Control Anxiety with Biofeedback

Biofeedback is a clinically-proven therapy that uses biofeedback equipment to monitor and display your physiological activity to expand your awareness and increase control of your body. Personal biofeedback training is an effective treatment for anxiety disorders that produces results comparable to those achieved by relaxation procedures like meditation and Progressive Relaxation.

Which are the major anxiety disorders?

All anxiety disorders share the symptoms of persistent irrational fear and uncertainty. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association lists the following anxiety disorders: 

  • panic disorder
  • the phobias
  • generalized anxiety disorder
  • obsessive-compulsive disorder
  • posttraumatic stress disorder
  • adjustment disorder with anxious features

Generalized anxiety disorder is one of the most common anxiety disorders. These patients exhibit symptoms that include:

  • anxiety
  • worry
  • restlessness
  • fatigue
  • concentration
  • muscle tension
  • sleep disturbance

Who is mainly affected?

Americans suffer from anxiety disorders more than any other psychological disorder. The National Institute of Mental Health (NIMH) estimates that 18 million Americans age 18 or older experience an anxiety disorder each year. Anxiety disorders interfere with job performance and social relationships. The high incidence of unhealthy behaviors like physical inactivity, alcohol abuse, smoking, and substance abuse may contribute to high rates of medical and psychiatric disorders.

Women have twice the rate of anxiety disorder as men. Anxiety disorders are more frequent among individuals 25-44 years of age who are separated or divorced and who have low socioeconomic status. Although the anxiety disorders have devastating effects on these patients’ lives, only 15 to 36 percent receive treatment.

How do biofeedback professionals assess anxiety disorder patients?

After a medical evaluation to rule out medical diseases and medications that can produce the symptoms of anxiety, a biofeedback practitioner may conduct a psychophysiological profile that monitors your breathing, EEG, finger temperature, heart rhythm, skeletal muscle activity, and skin conductance during resting, mild stressor, and recovery conditions using biofeedback electrodes. The psychophysiological profile will enable your biofeedback provider to develop an individualized training program to correct abnormal physiological changes associated with anxiety episodes.

Frequent findings during biofeedback stress tests of patients with anxiety disorders include:

  • shallow, rapid breathing
  • imbalances between fast-wave (beta rhythm) and slow-wave (alpha and theta rhythm) activity in the EEG
  • constriction of the small arteries of the fingers
  • reduced heart rate variability
  • contraction of muscles in the upper shoulders, neck, and forehead
  • increased sweat gland activity

What is biofeedback therapy?

Biofeedback techniques use biofeedback instruments to increase your awareness and control of your physiological performance. A clinician’s biofeedback instructions are guided by the information provided by the biofeedback devices suggested by the psychophysiological profile.

How does biofeedback treat anxiety disorders?

Biofeedback training methods may combine cognitive behavior therapy (CBT), which is a form of psychotherapy, with one or more kinds of biofeedback training, including:

  • EEG biofeedback (brain electrical activity)
  • EMG biofeedback (skeletal muscle activity)
  • heart rate variability biofeedback (timing between heartbeats)
  • respiratory biofeedback (breathing patterns)
  • skin conductance biofeedback (sweat gland activity)
  • temperature biofeedback (blood flow through small arteries)

What is your role in biofeedback training?

Biofeedback professionals assign “homework” during each training session. You are expected to chart symptoms and practice self-regulation skills in between training sessions. These assignments often involve:

  • lifestyle modification, in which you change routine behaviors like diet and exercise
  • biofeedback practice, in which you practice self-regulation using portable biofeedback devices that range in sophistication from a disposable thermometer to a compact heart rate variability trainer
  • relaxation exercises, which may involve practice in reducing arousal that takes from 15 seconds to 30 minutes
  • self-monitoring, in which you record your symptoms, performance, or daily experience

Why is “homework” important to your success?

These assignments help you to expand your awareness and control to the diverse settings and activities of your daily life. Practice allows you to transfer your new skills from the clinic to everyday life where you need them. Studies confirm that successful biofeedback patients practice at least occasionally.

There are many reasons why regular practice contributes to success:

  • Practice devotes more time on task. When you practice five times a week for 30 minutes, you have added 6 ½ hours to the 1-2 hours you spend in the biofeedback clinic.
  • Practice extends training to new settings and activities. Just because you can warm your hands in the clinic does not mean that you can warm them at home or at the office. You may need to practice in each setting to transfer your self-control skill to that setting.
  • Practice allows you to consciously correct unhealthy behaviors like shallow, rapid breathing or muscle bracing.
  • Practice makes self-control automatic. You may need to practice a relaxation skill like skeletal muscle relaxation for 6 months until you can perform it automatically at the first sign of trouble.

How effective is biofeedback for anxiety?

Most controlled, randomized biofeedback clinical trials have found that biofeedback reduces anxiety as much as popular relaxation procedures like meditation. They both may achieve comparable results because they correct core problems in attention, cognition, and physiological arousal. Stress management biofeedback may help patients control the events that trigger anxiety attacks.

The Association for Applied Psychophysiology and Biofeedback’s (AAPB) Evidence-Based Practice in Biofeedback and Neurofeedback by Carolyn Yucha, PhD, and Christopher Gilbert, PhD, awarded this treatment the second-highest rating of efficacious.

Who should treat anxiety disorders?

Biofeedback professionals who are experienced in treating anxiety disorders and certified by the Biofeedback Certification Institute of America (BCIA) in General Biofeedback or EEG biofeedback are qualified to treat these disorders.

Is there insurance coverage for biofeedback?

Reimbursement for biofeedback services varies across insurance companies and states. Psychologists may bill biofeedback services as psychotherapy so that they will be reimbursed.

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