Treating Depression with Neurofeedback: A New Approach to an Old Challenge

The brain grows into patterns of anxiety and depression, and it has to grow out of them and that involves insight and integration of the experiences that precipitated the anxiety to begin with.

—Dr. Richard Soutar

Understanding Depression

The concept of depression has been described in many different ways over the centuries, often marked by ambiguity and contradiction. Ancient Greek physicians were among the first to blur the line between depression and anxiety. Hippocrates, for instance, defined melancholia in terms that included what we would now recognize as anxiety, writing: “if fear or despondency lasts for a long time, it is melancholia” (Hippocrates [400 BCE] 1923, 175).

This tendency to merge anxiety and depression carried forward into the early modern period. Robert Burton, in his classic work The Anatomy of Melancholy (1621), also treated the two as overlapping, describing melancholy as:

[T]hat transitory melancholy which goes and comes upon every small occasion of sorrow, need, sickness, trouble, fear, grief, passion, or perturbation of the mind … causing anguish, dulness, heaviness, and vexation of spirit. (Burton 2001, Part I, §1.1.1 [c. 123])

Burton’s definition illustrates an awareness—more than a millennium after Hippocrates—that what we now separate into anxiety and depression often appear together as part of the same condition.

These ambiguities persisted well into the twentieth century, when researchers still struggled to pin down a clear definition of depression. By the 1960s, psychologists such as Aaron Beck and Martin Seligman began to reshape the modern understanding of the disorder by moving attention away from indistinct blends of anxiety and sadness and toward identifiable thought patterns and behaviors. Beck emphasized the role of negative automatic thoughts and cognitive distortions, while Seligman’s research on learned helplessness showed how repeated exposure to uncontrollable stress could produce withdrawal, hopelessness, and depressive symptoms. Their work influenced psychiatry at the same time the DSM-II (1968) formally defined depression as a “Depressive Reaction,” a category that reflected this growing focus on psychological mechanisms rather than purely physical explanations (American Psychiatric Association 1968, 39).

Later, with the rise of medications like Prozac, Zoloft, and Paxil in the 1980s and 90s, researchers and pharmaceutical companies increasingly promoted the view of depression as a “serotonin deficiency.” This theory, often called the serotonin hypothesis, suggested that low levels of the neurotransmitter serotonin were the root cause of depressive symptoms. While the idea gained enormous traction and helped popularize antidepressant use, it also narrowed the conversation about depression, reducing it to a chemical imbalance and overshadowing the psychological and environmental factors emphasized in earlier decades (Soutar 2025, para. 1).

More recently, science has continued to expand our idea of what depression really is and how to treat it. Research shows that depression may also be linked to the gut–brain connection, where imbalances in the microbiome can influence mood through inflammation and changes in serotonin production (Clinical Psychology Review). But stress also plays a critical role, increasing inflammation in both the brain and gut (Frontiers in Aging Neuroscience). This helps explain why depression often appears alongside anxiety—two conditions that seem to exist along a spectrum rather than as separate problems (Soutar 2025, para. 2).

The Role of Brainwaves

In the 1980s, researcher Richard Davidson discovered that depression is associated with differences in brain activity between the left and right hemispheres. People with depression often show higher alpha brainwave activity on the left side, which is linked to withdrawal and low mood. Later, studies confirmed that shifting brainwave patterns through neurofeedback could help lift mood and reduce symptoms of depression.

By the 1990s, neurofeedback pioneers began experimenting with “asymmetry training,” helping the brain restore balance between the hemispheres. Controlled clinical trials since then have consistently shown positive results, making neurofeedback a promising tool for depression treatment.

For instance, when the right hemisphere shows too much activity, it often drives anxiety and rumination. Neurofeedback protocols that reduce this overactivation, while encouraging healthy activity on the left, can help clients feel calmer, more engaged, and better able to regulate their emotions. This is possible thanks to neuroplasticity, our brain’s ability to rewire itself over time, which neurofeedback leverages as a training tool (see how it unfolds in our post on Brain Plasticity).

At NewMind, we’ve built on decades of research to create advanced asymmetry protocols, powered by qEEG and real-time monitoring, to guide training. If you’re curious how we layer in bio-psycho-social factors alongside brain signals, check out our more detailed breakdown in a comprehensive guide to Functional Neurofeedback.

