Welcome to Thriving Mind, a resource to help you understand your individual signs of stress, take small steps to recharge, and unlock better mental health.

As we observe World Mental Health Day, we’re hearing a lot about common mental health issues like stress, anxiety, and depression. Talking about and destigmatizing them is a noble mission. But to truly understand these issues, we need to look inside the brain. 

We used to think our brains were static. But we now know that they have an amazing capacity to change throughout life. Our brains are miraculous — 100 billion neurons firing and wiring together — forming the circuits that support our thoughts, emotions, and behaviors. Although this science of the brain might seem complicated and even intimidating, one thing is key to remember: Each of us has the power to change our own brain.

One way this power manifests is the way we respond to stress. Stress is a huge part of life, and it shapes how the brain changes and adapts — for good and for bad. When we’re stressed because we can’t control our situation, negative thoughts, and emotions take hold. 

My research focuses on what happens in times of extreme negative stress. Stress in itself isn’t bad — and in fact some kinds of stress are positive, such as stress associated with an ambitious project that’s important to you. But when negative stress becomes cumulative, we may experience a “short circuit” in the parts of our brain responsible for thoughts and emotions, and become stuck in a loop. These short circuits aren’t a form of weakness or a personality flaw — they’re biology interacting with our experience. And everyone experiences them at some point.

So how does this connect to our mental health? Using high-definition MRI technology, I’ve studied these short circuits and identified eight distinct ways that brain circuits can get disrupted or stuck, which I call biotypes. In situations where you have persistent negative stress that you don’t feel you can control, constant pressure will be put on your brain circuits. If you can’t find a way to adapt to the stress, your brain circuits will get more and more pressured and eventually become stuck. That state of being stuck and feeling like there isn’t a way out or a way to think around it is effectively what we call clinical depression or clinical anxiety disorder. In those situations, it may be very hard to be productive or maintain relationships.

We tend to think of depression as a monolithic thing, but just as there are different types of cancer, each with its own symptoms and course of treatment, there are different types of depression. Understanding these biotypes — which are effectively the different ways that negative stress can express itself — gives us a way to actually understand our own brain, and I believe that is our best asset. 

Mental health is just like any other aspect of health and just as we think about what foods we feed our body, we need to think about what we feed our brain. What information do we give it, what do we focus on, how do we train it and how do we seek out positive stress that helps us build resilience and learn strategies for managing the negative stress? My own belief is that the more that you understand the answers to these questions, and about your own brain in general, the better you are equipped to be in a state of prevention and live the optimized life that you want.

A person may worry excessively, find it hard to focus, or tend to dwell on a negative experience over and over. If someone recognizes themselves in a biotype, that may be their style of reacting to negative stress, and it wouldn’t necessarily mean that they’re in clinical depression. But it can be an important step toward learning about how their brain functions. When we can name the challenge we’re struggling with, we’re that much closer to addressing it; it’s empowering to understand how our own brain works.

My own mission began more than 20 years ago. I’m driven to understand how the brain works to better understand how we work as people. We can’t begin to tackle the global mental health crisis without understanding the root: our brains. I lost someone to suicide early in my career and, more recently, a loved one. These events have only crystallized the sense of urgency I’ve always felt to address this crisis. 

To accelerate new discoveries and solutions I have founded the Stanford Center for Precision Mental Health and Wellness (PMHW). PMHW is a dedicated team, building on strong foundations. We have completed thousands of hours of brain imaging and talked with tens of thousands of people, something I’ve made possible by orchestrating international collaborations to make this possible. We’re using every tool at our disposal to understand the neuroscience of mental health.

Here’s an introduction to the eight biotypes, the brain circuit that most defines them and some of the thoughts, emotions and behaviors implicated in each: 


  • Involves the brain’s default circuit.
  • Tendency to repeatedly worry and have negative thoughts from your inner voice.
  • Repeated negative self-talk can create internal tension and disrupt social and workplace function.

“Anxious Avoidance”

  • Involves the brain’s salience circuit.
  • Situations that cause anxiety can in turn have a physical expression such as tightness in the gut, sweaty palms, or palpitations. These physical expressions can cause a person to further avoid the situation that triggers stress.
  • May feel the need to remove yourself from stressful stimulation and to reorient attention.
  • Can impact satisfaction with life.

“Negative Bias”

  • Involves the brain’s negative affect circuit.
  • May feel stuck in a cycle of negativity and expecting the worst; we might think of this as “catastrophizing.” 
  • May tune in to negative input from others and from the environment, and not see the positive.

“Threat Response”

  • Involves the brain’s negative affect circuit when activated by threats (real or perceived) in your environment.
  • Being hyper-attuned to these threats.
  • Activates automatic reactions that put the brain and body into “alarm mode” and which may be hard to switch off.
  • These automatic reactions may be experienced as physical sensations such as shakiness and being startled.

“Emotional Numbness”

  • Involves the brain’s positive affect circuit, also known as the reward circuit.
  • Sometimes unable to take pleasure in activities that usually bring you joy and give you purpose.
  • May take more effort to respond to positive interactions and feel like you are going through the motions.

Context Insensitivity

  • Involves regulation of the brain’s positive affect circuit.
  • May feel so burned out that you lose motivation in all areas.
  • Can take extreme effort to function at work or in relationships.


  • Involves the brain’s attention circuit.
  • Difficulty concentrating and staying focused.
  • May feel worn out by the need to force yourself to concentrate on a task.
  • Basic functions at work and home may be hard to complete.

“Cognitive Fog”

  • Involves the brain’s cognitive control circuit.
  • Brain may feel foggy, rather than sharp.
  • Difficulty in executive thinking that relies on making decisions and inhibiting unwanted thoughts and reactions.
  • Can make planning ahead harder.

It’s tremendously gratifying to share this research with people who may benefit directly from it. Understanding these biotypes will help us move the mental health conversation from awareness to action; because when people can identify their own personal signs of stress, it can empower them to take meaningful action in their everyday lives. 

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 health-care provider about your individual needs, or visit NAMI for more information.

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  • 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.