Heart Rate Variability Biofeedback for Major Depression

Heart rate variability for the treatment of major depression is  a  novel,  alternative  approach  that  can  offer  symptom reduction  with  minimal-to-no  noxious  side  effects.  The following  material  will  illustrate  some  of  the  work  being conducted  at  our  laboratory  to  demonstrate  the  efficacy of  heart  rate  variability.  Namely,  results  will  be  presented regarding our published work on an initial open-label study and  subsequent  results  of  a  small,  unfinished  randomized controlled trial. Autonomic  nervous  system  (ANS)  dysfunction  is  thought to  play  a  significant  role  in  depression.  Prior  research indicates  that  individuals  suffering  from  depression  often show decreased vagal tone, increased heart rate, fatigue, sleep disturbance, and sympathetic arousal. Heart rate variability (HRV) biofeedback involves training subjects to adjust their breathing rate to a resonant frequency (RF), a breathing rate (usually slower than normal breathing) at which respiratory sinus arrhythmia (RSA) is maximized. Why HRV biofeedback for depression? Colleagues from our  laboratory  already  have  demonstrated  that  in  healthy individuals, HRV biofeedback produces a significant increase in  baroreflex  gain  (change  in  heart  rate  for  each  mm  Hg change in blood pressure), presumably leading to improved homeostatic control over blood pressure and other processes associated with it (Lehrer et al., 2003; Vaschillo, Lehrer, Rishe, & Konstantinov, 2002). It also appears to produce an increase in   vagus   nerve   activity.   Indirectly,   through   anatomical projections from the baroreceptors to the hypothalamus and limbic  system  and  increased  parasympathetic  activity,  this method  also  would  be  expected  to  increase  modulation  of emotionally and autonomically mediated reflexes throughout the body, resulting in reduction of depressive symptoms.

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