by Dr. Joseph Debé
Cranial Electrotherapy Stimulation (CES) is an FDA approved treatment for anxiety, depression and insomnia. Over 100 human and eighteen animal studies have demonstrated the effectiveness of CES in treating these and other disorders. CES involves the introduction of a very weak electrical current into the brain. Before you say, "No way! Not my brain!" understand CES is not "Shock therapy". The electrical current used in CES is typically less than one milliampere. To put this in perspective, the current needed to power a light bulb is about 11,000 times stronger. No serious side effects have been reported with CES.
CES was developed in France in 1902 but study did not begin in the United States until the 1970’s. It is presently an under-utilized therapy because of the chemical paradigm underlying mainstream medicine. The American public has been conditioned to believe that for every symptom or disease there is a solution in a pill. When it comes to treating anxiety and depression, conventional medicine focuses on manipulating activity of neurotransmitters in the brain. However, the brain is more than a chemistry lab. The brain and body are also electrical in nature. Electromedicine (including CES) is designed to primarily impact the electrical nature of the body. The current used in CES is very similar to the electrical fields naturally present in the body
How CES works still needs further clarification. It appears that CES influences areas of the brain called the thalamus, hypothalamus and the reticular activating system. It also seems to stimulate the vagus nerve, producing a state of parasympathetic nervous system dominance. The parasympathetic nervous system has a general calming effect on the body. This is certainly consistent with the effects observed with CES. CES has been documented to normalize the body’s electrical fields. This has been measured on EEG (brain wave tracing). For example, people with moderate to severe pain from osteoarthritis were found to have abnormal brain wave activity. After five minutes of CES treatment, brain waves were virtually normal and pain was reduced by more than fifty percent. It has been found that individuals whose brain waves improved the most had the greatest pain relief. It is postulated that CES restores normal electromagnetic communication between cells. This may have the effect of regulating cellular differentiation, tissue repair, and immune function.
The efficacy of CES has been demonstrated in many different ways. Studies have used twenty-seven different psychometric (pencil and paper) tests including the Minnesota Multiphasic Personality Inventory and the State/Trait Anxiety Inventory. CES has consistently demonstrated reductions in anxiety on these tests. Other studies have measured the physiological manifestations of anxiety before and after CES treatment. Slowing of brain waves and respiration rate, as well as reduction in blood pressure are physical signs of stress reduction that have been documented with CES treatment. One placebo-controlled study evaluated the effects of CES treatment in twenty individuals with chronic stress symptoms of at least a year’s duration. All of them had failed to respond to medication. Muscle tension, heart rate and finger temperature were measured before, immediately after, and one week following a single twenty minute CES treatment. Muscle tension and heart rate decreased and finger temperature increased immediately after treatment in those receiving active CES treatment but not in the placebo (sham CES) group. One week after treatment, those who had received active CES treatment still had significantly reduced muscle tension and heart rate! This is one of the many advantages of CES over medications. Whereas medications only work as long as they are taken, CES effects are long lasting and cumulative.
The long-term benefits of CES were demonstrated in another study, which examined the effects of CES on individuals with stress related attention deficit disorder (eight of the twenty-three subjects had a diagnosis of primary Attention Deficit Disorder). CES treatments of forty-five minutes duration were given daily for three weeks. The treatments resulted in reductions in anxiety and depression and improvement in IQ. Eighteen to twenty months after treatment, CES benefits were still retained, as demonstrated by maintenance or improvement of IQ scores!
