Building the Bridge Between Brain and Mind

Dr. Georg Northoff’s work at The Royal in Ottawa is motivated by these patients. A psychiatrist as well as a researcher, Dr. Northoff feels strongly that to improve mental health outcomes, we need to abolish the artificial divide between physical and mental brain health. In his view this is the missing link that’s preventing personalized treatment from becoming a reality in mental health care. 

Despite growing awareness, mental health conditions continue to carry some of the highest levels of stigma of any health condition in Canada – 60% of people with a mental health problem or illness won’t seek help for fear of being labelled. For those who do seek help, relief is often out of reach –22% of Canadians diagnosed with depression live with a treatment-resistant form, where standard treatments simply aren’t enough. And there are currently no definitive diagnostics, such as blood or imaging tests, for mental health conditions. Diagnosis happens through clinical evaluation, using a process that heavily relies on the individual's self-reported symptoms and experiences.  

Dr. Northoff’s work is changing that.  

He envisions a future where people with mental health conditions undergo a comprehensive diagnostic assessment that combines lived experience, psychological tests, and brain imaging to guide a personalized treatment plan. While this approach may seem novel in psychiatry, it is routine across much of medicine, from cardiology to oncology, where objective testing helps match patients with the care most likely to benefit them. Dr. Northoff’s research aims to bring that same level of precision to mental health care by uncovering how the brain and mind work together in mental illness.

Studying The Brain to Treat The Mind 

“For me, the real breakthrough is helping someone step out of debilitating anxiety or depression – and back into their life.”
- Dr. Georg Northoff 

For one patient, a public servant, the stakes couldn’t have been higher. He had lived with severe depression for two years and nothing worked — not medications, not newer drugs, not standard brain stimulation, not even electroconvulsive therapy. Dr. Northoff and his team mapped this patient’s brain and subjective experience in detail. What they found is that communication between the patient’s visual cortex and prefrontal cortex was disrupted, resulting in external input being partially blocked and filtered through the depressed prefrontal cortex. Using that information, Dr. Northoff and his team targeted the patient’s visual cortex and were able to pinpoint one precise brain stimulation frequency tailored just to him and his brain, using what’s called transcranial magnetic stimulation (TMS). When they applied this personalized protocol, the depression finally lifted — a powerful proof‑of‑concept that a more precise, diagnostic‑driven approach can change the trajectory for people who have run out of options. 

They’ve achieved similar success with a breathing intervention.  

Slow breathing is an effective, evidence-based tool that reduces anxiety by activating the parasympathetic nervous system, our rest-and-digest response that lowers heart rate, decreases stress hormones, and sends a signal of safety to the brain. The standard breathing advice for anxiety relief across the internet is six breaths per minute. But Dr. Northoff’s research found that for 90% of individuals, particularly patients experiencing high anxiety or trauma, this advice does not apply. In some cases, such as a patient with war experience, it actually backfired. Dr. Northoff found that individual neural "sweet spots" vary dramatically based on a person's baseline brain order or disorder (also referred to as entropy), and that there’s an optimal rhythm for each individual – the breathing speed at which entropy is lowest in their brain. He and his team developed a personalized breathing app that tests different breathing speeds with psychological and brain‑based measures, finding an individual user’s optimal number of breaths per minute. The result is a tailored protocol that acts like a steady ocean swell smoothing out choppy waves, helping to bring down anxiety, and restore a sense of control. The team has achieved the same success with music. 

Early results are striking. A study found that people using the app for just ten minutes of personalized breathing and personalized music therapy in the morning and evening saw 20–40% reductions in anxiety, and, equally important, of racing thoughts that typically accompany anxiety. One engineering professor with severe social anxiety, who had not responded to multiple medications, can now give public talks after just five minutes of her personalized breathing routine. While medication and psychotherapy can achieve good success rates when used in combination, these therapies do not act as quickly, come with financial barriers, and in the case of medications, can cause side effects.  

“Personalized breathing and music are much better than any benzodiazepine or cannabis, because those drugs can make you dependent and create huge problems over time.” 

