REVIEW

Tune in, Turn on, Zap Out

The Flow tDCS headset

One writer reflects on what she learned from a month of neurostimulation for depression, energy, and meditation.

The packages arrived in January like late holiday season gifts, and I unwrapped them. Blue box, white pads. White box, brown device. There are straps, sponges, adhesives, and sooo many instructions. But I am prepared. This isn’t my first time strapping electrodes to my head. 

My first exposure to neurostimulation came in 2015 when I wrote about a San Francisco-based company using an electrical device targeted to the motor cortex to improve athletic performance. Halo Neuroscience claimed to give many amateur and professional athletes an edge during their five years of operation and promised a shortcut to competitive excellence. But in 2021, Halo was acquired by the Swedish company Flow Neuroscience, which is focused on treating mental illness with neurostimulation. Flow shut down Halo’s athletic device, but the news prompted me to investigate the possibilities of these devices for mood improvement—partly out of journalistic curiosity, but also from personal interest.

I had been taking an SSRI antidepressant for four years and was advised by my psychiatrist to keep taking it indefinitely. I was disappointed to hear that my doc thought I had a permanent failure in my brain chemistry. But I needed relief, so I took the pill, playfully calling myself a “Lexaprofessional.” 

Before the prescription, I was already doing everything I could to regulate my mood naturally. Regular exercise is as effective as an antidepressant for mood regulation, and I have a serious running habit. I also carefully designed my diet to optimize brain-boosting nutrients. I tried the Wim Hof method of controlled breathing and cold immersion. I meditated regularly and made sure I had sufficient exposure to sunlight and nature. I saw an acupuncturist and an energy healer. And yet still I felt the yawning gap of depression-related flat affect. It seemed clear that I just needed some other advantage to realign my mental state to what I believe should be the birthright of all humans: general contentment. So I continued to rationalize taking the pill, because it really did help, even though I wanted to get off of it. 

That’s when I began to consider a neurostimulation device designed to treat depression.

As a writer and editor, I’m always looking for ways to improve my focus during long hours with my laptop. So I’m no stranger to brain enhancement. To get through my assignments, I’ll often eat coffee gummies, chew nicotine gum, and even pop in a troche of Troscriptions’ Blue Cannatine, a lozenge containing a small amount of methylene blue, an organic chloride salt, combined with a microdose of THC that assists with sustained concentration. (And yes, there was that assignment I once sprinted through with the help of a friend’s Adderall prescription.)

I decided to indulge in several cutting-edge nootropic “smart drug” supplements and stimulants that might boost my serotonin in a less pharmaceutical way while I slowly tapered off my medication over a month. I found some success through Qualia Mind, from Carlsbad, California-based Neurohacker Collective—and also from Dynamic Brain, which is sold by Newport Beach, California-based Stonehenge Health. Each uses a proprietary blend of vitamins and herbs and claims to create optimal brain functioning. All of this was good, and sometimes euphoric. Nevertheless I still found myself wallowing in anhedonia for longer than I thought was healthy. 

My $500 electric mood

At least four companies produce neurostimulation devices for depression at various price points, but only one had been around for long enough to have completed significant studies to prove its effectiveness. The Fisher Wallace device, which is basically a pocket-book sized battery pack connected to two sponge electrodes secured by a velcro headband, was cleared by the U.S. Food and Drug Administration in 1990 to treat depression, insomnia, and anxiety, and it turned out to be the most impactful intervention in all of my antidepressant exploration. At $499, it was an investment, but considering that most people with depression seek therapeutic treatments often not covered by health insurance, the possible savings on therapy and drugs over my lifetime seemed to justify the expense. People ordering the device must verify that they have a depression diagnosis, or have a physician assist with prescribing the device. Fisher Wallace, however, has made this a seamless, quick process.  

He used the device on 400 of his patients, with 70 percent experiencing improvement.

