September 28, 2017
Podcast from: https://bengreenfieldfitness.com/podcast/sleep-podcasts/the-fisher-wallace-circadia-for-sleep/
[00:00] Introduction/Casper
[03:10] Soothe
[06:41] Kelly Roman
[09:23] The Story of The Torpedo Fish
[13:16] The Torpedo Fish And Today's Electroconvulsive Therapy
[18:22] The Liss Brothers
[23:50] How The Liss Brothers’ Device Works
[28:30] Currents of TDCS Devices And Fisher Wallace Devices
[35:40] Quick Commercial Break/Organifi and Quip
[38:32] Continuation/The Default Mode Network
[42:41] How To Use The Circadia Device
[44:23] Why Use Circadia Regularly
[47:17] Cortisol and Other Similar Biomarkers
[49:06] Circadia and Devices Like The Muse And Thync
[1:00:25] End of Podcast
Ben: Hey. It's Ben Greenfield. I actually just returned from Sedona, Arizona where I had some pretty amazing sound healing and woo-woo experiences with people who were absolutely amazing, a guy named Porngi, Anahata Ananda, and I kept track of and posted some videos of some of the things I experienced down there, if you go over to facebook.com/bgfitness, you can check that out. It's a cool place on the face of the planet to go to, Sedona, Arizona. If you haven't been there, you must visit these folks. Anahata Ananda and Porngi, and also check out the restaurant ChocolaTree. Add that to your bucket list. Yeah, if you're sitting in Sydney, Australia listening in, I know it's a little bit of a haul, but just do it. Trust me. Do it. You'll enjoy it.
I'm headed down this weekend to Lake Tahoe to compete in the Spartan World Championships where they're also doing something called the “Pod Fest”. They're bringing in, flying in like 10 to 15 of some of the biggest health and fitness podcasters on the face of the planet, and we're all covering the race. If you want to follow the action for that, you can also go to facebook.com/bgfitness or follow me on Twitter. My Twitter handle's @BenGreenfield. And there's going to be some cool stuff. You don't have to be an athlete because we're focusing on interviewing the biohackers, and the nutritionists, and the people who have really gotten things figured out from like a longevity, anti-aging, productivity, fitness standpoint. So not just the meathead athletes. We're actually going to focus in on the good stuff. As much as I love meathead athletes, they're meatheads. I'm a meathead athlete. I fall into that category.
Anyways though, today's podcast is brought to you by something that is just up above my head right now. No, not my hair, or a hat, or the ceiling. It's in the room above me. It is a Casper mattress. Casper mattresses are really quite cool because they're extremely comfortable, they've got these foam layers for ideal firmness, they've got really good bounce, really good sink, which essentially translates to you sleeping and napping better. And not only that. They offer you a 100-night trial with free no-hassle returns if you're not happy. They're designed, developed, and assembled in the USA. And basically it's super comfortable and super affordable. So what I mean by that is that the price on these things is a fraction of the price of what you'd pay for an extremely expensive mattress. So Casper understands the importance of truly sleeping on a mattress before you commit, especially considering you have to spend a third of your life on it. So check 'em out. And you get a $50 discount. You just go to casper.com/ben and use promo code Ben to save $50 off your Casper mattress. casper.com, CASPER.com/ben and use promo code Ben.
This podcast is also brought to you by something that will go quite well hand-in-hand with your mattress, and that is Soothe. I just used this app and it's super slick. Here's the way it works: you open the app, you're super sore, your back is killing you, have these nagging aches and pains, your shoulders are tight, and you select on Soothe a massage therapist. So it's an on-demand massage service app. You get a hand-selected, licensed, experienced massage therapist to you wherever you're at. They'll come to your house. You don't have to get in your car and drive to the massage therapist's office, sit in traffic and honk the horn and get even tighter. No. Instead, they come to your home, they'll come to your hotel, they'll come to your office. They bring the massage table, the sheets, the oil, even the music. So you can unwind wherever you want. You can choose like Swedish massage, sports, deep tissue, they can even do couples massage. Ooh la-la. iPhone, Android, works anywhere. They're in 50 cities including most major US cities, London, Sydney, Melbourne, Toronto, Vancouver, Siberia. I don't know if they're in Siberia. Probably not. But you can book a massage today. $20 off! How do you like that? $20 off, you use code Green. So you go download Soothe, that's S-O-O-T-H-E in the App Store or the Google Play Store and you use code Green, G-R-E-E-N, like my last name, and you get $20 off your first massage. So there you go. Soothe, spa quality massage anytime, anywhere. Check it out.
Today's podcast episode is pretty cool. Kind of self-explanatory, but there's this guy who wrote an article called “How An Electric Torpedo Fish Can Put You Into A State of Deep Relaxation, Enhance Sleep, And Eliminate Stress“. This dude invented this head device that I travel with now. And now I sleep like a baby on airplanes, take naps, especially if I'm hard-charging and I'm stressed out, I turn that thing on for 20 minutes and I'm out like a light. You're going to find out all about how it works and everything you need to know. So check it out and enjoy.
In this episode of The Ben Greenfield Fitness Show:
“Our device, the Fisher Wallace stimulator and Circadia, which is the general wellness device that we have, they deliver between one and four milliamps. So a tiny fraction, and that's what we've been able to do with the AC current is to show through those different tests the elevations that are durable for serotonin, melatonin, GABA, and lowering the cortisol. But when you actually look at the video testimonials of PTSD patients, a lot of them talk about cognitive improvements and the ability to communicate and verbalize better.”
