The Future of Precision Psychiatry: Understanding Brain Networks

As a psychiatrist with 15 years of experience, I have witnessed the challenges in treating mental health disorders like depression and ADHD. In traditional psychiatry, diagnoses are generally made based on symptom clusters without any biological data. For example, if you feel depressed, you visit your primary care physician and say you’re depressed. You walk out with a diagnosis of depression and a prescription for antidepressant medication. Similarly, if you’re struggling with focus and attention and you seek help, you’re likely to be diagnosed with attention-deficit/hyperactivity disorder (ADHD), which may also be referred to as attention-deficit disorder (ADD). Along with this diagnosis, you may get a prescription for stimulant medication. Unfortunately, these treatments don’t always work. In the case of depression, one study found that more than 50% of people taking antidepressants did not experience full remission of their symptoms. In other cases, getting the wrong diagnosis or wrong treatment makes symptoms worse. This is simply not good enough. You deserve better. Recent advancements in understanding brain networks offer hope for more precise and effective treatment plans for mental health conditions. Recent advancements in understanding brain networks offer hope for more precise and effective treatment plans for mental health conditions.

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WHAT ARE BRAIN NETWORKS?

Your brain consists of multiple networks that work together to process information and guide our behavior. Some examples of the most important networks include:

• Default mode network (DMN)—This group of brain systems becomes more active when you’re at rest, such as while you’re sleeping, daydreaming, contemplating the future, or letting your thoughts wander. Activity in the DMN declines when you’re engaged in mental tasks that require focused attention or when you’re actively paying attention to external stimuli.
• Central executive network (CEN)—This network of brain regions works collaboratively to control cognitive tasks and engage in goal-oriented actions. Brain regions involved include the frontal lobe and the parietal lobe, which is why this system is sometimes called the frontoparietal network.
• Dorsal attention network (DAN)—This group of brain regions is involved in voluntarily focusing your attention. Rather than reacting to external stimuli, this crucial network allows you to intentionally shift your attention.
• Salience network—Think of this network as the brain’s moderator. It detects and filters salient stimuli, helping you identify what deserves your attention and shift between external stimuli and internal thinking.
• Reward network—This brain system is involved in desire, motivation, and pleasure. It activates in response to rewarding stimuli, including food and addictive substances.

Each network plays a specific role, and when they don’t function properly, it can lead to mental health issues. Research has indicated that brain networks may be involved in mental illnesses, such as:

• Major depressive disorder
• ADD/ADHD
• Anxiety disorders
• Autism spectrum disorder
• Bipolar disorder
• Obsessive-compulsive disorder (OCD)
• Schizophrenia
• Substance use disorders

HOW BRAIN NETWORKS IMPACT MENTAL HEALTH

Brain systems that aren’t functioning optimally are associated with certain mental health conditions. Let’s consider two patients: Lucy, who has depression, and Michael, who has ADHD. In Lucy’s case, her default mode network, which is active when she’s at rest or self-reflecting, may be overactive. This can lead to rumination and negative thoughts. In addition, her salience network, which helps identify important information, may be underactive. Research shows can lead to focusing on negative experiences. For Michael, his central executive network and dorsal attention network, which helps him focus on specific tasks to completion, may be underactive. This can result in difficulty concentrating and being easily distracted. Moreover, his reward network, which processes motivation and pleasure, may be altered. A study in Trends in Cognitive Sciences shows this can cause challenges in staying motivated and completing tasks.

HOW UNDERSTANDING BRAIN NETWORKS INFORMS TREATMENT OPTIONS

By understanding these brain networks, psychiatrists can develop more targeted treatments rather than the one-size-fits-all solutions often seen in standard mental healthcare. For example, researchers from Yale University have concluded that therapies like mindfulness and cognitive-behavioral therapy (CBT) can be tailored to help regulate the default mode network in patients with clinical depression. Medication and supplement options can also be refined. With more personalized treatment options based on brain networks, people like Lucy can overcome depressive symptoms faster and more fully. That leads to better moods, more energy, and greater contentment. For ADHD, findings in JAMA indicate that medications that increase dopamine levels can help improve the function of the reward network. Nutrition, exercise, and supplements can also help here. By implementing treatment plans that include optimizing key brain networks, individuals like Michael with ADHD can improve focus and attention. This can be beneficial in all aspects of an ADHD person’s life—work, school, home, and relationships.

THE FUTURE OF PRECISION PSYCHIATRY

In the future, precision psychiatry may involve using special brain scans and machine learning (AI) tools to identify which networks are not functioning optimally in each patient. This information could guide personalized treatment plans, combining medication, psychotherapy, and other interventions to specifically target the affected networks. While there is still much to learn about brain networks and their role in mental health, the field of psychiatry is making progress. With the world’s largest database of more than 300,000 functional brain scans related to behavior, Amen Clinics has found that with a better brain comes a better life. For more than 30 years, Amen Clinics has been using single photon emission computed tomography (SPECT) scans to help us create far more effective and individualized treatments for people struggling with their mental health. As we continue to research and understand these complex brain systems, we move closer to a future where precision psychiatry can enhance the way we help countless individuals lead happier, healthier lives. Depression, ADHD, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

Dr. Daniel Emina is a child/adolescent and adult psychiatrist and Associate Medical Director of Amen Clinics. Follow him on Instagram at @doceminamd