For my final project for Rest of You, I was crazy enough to try transcranial direct-current stimulation, aka tCDS. tCDS involves running a small electrical current, generally under 2 milliamps, between two electrodes placed on the head. It has been shown benefits in small-scale studies for everything from treating depression to accelerating learning, depending on where the electrodes are placed. Evidence is mixed, with many reporting striking effects, but no large-scale studies as of yet.
While it may reduce neuronal activity in the brain region under the cathode, most tCDS users are concerned with the effects on the brain region under the anode. Although tCDS may increase neuronal activity the anodal region, what’s more interesting to me is that it is believed to increase neuroplasticity there as well. The increased electrical potential lowers the threshold under which neurons may fire, resulting in an increase in firing of new neural pathways or connections. This effect is present both during the tCDS session and for a period of up to an hour and a half afterwards - hence, tCDS users generally pay special attention to what they do during this post-session period. For instance, practicing a new skill that they want to learn, or in the case of treating depression, doing activities like journaling or cognitive-behavioral therapy.
I was very intrigued by the potential for increasing neuroplasticity, for improvements in anxiety and depression generally, but also for its potential in treating chronic pain. I am particularly interested to try applying the alleged neuroplastic effects of tCDS in combination with other modalities of chronic pain treatment, such as exposure therapy and physical therapy. However, I decided to try the anxiety and depression montage (a montage is a term for the choice of electrode placement locations) first. I think this just felt like a safer and more comfortable option to me. I’m used to working on my mood, self-concept, and so forth, and used to handling waves of depression or anxiety. I had been seeing a lot of benefit here from starting journaling again, and was excited to see if tCDS would further enhance the effects of journaling. I have chronic pain and am starting physical therapy for it again, but due to the trauma and more intense negative feelings associated with it, it's a lot more difficult thing for me to work with. Hence, I didn't want to try tCDS with it until I had experimented with the method in general first.
The initial results were very dramatic and very positive. However, I wasn't able to repeat such a dramatic effect, and I started to encounter negative effects that make me question the reliability of the tool.
Before my first tCDS session, I was at a very emotionally low point. The tCDS session triggered a complete turnaround, and for the rest of the day I felt like one of the best versions of myself I've ever felt. I was energetic, confident, and very present-focused. I wouldn't say that the chatter in my head went away, but it felt distant and unimportant. I felt extremely in control of my own mind, able to quickly dismiss thoughts or feelings that I didn't want. Feelings of shame, guilt, or social self-consciousness were particularly easy to dismiss - I simply noticed how pointless they were, and they went away. There was a clarity to my perception of my environment and of other people, and to the direction of my own intentions - I rarely felt indecisive or confused, but seemed to easily enter and maintain a state of flow.
During the tCDS session itself, I definitely entered an altered state of consciousness. As I was sitting at home during the session, the first obvious sign of this was how the music I was listening to became much more intense and vibrant. For a couple hours afterwards, I seemed to experience a continuation of this altered state. The heightened awareness of my surroundings was reminiscent of a low-grade psychedelic state, but the dramatic decrease in anxiety and increase in control over my own thoughts was very different. An increase in confidence, mental clarity, and cognitive control lasted all day and into the next morning, but the clearly altered state of consciousness only lasted for a couple hours before a smooth but distinct "come-down" was felt.
However, the next three tCDS sessions, while they did produce similar states of heightened awareness and some relief from anxiety or self-consciousness, did not produce such dramatic positive effects. In fact, I began to find them detrimental. I began to notice a sense of dissociation and that would come up when I was starting to have negative feelings. After my second session, which was at home in the evening before attempting to do some cleanout of my room, I first noticed this dissociation, but it seemed to pass when I finally got started on my tasks to do - at which point I instead felt hyperactive and energetic, my body wanting to explode and my mind racing with a million thoughts about things I wanted to do to improve my life. After that experience, I decided to avoid tCDS in the evening or when staying home for the day, interpreting those events as evidence that since tCDS makes it easier to challenge myself to grow and expand and overcome anxieties, combining it with familiar surroundings would only lead to feelings of frustration and entrapment. Looking back, I think my feelings that night were even more specific than this - I was working on sorting through my closet to clean out clothes, and doing so brought up certain unhappy forms of nostalgia. Objects can often carry emotional weight, and in this case their relation to past times of my life not only brought up sadness over things lost, but also revived past ways of feeling about myself and the world. I anticipated this when planning my closet cleanout, but after such a positive experience from my first session, I believed that tCDS would help me grapple with these difficult emotions, and that I could apply the neuroplasticity and cognitive control to forge new ways of feeling about these past events. I was very wrong.
