Habits & Health episode 96 with Daniel Mansson, a clinical psychologist by training and in this episode we discuss Flow, a revolutionary new way of treating depression.
Daniel is the co-founder and previous CEO of Flow Neuroscience. A clinical psychologist by training. He now leads the scientific work at Flow as Chief Clinical Officer
In this episode we discuss:
96 – Daniel Mansson
Habits and health episode 96.
Welcome to another edition of habits and health. This week, my guest is Daniel Mansson, who is a clinical psychologist by training and he now leads the scientific work at Flow. As the chief clinical officer and we find out more, what is flow? How does it work?
What kind of people, is it for. We talk about depression. Mental illness and many other things around that sort of area as well. So that’s this week’s episode. With Daniel Manson, if you know anyone who would get some value from some of the stuff that Daniel talked about, please. I do share the episode with them.
[00:00:40] Tony Winyard: Habits and health. My guest today, Daniel Mansson. How are you, Daniel?
[00:00:44] Daniel Mansson: I’m all good. Thank you Tony for inviting me
[00:00:47] Tony Winyard: I think this is the first time I’ve had a guest from Sweden as far as I can remember.
AwesomeAnd your whereabouts inn Sweden.
[00:00:56] Daniel Mansson: I’m based in the south of Sweden and so next to Copenhagen in Denmark. it’s called Malma, it’s a very nice town.
I’ve been to Gutenberg and Stockholm, but I’ve never been to Malmo around
[00:01:11] Daniel Mansson: go. Gothenberg is about two and a half hours of, traveling by, car, up north. Malmo is in the south.
[00:01:20] Tony Winyard: What is Malmo famous for anything?
[00:01:24] Daniel Mansson: zlatan ibrahimovic I would say , the football player, one of the best in the world. and then it’s just a very nice, down to earth town. so it’s a little bit like Copenhagen, but smaller. so it’s very nice. It’s very easy to live here, I would say.
[00:01:39] Tony Winyard: And you are the, I know you are the co-founder but you are a clinical psychologist by training, aren’t you?
[00:01:45] Daniel Mansson: that’s correct. so I started out in IT, as a, person who, ran big networks, and then decided, at 26 that, I wanted to, Go deeper into the, to the minds of people. try to understand, why we become mentally ill, but also why we become very happy. and, basically the basics of the human mind, and therefore decided to become a psychologist.
and then after I practiced that for a while, I decided to start Flow. and then as you said, ran that,as the CEO for about six and a half.
[00:02:17] Tony Winyard: and how was that whole experience? Was it, did it go as you thought it would or was it quite different?
[00:02:24] Daniel Mansson: so starting the company. it never goes according to how you believe. when me and my co-founder, started this journey, we, I remember it very clearly. we sat in a room, in a, in an incubator, business incubator and we talked about, what we could potentially achieve with this company.
And we said, we are going to give this three years. and then we can potentially do something else because we’ll take about three years to develop the product and get it out in the market and get traction and so on. And here we are seven years later and, still in the beginning of that journey.
I would say we have accomplished a lot, but still in the beginning of the journey. So not really, but I’m very happy that we did it anyway.
[00:03:04] Tony Winyard: And is your thoughts on where you want to go now quite different to what your thoughts were when you originally set the company
[00:03:10] Daniel Mansson: up?
So So I would say that the basics of the companies actually, still there, very clearly. so we decided earlier on that we wanted to build a. I’m sure we’ll get
[00:03:21] Setting the company up
[00:03:21] Daniel Mansson: into what we are actually building, but I can just say that we are building a treatment for depression and from the beginning we wanted to build a holistic treatment.
So partly, a stimulation of the brain and partly a behavioral training program in the form of an app. That is the basics of the products, and that’s still true. The way we deliver it is also, basically the same thingwe, imagined in the the beginning. but of course everything that has to do with we, uh imagined in the get paid for the device and how you deliver it to the patients and so on, that has changed quite a lot I would say.
