When you're stressed out or concentrating hard, your body responds in certain ways that you may not even be aware of: your stomach muscles tighten, you hold your breath and you blink less often. Your palms become sweaty, your heart rate increases and you clench your teeth. Realizing that such bodily reactions are occurring, and that you can learn to control them, is the basis of biofeedback therapy.

Biofeedback is an alternative therapy that can help people suffering from all sorts of health issues including high blood pressure, attention-deficit hyperactivity disorder (ADHD), chronic pain, migraine headaches and urinary incontinence. Particular benefits are seen with biofeedback and depression, when bodily signals are used to help patients relax and elevate mood levels.

There are two main types of biofeedback. They are peripheral (body-based) biofeedback, and neural (EEG) biofeedback, which is often called neurofeedback. Neurofeedback focuses solely on brain waves, which are measured with an electro-encephalograph or EEG. Peripheral feedback utilizes all other bodily responses like respiratory rate, heart rate, skin temperature and sweat. These responses are measured with electrodes attached to the skin; the electrodes send information to a monitoring box that will interpret them with sound or visuals. When guided through a series of exercises by a biofeedback practitioner, clients can get an immediate sense of how the exercises affect these processes.

Conventional treatments for depression pay little to no attention to the impact of body movement and posture on brain function and mood, according to Dr. Erik Peper, biofeedback expert and professor at the Institute for Holistic Health Studies in San Francisco. Along with I-Mei Lin of Koahsiung Medical University in Taiwan, Peper carried out research [PDF] on how becoming aware of one's body posture has an effect on mood. Subjects who were consciously aware of their posture and movements, sitting up straight or engaging in certain types of physical activity like skipping, experienced more positive thinking and increased energy levels.

"The pharmaceutical approach of using antidepressant medications appears significantly less successful when long-term follow-up is included, and may contribute to the exacerbation of the depression," says Peper. "Cognitive therapy appears to be a more successful approach when clients are taught to observe and change their self-talk or internal dialogue."

Multiple studies on biofeedback and depression have found that this therapy can have significant positive effects. A 2008 study at the Clinic for Psychotherapy and Psychosomatic Medicine at the Technical University in Germany found that depressed patients had reduced anxiety, decreased heart rate and increased heart rate variability after treatment with heart rate variability (HRV) biofeedback.

"Research shows that heart rate variability biofeedback can be helpful in treating depression," says Dr. Inna Khazan, biofeedback practitioner and instructor of psychology at Harvard Medical School. "It works by exercising and rebalancing the person's autonomic nervous system, helping the body to increase arousal when it is appropriate and put on the breaks when that it most helpful. This is an important self-regulatory skill that is usually compromised in people who suffer from depression."

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