Results or placebo effect?

I’ve identified my first possible benefit of neurofeedback therapy… I think.

While I find reading enjoyable, it’s always been a laborious task. Only as an adult have I been able to find enough enjoyment in the occupation to meter the focus and concentration required to slog through a book. Frequently I would read several pages mechanically, trolling through the words only to pause and realize I was getting no meaning from what I was reading. I would have to stop, go back to where I last knew what was going on, and start over reading the same material. Depending on the topic, and whether my mental rhythm was in sync with my interest in the book dictated how often I had to jump back. This made reading a real chore, but it was something I’d grown accustomed to. I was a very slow reader because of this handicap.

Recently I’ve found myself energized by reading. I usually try to read at least an hour before bed, and it was often much less time as I could hardly keep my eyes open for very long. Lately I’ve not only been able to log many more pages in a short period of time, but I find myself unable to stop. Sometimes I return to the shelves to cross-reference something or simply to browse through other books in search of interesting topics.

Furthermore, the actual process of comprehension while reading has taken a positive turn. Instead of zoning out for pages at a time, I find myself not getting beyond a paragraph before I snap back to task. I can identify the same feeling in my brain as when I’m in a neurofeedback session and being made aware by the software that I’m not on task. I can sense a parallel between the two exercises.

I also noticed that my mental endurance has found new stamina. Today could easily have given way to a depressive episode but I didn’t slide. Instead I’m feeling optimistic and alert with the pre-occupation of current projects along with the anticipation of my newly acquired ability to remain focused.

I just counted my therapy receipts… 10 sessions so far, one-fifth of the distance. It really doesn’t matter to me if placebo is at work, something is making my head work better than it ever has before and I’ll take that as a win.

—

Last night I went to a favorite place in my dreams. It’s a wide river somewhere in the desert southwest. I’m with a group of kindred souls who enjoy the motion of the river. Sometimes in rafts, other times just floating freely through the gentle rapids under the warm sun. The water, wind, and landscape fills me with peace and hope that lasts throughout the day as I occasionally pause to wonder if and where such a place exists.

Electrode to the Forehead

The question is always the same, “What would you like today?”

I’ve almost exhausted my options. It’s either flying a geometric spacecraft through wormholes or driving one of several types of cars over various landscapes. I opted to take the Camaro for a spin through the lava fields. As usual, my mind wanders through fields of noise. I think about what I’ll do at work, wonder if the therapy is working, and probably the strangest obsession during therapy is wondering what the algorithms look like that guide the car through the course. I am always impressed at how robust the software appears to be. Jumping off cliffs, crashing into barricades, and plummeting into lakes of molten lava. The car shudders and smokes as the screen fades to various stages of inattention before righting itself on the course path. I want to reach for a steering wheel but can only do that virtually.

After 15 minutes the doctor paused the game and moved the electrode from the right side of my head to my forehead. He asked what I’d like to improve, anxiety or concentration. Since anxiety hasn’t ever really been an issue, I opted for the giant problem in the room, focus and concentration.

For the remainder of the session I raced the jacked up Chevy around the course. It didn’t feel much different other than I had a wire glued to the front of my head. I still couldn’t control the car like a Jedi master would. “Too much noise in the upper works,” as my 6th grade teacher would have said. Actually, he used the term, “Touched in the upper works” to describe the various misadventures of me and my compadres. Come to think of it, where did that memory just come from? That was 37 some-odd years ago. Maybe it’s working after all… I was advised (warned) that childhood memories could possibly percolate to the surface during therapy.

I wonder what other clowns and demons lurk beneath that swamp of childhood?

Depression vs. Sadness

In an early blog entry I distinguished clinical depression from the depression that comes from the inevitable tribulations of life. I used the example of a pet dog dying as a cause for depression. Well, that happened to me yesterday, and the experience has given me opportunity to reflect on the difference between causal depression and the type that seems to come out of no where.

