Biofeedback for Anxiety: How It Works

Biofeedback is a type of therapy that uses monitors and sensors to identify and control your body’s reactions to certain stimuli. It is designed to teach you how to manage your responses to things like stress and pain.

Biofeedback is generally considered safe for most people, with few reported negative side effects.

During a biofeedback session, a trained biofeedback therapist places sensors on your skin that monitor certain bodily functions, such as:

• heart rate
• breathing
• sweat output
• muscle movements and tension
• body temperature
• brain activity

Your biofeedback therapist reads the monitors and interprets how your body reacts to different stimuli. Based on this information, they may suggest ways to help you manage bodily responses using techniques such as:

• deep breathing
• guided imagery
• progressive muscle relaxation

Biofeedback sessions typically last 30-60 minutes, and a number of sessions are needed for biofeedback to be effective. Biofeedback is shown to be especially effective in conjunction with other typical forms of treatment for anxiety, and the number of sessions needed will depend on a variety of factors.

Once you have learned how your body responds to stress and ways to manage it, you will likely be given exercises to practice at home.

Types of biofeedback

Your biofeedback therapist may use one or more of several biofeedback methods available, depending on your wellness goals.

Different types of biofeedback include:

• Electromyography (EMG): monitors muscle response
• Respiratory biofeedback: records breathing and respiration rates
• Heart Rate (HR) biofeedback: registers heart rate, typically through a finger sensor
• Thermal biofeedback: uses sensors typically applied to your feet or fingers to detect body temperature changes
• Neurofeedback (EEG): monitors brain activity through sensors placed on your scalp

Biofeedback may be used as an alternative therapy for both physical and mental health issues for people who might not be comfortable using medications or invasive treatment options for certain conditions. It may also be implemented alongside more mainstream treatments.

Biofeedback can be used for many mental and physical health conditions, such as:

• attention deficit hyperactivity disorder (ADHD)
• anxiety disorders
• chronic pain
• insomnia
• substance use disorders (SUD)
• high blood pressure (hypertension)
• asthma

Although research is limited, some studies suggest that biofeedback is effective in reducing anxiety symptoms.

For example, one research review published in 2017 suggests that, compared with no treatment, neurofeedback — which is a type of biofeedback — can improve symptoms of post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD). It also found that supplementing treatment with biofeedback might be more beneficial and result in more rapid treatment gains than treatment without biofeedback.

Another 2017 article suggests that heart rate variability (HRV) biofeedback may reduce self-reported stress and anxiety. Therefore, it may be considered an effective treatment option for people experiencing symptoms of overwhelm and anxiety.

How can biofeedback help manage anxiety?

Biofeedback may offer ways to manage symptoms related to anxiety. For instance, you may not be aware of how your breathing patterns change during anxious moments. Biofeedback can detect those changes, and by practicing breathing exercises that change the pace or depth of your breathing, you may begin to feel less anxious, or feel that your anxiety is more manageable.

In addition, sometimes anxiety may not have an identifiable cause. Anxious feelings can often stem from worrying about an unknown outcome or feeling like you’re not in control of a situation.

Biofeedback may help you identify when you are becoming anxious, which can lead to a better understanding of what is causing your anxiety.

It might also help you learn how to manage your response to stressful stimuli, which may help you feel greater control in overwhelming, anxiety-producing situations.

What types of biofeedback are useful for anxiety?

There are several types of biofeedback used to treat anxiety. You and a mental health professional will determine which is most appropriate to help you reach your wellness goals.

Types of biofeedback most often used for anxiety may include:

• electromyography (EMG)
• respiratory (breathing) biofeedback
• neurofeedback (EEG)

Although there are biofeedback devices designed for personal, at-home use, limited research exists on their effectiveness. Further, many devices have not had any independent research conducted. A 2018 critical review of wearable devices, apps, and other biofeedback equipment suggests buyers should carefully investigate such products before purchase.

Additionally, it’s important to understand that at-home devices are not connected to a trained professional who can accurately read and interpret the data collected.

Just like any treatment or therapy for anxiety, biofeedback has pros and cons. That’s why it can be a good idea to research methods and therapists who do biofeedback thoroughly before signing up for sessions.

It may be a smart first step to speak with your doctor or therapist about biofeedback to determine if it could be right for you and your treatment plan.

Advantages of biofeedback may include:

• noninvasive
• relatively easy and brief to perform
• does not use medication, and can reduce the need for medication
• may help you feel more in control of your mental health
• can be done at home after OK’ed by a biofeedback therapist

Disadvantages of biofeedback may include:

• scientific research is limited on its effectiveness
• readings might be inaccurate for those who have health conditions such as a heart arrhythmia or certain skin conditions
• sessions can be time-consuming
• it may take several sessions to see improvements
• may not be covered by health insurance

One systematic review published in 2018 suggested that several challenges arose while using biofeedback for stress management. This review highlighted the importance of making improvements in user accessibility.

Biofeedback is noninvasive and may help you identify bodily response to anxious feelings as they arise, and provide you with tools to effectively manage symptoms in the moment.

Although there are several effective treatment options for anxiety, biofeedback can be a good option if you’re looking for alternatives to traditional methods. Oftentimes, biofeedback is used in addition to mainstream anxiety treatment options, like medication and therapy.

However, biofeedback is not for everyone, and scientists are still learning about the role biofeedback can play in treating anxiety.

If you are interested in exploring biofeedback for anxiety, speaking with your doctor or therapist is often the best first step. Like all therapies, you may have to try several types before you find an option that works best for you.

And if you need help finding a therapist, you can visit Psych Central’s guide on finding mental health support.