Clinical Use of Alpha Asymmetry Protocol In the Neurofeedback Treatment of Depression: Case Studies
Case study number two
Catherine is a forty-year old Caucasian female who has been a registered nurse for the past twelve years. She currently has a full-time position in a hospital setting as charge nurse in her department; overlooking all administrative as well as nursing aspects of her unit.
Catherine was married for three years while in college, has no children and lives alone in a condominium she owns. In the spring of 1993 she initially sought therapy and was diagnosed as having a single episode of Major Depressive Disorder (DSM-IV 296.2) at that time; symptoms included presence of Depression most of the day every day, psychomotor agitation, insomnia, weight loss, obsessive thoughts, and decrease in concentration. There is a history of Depression in Catherine’s family, her father suffering bouts of Depression as she was growing up.
Catherine identifies the onset of her recent Depression as related to feeling strained when given the responsibility of presenting a program to staff at her hospital. Following this assignment, Catherine found she was unable to meet her commitments and took a brief leave absence from her position. She then began speaking with a therapist once a week. After three weeks she returned to work, remaining reasonably stable for about one year. During this time she was placed on anti-depressant medication.
A second episode of Depression occurred when Catherine’s father became depressed, and a co-worker developed a serious illness. At that time she was diagnosed with Dysthymic Depressive Disorder (DSM-IV 300.4); her Depression characterized by chronic, non-severe depressive symptoms such as melancholy, low self-esteem and low energy, and weight gain due to overeating. This continued for approximately one year, Catherine becoming less and less socially active, despite encouragement from friends and her therapist. It was suggested that Catherine try neurofeedback as an adjunct to her weekly therapy sessions, as neither the medication nor the psychotherapy was apparently helpful in relieving her Depression.
After thirty-six sessions of neurofeedback, Catherine reported feeling more flexible and less oppositional. Her therapist also observed positive changes in her personality. Through the use of alpha-theta neurofeedback, Catherine learned to increase the difference in activation between the right and left frontal cortices. Statistically significant differences in her personality profile were also evidenced following the EEG asymmetry training sessions as measured by Minnesota Multiphasic Personality Inventory-2 (MMPI-2) administrated before and following the EEG training. Initially Catherine was described in the pre-EEG MMPI-2 test interpretative report as exhibiting “a pattern of chronic psychological maladjustment…She has endorsed a number of items suggesting that she is experiencing low morale and a depressed mood…She is likely to have difficult interpersonal relationships, often appearing sullen, resentful and quite uncompromising…marital breakup is relatively common.”
In the post-EEG MMPI-2 test interpretative report, Catherine was described,
as “quite outgoing and sociable, with a strong need to be around others. She
is gregarious and …her social behavior is not likely to change if
she is retested at a later time.” Catherine also reported increased
interest in friends and social events, and also entered into a
serious relationship. In addition, she realized that she had many more
career options previously left unexplored, and began to think about obtaining
a position more suitable to her needs. She reports a significant increase
in her self-esteem, and is optimistic about the future.