Ben: Hey, folks. It's Ben Greenfield. And if you read a recent article over on my website called “The Story of How An Electric Torpedo Fish Can Put You Into A State of Deep Relaxation, Enhance Sleep, and Eliminate Stress”, then you may be familiar with my guest today who helps to pen, or I should say type, that particular article. His name is Kelly Roman. And in that post Kelly, talks about how back in 46 AD, a personal physician to one of the Roman emperors, Emperor Claudius, used literally an electric torpedo fish, which is a kind of fish, and used that on the Emperor's forehead to successfully relieve his migraine headaches. And I didn't actually really believe this to be true, but then I actually found the historical anecdote that shows that thousands of years before modern electricity, ancient Romans used electrotherapy to treat neurological conditions. And so when it comes to wearable neurostimulation, it appears that this is something that is a practice that's been with us at least for a couple of thousand years.
Anyways though, there is this company that Kelly is involved with called Fisher Wallace. You may have heard of Fisher Wallace, it's a 10 year old medical device company. And at Fisher Wallace, Kelly leads product development and regulatory affairs. And one of the more recent things that the company, Fisher Wallace, has delved into has been this whole realm of deep brain stimulation and how we could get the body to not just, say, fight depression, or how we could get the body to have decreased amounts of pain or pain perception, or improve mood, but also how you could potentially elicit natural states of deep relaxation, natural releases of dopamine, of serotonin, et cetera without any actual pharmaceuticals, or drugs, or compounds at all. So I wanted to get Kelly on to talk about how exactly something like this could work and to kind of fill us in on this really interesting whole world of neurostimulation. So Kelly, welcome to the show, man.
Kelly: It's a pleasure to be here, Ben. Thank you.
Ben: Yeah. No problem. I'm honored to have on you on, man. You've got a wealth of knowledge on this stuff so I think you're the perfect person to talk about it. So I touched on the electric torpedo fish, but what do you know about that story? Was it an actual electrically charged fish, like an electrical eel, or how exactly did that work?
Kelly: Yeah. A torpedo fish is a ray. I think that's the species, is it's ray fish and it's an electrified ray. You're probably familiar with the big rays, not all of them I believe are electrified, but the torpedo fish is. What's interesting about that story, it was, I mean at the time fairly well-documented. Obviously because the patient was the Roman Emperor, so it was well documented. But just a few years ago the FDA for the first time actually approved a device, a neurostimulation device applied to the forehead to treat migraines. It's not something that Fisher Wallace makes, it's a product called Cefaly, but it was the first neurosimulator, FDA-approved to treat migraines. So that's kind of an interesting full circle. And the device itself almost looks like a tiny little mini ray. It's only a few inches wide and it has an adhesive that it sticks onto the forehead for migraine patients. So it took a couple of thousand years to get to the point where we have a device that's FDA-approved, but they were doing basically the same thing which is simulating the trigeminal nerve, which is underneath the forehead a couple thousand years ago.
Ben: Really? So that's where they would put it, under the trigeminal nerve?
Kelly: Yeah. The trigeminal nerve runs across the forehead and down to the sides of the face. So it's a pretty long nerve and it does have a lot of control over pain, and that's why the folks at Cefaly targeted that nerve when they were developing their product. And then they did about a 50-subject clinical trial, which was a fairly small number but large enough. And the results are strong enough for the FDA to give it what's called the de novo approval to treat migraines in 2014. So they've had a lot of success with that.
Ben: Yeah. The trigeminal nerve actually connects directly to the vagal nerve, which is responsible for a lot of parasympathetic nervous system activation, and that's the wandering nerve that innervates just about every organ in the body. I actually used to get, I don't do it anymore, but I used to get jaw realignment therapy which actually improves that connection between the trigeminal and the vagus nerve, and I would sleep like a baby on the nights after I got this jaw readjustment to relieve pressure and tension from my trigeminal nerve. Now what I do is I self-administer. I have like a little vibrating device called a MyoBuddy that I run on my head and my craniosacral muscles and around my jaw, but I specifically focus on that trigeminal nerve. I hold onto one side of my face and then open and close my mouth, and then on the other side of my face and open and close my mouth, and I feel amazing. I think a lot of people don't realize the amount of jaw stress that they have during the day and so it's really interesting that they would use these electrical fish as a way to stimulate the trigeminal nerve.
The other thing that I wanted to ask you about when it comes to just kind of like the history of electroconvulsive therapy is what happened in between this practice of using the electro torpedo fish and your early forms of neurostimulation and us getting to the point where we were doing the kind of things to people's brains that we see in like “One Flew Over A Cuckoo's Nest” where it's like full-on electroconvulsive therapy? ‘Cause obviously electroconvulsive therapy and electrostimulation of the head is something a lot of people kind of fear now because it did get such a bad rap from movies like that, for example.
Kelly: Yeah. And that probably has been the most, that movie, even though I love that movie and I love Jack Nicholson, but it's probably done the most damage to the neurostimulation industry of any media event or report of any kind. So the irony is that people who do get electroconvulsive therapy or electroshock therapy since the ‘70s have actually gone under full anesthesia. So although it makes for good movie watching to have someone kind of screaming and biting down on something while they're getting shocked, the reality is that electroconvulsive therapy happens to you when you're fully sedated and you don't even know it's happening. And the convulsion does occur, but it occurs when you're asleep, and when you wake up you may have some memory loss, that's one of the side effects of electroconvulsive therapy, but it also has saved thousands and thousands of lives. It's one of the most effective interventions for chronic depression, especially in patients who are kind of on the brink of suicide. It has really saved a lot of lives.