[00:03:58] Tony Winyard: and what was it that made you want to do this in the first place? Is like, specifically around sort of mental.
[00:04:05] Daniel Mansson: Yeah. So I would say that the, my career as a clinical psychologist started out with, what I said before. I was very interested and still am very interested in trying to understand why we do certain things, because sometimes we tell others. the story of why we do things and then there is another reason hidden maybe for others, but also for ourselves.
And I wanted to understand the real reasons why we do things. And why we think certain ways. So that was the start of the career there. but the reason why I then left psychology was basically I saw a tremendous opportunity to have a bigger impact. . so as a psychologist you can maybe meet, people, five to eight people per day.
you are quite exhausted when you are, when you’re done with that. If you put yourself into it, you’re, it’s very,it gives you a lot, but it’s also quite draining in certain ways. so if you have the ambition to, to do something for the many people, I think you need to bring technology into. And these opportunities that we have, when it comes to apps, but also hardware, in order to help as many people as possible. and that was the decision I took then. So I’m happy about that. I miss doing psychology, definitely. but I think it was the right choice.
[00:05:25] Tony Winyard: So well, let’s dig into what is flow and how does it.
[00:05:28] What is Flow?
. So Flow is the company and we also call our first, product flow. so it’s a treatment for what we call unipolar depression or regular depression. it’s a, should we say, two component solution, two component treatment where we combine a brain stimulation headset. I will go into what that actually is with a behavioral training program in the form of this app that I mentioned.
[00:05:54] Daniel Mansson: The hardware, is a thing that you put on your head. It looks like. like headphones, but it has two electrodes that goes on the frontal part of the head, parts of the brain. it’s a non-invasive treatment, so it means that nothing goes into the head or anything like that. Just put it on the outside.
we then send a very weak, electric current, you could say it’s 2.0 milli amp, so you can hardly feel it. it goes into the left side of the frontal parts of the brain, and we take out the current on the right side. And the effect of this, is that on the left side you can get the neurons in the brain, these tiny things that communicate with each other in order to create everything that has to do with feelings or thoughts.
[00:06:37] Daniel Mansson: Our whole, inner mental, program, whatever you wanna call it. try to activate those neurons in the left side and we try to make them less active on the right side. And this has been researched for many years and are big trials showing that if you do it this way, you can get an effect that is roughly equivalent to the effect of an antidepressant, but with the big advantage of not having any side effects. So we take this and we then, as I said, try to create a holistic treatment by adding. A behavioral training program where we teach the patients what depression is, but also how you can affect it yourself by changing things that you are very familiar with. nutrition, exercise, sleep and meditation practices in order to help them reduce depression symptoms right now, but also prevent it from coming back.
So that was a long harangue of information. I hope everybody got,so is this something that someone needs to do daily, weekly? how regular would they need to do?
[00:07:41] How often should it be used?
[00:07:41] Daniel Mansson: Yeah, so the stimulation sessions, the technique is called tDCS. You do that, 30 minutes per session, so that 30 minutes per day. And then depending on where you are in the program, if you’re in the beginning, you do it five times per week, and then after the three weeks, you move on to what we call maintenance phase, and that’s two times per.
[00:08:06] Tony Winyard: And so what kind of results do people get from doing.
it has been tested in numerous studies that I mentioned before, and these are, what’s called R C T studies, placebo control Studies. and, then you can see that, it’s better than placebo and it is better or roughly equivalent to, a normal antidepressant at a high dosage. So that’s the kind of level that you’re on.
[00:08:28] Daniel Mansson: It’s, if I’m naming a number here about, 40 to 50% get a 50% drop or more in depression if you do this for six weeks.
[00:08:40] Tony Winyard: So is it a case then people just what they buy the hardware or do they just need to use this for a few months or? Does that work
[00:08:49] The hardware
[00:08:49] Daniel Mansson: So we have a, we try to give access to as many people as possible. And we know that, if you buy a hardware, some people can do that and, some people cannot do that. and therefore we have provided. one purchase option. So you can buy the equipment that’s 399 pounds and then you can also rent it, and that’s, 79 pounds at the moment.
and how long? That rental period be?