That fuzzy dope who inhabited the backyard for the last 10 years was little more than background life to my domestic abode. Sure, I patted him on the head now and again, or scratched his neck, but admittedly took him for granted. He was more friends with the kids I suppose, I merely the landlord.

Yesterday he was blowing blood out of his nostrils and had become very weak so we loaded him in the car and rushed him over to the animal ER. After a half hour the veterinarian gave us the somber news. It was most likely nasal cancer but he wouldn’t know for certain unless they were able to A) stop the bleeding, and B) find a specialist who could perform the proper scoping and X-rays to determine cause. Procedures could easily run into the high four figures, and possibly higher.

It was a tough decision, but the only prudent action given the age and condition of the dog was euthanasia.

My youngest daughter was probably the dogs best friend. She had taken to him as a favorite playmate and they spent hours together rolling around on the back lawn. She was in the waiting room with us and broke into uncontrollable sobs which choked-up my wife and I as well.

It’s a very strange and emotional experience to spend time with a living creature knowing that it will soon undergo the separation of life. We surrounded the wheezing cur, stroking his head and assuring him that he’s always been a good dog. He certainly wasn’t his usual, chipper self as he strained for air behind dim eyes and bloody snout. The room was filled with profound emotion.

After about 20 minutes we bid him farewell and notified the assistant that the doctor may proceed with the procedure. You always hear about the master holding the dog as the lethal dose of anesthetic is injected, but we wanted our last memory to be of his kind brown eyes. The veterinarian was a gentle man with a long gray ponytail, so we knew our beloved dog would be comforted as he dozed off for the last time.

Last night the family was in an expected funk. We’d lost a member that day and needed some time to grieve. I have been searching my soul to identify the emotions I have been feeling and how those differed from depression. I have lost loved ones to death in the past but have not really taken the time to understand the feelings. I now know that grieving loss is not the same thing as being depressed. It’s sadness, which is a very different emotion from depression.

Sadness is also squarely a pain in the heart. It’s easy to understand the feeling of something suddenly missing from the left side of the chest. A broken heart is also a good description. This feeling or emotion is entirely different from the vacuum of feeling that accompanies depression. Considering that only now am I seeing 20/20 emotional vision after nearly 50 years of darkness, can I begin to understand what people have been talking about.

Depression is a void in the head, whereas sadness is a vacuum in the heart.

Depression Reflection

I don’t know if I’ve aptly described the depressive episode in this blog other than as reference within another topic. So, here goes… (note that since calibrating the meds I haven’t had an extreme ‘down’ episode since October. A few minor downers while adjusting meds, but nothing bad.)

Perhaps it’s the natural optimism of youth that structures the depressive episode differently as a young person. In looking back decades I can recall episodes of depression manifested in what I considered just a part of life. Everyone has their ups and downs and I was just weakly managing my down times.

It came on like any illness, a bad cold or flu, only the symptoms were based in my head. When I was young I could identify an oncoming depressive episode by the relative ‘high’ of the moment. Perhaps it was my upbringing in a religious atmosphere of cosmic equilibrium that dampened my good times with foreboding doom. I was taught that the universe relied on justice. If you had good fortune, you (or someone else) would be paying for it, in this life or the next. It was only as an adult that I realized that justice is merely a wish that people delude themselves with to cope with the inevitable misfortunes of life. Regardless, I blamed mood equilibrium for bouts of depression. I was paying for the good times.

As I reached adulthood and shed the superstitions of youth, the depressive episodes continued. I still held to the idea that I might be off-balance, but it wasn’t so much a zero-sum game anymore. I began to search for answers in books and ideas, thinking that perhaps I was simply missing something that would fill the void during my down times. I learned a lot about life during that phase and had many eye/mind-opening revelations that turned my childhood reality of life on end. None of those ‘revelations’ mattered anyway as the depression continued. I was finding answers to questions I never had, which in a way gave me a sense of personal purpose.