Now the amount of electricity that electroconvulsive therapy delivers, much, much more than what a wearable neurostimulation device. So they're really different. To give you an idea of the scale, electroconvulsive therapy delivers between 800 and a thousand milliamps. The seizure threshold is around 250 milliamps, I believe. Our device the Fisher Wallace stimulator and Circadia, which is the general wellness device that we have, they deliver between one and four milliamps. So a tiny fraction. And both electroconvulsive therapy and our technology both use alternating current, but electroshock therapy is really about realigning the brain through the seizure, whereas we're really about a daily dose of stimulation to help the brain manage its own neurochemical production and to dampen the default mode network, which is that center part of the brain that's active when you're stressed. And so we're really kind of a daily dose, small dose type of therapy, and electroshock therapy is a very high dose, expensive, kind of a very invasive form of stimulation, but saves a lot of lives, which hopefully many of your listeners won't be, but if you do get to that point…
Ben: So to clarify, something like electroconvulsive therapy, or electroshock therapy that you would see in something like “One Flew Over A Cuckoo's Nest” or even used in psychiatric hospitals or clinical settings nowadays, we're literally talking about hundreds of times the amount of power or stimulation compared to like something like a headset device or a wearable of the nature that we're going to talk about?
Kelly: Yes.
Ben: Okay. It's kind of like pulsed electromagnetic field therapy. People ask me about that and how I could be a proponent of grounding pads, or earthing mats, or grounding shoes, or these PEMF devices that one could use for stress fractures, etcetera and have at the same time a bunch of blog posts and things like that about the dangers of cell phones, which are also PEMF. The fact is that like the PEMF current from a cell phone compared to, say, like the 7 to 10 Hertz that the earth might emit is literally a million up to a billion times stronger when it comes the actual signal. So I think that one thing people always have to bear in mind is signal strength when it comes to electroconvulsive therapy versus some type of wearable on your head.
Kelly: Yeah. The Hertz level is much higher for a cell phone. Our device, actually one of the frequencies it uses is between 7 and 10 Hertz. So we're very aware of that Schumann frequency, resonance of the earth, and I think it's one of the reasons why that was of the eight frequencies that our device uses, why that was one of the ones that was chosen.
Ben: Yeah. And I want to get into a little bit about the type of frequencies you would use in something like this, because I've worn it several times now, I've owned one of these devices for about four weeks and I want to delve into how it actually works. But I want to back up a little bit too and talk about the point at which electrostimulation kind of entered the mainstream, or at least became a little bit more acceptable. And one of the things that you were telling me about was these couple of brothers named the Liss brothers. And I found an old New York Times article about them and it's called “An Electrical Device To Help Ease Pain” and describes these two brothers in New Jersey who kind of began the patent electrical cranial stimulation that seemed to be kind of like the next step after the stuff we see in “One Flew Over A Cuckoo's Nest”. But tell me about these Liss brothers and what they wound up developing.
Kelly: Sure. So the Liss brothers, one of them was an engineer at General Electric. They were both electrical engineers. Very talented and they went about producing a low amperage TENS device at first. That was their initial goal and that would be why the New York Times wrote about them in the context of pain therapy, because they were basically trying to create a device that could compete against traditional TENS devices which are around 50 milliamps or higher and can be a little over stimulating for geriatric patients. So their first goal was to create a TENS device that was lower amperage, one to four milliamps, but that would have equal or better pain reducing effect as the traditional TENS devices. They got FDA clearance for that device and then they also decided to start focusing on the use of electrotherapy to treat depression, anxiety, and insomnia. They used the same frequencies as the pain device and what they found is by putting the electrodes on the head at the frequencies that they had developed, the device was very comfortable to use just as it was on the body as a TENS device.
So they used the same frequencies, the same technology, but then started doing research for mood and sleep, and they also got FDA clearance to treat depression, anxiety, and insomnia. They developed the technology into that four different indications. One, anxiety, depression, and insomnia, so that's three. And then the other was pain. It's the only device I'm aware of that's ever gotten all of those clearances for the same device. So my business partner, Chip Fisher, then purchased the patents from them in 2006 and founded [0:20:17] ______ with his original co-founder, Martin Wallace, who is an addictionologist and was very interested in using the device to treat drug and alcohol addiction patients. And unfortunately Martin Wallace passed away from cancer within a year of getting involved in Fisher Wallace and I replaced him. So I became the co-founder that replaced Wallace, and then we, Chip and I proceeded to build a business around this very special technology that these Liss brothers had developed and had sold to Chip.
Ben: Okay. So the Liss brothers figured out how to increase serotonin with this wearable device that was kind of like a smaller version of the old school electroconvulsive or electroshock therapy, just a basic cranial electrotherapy stimulation unit, and that one was called the Liss Cranial Stimulator, I believe, right? That was the original title for it?
Kelly: That's correct.
Ben: Okay. And this was at the same time though that big pharma was launching things like Paxil, and Lexapro, and Zoloft, and Ambien, and Wellbutrin, and Xanax, all these blockbuster antidepressants. And were they kind of positioning this as an alternative to those?
Kelly: Yeah. And from a business perspective, it was extremely challenging, I would say probably impossible challenge for them to build a business in the mid to late ‘90s. And because of what you just said, all of these blockbuster drugs were still in patent, they were being heavily advertised, and they had very strong sales forces to the physicians. And so I think when we took over the technology in the mid-2000’s, that was actually, I think, a turning point culturally in the country where you had patients who had been on these drugs for many, many years and knew that the side effect rate was high, the efficacy was not great. You had a lot of long term published studies coming out that were showing the same thing, so SSRIs historically now have a 38% side effect rate and about a 35% remission rate. So the side effect rates are actually higher than the remission rate. And so, there's obviously an opportunity to compete in terms of a clinical benefit, but it wasn't until you could advertise online and really leverage things like Facebook and Google that you could effectively compete on a business level. And so that combination of, I think, a cultural shift to looking for non-drug alternatives after having been very much kind of a captive market that there are people who are now looking for a lot of other things and the ability for us to get our message out without having to take out enormous TV budget advertising allowed us to build a business. So we still today use Google and Facebook as our primary ways to get our message out and that's really leveled the playing field.