[00:09:14] Daniel Mansson: So it depends on your severity of depression, whether, you need, the maintenance phase and so on. But we tend to recommend or basically see that if people choose themselves. A big majority of people use it for about six months, and then we have, of course, many patients are using it for a year, two years, and so on.
But, but the big majority is using it for roughly six months,
[00:09:38] Tony Winyard: And so you said, so during the actual session when someone’s got this on their head, so how long did you say that session was?
[00:09:44] Daniel Mansson: 30 minutes, three zero. Yeah.
and is that, are they sitting in a, like a meditative state or how does it actually, how is the session?
[00:09:52] The 30 minute sessions
[00:09:52] Daniel Mansson: So we recommend that you shouldn’t do anything that, may. Get the headset to fall off, so you shouldn’t be running or anything. But otherwise you can do home chores, you can be sitting in a chair comfortably, watching tv. You can do the app sessions. you can do many different things, but you shouldn’t be running around.
But otherwise, it’s fine.
and so how has the reaction been since people have started using.
[00:10:15] Reactions from users to the product
it’s quite overwhelming, to be honest. of course. Kind of bias because I’m in the company. so you can read the reviews for yourself, but it’s overwhelming to see the amount of people that haven’t been helped by an antidepressant or have been depressed for a very long time and then tried many different things, and they can suddenly go back to.
[00:10:37] Daniel Mansson: Painting, the, you have reviews saying that there is color in the paintings again. I can go to the gym, I can hang out with my children and all these things that we want to be able to do with some kind of emotional, expression. You wanna feel something in connection to other people and or, things that you do in your everyday life.
so it’s very. it’s actually overwhelming to see that, something that I didn’t see on this scale when I was, myself practicing as a psychologist. It’s, it’s quite overwhelming actually to see the reviews.
[00:11:08] Tony Winyard: Did you initially just release this in Sweden and then it’s gone to the international market, or how did that develop?
[00:11:15] Where it’s available
[00:11:15] Daniel Mansson: So it’s a medical device, which means that when you get the medical approval in Europe, you are able to sell all over Europe. So we are available now, I think in, 28 or 29, countries. So that’s the whole of Europe, the UK and Brazil also.
[00:11:32] Tony Winyard: And is there anything similar to this on the market?
so the technology is widely used. and you, there are other, firms, that are developing devices using tDCS, which by the way stands for Transcranial Direct Current Stimulation. but these devices are normally research devices or made for clinicians, so they. Quite highly priced from 3000 Euros and up.
and then they’re used in the clinics. So you go to the doctor and then you get your treatment. And we have focused on getting this to, as I said before, as to as many people as possible, taking something that works in the clinic and delivering it to the many people, because we want that kind of impact.
so there we are quite unique. I would say.
[00:12:16] Can it be used for other ailments?
[00:12:16] Tony Winyard: and is, can you see how this might progress in the future? Is there, can it be used for other ailments as well?
[00:12:25] Daniel Mansson: Yeah, that’s an interesting question. this is a big research field. so first you have the brain stimulation research field where you look at things like, Tms, which is quite popular now. You go to a doctor and you get this magnetic stimulation. but you also have these, E C T sessions, electroconvulsive therapy for very severely depressed patients.
Works very well. It’s a bit controversial because of the media picture of it, but it works very well if you look at the research. and then there is. That have a lot weak occurrence such as tDCS that we are using. and in that field of tDCS, they have seen very positive effects on anxiety, diseases, PTSD, phobias, many different time, generalized anxiety and so on.
but also it’s beginning to. , we published big studies on adhd, certain symptoms of schizophrenia such as auditory hallucinations, for example, but also pain management. And then when you hear these things, you may say, okay, this works for everything. That sounds a little bit strange. but in a way it’s not that strange because you change the positioning of the electrodes and it’s just an effect on the actual neurons that you’re trying to have. and that can of course be true for many parts of the brain. And if you believe that these diseases are based in the brain, which we believe and many others, then of course you can affect them.