Twice a day for a month, I sent tiny electrical pulses to generate serotonin production in the limbic system of my brain, which controls behavior and regulates emotional responses. I’d strap the wet sponge electrodes near my temples, place the controller in my pocket, and go about my day—reading, making coffee, doing dishes. The device would beep and shut off after each 20-minute session. I had read that the side effects were minimal—some users reported slight headaches, nausea, and itching at the site of the electrodes. I experienced none of those, but I did register the distinct feeling of electric current buzzing against my skin. I was always relieved when the session ended.

It only took five days before I noticed that my hair-trigger weeping reflex was muted: I could watch sad movies tear-free! My day-to-day ups and downs were much less extreme. I was bouncing back from disappointment and frustration with ease. Eventually I started using the device only once a week, with the goal of discontinuing completely after several months. And I began to think I achieved my goal of maintaining a relatively happy state without a Big Pharma solution.  

Clinical trials and multiple published studies have shown the Fisher Wallace device to be significantly effective in alleviating depression symptoms. Since 2009, it has been prescribed by 2,000 board-certified psychiatrists and has been approved for use by New York City’s eleven largest hospitals. Columbia University psychiatrist and professor Richard Brown reported that he used the device on 400 of his patients, with 70 percent experiencing improvement

The Fisher Wallace Stimulator

By contrast, SSRI antidepressant medications are only 50 percent effective on average, despite the fact that eleven percent of Americans are currently taking them.

Neurostimulation treatment also seems like it should be superior to medication because it stimulates neuroplasticity, possibly leading to permanent or semi-permanent changes in how the brain functions—hence my eventual goal of not needing the device at all. Bashar Badran, a neuroscientist who develops neurostimulation devices for clinical applications, including a device called the  Zendo, foresees the eventual replacement of pharmacological treatment of depression and related disorders with neurostimulation. “Using a variety of different brain stimulation techniques including vagus nerve stimulation, transcranial direct stimulation, transcranial magnetic stimulation, trigeminal nerve stimulation, and electroconvulsive therapy [is] the future of psychiatry,” he says. 

Once I finished weaning myself off the antidepressant last year, I felt like I was on a roll. I wanted to relieve my other possible addictions (caffeine and nicotine gum), and if I couldn’t do that (there’s a reason they’re addictions), I at least wanted to upgrade my ability to calm down from those stimulants. I was primed to try more neurostimulation to address concentration and relaxation, which are two areas that this technology excels at. Initial internet searches turned up a flooded market of non-neurostimulation apps, exercises, and even EEG devices for triggering peak states of productivity and calm. With daily reminders and gamified tracking, apps like Calm, Headspace, 10% Happier, Simple Habit, Larkr, Pacifica, and Shine all promise the average desk worker simple stress reduction and improved productivity with a few swipes… if they can develop a regular habit. However—that’s a big if. I am guessing the vast majority of these users are optimistic downloaders who abandon the app, like a New Year’s resolution, after less than one month. 

Nor did any of these seem quite right for me. They all appeared to employ audio recordings, music, and sounds that all distract a one-track mind from the ultimate goal of total concentration on the present moment. Studies demonstrating their effectiveness were not consistent, and often biased. Another drawback is that, like all apps, users’ data is used for secondary purposes like marketing, product improvement, and identifying consumer preferences for future targeted advertising. Influenced by thinkers like Jaron Lanier, I am wary of any app, no matter how benign, keeping track of my activities. 

Thus when I was suddenly asked late last year by proto.life to review the FeelZing neurostimulation energy patch and the Zendo meditation device, I was thrilled to find two products that didn’t require an app, a steady internet connection, or any kind of ongoing subscription-based feedback from a Silicon Valley startup. 

Nirvana in a patch?