Ben: Okay. Got it. So this device that the Liss brothers created, this original cranial device, you mentioned earlier when you're talking about devices that, I believe the way that you described it was with relation to what it does to, is it the frontal cortex as far as the area of the brain that it's acting upon?
Kelly: So the Fisher Wallace stimulator and Circadia are identical, and this is what, basically the Liss Cranial Stimulator, which you were talking about, is developed by the Liss brothers. When we took it over, we renamed it the Fisher Wallace Stimulator. So it inherited all the same technology, research. We started funding new research with it immediately and we have some new clinical trials I can talk about that have been published since we took it over. And then we've also now released a general wellness version called Circadia that is indicated for stress and sleep management. So Fisher Wallace Stimulator is a prescription device just like the Liss device was. That's indicated for depression, anxiety, and insomnia. And Circadia is our general wellness device. No prescription required. Indicated for stress and sleep management. Both of those devices use two electrodes, one placed on either side of the head under a headband, and the stimulation actually is quite a whole brain, it's not a highly targeted form of stimulation and that's a good thing for treating mood and sleep. If you're treating something like Parkinson's and you want to, say, reduce tremors and increase balance, you really want to target the motor cortex, targeting is more important for conditions like that. But with depression and sleep, there's so many aspects, so many areas of the brain involved in that that having a more broader form of brain stimulation has proven to be very useful.
Now that said we know that the stimulation reaches the center brain, we know that it simulates serotonin, this is all through published studies. We know that it simulates serotonin, melatonin, GABA, it lowers cortisol, and it calms these center brain called “the default mode network”. The thalamus is the part where the brain stem connects to the brain that is responsible for a lot of serotonin production in the brain. And when you use antidepressant medication, the way that that increases serotonin in your brain is by basically preventing certain neuronal receptors from absorbing serotonin. And so if they can't absorb, then it increases in your brain.
Ben: That would be your basic selective serotonin reuptake inhibitor, or your SSRI antidepressants?
Kelly: That's correct. And now the problem with that is that it's not able to only just do that in your brain. It can do that, for instance, in your gastro tract as well. 80% of your serotonin production in your body is actually in your gastro track, it's not in your brain. And so it's of course no surprise that a lot of people have gastro issues when they take SSRIs. So whether that means that they constantly feel hungry, or they have trouble with digestion, or other problems, and that's just one of the ways that SSRI side effects can kind of really inhibit the patient experience. With brain stimulation, you don't have that problem 'cause you're only delivering electrical stimulation to the brain. And so that serotonin production is actually something that's, the electrical stimulation itself is what's called neural priming. And so it's really, the best way to think of it is it's kind of helping the neurons do what they do naturally.
Ben: Yeah. We've talked about neural priming before because I had the people who develop the TDCS device that you'd use prior to something like motor skill acquisition or a workout, this device called the Halo made by a company called Neuroscience, I had them on the show and we talked quite a bit about this concept of basically increasing the rate at which neurons fire. But for that particular device, that's something like pre-workout. It almost kind of amps you up a little bit. What you're saying is that depending on the area of the head that a cranial therapy device is placed, you can elicit a release of different types of hormones? Is that what you're suggesting?
Kelly: I think I would say that with Halo, and I have a lot of respect for Halo Neuroscience and in Daniel Chao there, I've actually spoken to him before and I think they have a lot of integrity, they are targeting the motor cortex. That's why the electrodes are on the top. And TDCS is different than alternating current. It does polarized brain tissue whereas alternating current does not. So there's a lot of reasons why the effects of TDCS can be a little bit different.
Ben: Okay. Explain to me that in a little bit more detail 'cause we have time, the difference between something like TDCS and something like electrostimulation with, say, like a Fisher Wallace device for sleep. What's the difference between the currents here?
Kelly: So TDCS is direct current and Fisher Wallace device is AC, which is alternating current. And by the way, electroconvulsive therapy is also alternating current. There's a there's a few differences, and to be honest there's still a lot that's not known, just like there's a lot that's not known about how drug therapy works in the brain because there's so much interconnectedness that it's very hard to point to specific mechanisms of action to see a through line. What you can do is say, “Alright, I've done some stimulation and then I'm going to do some saliva testing, and some cerebral spinal cord fluid testing, and some blood testing, and see what neurochemicals are present and elevated after I do the stimulation.” And that's what we've been able to do with the AC current is to show through those different tests elevations that are durable for serotonin, melatonin, GABA, and lowering in cortisol. Now that's different from saying I know exactly why those things are elevated. We don't. And TDCS doesn't know exactly why they would see neurochemical changes as well. What we do know with TDCS is that the brain tissue is polarized, that's pretty easy to test. You can take a sliver of rat brain and you can polarize the neurons and see that. The alternating current does not polarize.
And so, what we actually see with alternating current is that even though you're delivering electricity to the brain, you may think intuitively that that's going increase neuronal activity. It actually does the opposite, it decreases neuronal activity even though you're adding electricity. With TDCS there seems to be more of an increase in neuronal activity. And that could be potentially one reason why you feel a little bit amped up. I'm not aware of research, there probably is by now and I have to check on Pub Med, about TDCS and the default mode network. I know there's a 2012 study that's published and well-cited on alternating current, low dose alternating current like our device that shows a dampening of the default mode network, similar to what you would see if you do rapid eye movement therapy.
