In a new reality where COVID-19 is at the forefront of the global collective consciousness, it is clear that the physical health of the world’s population is threatened. Our ways of life have adjusted dramatically to mitigate this public health crisis, causing reverberating impacts across domains beyond physical health alone. The economic consequences are dire, and even those spared from the economic impact of the pandemic are often confronted with sudden and evolving changes to their work and home lives to which they must adapt.

As a consequence of these varied challenges, a new one has become increasingly pronounced: our collective and individual mental health is being taxed in novel and profound ways, and existing mental health conditions are exacerbated in the face of novel stressors.
Dr. Leanne Williams, founder of the Stanford Center for Precision Mental Health and Wellness (PMHW) and her lab research how the brain responds to mental health challenges using high-definition M.R.I. technology. As neuroscience researchers, we feel it is apropos to leverage our understanding of brain circuits, and the mental health symptoms that arise when functioning across these circuits become aberrant, to advance strategies for mitigating the harmful psychological impacts of the pandemic. It is essential to advance effective mitigation strategies at this crucial juncture so that people can maintain functioning and reduce suffering.

We typically use this framework to describe how the dysfunction of these brain circuits map onto heterogeneous subtypes of depression, which could inform personally tailored, maximally effective treatment approaches. However, dysfunction of these circuits can also underlie mental health challenges among individuals who do not meet the threshold for a clinical diagnosis, and it would be similarly beneficial to target mental health symptoms using personally tailored intervention approaches in these individuals as well, especially at a time when increased strain on mental health is nearly universal.

In previous articles, we have described the interaction between six biotypes, or brain styles, each of which are associated with distinct brain circuits and mental health symptoms relevant to the COVID-19 pandemic. Two more circuit-based biotypes bear mentioning: negative bias and context insensitivity. In this continuation of our previous writing, we will detail the importance of these two additional biotypes and how they can be affected by the changing world dealing with COVID-19.

“Negative Bias”

  • This biotype is characterized by the brain’s negative affect circuit being hyper-attuned to negative stimuli, such as angry or sad facial expressions.
  • Negative bias can cause your brain to increase activity when processing negative information, leading to having a greater focus on the negative aspects of your experience.
  • This could give rise to the repeated worries and negative thoughts involved in the related Rumination biotype.
  • It impacts mood, causing your emotional state to match the negatively-biased state of your brain.
  • Much of the world is paying extra attention to news and media during this crisis, and giving increased weight to information that is negative and frightening could bias you toward an outlook stripped of hope.
  • A tip to counteract this effect: Make a conscious effort to seek out and celebrate good news. For example, while it can be easy to consume story after story about grim statistics, remember to take time to reflect on the many stories of incredible kindness and humanity that have risen out of the pandemic.
  • As social interaction is limited, communications could be interpreted as more negative than they are intended to be. For example, you might read emails or text messages without the warmth in tone or manner conveyed by an in-person conversation and might incorrectly interpret your relationship with the sender as more strained. You might, in turn, react to this person with less patience or understanding, perpetuating the (incorrectly) perceived strain on the relationship.
  • A common-sense tip for this biotype could be to notice when you have an experience you perceive as negative — a bad day or a cold social interaction — and “play devil’s advocate” with yourself, noticing potential positive aspects of the situation and questioning your negative interpretation. While you might not think there is any other way to understand the situation, entertaining a more positive reframing could lend enhanced perspective.

“Context Insensitivity”