FeelZing, developed by the Menlo Park, California, company Thync, is a two-inch-diameter circular patch embedded with a battery powering a tiny circuit on a timer that delivers seven minutes of electrical pulses to the centers of the brain responsible for the autonomic nervous system. Its sticky silicone surface adheres to a spot behind the ear, which targets branches of the occipital and vagus nerves. The company claims that the stimulation helps balance neuron activity and optimize the activity of the nervous system. They say it is intended for anyone looking to improve their energy levels and concentration, and like other neurostimulation devices, doesn’t create notable side effects. It’s billed as costing less than a fancy cup of coffee at a cafe (under $5 per use), and each patch can be used twice and then disposed of. The company even offers a recycling service if the patches are returned. 

Peeling the patch away from its attractive black packaging, I found it easy to apply and adhere to the spot between the back of my ear and my hairline. Immediately, I felt an electric, tingly sensation in regular pulses that wasn’t entirely pleasant. An impotent bee sting? A detoxified scorpion’s caress? Fortunately, my negative reaction subsided as the product began to take effect, and I realized that I was suddenly very enthused to keep working on this article. I felt a blaze of curiosity that inspired new connections for about two hours after wearing the patch for seven minutes. In a double-blind, placebo-controlled case study with 70 participants in 2016, 84 percent of users reported a moderate to strong positive energy boost and another independent study three years later found that FeelZing created feelings of greater alertness, focus, and motivation while reducing mental and physical fatigue. Thync recommends trying the patches for twenty-four consecutive once- or twice-a-day uses to get acclimated to the effects of neurostimulation. 

FeelZing patch

As I continued to try FeelZing while working, I noticed I was starting to crave its pincer-like pulses, because I knew I would be more attentive to what I was writing and finish faster. It seemed to diminish the necessity for strong-armed will power. Still, over twenty-four days, FeelZing became just another addition to my arsenal of energy hacks. It wasn’t satisfying enough to replace my old standbys of caffeine and nicotine. 

Unfortunately, my occasional problem of overstimulation had yet to be resolved. Jitters and anxiety would linger after I had amped myself up in order to complete an assignment. Thus I was eager to try Zendo, a neurostimulation device sold for $229 that is intended to amplify the effects of a twenty-minute meditation. 

The monkey in the mind

A team of neuroscientists and psychiatrists at the Medical University of South Carolina’s Brain Stimulation Division developed the technology for their own meditation practice and realized that they had created a surprisingly effective shortcut to “less mindless hustle, more mindful magic,” as the Zendo website claims. Zendo also did not enforce any particular method of meditation, meaning that I could simply breathe while using it, instead of listening or watching something on a screen. 

Creating a meditation habit is often confounding for busy working people—it takes significant time and perseverance to train the “monkey in the mind”—yet on-the-go folks are the ones who might benefit the most from the stress-reduction benefits. Hence, Zendo’s appeal. In a 2016 study, meditation with the device increased self-reported mindfulness scores 2.5 times more effective than meditation alone—as measured in outcomes on the Five Facet Mindfulness Questionnaire and Toronto Mindfulness Scale. Furthermore, just one session with Zendo can produce effects that advance a meditator to the same level as someone who has trained in Mindfulness-Based Stress Reduction techniques for six weeks. Founder Baron Short told me that his Zendo meditation sessions make him feel like he’s been sitting in the ashram all day. After a session, it is easier to focus and he feels more calm and productive, he says. His team has preliminary evidence suggesting that Zendo might therefore be a promising intervention in the treatment of anxiety and ADHD, should they be able to gain FDA clearance, which they have recently applied for. 

Even after turning Zendo off, the downshifted vibe lasted a couple of hours.