Basically you can think of it, if you're very worried about something, your default mode network, center brain is very active. But if your attention is then suddenly brought to an outside stimulus, like you see a dog running across a yard and you focus on the dog, then your default mode network will calm down and that's what alternating current is doing physiologically in the brain. That also strongly suggests why it's helping people get to sleep, why it's helping to reduce anxiety. There's also a circadian effect that needs to be studied a bit, more focused on the circadian rhythm effect. But for instance when you wear the Fisher Wallace stimulator or Circadia, you are getting a little bit of optic nerve stimulation, and there are retina related effects to circadian rhythms that we can achieve through a pulsed current that's actually stimulating optic nerves. And when you're wearing either Circadia or Fisher Wallace, especially on the higher level, level three or four, three or four milliamps, you'll see some flashing lights in your periphery.
Ben: That's exactly what I see. Even though there's nothing on my eyes, I thought for a second that the device was just placed too closely to my eyes. ‘Cause I'd put it on before bed and I'd lay there in bed with it on. So the pulses that I see in my eyes, those are actually coming straight from my brain and the stimulation on either side of my head.
Kelly: Of the optic nerve. Yeah, the optic nerve is actually…
Ben: So it is hitting the optic nerve. Interesting.
Kelly: And so there is probably…
Ben: I thought I was just tripping out.
Kelly: No. There's probably a connection between the success the device has had in treating sleep and that optic nerve stimulation. But what we do know and what we point to more is that we have real evidence, which is increases in melatonin and serotonin, which are neurochemicals at that have a lot of impact on sleep quality. And also the calming of the default mode network tends to be what can help you get to sleep and will help you stay asleep. So there's really two kinds of research, right? There's the physiological effects research, which we've been talking about a lot right now. And then there's also the symptom reduction research which is you choose a population, with the Fisher Wallace stimulator for instance, we did a study at Mount Sinai Beth Israel Hospital published in 2015 on bipolar II depression. And the researcher Igor Galynker, who's a world renowned bipolar researcher, was looking at can this device reduce symptoms of depression in bipolar II patients and are there any side effects or increases in the hypomania, which is the other side of bipolar. Bipolar has the mania side and the depression side. And what that study found is that all of the patients thought that got active treatment had durable decreases in depression symptoms, none had side effects, none had increases in mania, hypomania. And the placebo group had initial effects for about a week and then went back to baseline by the end of week two. And then when that placebo group was given active treatment, which is what's called the crossover design, those same placebo group people who now were given active treatment then had durable decreases in depression.
So that was a very encouraging study. In order for it to be definitive, we're going to have to do it with at least a couple hundred patients, that was done with about 20 patients. So it still had some statistical significance, but not as much as if we did a 200-person study. And so that's kind of our next step on bipolar. But the reason why that's so exciting and why bipolar patients really should be using the Fisher Wallace stimulator even though we don't have a huge study, we have this small study is because SSRIs, which we were just talking about, they actually will amplify the mania side of bipolar. So even if you're in that 35% that get depression help, you may find that the mania is much worse. And there's all these side effects with SSRIs. With our device, there's a 1% side effect rate, and those side effects are only headache, dizziness, you can’t sometimes feel restlessness, but again less than one out of 100 people as opposed to 38 out of a hundred people. And so this is really something, the Fisher Wallace stimulator that bipolar depressions patients, 6 million of them in the US, can now tell their doctor, “Look, here's a study. Fisher Wallace is 25,000 patients,” which we do, which is in a sense larger than any clinical trial you'd ever do that have that many patients, “and there's almost no risk. So let me try this.” And that's a conversation we're seeing happen a lot more today.
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Ben: You talked about the default mode network, and that's the part, for people who aren't familiar with this, it's commonly shown to be active when you're not focused on the outside world and when your brain is at rest, like when you're daydreaming and when your mind wandering. It's kind of interesting when you even look at like some psychedelics like LSD, for example, one of the things that it does is it kind of like, it allows you to have that default mode network kind of active as you're still engaged in some left-brained activity so you almost can daydream and also be analytical at the same time. And when you're looking at this default mode network and how it would work with something like this Circadia device, again that this thing that I've, I'll explain how it's used in a moment here, but you attach it to your head and you turn it on for like 20 minutes, is it shutting down the default mode network or is it more activating it so that you can kind of just like block things out and relax and get the serotonin and dopamine release, and fall asleep, or take a nap or be de-stressed?
Kelly: No, it's calming the default mode network.
Ben: It's calming it. Okay.
Kelly: And at the same time it is, there's not a correlation between active, it's not a necessary correlation between having to increase the default mode network activity and increase serotonin production. In fact, the device will dampen the default mode network and increase serotonin production, and we have published studies that show that.
Ben: Gotcha.
Kelly: And I'm not sure, I don't know about the mechanisms of action for LSD. I would say that if there is some default mode network, you just don't want it to be hyperactive. I think that's what you see with people, for instance, post-traumatic stress or in states of hyper vigilance all the time. We've treated a lot of veterans, and people who have PTSD, it's amazing to see their reaction. A lot of them, when they use the device, it's like they get a level of relaxation they've never experienced before. We hear that over, and over, and over, and over again. And it plays out in the research, but to actually see patients articulate this incredible sense of relief when they put the device on after never having felt that level of calm for years, it's really profound. Frankly, it's why I love waking up and doing this every day because there are just an enormous number of veterans alone that need help like this.