Moving into the ‘productive years’ of adulthood, my doctor (at the time) suggested I was experiencing a biological condition of which I had no control over. This was to be the single biggest breakthrough both physically and psychologically in my depression. I’d spent my whole life taking responsibility for something I had no control over. That was about 15 years ago.

Here’s what a depressive episode looks like…

Sometimes there is a trigger. Bad news of some sort: unexpected bill, family tension… the neighbor cutting down a tree. But most of the time it simply happens. During the onset of an episode are foreboding symptoms, similar to the swollen glands or a swore throat precedes the flu, a certain headstorm begins to form in the brain. I know that in a day or two I’ll be in a full-blown depression.

My head turns gray and I lose emotion, empathy, and hope. I shut down socially finding everyone, including my closest family to be an annoyance. I just want to be left alone, but feel extreme pain in doing so. I wish I could sleep through it but the body can only withstand so much unconsciousness at one time. I bury my face in the pillow while my ears scream in a high pitch and the only hope I have is that life would end and take the pain away. I can appreciated the motivation of ‘cutters’ during this phase as any sensation is better than no sensation. I don’t act, merely endure. Time crawls as I function minimally. If I have obligations such as work or domestic duties during these phases, my gray turns to anger as I am unable to process thoughts. Little frustrations are amplified and trigger outbursts of irrational rage. Fortunately I’ve not harmed anyone physically, but I’m sure plenty have been offended emotionally by my harsh words or actions.

The duration is anywhere between three and ten days. During this time I just want to escape, to fade away, to find respite from the dull pain. One big difference between youth and middle age is that during my youth I could fantasize about escaping to a better life by physical movement. If only I could live in a better environment, enjoyed the company of other, more enlightened people, if only I could do this or that, life would be better. Truth is, it is all in my head. I’ve discovered that hell and paradise can be experienced anywhere, and has little to do with environment. Perhaps it’s maturity, or rational conclusion that has contributed to some very low lows. Where I could one time fantasize of a better life, I can now only suffer.

Suicide.

It is always a possibility during depression. I have spent a lot of time pondering the subject during my depressive episodes but have not acted upon it. During the darkness I just wish that life could end. Nothing seems worth living for, and knowing there will be future episodes with the same pain, it becomes unbearable. The flawed rationality in my head considers my life to be a failed experiment in biology. Suicide becomes nothing more than the natural thinning of the herd.

It’s hard to say what might ramp out of an episode. I don’t think anything other than brain chemicals starting to function properly once again. Just as bad news might trigger a downward spiral, sometimes good news during a neural springtime provides hope and catalyst for recovery. Just as recovering from influenza, weakness and vulnerability provide for a hopscotch recovery.

In recent years there has been less hope and more foreboding during depression, mostly in knowing that there would be future episodes. Prior to this exploration I had been self medicating for about five years. I was taking a heap of vitamins. Multi, 1000mg garlic, B-complex, D, fish oil, st. Johns wart, 5-htc. Since taking the Symbyax I can’t say my vitamin routine provided any results, although I will say that I haven’t been sick for a long time. When I was young I constantly caught whatever illness that was making the rounds. Even though I’m taking the Symbyax/Adderall combo, I still take my vitamins. I suppose it can’t hurt.

Food allergies have always been on my radar for cause, but I’ve never identified a positive correlation between depression and anything I’ve eaten. Exercise is another exploration. When I was younger and had the time and place, I rode my bicycle for long stretches. I can still identify periods of depression during that time, but have a general recall of feeling good. As I get older, exercise seems to cost more in terms of recovery than in any benefit.

It’s difficult to describe depression to those who haven’t experienced it. Everyone experiences causal depression at some point in their life… it’s a part of life. But clinical or biological depression is another animal, and only those who have it can relate. To understand it you need to temporarily erase all the good times from past memory, and abandon all hope for the future. There is no thought or feeling other than doom, and certainly all rationality flies out of the head. No one can say anything helpful and there is no base for optimism.

