Neurofeedback is a training technique that helps you learn how to consciously change the electrical activity (brain waves) in your brain. All electrical oscillations influence your state of consciousness, arousal, and ability to function. Neurofeedback is based on the idea that many individuals, particularly those with psychological conditions (e.g. ADHD) have suboptimal brain waves in certain regions.
The goal is to target the suboptimal brain wave production in specific regions and correct them. In other words, someone with an inability to concentrate may experience excess slow waves (theta waves) in their prefrontal cortex. In this case, neurofeedback training may involve increasing (uptraining) faster waves (beta waves) in the prefrontal cortex, while decreasing (downtraining) slower waves; in theory, this should improve the individual’s ability to focus.
Most people regard neurofeedback as a relatively benign, yet effective way to improve mental performance. While this practice is considered safer than taking a medication that carries side effects and withdrawals, there is still a chance that you may experience side effects from neurofeedback. Fortunately, most side effects are not considered severe and can usually be prevented or reduced by working with an experienced neurofeedback practitioner.
Factors that influence side effects from neurofeedback
There are some possible factors that should be considered as culpable for inducing side effects. These factors include things like: individual variation, the specific brain waves being uptrained or downtrained, the brain region getting trained, experience of the professional, and whether a person has preexisting neurological conditions.
1. Individual variation
Any activity or substance that alters brain activity is likely to provoke side effects. Although most neurofeedback practitioners suggest that side effects are minimal or nonexistent, it is important to always trust your own experience. Every person is different and just because most people don’t experience side effects from neurofeedback doesn’t mean that you’ll have the same reaction.
Some people may experience noticeable side effects, resulting from individual variation. Two people with nearly identical QEEGs may experience the same training, yet one person may report harsher side effects than another. These side effects may be a result of subjective interpretation, a placebo effect, or various other neurochemical, neuroanatomical, and genetic influences.
2. Quality of training
Anyone partaking in neurofeedback to improve brain functionality should consider the quality of their training. You should be working with a qualified professional, preferably someone with years of experience and success in the field of neurofeedback. Additionally, you should only work with someone that conducts a QEEG prior to training; a QEEG ensures that the practitioner is targeting abnormalities rather than “guessing” what is wrong.
Working with a practitioner that is outdated and/or who does not conduct a QEEG prior to training will increase your risk of unwanted side effects. Make sure that you’re working with someone who not only has experience, but a good track record in the field of neurofeedback. Quality training can make a big difference between a person experiencing adverse reactions and experiencing no side effects.
3. Location (site) of training
Based on your QEEG scan, a neurofeedback practitioner will be able to pinpoint some specific locations that should be targeted for training. The training generally involves either increasing (uptraining) certain frequencies and/or decreasing (downtraining) others. Certain locations of the brain are inherently more risky to modify compared to others and may lead to many side effects.
To minimize your risk of side effects, you should target areas of the brain that are well-known to improve performance, rather than areas that may be risky to alter. The best neurofeedback practitioners know areas of the brain to target based on QEEG scans. Furthermore, they will ensure that the sensors are placed in precise locations rather than inadvertently misaligned.
4. Brain waves
Certain frequencies of brain waves may produce more substantial side effects than others. Those attempting to increase certain frequencies of beta waves and/or gamma waves may experience side effects related to increased arousal. For example, uptraining mid to high beta waves may result in transient feelings of panic, racing thoughts, and/or generalized anxiety.
Increasing slower wave frequencies such as alpha and theta may result in decreased energy, fatigue, and inability to concentrate. It is possible for the slower frequencies to produce a sense of depersonalization or emotional upheavals. While these may be transient, they could become difficult to overcome if they are improperly trained.
5. Preexisting neurological conditions
If you have a preexisting neurological condition, you should always tell a neurofeedback practitioner. There may be greater risk of adverse reactions during neurofeedback among those with neurological conditions. For example, it is known that those with epilepsy experience abnormal surges of electrical activity that increase likelihood of seizures.
Should you have any significant neurological condition, realize that you may be prone to side effects that others won’t experience. While neurofeedback may end up improving your condition, it is important to discuss any potential risks to minimize the probability of adverse reactions.
Neurofeedback Side Effects / Adverse Reactions: List of Possibilities
While neurofeedback is generally recognized as a safe intervention for improving electroneurological flexibility, some people report side effects. A majority of reported side effects aren’t considered dangerous and usually transitory in that they’ll eventually subside. That said, if you aren’t working with a skilled professional, haven’t gotten a QEEG assessment, and/or are conducting neurofeedback on your own – you may increase the risk of experiencing side effects.