Ben: Yeah. With the default mode network, I know basically it's a matter of modulating it. Like for example when it comes to activating it, which I really do think is what's going on when you are entering this state where you are more relaxed or more de-stressed, I know transcendental meditation and some other forms of meditation have definitely been shown to activate that default mode network. And then the other thing that I know for sure is it appears that psychotropic drugs, like psilocybin or LSD, for example, seem to also modulate the default mode network in specifically a manner that allows it to kind of like become more active even when you're just busy during the day, for example. So again it's almost like you're daydreaming and task achieving at the same time. But it's kind of interesting that you guys have now created this ability to just be able to slap something on your head and do the same thing.
And so what I wanted to ask you next was basically how it works. So what I got when I got one of these Circadia devices was this little black package in the mail. And I opened it up and I had my little headband and the two electrodes, and those go on either side of the head close to the ears, and then the headband goes around them. Now you need to get the electrodes wet, so I was simply dipping those in water. Is that the best way to do it or should you use conductive gel?
Kelly: Yeah, no, no. Just run them under a tap, tap water. Very simple.
Ben: Okay. Gotcha. So at that point then I've got this little dial on the side of this handheld device that is attached to these two electrodes, one on either side of my head. And by moving that dial up, what's actually happening?
Kelly: You're increasing the amperage. So as you move the dial up, at first there won't be any output. There'll just be a green light that says the device is on. And then as you continue to dial it up, you see there's four lights that are yellow, the first labeled one through four, and that is the amperage. So that's the amperage we were talking about, level one through four, and we recommend starting on level two, which would be two milliamps.
Ben: Okay. Gotcha. And that's what I started on, but I'm a masochist so I just jacked it up to four right away 'cause I wanted to see what it would feel like.
Kelly: Everyone does that.
Ben: And it's like a tingling sensation on either side of your head, but it's really odd because after like a minute, you start to get relaxed. And I started to put it on before I would take a nap and then again because you say twice a day and I want to know why you guys recommend twice a day, but I would put it on again before bed and again feel that, I suppose it's just that surge of serotonin and dopamine and that activation of the default mode network when I have this on either side of my head in addition to that strange lighting pulse-like sensation that I see in the back of my eyes when I close my eyes, which you now have elucidated as optic nerve stimulation. But explain to me why it is that you would want to use this over time. Is it an entrainment effect? Is it something else going on that you would recommend using it one to two times a day regularly?
Kelly: Yeah. So we recommend the daily usage because there does appear in the research as well as clinical practice to be a cumulative effect from using it, and it may have to do with the increases in plasticity that the device can render over time. But what we found in treating, we did a 400-subject study of opioid addiction patients at Phoenix House, we've done a lot of other work is that twice a day is ideal. We also found that the neurochemical duration is roughly six hours or less.
Ben: Okay. Gotcha. So the effects would last for like six hours?
Kelly: Well the neurochemical effects would.
Ben: Meaning the serotonin and the dopamine release?
Kelly: Yes. But again there appear to be, and again we have to do some more research to give you a better answer, but there appears to be other benefits from the device in terms of helping the brain manage to the limbic system that are rendered with this lots of cumulative use it. So for instance we have patients with autism who have experienced increases in their verbal communication abilities. And when you actually look at the video testimonials of PTSD patients, a lot of them talk about cognitive improvements and the ability to communicate and verbalize better as they continue to use the device. Now those are not end points that we're trying to study because we're in the business of treating depression, anxiety, insomnia. So we're not putting a ton of money into research looking at verbal skills, right? Because that's not what we're marketing the device for. But over, and over, and over, and over, these are what patients are saying. And so from what scientists and neuroscientists understand about brain stimulation, both AC and DC frankly have shown increases in focus, concentration. We have one study for a device on alternating current that we have on our website on this that was done independently. So there's a lot of reasons to use device other than treating these specific symptoms. And a lot of patients will experience benefit, and a lot of patients, even when they're no longer having trouble with mood or sleep, will continue to use the device because of these other benefits that they're getting.
Ben: Now one of the things that you mentioned to me, and this is something that I've personally tested high and I know a lot of hard charging high achievers have this issue is cortisol as one of the biomarkers that is affected. Now serotonin and dopamine, we know that those are going up, but in terms of biomarker research, have you guys actually looked at plasma, or salivary cortisol, or anything along those lines?
Kelly: Yeah. We do. There's one study that's on our website by Shelley that showed decreases in cortisol levels from using our device, the Fisher Wallace stimulator. So that's the one study we have that we point to that shows reductions in cortisol. And that's a pretty easy thing to test for. In fact, they're even building sensors today that can test for cortisol in microscopic drops of sweat, and ultimately we would love to incorporate those sensors into our headband.
Ben: That would pretty cool. You mean like you would actually be able to monitor in real time what's going on to your cortisol levels?
Kelly: Yeah. With surface body sensors that are looking at sweat. You're very good at research, so I will send you the link after this, but there is some really exciting research on body sensors that are doing that even today.
Ben: That'd be pretty cool to be able to quantify at a moment's glance the amount of cortisol in the sweat. I was aware that they were kind of looking into one for inflammatory cytokines in human sweat, but if you send me the information on the sweat-based sensor for cortisol, I'll totally put a link to that in the show note 'cause that'd be really interesting.
Another thing that I wanted to ask you about was that there's a lot of devices out there that also claim to either work on the default mode network or to enhance serotonin and dopamine in a manner similar to what you've described with something like this Circadia device. Two that I'm aware of, one would be the Muse headband which is like a meditation type of headband, the other one is an interesting little device called the Thync, T-H-Y-N-C, which they market as a wearable for relaxation and for energy that you wear on your head. What's the difference between either of these devices that have been around, frankly, I think for at least a year or so, and the Circadia?
Kelly: Sure. So let's start with Muse. Muse is an EEG headset. So that is a sensor headset. It's actually not delivering any stimulation, which is what we're doing. So the way that…
Ben: So Muse is sensing, not actually delivering any form of electricity?