I’m happy to say that I’ve not had an extended depressive episode for better than six months. It was interesting that prior to my ADD diagnosis I was having episodes of mental frustration where I questioned whether the Symbyax was working.  That was when Dr.Kkjsez suggested the Adderal, which proved to be the balancing ointment. Since then I have been able to meter my days with varying dosages, predictably throttling my mental states as needed.

3 down, 47 to go

The novelty has worn off now. I know what to expect during a session. I sit in the egg chair while the doctor glues electrodes to my head. Snapping the headphones to my skull I slump back into the chair and await the first-person video game on the wide screen television in front of me.

The doctor asks what I would like to do today, fly or drive. “Are there any other choices?” He replies, “there’s a train, but that’s more for little kids.” It’s my third session and I’ve already done a ‘flier’ and a ‘driver’ so I opt to do another driver. I pick the dune buggy this time and start the course selections top of the order.

I start down the course rather bumpy. The car bucks and slams into other cars. The screen fades to various levels of gray as I attempt to control the movement with my brain waves. I want desperately to control the movement of the car by my conscious thoughts but I can’t find a pattern of intent that is predictable. On either side of the screen are gauges that indicate whether my brain is on task and my vision wanders to the sides to try and control motion by meter. No luck there either.

When I’m in ‘the zone’ a blue vapor trail escapes the rear of the buggy as it races through the middle track of the course. When off task, the vapor turns to red, and/or the car slows or stops. I only experience momentary states of flow throughout the entire 30 minute session.

—

I felt more irritable than usual after this session. However, I have to place blame on a project at work that has made me frustrated the past couple days. What should have been a quick bug fix took nearly two full days of code study to figure out how the application was working. I get irritated when I spend so much time on something that should only take a few minutes. Until further reflection indicates differently, I’ll blame it on OPCC (Other Peoples Computer Code)

Even though I have a cause, I need to note that 2 out of my 3 sessions thus far have resulted in unusual stress and a headache later in the day that required Excedrin treatment. Whether the therapy was causal or coincidence remains to be determined.

Neurofeedback: Session #1

The doctor was in and ready for my appointment this time. I felt a little guilty for writing smack about the office in my last post so I made an extra effort to try and notice why I considered it cluttered. In looking around the conference room I realized that it really wasn’t messy at all, just the usual stuffs of any well-used office.

I was invited to sit in the egg chair. As soon as I eased back into the aural dead zone of the cocoon the doctor confirmed my suspicions that it was a modified stereo chair from a 1970’s Sharper Image catalog. I leaned forward while the doc glued-up electrodes for each side of my head just above my ears, and clipped a third ‘trode to my left earlobe explaining that it was the ground wire. A set of stereo headphones comfortably squeezing my head completed the wiring and I eased back into the egg in my favorite position for relaxation… slouched.

On the flat panel television in front of me the doc was queuing up what looked to be a video game. I got to pick my car make (Cobra), color (green), and starting track (mountain). For the next 10 minutes I just sat in my egg and watched the screen while the doctor scooted the mouse around outside the periphery of my vision. The car on the screen jumped around much like the cartoon antics of Mario Cart on the home Nintendo Wii. Finally the doctor announced a lock on the frequency that I would be sensitive to.

Without any instruction he started the ‘game’ and left me to my puzzle. I had a lot of thoughts running around my head, mostly what was happening and how it was beginning to re-map my neural pathways. As my mind wandered to different places the car would stop, crash into other cars, and sometimes the screen would fade to gray indicating that I wasn’t consciously in attendance. Amazingly I found the game strikingly accurate in response to my thoughts, even though I couldn’t consciously make the car travel predictably. It was obvious that there was subconscious calisthenics at work.