That second session unfortunately set the tone for the remaining two sessions. I made sure to leave my house and do something after both of them. Howeiver, the things that I did were also emotionally challenging in ways that were connected to past negativity. More importantly, I think, they were solitary activities - I moved through public spaces, but whereas I went to ITP and interacted with frds and peers following my first session, my remaining sessions were followed by days alone. It's typical for me to get very lost in my own head on days like this, and repeat negative thought patterns. That first positive tCDS experience made me overconfident that things would be different this time. More importantly, the dissociation continued and worsened. It seemed to become my emotional reaction to painful thought patterns. I could stop unhappy thoughts more easily - my mental chatter was still significantly reduced. But instead, I became dissociated when unwanted feelings threatened to fill my head. I became unable to feel those feelings even when I wanted to - at several points, I tried to release certain emotional pain by crying, but was unable to cry. Since I couldn't overcome the dissociation, I couldn't apply my usual techniques for working through such negative headspaces. Although it was nice to have more control over negative thoughts, the dissociation became extremely unpleasant - I felt less anxious but much more depressed. It reminded me of my brief experiences with antidepressants, for which I decided to quit them. Several hours after my fourth session, feeling completely dissociated and depressed, I gave up on introspection and went home, with a decision to avoid tCDS for a while and rethink how and when to use it.
I still think that tCDS may be a useful tool. It is clearly a powerful technique, and with potentially a greater possibility for controlling its effects than equally strong methods of tampering with the brain - drugs can be equally powerful and undeniable in their effects, but a little bit harder to control overall, due to the duration and lack of localization of effect. However, set and setting are clearly very disappointing with tCDS. Looking back, a huge factor in my initial positive experience was the "rebound effect" that I often experience following a particular bad emotional day. Putting aside the tCDS, the day had all the hallmarks of the sort of sudden mood lift and expansion of the self that can follow a "breakthrough moment" when negative thought patterns build up to a breaking point and then produce a sudden shift in attitude. That sudden shift in attitude occurred during my tCDS session, with me suddenly letting go and crying my eyes out. I have no doubt that tCDS triggered this sudden shift, nor do I have any doubt that it produced an altered state of consciousness and an increase in cognitive control. However, the circumstances and mindset probably played a huge role in the intensity and positivity of the effects. For that first session, I had no expectations but that I was done procrastinating on trying tCDS out, and had no particular intention of what to do afterwards - I left the session knowing nothing except that I needed to get out of the house, and then let the day happen from there. In later sessions, I had specific goals afterwards in mind rather than an open mind, and I was trying desperately to repeat the positive effects of the first session.
Another difference was that in later sessions I tried a different protocol - instead of 20 continuous minutes, I did two 13 minute periods with 20 minutes in between. I had read that this method could extend the after-effects up to 24 hours. I can confirm that the effects were less dramatic immediately afterwards, but seemed to last the entire day. But I don't think this was a good thing - I think that my brain was exhausted by the end of the day, contributing to the dissociation. Moreover, if the activity ones does afterwards is so important due to neuroplasticity, it's worth considering that one has a great deal less control over what one does or what situations one encounters over the course of an entire day. I am disappointed that I was not able to use this protocol to gain the benefits some describe - just feeling a little different, no dramatic effects, but a steady and significant change in negative thought patterns. But I think that I still gained some positive self-growth from that initial tCDS experience, so I'm grateful for it.
I'm still curious to try tCDS for chronic pain, but want to first get a little more comfortable with the kinds of exercises that I'd be doing after it. I don't know if I'll ever try combining it with journaling, as I originally intended. I never found myself motivated to journal after the tCDS sessions, and given the topics I generally explore in my journaling, I do fear that tCDS plus journaling would lead to yet another case of revisiting and reinforcing old, unhelpful thought patterns.
Overall, my experiences with tCDS followed an arc very similar to lots of ways that I attempt to talk to my elephant: novelty leads to immediate positive effects, which I then desperately try to extend indefinitely, only to find myself returning closer to my normal self. The struggle with one's unconscious goes just like this: I wish that I could live forever in that heightened, expanded, confident state that I was in after that first session. But there's no magic bullet to make that happen. The real way to manage your elephant is small, consistent actions that build up to change over time. In that spirit, as a way to feel less disappointed and more proud of my progress, here are various habits that I have or am becoming consitent about, that I've seen benefit from.
- Working out in the morning.
- Using an app to keep my cell phone screen in greyscale most of the time (fights phone addiction).
- Changing my mobile browser homepage to a blank page, in order to fight the habit of mindlessly opening a tab and navigating to one of my distraction websites.
- Waking up between 5 and 6 am.
- Time-restricted eating (I just started this over break, actually, but am starting to adapt to it.)
- Journaling regularly.
- Physical therapy.
- Talk therapy.
- Listening to music in the morning as I cook breakfast.
- Probably some other small ones that I can't think of right now.