There are other reasons to choose CES over medication in the treatment of anxiety. Side effects and addiction are not uncommon with use of these medications. And whereas anti-anxiety drugs may leave the patient in a stupor, CES produces a state of relaxation combined with mental alertness and creativity. This is referred to as the alpha state. CES is superior to medication in another way. CES improves both state and trait anxiety. State anxiety is situational; for example, the stress many experience in undergoing a dental procedure. Trait anxiety is more engrained in the personality. Drugs only work as long as they are taken but CES has demonstrated excellent long-term effects on trait anxiety. Dr. Ray Smith, a leading researcher in CES, shared with me some amazing statistics. He has measured the effects of CES on anxiety and depression in hundreds of patients. He has used daily one-hour treatments, five days per week. After seven treatments, 96 % of anxiety patients are free of anxiety! After ten to thirteen treatments, 94 % of patients have resolution of depression! Dr. Smith has seen these results maintained for twelve months after treatment in 111 patients! Thirty-three patients were followed for thirteen to twenty months after treatment and were still cured!
The ability to improve anxiety, depression and insomnia has made CES a powerful adjunct for a variety of disorders, including drug and alcohol rehabilitation. CES helps reduce withdrawal symptoms regardless of the involved substance. CES has been studied with people recovering from addictions to alcohol, heroin, cocaine, marijuana, morphine and barbiturates. Studies have found CES to produce many beneficial psychological changes in recovering addicts, including: reduced anxiety, hostility and depression, improved planning, self esteem, assertiveness, decision-making skills, feeling expression, energy levels and capacity for intimate contact. CES speeds time to fall asleep, increases time spent in deepest sleep and amount of time in bed spent asleep. It also reduces confusion and bewilderment and increases IQ in recovering addicts. All of these beneficial effects add up to a fifty % reduction in recidivism (over two years of study) for substance abusers!
CES can be used in conjunction with medication, psychotherapy, biofeedback and other therapies. It often augments the effects of other treatments. CES helps prevent rebound depression in patients being weaned off anti–anxiety medication. While medication may be effective in treating symptoms of anxiety or depression, it interferes with the re-establishment of homeostasis in the brain. In contrast, CES does restore balance to the brain.
CES is also very effective for pain relief. In addition to the arthritis study previously cited, headaches, fibromyalgia, low back pain, reflex sympathetic dystrophy, and Temporomandibular joint (TMJ) dysfunction syndrome are a few of the chronic pain states documented to respond to CES.
CES has been found to reduce frequency, intensity and duration of migraine headaches. Fibromyalgia patients with severe chronic headaches were treated with CES. These patients had failed to respond to various medications, biofeedback, low tyramine diet, physical therapy and local injections. About half of the seventy-five subjects had a significant reduction in the frequency and intensity of headaches. This study also found an overall net decrease in the sensitivity of six main tender points on various parts of the body.
CES has shown benefit for a variety of other conditions. Phobias, closed head injuries, cigarette withdrawal, bronchial asthma, excess acid secretion by the stomach, bulimia, and anorexia nervosa all respond to CES. The alpha state induced by CES may also improve sports performance.
The CES device I use is called an "Alpha-Stim". It is about the size of a cellphone. The instrument attaches to the ear lobes with clips that are connected by wires to the unit. To give a CES treatment, the ear clips are attached and the unit is turned on. People often feel relaxed and alert from a CES treatment. This state may last for twelve to seventy-two hours after the first few treatments. Initially, treatments are more frequent, then, as results are seen, the frequency of treatments can be tapered off to an as–needed basis. Typically, anxiety is reduced during the initial treatment. In fact, double blind, placebo controlled studies have found CES to reduce anxiety and the requirement for anesthesia during dental procedures. In some instances however, anxiety reduction may occur up to a day after treatment. In some individuals it may require five to ten daily treatments to be effective. Results in treating anxiety are usually long lasting, provided four to six treatments have been given. Side effects from CES, consisting of headache, skin irritation or vertigo, occurred in less than one percent of subjects and were temporary. CES is contraindicated in pregnancy and for individuals with pacemakers. Care needs to be taken with individuals on anti–hypertensive medication as CES can lower blood pressure.
Some of the published results with CES discussed in this article are truly phenomenal. My limited personal experience with CES has been good but not as dramatic.