[00:13:49] Are some people more receptive to this?
[00:13:49] Tony Winyard: And is it a case that some people are more receptive to this than others? Like for example, would it not work on some people?
[00:13:57] Daniel Mansson: And that is definitely correct. Like with all treatments, antidepressants or other types of pharmaceuticals, but also TMS or EFT for example. it only works for
a certain, amount of people. Who those people exactly are, is a little bit more difficult to say. It’s different in different disease groups, patient populations.
so for example, we know that if you, if add a certain type TMS or EFT are used for anxiety. the effect of tDCS seems to go down a little bit. so that’s one thing. and then there are probably, genetic differences that could potentially affect it.
but otherwise we don’t really know why it’s not working. As with an antidepressant, for example, we won’t really exactly know why it’s not working.
[00:14:44] Do you get different reactions in different countries?
[00:14:44] Tony Winyard: and you mentioned that it’s available in, most of Europe now, I just wondered if there’s any difference in reaction to, because the people in different countries in Europe, the cultures are quite different. And so have had, there been some countries that have been really much more positive and I dunno, yet, really much more into it than other countries though.
[00:15:04] Daniel Mansson: Interesting question. I haven’t really thought about it like that. what we can see is that we have focused quite a lot on the uk and people have been, I would say very open to it. much more so than I, I thought in the beginning because it’s, it has these connotations to send, electricity into the brain, of course.
but people use what works. We have found, so I wouldn’t say that a certain country is more skeptical towards this. If I were to name any country, I would actually say Sweden because we, for some reason, we are a very skeptical people. and, especially, there’s this saying, you can’t become a prophet in a, in your own country or your own village.
[00:15:48] Daniel Mansson: And I think that’s pretty true actually. it’s, people are very skeptical towards new things that come from Sweden. In Sweden, I were to name one country, it would be actually Sweden.
[00:16:02] How do users discover this?
[00:16:02] Tony Winyard: And so is this now being like, for example, recommended by psychologists or how do most of your clients find out about this in the first place?
we decided early on that we wanted to go directly to the patients, in order to quickly get a sense of, Yeah, basically how they perceive the treatment. we know that it works from the science. We know that it’s safe, that has been established and otherwise we wouldn’t have gotten the medical, device approval.
but still the other aspect of it is the patients actually like it. So we wanted to test that quickly and therefore we went out and we now have. X amount of thousands of people. I think it’s about 8,000 now and that have been using it. in the future though, we see that, the connection to a physician, psychologist or a doctor, is very important.
and,the reason for that is that, most patients actually go to their doctor first when they feel that they, that they might be depressed.
so it’s important. so therefore, in the future we would see the, if I’m talking business now, business language, the B2B to C
[00:17:08] Tony Winyard: mm.
[00:17:08] Daniel Mansson: kind approach would be, the bigger part of the market, but right now it’s directly to, to patients.
[00:17:16] Have any of the reviews surprised you?
[00:17:16] Tony Winyard: You mentioned about you’ve got your testimonials, it reviewsiews of people who have found lot of benefit from this. Have you been surprised sort of testimonials, it reviews found benefits which they just weren’t expecting from this?
it depends on if you mean we didn’t expect it or if the patient didn’t expect it. either. Either one. Yeah. I think that when it comes to our, analysis that we are doing internally, we have a lot of data coming in and, I was. Maybe I was mostly surprised, I would say, on the effect of the severely depressed, because normally this is a technology that’s deemed, as something that, that, that is mostly targeted towards mild and moderately depressed patients.
