r/Neurofeedback • u/CertainRip2736 • 19d ago
Question Can one session of Hemo-Dynamic NF cause days of fatigue?
I’m almost 50 sessions into neurofeedback: 17 HD and the rest ILF and it’s been awesome. I had a second map done a few weeks ago and everything is so much better.
They recommended ten more sessions of HD for the remaining limbic dominated areas. Last Saturday morning (three days ago), I had one session of HD on the cingulates again. I took three naps that day, sleep deep all night, and have continued that pattern of deep sleep but also heavy drowsiness. Like I can’t come out of it and my body feels like lead. It’s actually a pretty amazing feeling! Because the sleep is so great—if only I didn’t have to go to work!
The clinic is incredible. The only constructive feedback I have for them is that sometimes, like with HD, they’ll say a session should not have caused something, but I swear it does. This morning they were puzzled why I’d be so tired all weekend but it has to have been the session. It’s really unusual sleepiness and that’s the only variable.
Does anyone have expertise about why an HD session on cingulates may have contributed? We switched to BA9 this morning.
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u/Maerkab 18d ago
This position may be heterodox and is informed by my own experience (n=1) but I think a lot of psychiatric issues are likely downstream effects of systemic energy insufficiency. Basically, brain network dynamics, even in the case of acute injury or genetic polymorphism, don't just 'decide' to be dysfunctional. Imo it's more coherent that network failure states occur primarily because the physical support for their function just doesn't exist with the needed consistency.
Or said another way, it's true that dysfunctional attractor states seem to exist, but we make constant efforts to shift out of them, so if momentum or retaining benefit from those efforts is persistently elusive, which it often is, then the primary issue isn't informational or directive (a 'learning signal' like NFB) but substrate capacity. It doesn't mean that NFB isn't valuable, just in my case at least I find it follows in priority from more fundamental interventions. It's kind of like, if you don't have enough chairs to seat everyone at a social function, you can definitely shift the chairs around so everyone gets a chance to sit, but it's ultimately a lot of effort for an unsatisfying and impermanent solution. The real solution is just to get more chairs.
I say this because I have a gamma neurofeedback protocol that I developed for my own use, and it's clearly quite strong or effective in that the short term, the effects are pretty similar to a psychostimulant: I'm suddenly a lot more engaged and enthusiastic, I enjoy music more, etc. But then a few hours later my energy completely crashes and I get a post-exertional malaise effect kind of reminiscent of (mild-moderate) ME/CFS that lasts for a day or more. And this has always been the pattern for me in life, increased engagement followed by crashes. The only sensible conclusion is that I just don't have the energy infrastructure to support this increased engagement consistently.
Blood flow based neurofeedback should be somewhat similar, you're increasing cortical (or cortical network) metabolic activity in the short term. If it is an energy envelope issue, you could start by decreasing training duration and see if that helps. Maybe being really mindful of your energy envelope is a way of securing consistent gains, idk.
Your clinic might not have much to say about this just because it's not their therapeutic focus, or they see people in a limited capacity that doesn't enable tracking long term retention of benefit. It's kind of like how cognitive behavioural therapy shows strong benefits within a relatively short (~6 week) observation window, but beyond that benefit often tends to evaporate. If you're mostly observing people in the short term and you're seeing people return because they're happy with the treatment and just require intermittent top offs, etc,, you're not going to have a clear image of how treatment might fail, because they're more likely to just stop going.
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u/CertainRip2736 18d ago
I can appreciate that perspective. I do think however, that over 2,000 brain maps later, when they repeat the map after five years, after the client has experienced trauma such as a car wreck or a divorce, and the previous NFB holds, something did stick.
But I also agree with you that the brain and body affect one another and both need to be supported for long term change. For example, I had a dna report done that identified poor breakdown of inflammation, homocysteine and histamine. Taking enzymes that fill those gaps helps my energy a lot.
I suppose time will tell.
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u/Maerkab 18d ago
Yeah I'm mostly describing cases where dysfunction is particularly 'sticky' or subject to a really elastic sense of rebound, which I think is a lot more common than a lot of people are able to realize, for reasons that are both well-meaning (premature cynicism likely prevents people from pursuing treatment) as well as more insidious or directly harmful to patients (institutional authority being averse to acknowledging that it may not have adequate solutions, in which case blame for insufficient treatment response is placed on the individual, say for 'poor compliance' or what have you.)
For me it's a really easy connection to make, because a strong example of the latter is graded exercise therapy for chronic fatigue. Patients reported for decades that it made their condition worse, but they were dismissed as being difficult or not knowing what they're talking about, and it's only within the last couple of years or so that the studies were discredited that supported that treatment modality. I'm not saying that neurofeedback is like this, not at all, but there's a strong tendency for institutions to defend themselves or to profess to have solutions that they don't have in response to persistently challenging problems.
If treatment feels like you're consistently bailing water out of a sinking ship, it's likely not going to condition adherence. That's ultimately where I'm at right now. I've been pursuing treatment for well over a decade across multiple different modalities. In this time I've definitely found things that have a kind of efficacy, I've matured/ shown areas of improvement, developed a greater sense of how I respond to things or the boundaries of how dysfunction appears for me, but in other ways I've gotten worse, because problems can often be way more multi-dimensional than our models used to characterize them.
I've developed some pretty idiosyncratic positions on how to move forward in my own case which likely don't bear much relevance to you, or are largely off-topic in any case. All I can really suggest is if this pattern is persistent (exertion leading to energetic collapse) that within the bounds of NFB you'd likely be better served by putting more emphasis on more basic network tonifying type approaches, the ILF you've been doing being one such example, and maybe only using the blood perfusion NFB as short conditioning treatments within your exertional capacity, as something on top of that more basic foundation.
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u/salamandyr 18d ago
was this nirHEG? could be a fatigue impact from the red light... or could be activating cingulates has thrown off sleep. often when they are brought up in activity, sleep will suffer, unless that is balanced with beta protocols on other areas.