I finished the 3 or 4 laps of the mountain circuit and it queued up another course automatically. This time I was on snow and ice. The Cobra did most of the same maneuvers only with a different backdrop. The music in the headphones changed as well. Instead of the usually synthesized motor and metal sounds of a video race game, I listened to soothing instrumental music. The doctor checked on me after about 10 minutes and announced that I had another 10 minute exercise ahead. I really wanted to feel control of the game but at the same time realizing that ‘letting go’ was what made my car stay on the path in steady acceleration. There was definitely something my brain was learning with this exercise but I couldn’t articulate anything other than it was important.

After the final session the doctor removed the electrodes and swabbed the glue from the sides of my head with a sterile gauze. I mentioned the traffic in my head and the doctor confirmed from his vantage point of computerized charts and graphs that there was plenty of mental pollution going on. Besides the usual chaos in my head, there was a certain novelty I was fighting with as well. It’s not every day that; A) I’m up this early, and B) that I’m wired up to a video game that I’m controlling using only my brain waves.

I drove to work thinking about what I’d just experienced, and what did it possibly mean. No answers yet, but 49 sessions to go. There were no after effects except toward late morning I started getting a low-grade headache. I popped a couple Excedrin to move the pain from my head to my stomach. Nothing else noticeable other than returning to memory of my feedback session throughout the day, dreaming possibly of a future time when I could command my head to function with focus and concentration.

Scanners

I arrived promptly, even 10 minutes before my scheduled appointment to get my initial brain mapping. Signs on the wall of the waiting area were adamant about being early for appointments.

Appointment time

15 minutes later…

…30 minutes later…

… finally, 45 minutes after my scheduled appointment I get called back to the lab. 15 minutes later and I would have walked out of the office probably never to return.

The doctor apologized profusely for the delay and wasted no time wiring my head. He placed two electrodes near the hairline in front, a couple on the back of my neck, and one on each ear lobe. He then pulled a skull cap over the remainder of my exposed cranium. On the monitor in front of me was a graphic of the top view of my head with about 25 dots that kept bouncing numbers. He explained that the numbers represented electrical impedance. The numbers varied but the color was a steady red. “When all the dots turn blue or green, we’ll have good connections,” he said.

Then he took a tube of goo and began injecting each of the dots in the skull cap. I could feel the cool electrical gel make contact with my scalp as each of the dots on the monitor began to register lower numbers and turning into cool colors.

when all the electrodes were in place the doctor described the test:

1) Eyes open – staring at the brain poster on the wall

2) Eyes closed – just that, eyes closed

3) On task – reading something

At each task he would announce that he was recording for 4 minutes each. I couldn’t see the monitor anymore as he had turned it to face him more directly. He seemed to be paying attention to the monitor which was now recording my brain waves from several angles. After the last test he removed the skull cap, electrodes, and let me wash my hair in the adjacent sink.

The results of the analysis would require a couple hours to compile so I agreed to return early afternoon.

…later that same day…

I’m back in the waiting area promptly at the designated time, even 5 minutes early.

10 minutes later…

15 minutes later…

This was my third visit to the waiting room and not once had they been on time. I wouldn’t really have cared except there seemed to be a little hypocrisy in the warning about being on time for the appointments.

The doctor grabbed a pile of paper off the printer and sat down with me in the conference room. He flipped pages and explained things about the brain and results that I didn’t comprehend. I just wanted some validation for my ADD/Depression. When he finished I asked what a normal map looked like. He responded that in 14 years of doing neural feedback, he’d never seen a ‘normal’ map. That was fine, but I still needed something to compare my eval to so he flipped open some other maps from previous patients and showed before and after. That was a little more helpful, but still not answering my question directly.

He showed me several pages of the various colored heads from the printout and showed where the ADD and Depression patterns were apparent. Then he caught me off guard by showing me some yellow and orange wave patterns normally attributed to Aspergers and Autism, or perhaps a historical head injury. I’d always kinda thought that I was a highly functioning retard, but now I had the evidence.