[00:17:59] Daniel Mansson: But we have, what we have seen in our data is that people with quite severe depression, are also getting a lot of. And, that is very encouraging, I would say because it’s such a, such an easy technology to use and it’s such a inexpensive, also in a way, and very accessible. so that’s very encouraging. For the patients I think we have reports of people saying that they have. Their cognitive effects. for example, at memory function, or works, better people feel that they have,effects on other types of diseases. for example, if they have OCD. People have reported back to us that,that has become a lot better. People sleep in a little bit different ways. so they have, more interesting dreams and stuff like that. but that’s more like case studies. should we say stories from individual patients
[00:18:54] Does a user have to believe this will work?
[00:18:54] Tony Winyard: is there a case of if, how much does belief play in to this? So if someone is determined that this is not gonna work for them and they’re really skeptical, it work for them or that is what you test in the placebo controlled trials. so I would say that people that are coming in, in those trials, they get the information that, we are now giving you this treatment. It could either be, a non-treatment, a placebo, or it could be the active treatment. And then we measure the difference between those groups.
[00:19:22] Daniel Mansson: So that’s important from a scientific point of view. we also know. other things from psychological research in general that if you feel that a treatment is the right one for you, especially when it comes to talk therapies, I believe in C B T or I believe in psychodynamic therapy, then the effects of that specific therapy goes up quite dramatically.
Actually, you know about this. and that is, is very interesting, I would presume. but this is a presumption, that this, would be true for our treatment also. So if you believe it, it becomes a little bit better. If you don’t believe it, it doesn’t,
[00:19:59] The next step
[00:19:59] Tony Winyard: If someone’s listening to this and they’re thinking, okay, I’m interested to learn more about this. Where would they just go to your website? Where, what would be the next step?
[00:20:07] Daniel Mansson: Yeah, I think you should look broadly,look for the evidence, and if you are a scientifically inclined person, you should read the research reports. The clinical studies, you can definitely go to our website. We have a research section, where we list, many of the different trials that have been done on tDCS, comparing it to antidepressants, comparing it to TMS that I mentioned before.
looking at the safety aspects of this, for short term and long term. so there are many different resources at our website, but look.
[00:20:35] Daniel Mansson: There are, for example, there are also podcasts,and researchers specifically talking about it, trying to explain the effects,and why it actually works.
Mechanistically,I think that this popular podcast, the Huberman,
talked about, brain stimulation in general, a couple of episodes ago. he talked, I think, specifically about tms, but that could be also a very good source.
[00:20:58] Tony Winyard: Over the next few years, what further developments do you see your company making? Are there other areas that maybe you are able to go into? How do you see technology in this whole area progressing?
so I think that what we talked about before, that there are numerous studies showing, very interesting effects in other disease types, in the mental health area. I think that we are. Closely watching this, we are also doing our own research as a, at a quite advanced level. so there may be, I can’t say too much, but there, there may be advances, when it comes to, partly how we attack depression.
there are different ways that you can change the way you do the stimulation for, depression sufferers. but. Again, as I said before, we can also go to other disease types and we actually have, should we say a hardware devices internally in the company that can do this differently. so I think that, we’re watching the science that comes out.
[00:21:55] Daniel Mansson: We’re doing our own science, and then that will lead to, advancements in how we stimulate.
[00:22:01] Social media and the Flow community
[00:22:01] Tony Winyard: So what is your url, your social media? how can people find out more about.
[00:22:08] Daniel Mansson: Yeah, I think the primary source of, of information would come from the website. But then we’re on some of the social media, Twitter and Facebook and so on. if, the patients decide that they want to, To buy a device, start using device. they can also get access to our Facebook forum, where we have several hundred, people that are daily discussing, how they got on with the treatment, what they are doing, otherwise, and how they’re feeling and so which has turned out to be a very, vital, part of the company.
where people are very active in talking about the treatment. So that’s a great source of knowledge.
[00:22:44] Tony Winyard: Yeah, communities always helps that kind of
[00:22:46] Daniel Mansson: Yeah, it’s amazing to see these discussions taking place and how many different stories there are, about the treatment pathway, but also the disease history and so on. it’s very empowering.
