Cranial Electrotherapy Stimulation (CES) "Zapped" My Anxiety Away

Lincoln Agnew

I'm no stranger to panic attacks. I've suffered from anxiety and depression since my teens. The panic attack fight-or-flight response is well-known to me. Anxiety was a constant companion.

I almost died in 2016. OK, in reality, I only felt like I was dying. I was at my computer when mild queasiness turned into violent nausea. I stood, and my legs buckled. My heart was racing, my vision tunneling; something far worse than a virus or a bad sandwich had hit me, and even though I knew what it was, I was still terrified.

In my 20s I began taking Prozac (fluoxetine), which worked wonders. But a couple of years ago, my panic attacks returned for weekly visits, and my psychiatrist upped my dosage. Then I developed akathisia—a state of constant restlessness and agitation—which did not help my mood. Akathisia is a neuropsychiatric syndrome that can be a side effect of some medications says StatPearls.

"There are medications we can give you for that," my psychiatrist suggested, "or we can try something else."

Enter Cranial Electrotherapy Stimulation

The "something else" turned out to be cranial electrotherapy stimulation (CES). CES is a treatment in which the brain is stimulated by a pulsed, low-intensity electrical current that can be applied to either the earlobes or the scalp, states research published in Brain and Behavior.

The device she used is called the Alpha-Stim, an iPhone-size gizmo with electrodes you clip onto your earlobes. With this, she explained, I would spend one hour a day receiving a tiny electric current, so low I could barely feel it. Its side effects were minimal and, according to an Open Journal of Psychiatry study published in July 2021, Alpha-Stim was safe and effective.

"Hook me up," I said.

CES Treatment

The 2020 National Survey on Drug Use and Health (NHDUH) estimated that 21.0 million adults in the U.S. experienced at least one major depressive episode in the last year. Roughly 40 million suffer from anxiety disorders, said the Anxiety and Depression Association of America (ADAA). Medication is a miracle cure for many—including me—but sometimes it's not enough, or the side effects become hard to tolerate.

Although CES has been around since the 1970s, it's gained new attention. Alpha-Stim is such a CES device and is FDA-cleared to treat depression, anxiety, and insomnia.

These devices can be used in both the home and clinical settings. And the treatment is relatively free of side effects. According to the manufacturer of Alpha-Stim, headaches have been reported in 0.1% of patients, and skin irritation in about 0.07%.

Though it's unclear exactly how this treatment works, experts believe the current travel diffusely into the brain, stimulating areas that are underactive and calming the overactive spots, explained San Antonio psychologist Kasi Howard, PsyD, who prescribes CES in her practice.

How This Therpy Works for Anxiety

For patients suffering from anxiety, "The current activates the 5-HT axis of the brain"—the area that produces serotonin—"as well as the frontal lobe, your decision-making center," Dr. Howard told Health. Serotonin is a chemical in your body that helps you to feel happy and relaxed. Meanwhile, the amygdala (which processes fear and anxiety) quiets down.

While the idea of running electricity through their brain may give some people pause, CES delivers only 50 to 500 millionths of an ampere, a minuscule amount. It's very different from electroconvulsive therapy (ECT)—better known as electroshock therapy—which is administered under general anesthesia. According to the American Psychiatric Association, ECT is used to treat conditions like severe depression and mania (often when nothing else helps).

Although the research isn't definitive, some findings look positive. For example, one study published in The Journal of Affective Disorders found that people using Alpha-Stim had more than three times the decrease in anxiety symptoms and more than 12 times the decrease in depression symptoms compared with those getting a sham treatment.

"I haven't had a patient who's used it and didn't have results," Dr. Howard said.

Ralph Harvey, MD, an associate professor of family medicine at Michigan State University, was similarly impressed: "I've seen phenomenal improvement in patients in my practice."

Ilene Witt, a licensed vocational nurse in San Antonio, has spent years battling trigeminal neuralgia, a chronic pain condition so excruciating that it's infamously known as the "suicide disease."

"When I got the diagnosis, my neurologist said, 'You need to let me know if you have any suicidal thoughts or feelings because that's very normal with this,'" Witt said. After multiple brain surgeries failed to provide meaningful relief, she found herself in "such a dark place."

When Witt started using CES under Dr. Howard's care, however, the dark moods related to her pain began to lift. "It was amazing," Witt said. "I was like, 'Wait a minute. I'm in a lot of pain. Where is the hopelessness and where is the despair? I'm actually OK.'"

Alpha-Stim Review

During my first session with the Alpha-Stim, I felt slightly buzzed, as if I'd had half a glass of wine. I didn't feel different afterward and wondered whether I had imagined the sensation. Clipping electrodes onto your earlobes can leave you suggestible.

But during my second session, as soon as the device was switched on, that same calm washed over me. The rest of that day, I felt steadier and more focused.

I decided to get a prescription for my own device. CES devices are not cheap: The Alpha-Stim set me back $800, and my insurance didn't cover any of it. But after nearly a year of use, I don't regret my purchase one bit.

The daily sessions themselves are relaxing, but it's what the Alpha-Stim does the rest of the time that has me sold. My mood is improved. I sleep through the night. And, best of all, I haven't had a single panic attack.

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