Can the headset and smartphone application really cure depression? This is Flow's claim to its medically-approved brain-stimulating headset, a device that feeds your neurons with gentle electrical current and one that you can buy and use in your own home.
For more information about major depressive disorders, you can also read more at the mental health charity, the NHS website or WebMD.
Flow is a medical technology company, founded in 2016 and currently based in Sweden. Its CEO, clinical psychologist Daniel Munson, founded the company after writing his master's thesis on brain stimulation and has many years of experience working at the crossroads between psychology and software.
We've heard about headphone shocks that help you juggle, but can a hardware product really succeed instead of or even begin to support existing medical treatments for depression?
To circumvent the potential health benefits of such a product, I spoke with Flow CEO Daniel Manson while working with Flow's headphones to figure out the hardware that was being offered.
What is Flow Handset?
Flow's headphones look a bit like miniature VR headsets, except the curved white visor sits solely on your forehead, with a strap hung above the top of your head to keep it in place.
The box also comes with a box with disposable cloth pads that you can place between the skin and the suction pads of the handset, since your skin may not respond well to direct electrical currents.
Treatment lasts approximately 30 minutes, "with 18 sessions over a period of 6 weeks" (three times a week) or "as long as necessary". The headset is designed to be used in tandem with a virtual therapy application that helps inform consumers about depression and the type of "lifestyle changes" a patient can make with their diet, exercise regime, sleep hygiene and meditation (the app is iOS only).
There is something mildly disturbing about the idea of self-administering mild shock therapy, but there are existing treatments that use the same basic technology: direct current transcranial stimulation (or TDCS).
This treatment is a non-invasive way of stimulating the brain with light electric currents using battery-powered electrodes.
Flow's website says that "People diagnosed with depression often have lower activity in the left frontal cortex of their brain. The headphones deliver a gentle electrical signal that activates neurons and balances activity in the frontal lobe.
"The headset is based on a well-researched brain stimulation technology called Transcranial Direct Current Stimulation, which has been shown in clinical trials to improve the symptoms of depression."
Hold it, is this a real thing?
The claims sound kind of sci-fi, the technology has been subjected to a number of medical tests, and the evidence is sufficient to get Flow approved headsets for medical use in the UK and Europe.
Manson tells me that Flow is seeking similar medical approval in the US and is talking to the UK National Health Service to offer the handset through a prescription.
The treatment is listed on the NHS website as a method of treatment, and the National Institute of Excellence in Health and Care (NICE) states that "there are no major safety concerns", although patients must be admitted through the risks and side effects related to it.
We strongly advise you no use the handset without a doctor's approval and official diagnosis Major Depression Disorder. Anyone with an "existing neurological" condition or with broken skin at the point of contact with the handset should be extra careful.
I made the mistake of caution here – as someone more familiar with the treatment of anxiety than those used for depression – so I cannot speak of effectiveness alone.
However, both British Journal of Psychiatry and New England Journal of Medicine have published the results of randomized controlled trials using the type of brain stimulation used in the Flow handset.
Both studies cited above have worked with several hundred patients (289 in the first, 245 in the second), with the British Journal of Psychiatry calling the treatment "comparable" to "treatment with primary care antidepressants."
The New England Journal of Medicine, however, hesitated more, reporting "worse" effects – such as "redness of the skin, tinnitus and nervousness […] and a new mania ”- with no obvious improvements compared to other forms of therapy. Another study, published by the online journal Brain Stimulation, recommends using it for patients who are predisposed to seizures or epilepsy.
Flow CEO Daniel Manson says the company has worked for more than two years to "ensure that all safety standards and good manufacturing practices are met and documented" before receiving approval stamp in June 2019.
But some skepticism is appropriate, given the inconsistent results of mental health treatment so far available to patients in the UK and Europe.
Depression, despite its prevalence in our society (the World Health Organization estimates 300 million people living with the condition worldwide), is really not well understood – and there are many different strategies for coping with suffering.
I may recommend a thorough psychoanalysis to understand the underlying psychological causes, cognitive-behavioral therapy for dealing with behavioral symptoms, or a drug as a chemical solution – if not a combination of the three, with varying degrees of success.
You may not recommend these things when you need them, given how difficult it can be to diagnose a mental illness. So offering a DIY solution that you can buy – bypassing lengthy and potentially triggering consultations, even if you have not done so without medical approval – is a convenience in itself.
"The combination of brain stimulation headphones and therapy applications," says Munson, "creates a new, very powerful but also very safe home treatment solution."
There has been a huge growth in self-medication and meditation applications such as HeadSpace – often actively recommended by GPs in the UK – offering ways to manage stress, pain or anxiety.
Of course, costs become a problem when patients are expected to find healthcare solutions outside the national health services. Flow headsets cost £ 399 (about $ 480 / AU $ 710), at no extra cost – while the HeadSpace app, for comparison, will set you back $ 95 / £ 72 / AU $ 149 per year subscription.
Mansson guarantees that he says Flow is just one tool "in the treatment toolbox", but as commercially available hardware, it has the potential to change the way patients typically receive treatment, especially if costs are reduced.
"We are currently seeing a shift from pharmacological treatment to more digital alternatives based on digital therapy," says Munson, "which empowers patients to motivate them to treat their own condition from the comfort of their home.
"Given that brain stimulation devices (if they are medically approved) offer few side effects and are affordable and affordable, it makes perfect sense for devices like Flow to become more and more popular."
So … should I have one?
Well, not from your own bat. The jury is not into the efficacy of tDCS, even if it is slowly gaining more traction as a potential aid for major depressive disorders.
However, given the growing push for more digitally based therapies and treatments, signs suggest that there will be more treatments available than those offered by physicians ahead.
But neither Flow nor I would recommend taking this at a whim and you really have to wait for your doctor to recommend it to help with your specific needs.
For more information, refer to Stream website,