The doctor turned me over to his assistant to close the deal. I wrote the check for $3,490.00 and scheduled my first appointment for calibration. Insurance will only pay 60%, and only after I prove that I’m actually doing the therapy.

From nearly walking out the door to enthusiastically embracing the journey of my next six months, all in one day. I start my first appointment in less than two days. I’ll be back here with a report.

Pharmaceutical Madness

Mrs. Bloom returned from the pharmacy with my latest prescription, a month supply of Adderall which includes 30 XR capsules and 90 supplemental IR tablets. Even on my lousy insurance I was only paying a co-pay of 15 bucks each for generics. The receipt the Mrs. presented today… $231 and some change. I went a little ballistic.

I bypassed the online help as I didn’t have the patience to click around and dialed the 24/7 number on my insurance card. I got the automated help who couldn’t understand anything I was shouting into the receiver. I held the zero button down hard until the bit Betty shut the hell up. Finally, the recording said, “Just a few more questions and a customer service rep will be able to help you.” I entered my group policy number, verified my name, did some jumping jacks to finally be told that the offices were closed.

The Mrs. was finally able to track down my benefits on the web tangle… there it was in striking font, generic medications, $15 co-pay. I printed the page, rounded up the receipts and bounded for Walgreens on a mission for justice.

The mouth-breather across the counter looked at my prescription and said, “You must have a deductble.” I countered with a stern gaze that I didn’t. He asked to see my card and I asked how he knew I was on Aetna considering I hadn’t given them my new insurance info. He mumbled something about an Aetna ABM number that I was under. The only thing I could think of was that when people expire under one policy that it falls into a bucket that Walgreens can use to make claims against. It sounded fishy for sure.

After punching in a few numbers and telling me the real cost of the meds (about 10 dollars more than the 230+ I’d just paid) I countered that I could buy it online for 17 dollars and would happily take my business to the US postal service. Neither of the attending lab coats seemed to care. A few minutes later the clerk came back that indeed, each prescription was only $15. The store manager was called in to authorize the refund and I was relieved by a $200 error in my favor.

Here’s what I don’t get. Pharmaceuticals, even generic are priced ridiculously. The retail price of those generic meds was nearly 250 dollars, of which I was paying 230. Does that mean the pharmaceutical companies get charged the difference between my co-pay and the retail price? I got to thinking about my Symbyax which has a price tag of close to $600/month. That’s more than my entire insurance premium. I can’t imagine an insurance company paying that much. I can only guess that there is some legal racketeering transpiring between the insurance companies, pharma, and the dispensaries. Perhaps there are enough poor schlubs who don’t have insurance that they pay for those of us that do. Maybe I’m wrong, but I highly doubt that Walgreens is getting a check for full retail.

The Cranium Gymnasium

I arrived promptly at my designated appointment time, 5pm. No one was in the reception area, nor inside the reception window. Only Musak and my own curious anticipation to occupy my thoughts. A few minutes later the Ph.D. in charge appeared in the receptionist office to riffle through some paper work. Following his apparent search he opened the door and stepped into the waiting area. “You must by E, I’m Dr. Fannin… sorry about the wait, my office assistant had to leave unexpectedly due to a family emergency.” I was impressed that he greeted me by name and finally felt that I was in the right place.

After only a few minutes, several patients exited the building followed by the doctor who invited me back. I was escorted into a conference room where a plastic brain sat on the middle of a large conference table. Lining the walls were various medical posters depicting the human neural system. The chairs were in disarray and the office appeared a bit scattered and disorganized.

I took a chair and propped my elbow upon the table. Dr. Fannin did the same. We sat there and stared at each other awaiting mutual response. The doctor finally offered his presentation, “I’m all yours.”

