causes include environmental stressors, genetics, medical factors (for example, as a comorbidity of other disorders), brain chemistry, and withdrawal from an illicit substance. The research surrounding this has created treatments that consist of a combination of psychotherapy, behavioural therapy, self-therapy (such as stress-management and relaxation techniques), and medication. Medicines that might control some of the physical and mental symptoms include antidepressants, benzodiazepines, tricyclics, and beta-blockers. Recent research, however, has developed interventions such as Neurofeedback to help relieve the symptoms of anxiety.


Neurofeedback is a type of biofeedback through which neural activity is measured by self-regulation of activity in the sensory channels. Various invasive and non-invasive recording methods can be used here. EEG (electroencephalogram) is usually used to administer the therapeutic intervention. It provides immediate feedback from a computer-based program that assesses a client’s brainwave activity, to then use sound or visual signals to reorganize or retrain these brain signals. By responding to this process, clients learn to regulate and improve their brain function and alleviate symptoms of various neurological and mental health disorders. Accumulating evidence suggests the involvement of the thalamus and the dorsolateral prefrontal, posterior parietal and occipital cortices in neurofeedback control, and the dorsal and ventral striatum, anterior cingulate cortex, and anterior insula in neurofeedback reward processing.

The Study

A study by Gadea, Alino, Hidalgo et al. (2020) included 32 right-handed young men aged between 18-28 years old, all of which were undergraduate students. The participants took part in psychometric measures of mood including the POMS: Profile of Mood State questionnaire, or the STAI: State Trait Anxiety Inventory. Saliva samples were also extracted to give biological correlation of mood through cortisol. Lastly, the Neurofeedback which included the EEG recording and neurofeedback was included.

There was a significant decrease in POMS-tension-anxiety, as well as in POMS-anger-hostility scores. STAI scores, however, saw an increase. Further, there was a significant decrease of cortisol levels for both the experimental and the control group. The majority of the EEG results – both SRM and middle beta – in the experimental group, show a significant increase in amplitudes, whereas, the control group showed none. These results therefore do suggest that participants receiving real neurofeedback have reduced feelings of anxiety and tension.

Future neurofeedback research will probably clarify the psychological and neural mechanisms that may help to address issues in clinical translation.


Main Study: Gadea, M., Aliño, M., Hidalgo, V., Espert, R., & Salvador, A. (2020). Effects of a single session of SMR neurofeedback training on anxiety and cortisol levels. Neurophysiologie Clinique50(3), 167-173. doi: 10.1016/j.neucli.2020.03.001

Featured Image Source: Passeport Santé 

Edited by Sophie

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