For now at least, every Zendo customer receives a one-on-one training session with Short via Zoom. During mine, he walked me through swabbing my skin with alcohol before placing the electrode pads onto my left forehead and right temple. The wires protruded from my head, making me truly look like an experimental subject in a psych ward, comically far from the yogi-on-a-mountain at sunset vision I had for my deep meditative experience. After he explained how the device worked, I turned the Zendo on, and with the prickly static of neurostimulation vibrating my head, I settled into a twenty-minute body-scan mindfulness exercise that Short recited for me. Within minutes, the initial stimulation sensation faded, and I entered a pleasurable, deeply relaxed state. It felt as if I were sitting in a soft cocoon gradually floating away from my environment. Outside noises and outside thoughts had less “sticky-ness” and I was able, as the device promised, to drop into a meditative depth that might normally have taken much longer to achieve. Some have termed this effect “nine-volt Nirvana,” and I found that even after turning Zendo off, the downshifted vibe lasted a couple of hours. According to the company, most users plug into Zendo a few times a week, and many find that they can still get the same effects with even less frequent use after they’ve established a solid meditation habit with it. 

I can see why the device would sell out. It creates a wormhole to “the zone” that Zendo’s customers—everyone from professional baseball players to Buddhist monks—benefit from. The effects can be measured clinically, but there is also an intangibly spiritual aspect to the technology that Short doesn’t shy away from. “Zendo can allow you to just be. As we repetitively tap into an experience of no space, no time, no self, we start to know the depth of our experiential being,” he says. “As a result, things we normally get hung up about don’t have the same power over us.” 

I have practiced many styles of meditation on and off for over twenty years but have always found that my running habit offers me the same benefits that meditation advocates proclaim. I did enjoy the Zendo experience, and its effect was almost immediate and powerful. It was much easier to keep my mind in an undistracted, calm state than it usually would be after just twenty minutes of normal meditation. However, this calm lingered for several hours; I am accustomed to having more excitability during my day, so I thought its effect was too strong for me to consider making it part of my daily routine. I didn’t want to give it up, though. Just knowing that I have access to bliss in a box feels like one of the best emergency-preparedness tactics I could imagine. I stored it away in my liquor cabinet; a reminder that there is a healthier alternative to any sort of liquid stress-release during the evenings when I don’t need to energize. 

This experimental foray into neurostimulation created an unusual situation that may become more and more common as this technology becomes more widely available. There are no guidelines for how many devices an individual can use at any given time. Was I possibly at risk by using my Fisher Wallace device to keep my depression at bay while also using FeelZing to keep me motivated at work and plugging into Zendo at night to wind down? When I asked Bashar Badran, Zendo’s other cofounder, he admitted that he had never considered the question. As far as he knew, there was no literature investigating the use of multiple neurostimulation modalities at the same time. He speculated that there may eventually be a situation where I could “overstimulate” myself and end up feeling groggy, tired, and spaced out as a result of the confounding brain effects. He didn’t think stacking these devices would present any serious risk, though. His general guideline? “Be safe and check in with your body if you do this, and if you feel weird, altered, or different, take a pause,” he says.

I had clearly felt effects from each of these technologies that targeted three different functions of my nervous system. While I was able to operate them all with minimal instruction and coaching, there were still many moments of malfunction and awkwardness with each one, and I didn’t feel comfortable using the devices around other people, or even leaving them around my house. “Mommy, what are you doing with those weird wires?” was a question I wasn’t prepared to answer for my eight-year-old. Properly placing electrodes, enduring never-before-felt sensations, and simply looking like a psych ward patient were all significant barriers to the seamless experience that consumers have become used to with apps. 

I also wondered if the one-size-fits all approach to neurostimulation units ignores potential gender and other biological differences across the population. Might we discover in the future that adaptations and more personalized approaches are necessary to create a more optimal experience for certain folks? And wouldn’t it be easier if all of the possible clinically validated applications for neurostimulation were available from one device and an array of electrode pads—dial “4” for depression, “5” for meditation? But for those who are serious about getting off pharmaceuticals, upgrading their energy, or deepening their relaxation without chemicals, neurostimulation—even in its nascent state—looks incredibly promising.

Editor’s note: This article was updated on 6/7/22 to clarify Bashar Badran is a neuroscientist, not a psychiatrist, and also to correct that Zendo was created at the Medical University of South Carolina’s “Brain Stimulation Division.”

The Zendo meditation device
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