Expecting a formal presentation about the business/therapy, I was a bit caught off guard. I had expected some sort of formal presentation about the practice but instead got the doctors full attention for Q&A. Having recently read the book Symphony in the Brain, I was somewhat versed in the therapy and had plenty of questions ready anyway.

I started the discussion with my personal history of mental illness and then mentioned that my psychiatrist had referred me to the Center. The doctor complimented my pronunciation of Dr. Szprem saying that most people say it wrong. He also reinforced his own credentials by dropping a few names including personal endorsements by the Symphony author and doing work with West Point Military Academy and a few other high profile organizations investigating brain training. To my question of success rate he responded, 92%. My follow-up of why the 8% that didn’t respond to the treatment he cited outside influences in the patients’ life. He also said that it’s critical that people must want to change. That threw up a tiny red flag of placebo in my mind.

My next question was to find out what his critics thought of his practice. He responded with nothing really different from what I’d read in the book. Essentially that there had been no double-blind scientific studies of the therapy, but also said that it’s impossible to perform such a test with this type of therapy. I didn’t understand why, and still need to re-visit my definition of the scientific method to figure out what he meant.

Next he offered a tour of the facility, which constituted a walk through the office area. There was a large room surrounded by smaller offices. It seemed disorganized and perhaps cluttered, as if in mid-move. I didn’t put too much stock in that observation though, chalking it up to the lab of a mad scientist. I guess what bothered me is that I expected more of an orderly presentation of institutionally sanitary fixtures. Intead it looked like they’d raided the Salvation Army’s furniture department. An well-worn egg-shaped chair sat off the the side on one NF ’station’ that was begging for narrative. I’m pretty sure I’d seen the same chair advertised in a Sharper Image catalog as a stereo listening chair. I suppose like astronauts can be trained for gravity with playground equipment, neuronauts can be trained with cast off relics of the 70’s.

The doctor demonstrated a recording of a NF session. In the big room was a large, flat screen television opposite a computer station. He queued the recording and I watched as what appeared to be a game of Grand Theft Auto lit up the screen. The blocky image of the car would accelerate and decelerate with the impulses of the patients exercising of the parts of the brain that needed toning. There was no steering involved, only speed. I asked how he assumed that everyone wanted to go faster.

Now it was money time.

For $525 I could get an initial brain map. This is where the patient wears a skull cap with numerous electrodes attached to determine brain wave activity. Like an initial muscle assessment at a gym, this map would provide the trainer with some areas that could use re-wiring. The initial payment would be applied toward the standard treatment fee of $3,495 if it was agreed to proceed with therapy. This price applied to an average of 50 treatments from start to finish, although he said further training could be done if needed in batch rates.

The Symphony book claimed that insurance didn’t cover NF, but I was hoping that in the 10 years between the copyright date of the book and today, perhaps some inroads had been made… but apparently not. He said that it was hit or miss whether insurance would cover the treatment, and said with astonishment that Blue Cross Blue Shield had recently approved a brain mapping for a customer. I stared incredulously at the doctor and exclaimed, “That’s amazing! Those tightwads at BCBS deny everything!” He agreed to copy my current insurance card and have his assistant perform some due diligence to determine if I could get any coverage. (note, that was Wednesday and I have to assume that no news is bad news.)

So here I sit, wondering whether I should swallow the expensive pill of Neuro Feedback therapy. Not only will I need to pony-up  3.5 large, but I’d also need to figure out a schedule that would allow me two business hours per week for the next half year. The office is opposite ends of the metro area from my work and they are only open during usual business hours. I would think they would accommodate working folk better by providing evening hours, but I also learned that there are only 2 employees running the facility. I also asked if there were any financing options and the doctor responded with, “Make me an offer.”

I just don’t know. I’m intrigued but was underwhelmed by my ‘tour.’ I’m curious to get a brain map because from that they can identify brain wave signatures for Depression and ADD. It would be interesting to finally see some scientific validation for my ailments. For now I’ll wait and see what the insurance company says. I have new insurance that carries a $1,000 deductable and I’d be willing to pay that to start treatment, but I’m not sure about the 3.5G.