Kelly: That's correct. Muse is using sensors. Now they can influence neurochemical production and meditative brain states by basically using sound to impact the way you feel and then change that sound in real time depending on how your brain is reacting to it. So Muse kind of creates this feedback loop where it's using the Muse headband to see how your brain is reacting to stimulus and then changing the stimulus accordingly to get you to a more relaxed state. And so it's a very clever device, but there are limits to how much sound and kind of some other external sensory stimuli can impact your mood states. Now I'm sure that as they do more work with VR, you can actually really start using Muse, for instance, in combination with rapid eye movement therapy in a VR setting and some other kinds of exposure therapy and so forth, and having that EEG data to modulate what kind of visual and audio stimulation you're providing is really important and useful.
And frankly, I would love to eventually integrate EEG sensors and potentially cortisol sensors into what we're doing. The reason we don't today is because it would just add more cost to a device that's already not cheap and we want to keep the device affordable. And so you kind of have to make some decisions about what kind of technology you want to offer. And what we're offering is actually an intervention in and of itself. So electrical stimulation. Thync is doing that. Thync is providing electrical stimulation. The big difference is that Thync goes up to, I believe up to 20 milliamps. It's a much much higher dose. I know that was the first generation. I know they've come out with a couple since. So I don't know what they max out at. Thync is a TDCS device and it also, I think, uses some microwave theory, sorry not microwave, it's TDCS combined with another form of stimulation that I'm forgetting. But I know that they've…
Ben: That's what the Thync does?
Kelly: That's what Thync does. So Thync is actually delivering, unlike Muse, Thync is actually delivering electricity. It's a lot higher amount. To a point where, at least their older device, it was a bit uncomfortable. For Thync, there's just not a lot of scientific data on efficacy yet. I'm sure that they're investing in that. And so they've done some, basically sampling of consumers who have used the technology and provided feedback, and they use that as a means to demonstrate some effectiveness. And I think they've made the product inexpensive enough where a lot of people will just say, “Well, it's only a hundred bucks to try it or a 150 bucks to try it. I'll just give it a shot.” We're different in the sense that, first of all, Fisher Wallace stimulator is regulated by FDA and has been for many, many years. We have done a lot of clinical trial work and we have 7,000 prescribers. Over 2,000 of them are board certified psychiatrists. We're in contact with most of those patients. So we just have a very different target with the Fisher Wallace stimulator.
With Circadia, which is our over the counter version, we're kind of moving into that same market that Thync has, but our advantage is that we can say we're using the exact same technology as the Fisher Wallace stimulator. So if you're buying Circadia, you're buying a technology that has been validated for many, many years. We're targeting a different population with Circadia, one that's not medically acute. We're targeting really your everyday consumer that's trying to get better sleep and stress reduction as opposed to people that have diagnosed conditions, and that's really what the Fisher Wallace stimulator is there to treat. So with Circadia, you're getting something that just has a lot more scientific validation, and from what I've seen, is just a lot more comfortable. I haven't used Thync myself, but I know that their amperage, at least in their first generation device, was very high. And as a result, I know from the reviews I've read that people would find it a bit uncomfortable. But I haven't used their most recent device, which now actually I see is attaching to the back of kind of the base of the neck, and they really seem to be targeting pain more and trying to influence sleep with a back mounted…
Ben: I haven't used it before. But if anybody's listening in and you have used that one, you can go to the link for today's show, it's bengreenfieldfitness.com/electricfish. That's bengreenfieldfitness.com/electricfish and leave your comments if you used that one before. I'll link to some of these other things that Kelly and I are talking about too, including this Circadia device that we're discussing right now. So one of the main differences, it sounds like, Kelly, is that in addition to a lower amount of actual electrical stimulation, the Circadia is an actual FDA approved device?
Kelly: I need to make a distinction there. The Fisher Wallace stimulator is the FDA regulated device. Circadia uses the exact same technology as the Fisher Wallace stimulator. But because we've changed the population that we're marketing it to, to everyday consumers that are looking to improve sleep and stress, it's not a medical device unlike the Fisher Wallace stimulator. And it's a little bit weird, but the only difference between defining something as a medical device and defining something as a general wellness device is its intended use and the population that you're targeting.
Ben: Gotcha.
Kelly: You see that with Nexium. Nexium, there's prescription Nexium and there's over the counter Nexium for heartburn. Both have the exact same ingredient, but they market one differently. The prescription Nexium is marketed to people who have diagnosed gastro conditions. The OTC Nexium is for people who just, “Hey, I have some heartburn.” So that's a similar way to think about Fisher Wallace stimulator and Circadia. It's a little bit different, I mean 'cause it's not a drug and it's regulated differently. But Fisher Wallace stimulator is the medical prescription version for treating diagnosed conditions. Circadia, even though, it's the same technology, the same active ingredients so to speak, it's not a prescription device, it's not a medical device, it's considered a general wellness device. But it is using the exact same technology as Fisher Wallace stimulator.
Ben: Okay. Gotcha. One of the most interesting things that I noticed, and I did this last night just to test this before we hopped on the show today, is heart rate variability, measurement of the strength of the nervous system, activation of the vagus nerve, and one of the full body measurements that I do every single morning to kind of quantify my body, and my brain, and my nervous system health. It gave me very interesting values. It gave me a value of 104, which is actually like off the charts high, and it also showed an enormous, like a three-fold increase in specifically your high frequency power score, which is a measurement of your parasympathetic nervous system. So using it for 20 minutes before bed, eight hours later when I woke up this morning, appeared to have jacked my HRV and specifically my parasympathetic stimulation through the roof. Which I suppose would mean you wouldn't want to use this before you operate heavy machinery. But at the same time, it seems to have helped tremendously with a night of sleep and with heart rate variability. And what I like is I can also toss it on and either use it during a nap or use it to replace the same feeling that I get from a nap.