  • Like the Emotional Numbness/Anhedonia biotype, context insensitivity involves the brain’s reward processing circuitry.
  • This biotype confers difficulty feeling an emotional response to things that might normally bring you pleasure, like your favorite meal or the smile of a friend. Because you don’t feel the emotion you might expect, it can become difficult to properly interpret facial expressions or react appropriately to emotionally relevant situations.
  • This might manifest as feeling emotionally “blunted” such that it is difficult to experience either positive or negative emotions and to differentiate between these, or the world seeming “gray” or desaturated. This can discourage imagination and hope.
  • For example, research shows that engaging in social interactions makes us happier, but individuals with the context insensitivity biotype may not seek these out because they miss the initial cues that suggest a social interaction might prove rewarding. For example, when someone begins a conversation with you with a warm smile, normally you smile back without even thinking about it, and a positive interaction ensues. To someone with the context insensitivity biotype, the enthusiastic greeting may not register, and they might fail to respond as keenly, resulting in a less constructive interaction.
  • A helpful tip for this biotype might be choosing to reach out to people with whom you might connect socially under normal circumstances, but are cut off from during the pandemic, or making extra effort to connect with friends and family, even if you don’t feel motivated to do so. You might reach out to a coworker you normally chat with at work to check how they’re doing. You could build toward more meaningful connection by increasing how often you connect with members of your social circle via phone calls or text messages, intentionally attending to positive signals, such as an inviting emoji or an encouraging tone of voice. Eventually, you could progress toward longer phone calls and video chats as you learn to recognize and feel motivated by these positive, rewarding social signals. Research suggest that there is a greater benefit from these deeper social interactions as compared to more superficial ones.
  • By challenging the notion that such connections might not be valuable, you might find such social connection surprisingly rewarding and improve your own mood in the process.
  • Another tip to address the hopelessness individuals with this biotype can experience is to imagine positive future events. Be as specific about the people, places, and events involved as you can.
  • For example, you might visualize achieving a specific personal or professional goal within the next six months. You could imagine bringing together a small team to initiate a professional project that truly excites you, or crossing the finish line of a half-marathon while your loved ones cheer you on.
  • These visualizations will help to train your brain to recognize positive emotional events and take steps to create them in your life.

Becoming aware of these targets for the improvement of mental health, in combination with the other six biotypes described in previous writings, and understanding which biotypes we identify with can foster feelings of empowerment, agency, and mastery over our experience and, in turn, lead to action. Taking steps to improve our mental health is not only critically important during this time of uncertainty, but also in our everyday lives. This crisis has amplified the conversation about mental health and presents an opportunity to identify and confront issues that might otherwise persist long after the world recovers from the pandemic.

For more information on our work, please visit http://med.stanford.edu/pmhw.

This content is informational and educational, and it does not replace medical advice, diagnosis or treatment from a health professional. We encourage you to speak with your healthcare provider about your individual needs, or visit NAMI for more information.

Author(s)

  • Leanne Williams, Ph.D.

    Professor of Psychiatry and Behavioral Sciences at Stanford University School of Medicine

    Leanne Williams, Ph.D. is a Professor of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. Dr. Williams is the founding Director of the Williams PanLab for Precision Psychiatry and Translational Neuroscience. She has developed a radical new way to understand and treat mental disorders, anchored in a neuroscience-informed model for precision mental health. In 2018, Dr. Williams launched as founding Director Stanford's Center for Precision Mental Health and Wellness. The Center connects researchers across the campus and country to advance high definition imaging biotypes for mental health, sensor technology, machine learning approaches, targeted therapeutics and the world's first biotype-guided trials. Dr. Williams also leads department-wide initiatives in precision mental health as Associate Chair of Translational Neuroscience. She has a joint position at the Palo Alto VA Mental Illness Research, Education and Clinical Center where she is Director of education and dissemination. After first graduating Dr. Williams worked with patients experiencing serious mental disorders and who had been hospitalized for many years. This experience transformed the trajectory of her career. She went on to complete her PhD in 1996 with a British Council scholarship for study at Oxford University. She joined the Stanford faculty as a Professor of Psychiatry and Behavioral Sciences in 2013. Prior to this time, she was foundation Professor of Cognitive Neuropsychiatry at the Sydney Medical School and Director of the interdisciplinary Sydney Brain Dynamics Center for 12 years. Her translational programs integrate advanced neuroimaging, technology and digital innovation to transform the way we detect mental disorders, predict mental states, tailor interventions and promote wellness. Data-driven computational approaches are used to refine this transformative approach. Her experience is that a neuroscience-informed model empowers each person with an understanding of their own brain function and can reduce stigma. Her research forms the foundation of the first patented taxonomy for depression and anxiety that quantifies brain circuits for diagnostic precision and prediction. She has contributed over 290 scientific papers to the field.
  • Laura M. Hack, M.D., Ph.D.

    M.D. Fellow, Stanford Center for Precision Mental Health and Wellness

    Laura is an M.D. Fellow with the Stanford Center for Precision Mental Health and Wellness.
  • C. Lauren Whicker

    Neuroimaging Research Coordinator, Stanford Center for Precision Mental Health and Wellness

    Lauren Whicker is a Neuroimaging Research Coordinator at the Stanford Center for Precision Mental Health and Wellness.
  • Sarah L. Hagerty

    Research Affiliate, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine

    Sarah L. Hagerty is a dual Ph.D. candidate in clinical psychology and neuroscience and a research affiliate at the Stanford University School of Medicine Department of Psychiatry and Behavioral Sciences.