- Anxiety: Many people report anxiety associated with the neurofeedback. Some of the anxiety may be a placebo or circumstantial based on the fact that electrodes are being attached to their head. This may result in the perception that a person’s brain could be damaged, etc. It is important to consider this circumstantial anxiety stemming from the neurofeedback setup itself. Improper training could exacerbate anxiety as could adverse reactions. Some people have reported increased anxiety following neurofeedback sessions.
- Brain fog: While neurofeedback can be a great tool for reducing brain fog and improving concentration, not everyone has a favorable reaction. Some people actually experience impaired concentration following their training. An increase in brain fog may be a transient reaction and may subside with continued training. That said, improper training could potentially make you feel “spacey” and decrease your ability to focus.
- Cognitive impairment: Those attempting to maximize cognitive performance may engage in neurofeedback. The problem is that training the wrong frequencies in suboptimal locations may result in impaired cognitive function. In other words, your thinking may become slower and your performance could actually decrease as a result of the training.
- Chattering teeth: A rarer side effect that has been reported is that of chattering teeth. While this chattering may not occur during sessions, it may occur following a session. Those that have experienced teeth chattering compare it to the same as you’d experience if your body was shivering (e.g. on a winter day).
- Fatigue: Should you experience fatigue from neurofeedback, it may be transient. If you are increasing a faster frequency in a region where a slower one was dominant and/or increasing a slower frequency in a region where a faster one was dominant, you may end up with transient fatigue. Over time, your energy level should normalize and fatigue will subside. That said, there’s a chance that improper training could cause fatigue.
- Depersonalization: Anytime you’re changing the electrical activity in your brain, regardless of whether you’re doing neurofeedback or using brainwave entrainment, you may feel depersonalized. This depersonalization or feeling “unlike” your normal self may be uncomfortable and less appealing to some individuals. While you may eventually adapt to your new state of consciousness, you may also dread it and experience discomfort.
- Depression: Some people may experience depression during neurofeedback. Depression is thought to be more common among those increasing slower brain waves, while anxiety is thought to be more common among those increasing faster ones. While the depression may be temporary, it is important to consider that too much slow wave training could decrease neurophysiological arousal to the point of depression.
- Dizziness: If you start to feel dizzy following neurofeedback, it may stem from the electrical adjustment taking place in your brain. It could also be from overtraining certain frequencies and/or too intense of training over a short-term. Understand that dizziness may also be related to anxiety and/or a placebo-based side effect.
- Headaches: While headaches could certainly be a placebo effect, training faster waves (of higher frequencies) can certainly produce headaches. Should a practitioner improperly train certain brain waves, target the wrong region, etc. – a person may experience full-blown migraines.
- Head pressure: It has been reported that some people experience pressure on their head. This pressure may be in the area that was being trained via neurofeedback. It may even be in another area and/or more widespread than in one specific location. The pressure is a relatively uncommon side effect, but may occur as a result of electroneurological alterations.
- Internal vibrations: Another side effect that has been anecdotally mentioned is that of internal vibrations, almost as if your insides are buzzing. These vibrations may be troubling and/or feel as if something is internally amiss. It is certainly possible that electrical alterations may have provoked physiological changes that lead to these vibrations.
- Low energy: If you’re a very high energy person and/or certain brain waves are triggering hyperactivity and are a byproduct of excess CNS stimulation – reducing these waves may result in temporary bouts of low energy. This energy reduction is due to the fact that you’re comparing your hyperaroused brain to a calmer one. That said, it is possible for some individuals to experience transient energy reductions with neurofeedback training. More permanent reductions may stem from improper training.
- Muscle tension: Experiencing muscle tension is often a result of improper neurofeedback training. That said, training faster frequencies such as beta and gamma in certain areas may result in increased tension. Proper neurofeedback training has significant potential to reduce perceptions of muscle tension.
- Social anxiety: It is possible to become more anxious in social situations after neurofeedback. While an experienced professional will decrease the likelihood that you’ll experience social anxiety, some have reported this as a side effect. This may be a more likely effect among those that have a history of anxiety.
- Tiredness: In some cases, neurofeedback feels like a mental workout. You may find that your brain becomes tired afterwards because you were trying so hard to improve the electrical activity in your brain. This mental exertion may result in both mental and physical tiredness. Overtraining and/or training the wrong frequencies can also provoke tiredness.