[00:22:56] Tony Winyard: and are people able to join that group before renting or purchasing the product?
[00:23:02] Daniel Mansson: So normally you wouldn’t get that invite. So we have quite few patients that are actually, because we’re not really promoting it before they, they buy it. But if someone wants access to it, that’s no problem.
and the website, is it flow neuroscience.com.
[00:23:17] Daniel Mansson: Exactly. It’s a bit long, , but, you can probably find it if you search for flow and depression in Google, for example, or some other searching.
[00:23:25] A book that really moved Daniel
[00:23:25] Tony Winyard: I always ask people about if there’s a book that has really moved you for any reason. Does anything come to mind when I ask that question?
[00:23:33] Daniel Mansson: Yeah, it’s a very interesting question. I think,from my, there are many books that have moved me, deeply, but I would say that the book that I tend to reread every year is, Tuesdays with Morrie, it’s a quite short book, but it’s about a,a professor that is, about to, To die from a disease
and he knows about this, I think it’s a year before or something like that. And then he, get contacted by one of his pupils, from before and they, go on a philosophical journey. So they meet every Tuesday, and talk about life and talk about what he learned so on, and what’s important.
And I think that. always comes back to me because it’s,yeah,the most important things in life, gets very accentuated when you talk about it from a, dying in this case, man’s perspective. so I think that’s a very good book for those who hasn’t.
[00:24:26] Tony Winyard: I’m wondering what is it about the book that you think resonates with you so much? Why is it that you keep going back to it? What is it you are getting from the book?
[00:24:35] Daniel Mansson: I think that, obviously, as I’m a psychologist, I’m very interested in the conversation, in the meeting with other people and authenticity in, in general. I think that the. Why I start my career and left my old career and started this career is because I was almost, obsessed with getting to the truth of, as I said before, why we do certain things, but also this connection.
when you really have like a real conversation with someone. So I think that’s the kind of underpinning, and in the book, they convey this a, in a very nice way. the conversation is real, it’s emotional. You can feel the emotions between them. and then, that is actually intellectually also very intriguing because it’s between a professor, if I remember correctly of philosophy and, this, student of philosophy. so it’s, yeah, it’s a very intriguing and very short also, so it’s very, easy to, to reread and, and think about it again, and the new meanings of what they said as well.
[00:25:39] Tony Winyard: I’ve heard a few people, recommend this book. I think it’s about I explored it myself, so yeah, I’ve heard other people rave about it.
[00:25:46] Daniel Mansson: Okay. Okay. I hope you will, you’ll enjoy it as much as I have done through the years.
Daniel, thank you for letting us know about flow, cuz it sounds like something that’s gonna be really useful for many people.
[00:25:56] Daniel Mansson: Thank you so much for inviting me and thank you for the very, thoughtful call.
[00:26:00] Tony Winyard: Thank you Daniel.
[00:26:02] Daniel Mansson: Okay, thank you.
Next week is episode 97 with Luke you Oreo. Who is the host of the, on this podcast where he and his guests shared a real stories and experiences on a challenges as well as what it takes to be centered, connected, fulfilled, and balanced. And so we talk a lot about what does that mean and what does balance mean to, to look cause it’s, I don’t think it’s the same as what many other people often.
Express when they talk about being balanced. Um, he used to be the president of, and CEO of AIPAC, the Institute for professional excellence in coaching. So we also discussed that and about coaching in general. And so that’s next week’s episode 97 with Luke. Oreo hope you enjoyed this week show we’ve Daniel. If you know anyone who could we benefit, maybe anyone, you know, has got depression.
Could well be worth their while trying out this device. It’s um, I mean, it’s not that much to, to rent you. You know, it’s just as, as a first call, maybe just to give it a, give it a go. See if it works for you or for anyone, you know, who does suffer from depression? And hope you have a fantastic week
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