So I've been finding all sorts of interesting uses for this, and I've actually slapped it on a few friends to let them try and they can't believe how relaxed they feel after just laying with this thing on their head for 20 minutes. So I'm a fan of it and I would recommend, like if you're listening in, that you head over to the show notes and check this thing out because they do have a 30-day guarantee, no questions asked, 30-day refund and return guarantee if it doesn't work out for you. And it's really easy, just go to circadia.info. They have a coupon code, the coupon code is Greenfield, and that gives you $100 discount, gives you free FedEx shipping, and you can try this Circadia device out for yourself. Again super easy to use. I just took mine out of the box and wet the little sponge electrodes, attached those on my head, slapped the headband on, and I had jacked it up to four. Like Kelly said, he recommends starting it as a two, but that was it. And then you just lay there and let it do its thing. So anyways, Kelly, anything else that you wanted to add in or tell folks about this thing?
Kelly: Well, I think we covered it. That was a great conversation. I really appreciate it.
Ben: Cool, cool. Alright. So one more time, it's called the Circadia, S-I-R-C-A-D-I-A. I'll put a link to it.
Kelly: It's C-I-R.
Ben: Oh. Did I spell it wrong? Sorry. Yeah, I said S-I-R, didn't I? And the show notes for this episode are at bengreenfieldfitness.com/electricfish if you want to check out this cool little device to decrease cortisol and increase HRV, serotonin, dopamine, all drug-free, very safe, FDA approved. I've been using it, I like it, I'm a big fan of these gadgets that can make life better and this is definitely one of them. So Kelly, thanks for coming on the show today and sharing all this stuff with us, man.
Kelly: Thank you so much, Ben.
Ben: Alright, folks. Well I'm Ben Greenfield along with Kelly Roman signing out from bengreenfieldfitness.com. Have a healthy week.
If you read the recent article “The Story Of How An Electric Torpedo Fish Can Put You Into A State Of Deep Relaxation, Enhance Sleep & Eliminate Stress“, then you're no doubt familiar with Kelly Roman…
In that article, Kelly describes how, in 46 AD, the personal physician to the Roman Emperor Claudius applied an electric torpedo fish to the Emperor’s forehead to successfully relieve his migraines.
Don't believe me? Check out “Thousands of Years Before Modern Electricity, Ancient Romans Used Electrotherapy to Effectively Treat Neurological Conditions“. Anyways, this first “wearable” was actually alive, and the “user experience” was provided by the twitching underbelly of the fish, which was enraged from being pulled out of the sea and which covered the top half of the patient’s face. It filled the patient’s nose with its fishy scent, and delivered at first a painful and then numbing electric shock (roughly the same voltage as a hairdryer dropped in a bathtub).
“These are still the early days of wearable neurostimulation,” an ancient tech blogger would have reported, “But on the bright side, the device, while possessing eyes and teeth, is at least conveniently wireless.”
Heh.
Today we know that electrically stimulating the trigeminal nerve, which runs, in part, beneath the forehead, does in fact effectively suppress migraines. Indeed, the FDA approved the first wearable neurostimulation device to treat migraines in 2012 and like the torpedo fish, the wearable’s electrode is placed on the forehead.
But the idea of using electrical stimulation to affect not only pain perception, but mood and sleep, arose more recently in human history, and in today's podcast with Kelly you'll not only discover the fascinating history of electrical stimulation for addressing cognitive issues, but you'll also discover how a small company called “Fisher Wallace” developed a brand new deep brain stimulation device called the “Circadia” that causes your body to experience a massive natural release of dopamine, serotonin and fall into a state of deep relaxation, no drugs required.
Kelly co-founded Fisher Wallace Labs, a 10-year-old medical device company, where he leads product development, regulatory affairs, marketing, and VR strategy. Prior to Fisher Wallace, Kelly served as a business development executive at several media and technology companies, including Nielsen Media and the scientific journal Nature. Kelly is known in the medical device industry as leading the commercialization of medical grade, wearable neurostimulation.
During our discussion, you'll discover:
-The fascinating story of the electric torpedo fish that the ancient Romans used for neurostimulation…[9:15]
-How electroconvulsive therapy got such a bad reputation…[13:10]
-How two brothers called “the Liss brothers” fit in to bring electrostimulation to the modern psychiatric industry…[18:00]
-How Kelly discovered the device that the Liss brothers created and turned it into the Fisher Wallace stimulator…[23:30]
-Why electrostimulation has now entered the mainstream, and Kelly's thoughts on the new devices out there like Muse and Thync…[28:20]
-How electrostimulation can be used to increase HRV, serotonin and dopamine and to decrease cortisol…[47:00]
-How the Circadia devices compares to other sleep enhancing devices out there like Muse and Thync…[48:15]
-And much more…
Resources from this episode:
-How To Get Your Own CIRCADIA®: Here's how you get one for yourself, along with a no-questions-asked 30 day refund and return guarantee. Fisher Wallace Labs has partnered with Ben Greenfield Fitness to offer anyone who discovers this article a $100 discount on any purchase of CIRCADIA®: just go to Circadia.info and when you checkout, enter the coupon code GREENFIELD.
Circadia has live customer service via phone, chat and email from 10AM – midnight EST on Mondays-Fridays, and from noon – midnight EST on the weekends. You can also feel free to leave any comments or questions below this article, or to send Kelly questions at [email protected] and he will read and respond within 24 hours.
–The Myobuddy device Ben uses for jaw realignment therapy
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