- Trembling: The electrical changes occurring within a person’s brain during neurofeedback could result in physiological alterations. These physiological alterations may trigger sensations of shivering and/or trembling. While the trembling could be related to anxiety and may even be temporary, it is a rare adverse reaction that has bee noted.
- Vocal changes: Anecdotal reports have suggested that neurofeedback may result in vocal changes and/or subjective perceptions that a person’s voice has changed. Obviously if a person experiences an increase in anxiety and/or trembling, these may be culpable for any reported vocal changes.
- Worsening of symptoms: The goal of neurofeedback is to improve brain functioning by optimizing electrical activity. If you have anxiety, depression, ADHD, or another condition – it is important to consider the possibility that your symptoms may worsen. A worsening of symptoms may be temporary, but may be induced by suboptimal or improper training.
Note: Many people report symptoms stemming from neurofeedback that they had never experienced prior to the training. In other words, a person could develop anxiety despite never having experienced anxiety prior to the training.
How to Reduce and/or Cope with Neurofeedback Side Effects
To reduce the likelihood that you’ll experience side effects, adverse reactions, and/or dangers associated with neurofeedback, you may want to follow some of the suggestions discussed below.
1. Get a QEEG “brain map”
Prior to engaging in neurofeedback training, you should always get a complete QEEG (quantitative electroencephalograph). This QEEG provides the neurofeedback practitioner with a blueprint of the electrical activity in your brain. It allows them to diagnose abnormalities and certain areas that you’d benefit from targeting in your training.
Individuals that don’t get a QEEG are blindly “guessing” at what should be corrected. Blindly guessing the electrical activity that should be corrected is a bad strategy if you want good results. Additionally, hypothesizing what “could be wrong” with your brain waves increases your risk of adverse reactions.
2. Work with an experienced practitioner
Working with an experienced practitioner will likely ensure that you’re getting the best possible treatment. Individuals that conduct neurofeedback, but lack significant experience may be unprepared to discuss potential side effects and/or adverse reactions. Inexperienced practitioners may assume that their training is optimal when in reality, it is doing more harm than good.
Experienced practitioners should have new, functioning, updated equipment and should be up-to-date with the latest literature. They should be aware of the safest frequencies to train and the regions of the brain that are safest to target. Take the time to work with someone that’s highly qualified rather than the cheapest practitioner available – it’ll reduce your chances of side effects.
3. Communicate with the practitioner
Communication is extremely important during neurofeedback – especially after sessions. You should be keeping a journal (I recommend “The Journal“) to note how you feel each day. If you notice any significant side effects, these should be mentioned to your practitioner. The neurofeedback practitioner should be actively listening to your side effects and should discuss them with you.
In some cases the practitioner may inform you that the side effects are transient and will eventually subside. In other cases, the side effects may be unexpected and brain waves may have been improperly trained or a region may have been mis-targeted. The neurofeedback practitioner should be considering any feedback you’ve given throughout the process.
4. Cut back on training
Some people end up “overtraining” their brain in that the neurofeedback sessions are too long and/or too intense. Overtraining may increase risk of side effects and/or adverse reactions. Neurofeedback may feel like a “brain workout” but shouldn’t necessarily result in significant side effects and/or adverse reactions.
If you are training several times per week for long durations each session, you may want to reduce the number of weekly sessions and/or the length of each session. As with any medication, the minimal effective dose concept also applies to neurofeedback.
5. Fuel your brain
If you were working out your body (e.g. lifting weights), you’d hopefully provide it with nutritious fuel in the form of food. If you are working out your brain with neurofeedback, you should also provide it with fuel. Ensure that you are eating an optimal diet for mental health with foods such as: vegetables, healthy fats, protein, some fruit, and healthy whole grains can minimize your risk of fatigue and overtraining-related side effects.
6. Persist with training
Should you experience minor side effects, it is important to realize that they may be transitory. Whenever a person is changing their electrical “QEEG” signature, it’s possible that they will meet some resistance. The brain wants to function how it has always functioned, and changing it to adapt to a new set of frequencies may carry some side effects.
Should you persist with the training, you may find that the side effects fade in time. Obviously if the side effects are severe, you may want to stop the neurofeedback altogether. However, if the side effects are minor and the neurofeedback practitioner has suggested that they are likely to be transitory, you may want to persist with your training.