The good news is that I’m in no hurry. As long as the shrinker doctor can keep me supplied with the octane booster Adderall, I can continue to function. Like most things in life, as long as something is on my personal radar, and I have patience, the planets usually align at some point and everything works out.

Book Review: A Symphony in the Brain

(A Symphony in the Brain by Jim Robbins)

I would have overlooked this book easily were it not for the recommendation of Dr. Pytwq. Bio-feedback, the distant ancestor to Neurofeedback got a bad name for itself back in the 1970’s. During the wide lapel days of disco and designer drugs, bio-feedback was the thinking fro’s key to unlocking the mysteries of the brain. Had it instead attracted a following of geeks, it may not have gotten the bad reputation that it did.

Fast forward 20 years…

A few pioneers took the concept of bio-feedback seriously and applied it with astounding results. Margaret Ayers, along with Sue and Siegfried Othmer are credited with birthing the concept of neurofeedback from the labs of academia to the general public. Following powerful personal experience, both Ayers and the Othmers set out to provide this technology to the public. The book describes several case studies of miraculous results in bringing people out of their various states of mental slumber. Unfortunately they had a tough climb out of the shadows of bio-feedbacks’ ill repute.

The concept of neurofeedback is simple. Identify portions of the brain that are not functioning optimally, and perform exercises that regenerate those neural pathways. Unlike body building where specific muscles can be targeted by certain calisthenics, the brain requires technological assistance to help identify poorly performing areas. A device known as an electroencephalogram or EEG is used to monitor wave frequencies of various portions of the brain. Medical science has proven that the brain functions on electrical impulses so it stands to reason that a sensitive device could monitor those signals.

A huge difference between the bio-feedback of the 70’s and neuro-feedback of the 90’s is not only the sensitivity of the monitoring instruments, but also the increased knowledge of the brain. Everything from Epilepsy to simply desiring more clarity of thought can now be identified by electrical frequencies in certain parts of the brain with an EEG device.

Armed with information about cranial activity, exercises can be administered to stimulate areas with diminished electrical frequencies. Neurofeedback is essentially administered by software that monitors this information and guides the brain through exercises that stimulate and re-condition the dormant neural pathways into new patterns.

As I have stated before, I believe the brain is an organ rather than a muscle. It can be abused rather than toned from over-use. However, in this new light I need to reconsider my understanding. perhaps the brain is neither an organ nor a muscle, but a body component that can be strengthened or abused. Perhaps incorrect encoding, or neglected neural pathways of youth carry into adulthood. (Accepting that I’m not a neural scientist, I just need some Fischer-Price analogies to make sense of my new personal discovery.)

The medical community is still skeptical of the practice only because scientific studies have not yet been done. At least I don’t think so, the book holds a copyright date of 2000 so perhaps some studies have been performed in the past decade. Regardless, the anecdotal evidence is nothing short of miraculous. And even if there was a placebo effect, the results are reported to be permanent. Reportedly 90% of neurofeedback recipients have reported a permanent recovery from ADD and Depression. I have to conclude that there is some merit in the practice.

The book was a page-turner for me, probably because of the relevance of the subject. ADD and Depression were both addressed throughout the book and Robbins writes very well to a non-academic audience. I would recommend this book to anyone interested in learning more about neurofeedback.

–

Just when I had reconciled my future to medication, along comes the promise of a cure. I still need to determine if my insurance will cover any part of the therapy but I intend on starting my due diligence this week with a phone call to my Dr’s referral. When the book was published it was reported that insurance rarely covered the treatment, but having 10 years to gather data, I think perhaps insurance companies might find a cure to be less expensive than years of high-cost  pharma. I’m so jazzed about the possibilities that I would probably be willing to pay for the therapy myself.

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