Neurofeedback Pioneer, Dr. Richard Soutar, who has published extensively on the relationship between anxiety and depression, has shown that anxiety often precedes depression. His work with qEEG brain mapping has revealed how one condition gradually blends into the other: “We found it was necessary with a majority of clients to do alpha asymmetry training first to reduce the depression but then we found that ironically the client increased in anxiety” (Soutar 2025, para. 10).

What Dr. Soutar’s work shows is that when anxiety peaks, depression can take over as a protective mechanism—shutting the system down to prevent further stress. More importantly, when anxiety builds to an extreme, depression can act as a protective mechinism—something we’ve also observed in protocols like alpha-theta neurofeedback aimed at trauma recovery. Our previous post, Managing and Integrating Trauma with Alpha Theta Neurofeedback, explores this method in depth.

Because anxiety and depression often unfold in a dynamic cycle rather than as isolated conditions, neurofeedback treatment works best when it follows a carefully staged process that addresses each layer of the problem in sequence:

• Step 1: Reduce depression through alpha asymmetry training.
• Step 2: Address the rebound in anxiety by training beta activity in the hemispheres.
• Step 3: Support neurofeedback with counseling, HRV (heart rate variability) training, and breathing exercises.

Dr. Soutar underscores that simply treating depression through alpha asymmetry training is not enough: 

It was easily observed that beta amplitude was migrating to the right hemisphere as the alpha diminished in the left hemisphere. As a consequence beta needed to be suppressed in the right hemisphere and increased in the left. (Soutar 2025, para. 10)

In some cases, nutritional support, such as methyl folate for depression or magnesium for anxiety, also helps address underlying physiological imbalances.

Why This Matters for Clients and Clinicians

Neurofeedback offers a way of addressing depression that goes beyond symptom management. By targeting both the psychological and physiological contributors (brainwave patterns, stress responses, and even gut health), it provides a framework for understanding depression as a whole-system condition rather than a single-cause disorder. This perspective is critical, because many people struggling with depression don’t fit neatly into one category of “chemical imbalance” or “life stress.” Their experience is usually a blend of both.

For clinicians, neurofeedback opens the door to a structured, evidence-based method that integrates seamlessly with counseling, lifestyle changes, and, in some cases, medication. It gives providers measurable tools to track progress while tailoring protocols to the individual brain, not just the average patient profile. This allows for a more personalized, flexible approach to treatment, one that adapts as the client’s brain shifts and heals.

For clients, the impact can be profound. Instead of relying solely on external solutions, neurofeedback invites them into an active role in their own recovery. Each session offers real-time feedback that helps the brain learn healthier patterns, building resilience, improving emotional regulation, and restoring balance over time. When combined with supportive practices such as breathing exercises, HRV training, or nutritional support, neurofeedback can provide a foundation for long-lasting change rather than temporary relief.

Ultimately, this approach reshapes how we think about depression treatment. It encourages a view of the brain as adaptable, capable of recovery, and responsive to training. For those who have found limited success with traditional treatments, neurofeedback offers a hopeful path forward, one rooted in science, practice, and the growing understanding that the brain can learn its way back to health.

If you’re interested in exploring this subject in greater depth, Dr. Richard Soutar will be publishing a longer, research-focused article on treating depression with neurofeedback in the NewMind Journal. For clinicians and advanced practitioners, it will offer a deeper look at the methods and evidence shaping these protocols. Stay tuned for its release on the NewMind Journal so you can continue learning from the latest insights in the field.

 

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Works Cited

American Psychiatric Association. 1968. Diagnostic and Statistical Manual of Mental Disorders, Second Edition. Washington, DC: American Psychiatric Association.

Burton, Robert. The anatomy of melancholy. Edited by Holbrook Jackson, New York Review Books, 2001.

Hippocrates. Hippocrates. Edited by Paul Potter, translated by Paul Potter, Harvard University Press, 2023.

Soutar, Richard. “Treating Depression With Neurofeedback.” NewMind Journal, 2025. NewMind Journal, https://nmindjournal.com/. Accessed September 2025.