7. Stop neurofeedback
If you suspect that your neurofeedback practitioner is inexperienced or you cannot deal with the side effects you’re experiencing, you may want to just stop neurofeedback. Despite the fact that neurofeedback has been hyped in the media as having “no side effects” – clearly this isn’t the case for everyone. Not everyone will benefit from having their brain’s electrical signature altered to fit a consensus “average” of what’s considered normal activity. If you feel the drawbacks (side effects) outweigh the benefits, discontinuing neurofeedback may be smart.
FAQs: Neurofeedback Side Effects
Below are some frequently asked questions related to neurofeedback and potential side effects and/or adverse reactions.
When does a person experience side effects from neurofeedback?
Side effects resulting from neurofeedback can be experienced at any time throughout training. They may be experienced during the very first session, or may become noticeable after several sessions. Most people report side effects within their first 10 neurofeedback sessions.
Neurofeedback is unlikely to produce significant change within the first session, but the cumulative effect of training could trigger side effects. It is less common to experience side effects “immediately.” That said, all side effects you experience as a result of your training should be reported and noted as soon as you experience them.
Is neurofeedback guaranteed to make my brain perform better?
No. First of all, not all neurofeedback practitioners are good at what they do. There are also many styles of neurofeedback training – some of which may be more effective than others. In addition, even if a neurofeedback practitioner is following a specific protocol and has extensive experience, there’s no guarantee that making electrical corrections to your brain activity will provide benefit.
Sometimes corrections to fit a “norm” (based on “normal” QEEG readings) may result in significantly more drawbacks than benefits. Having an abnormal QEEG may provide you with certain adaptive advantages that another person with a QEEG “normalized” by neurofeedback wouldn’t. It is also important to consider the possibility that electrical corrections may result in a worsening or exacerbation of the condition you were attempting to correct with neurofeedback.
While most people will get some benefit from neurofeedback, individual variation suggests that not everyone will feel better following training. In fact, some people may note no significant change, while others may notice that their performance is compromised. Any treatment that has potential to help you, also has potential to inflict harm and impair performance.
Could neurofeedback training be dangerous?
While there isn’t significant that neurofeedback is dangerous, it could be dangerous to work with an incompetent practitioner. An incompetent practitioner may actually “screw up” your brain’s electrical activity, making it tougher for you to function in society. If you notice that you cannot think, have developed odd side effects, and feel as if neurofeedback has made you feel significantly worse – you may want to avoid it.
Most practitioners market neurofeedback as a risk-free practice. In other words, they suggest that it only has potential to improve functioning, rather than impair it. Any technology that can alter the brain for the better could also alter it for the worse. Certain frequencies within the gamma range can overlap frequencies of an electrical outlet – and one mistake could result in a literal “brain zap” of electricity.
Comparing the therapeutic benefit with the side effects
Whenever engaging in any treatment, regardless of whether it’s natural, low risk, pharmaceutical, etc. – it is important to conduct a cost-benefit analysis. In other words, you should constantly be comparing the therapeutic benefit derived from the treatment with the side effects you experience. Some individuals engaging in neurofeedback will experience side effects, but their performance may improve.
In this case, it may be justified to continue treatment for the performance benefit in spite of few pesky side effects. In other cases, a person may experience side effects and have a poor response to the neurofeedback treatment. In this case, it’s probably a smart idea to discontinue the practice and/or consider that the practitioner you’re working with may be underqualified.
Many people will report noticeable benefits without any side effects; this is the ideal scenario. If neurofeedback is improving your mental functioning without any adverse reactions, there’s an incentive to continue treatment.
Have you experienced side effects from neurofeedback training?
Just like improper weight lifting technique could result in physical injury – improper neurofeedback training could result in side effects and/or adverse reactions. These adverse reactions shouldn’t be undermined and/or glossed over. Altering electrical activity in the brain can simultaneously alter physiology, neurotransmission, and cognitive processing.
If you’ve engaged in neurofeedback, feel free to share a comment mentioning whether you’ve experienced any side effects or adverse reactions. Be sure to mention what side effects you experienced, their severity, and what you believed caused them. Were they transitory or a byproduct of improper neurofeedback training? Share details about your training such as: number of sessions, duration of the sessions, regional targeting, and brain waves being trained.
If you’re experiencing unwanted side effects, there’s a chance it may be chalked up to individual variation, but more likely that you’re working with an incompetent professional that may not have taken a QEEG scan to know what should be targeted. The goal of neurofeedback should be to improve your performance, and if performed correctly, side effects should be virtually unnoticeable and/or transient.