Scaling the Brain-Mind Connection 

For Dr. Northoff, the brain and mind share a common currency of time and space, where neural waves directly transform into mental waves. His research shows how bridging this brain–mind connection opens up new paths for people living with anxiety and other mental health conditions – rapidly and without drugs.  

To move beyond single‑patient breakthroughs, Dr. Northoff’s team is now expanding their approach and pursuing larger clinical studies. In the meantime, Dr. Northoff has established a company and just released the personalized breathing app, which is being made available through participating clinicians and research partners as data on its effectiveness continues to be collected. His company’s mission is to advance evidence‑based psychiatry, in explicit contrast to the many digital mental health offerings he sees as built on a shaky scientific foundation.  

Dr. Northoff sees the app and related tools as the translation of complex neuroscience into something people can benefit from in daily life. His hope is that patients facing other mental health conditions, including schizophrenia, will benefit from the app as well.

Anatomy of Anxiety 

Every one of us, at some point in our lives, will experience anxious moments. Maybe it becomes worse and you need to see a doctor or a psychologist, maybe not. 

Dr. Northoff describes anxiety as a state where your brain’s activity becomes irregular and chaotic, with many fast, unstable “waves.” It’s like a cooking pot where everything is splashing around irregularly. It’s like a stormy seaside with fast and slow waves crashing in all directions and with your brain, the ship, working hard to navigate. 

Scientifically, he links this chaos to high entropy in the brain – lots of disorder and unpredictability – which people experience psychologically as uncertainty and not knowing what will happen next. That uncertainty is what drives anxiety. 

When anxiety hits, your brain’s regions and networks interact in an abnormal way. For example, a region called the amygdala misinterprets a threat and sends a distress signal to another region, the hypothalamus, which hijacks your brain's rational thinking center, the prefrontal cortex. This triggers a massive surge of stress hormones like adrenaline and cortisol through your sympathetic nervous system. As a result, your body instantly enters fight-or-flight mode, causing immediate physical changes like a racing heart, shallow breathing, and heightened alertness.  

That’s why Dr. Northoff’s personalized slow‑breathing approach works: it introduces a slow, steady “wave” that “swallows” the chaotic fast waves, integrating them and reducing their impact on consciousness, and directly signaling your brain to turn off this fight-or-flight response. The result is less anxiety. 

Why Research Matters 

Disturbed by the trial‑and‑error treatment approach common in psychiatry, Dr. Northoff reflects on fields like oncology, where in the last 20-30 years research has successfully linked symptoms to underlying mechanisms, leading to significant improvements in health outcomes.  

“Researchers made enormous progress because they found a relationship between the manifestation of cancer, the symptoms of cancer, and the underlying mechanism in the blood and the genes. That’s exactly what we’re lacking. We lack an understanding of the relationship between brain and symptoms.” 
- Dr. Georg Northoff

What psychiatry needs is a reliable bridge between what people feel and what’s happening in the brain. Dr. Northoff is building that bridge by combining multiple layers of information: how people experience time and space, psychological tests, and different types of imaging. By integrating these data into a single, spatiotemporal “profile” for each person, and refining it further with individualized AI-based brain models, his team is effectively building the kind of brain-based markers that can guide precise diagnosis and personalized treatment in mental health, much like biomarkers do in oncology and cardiology. 

Because mental health conditions have no biomarkers. Unlike physical brain conditions with clear structural manifestations such as lesions, tumours, or inflammation, mental illnesses such as major depression or schizophrenia are highly complex – they lack singular brain markers and therefore diagnostic tests. Clinicians need to rely on observation, clinical interviews, and standardized manuals to evaluate a patient's symptoms and history and come to a diagnosis.   

A deeper understanding of the complex relationship between brain and mind is the foundation for overcoming this challenge. Research funded by Brain Canada is identifying biomarkers, advancing diagnostics, and ultimately enabling more personalized treatments tailored to each individual brain. It is the only way to hope for more treatments — and ultimately to hope for healing. 

Together, We Will Break Through.  

“If it comes together that your science can help another person to get out of depression, that's the best you can get as a scientist,” says Dr. Northoff.  

It is the entire Brain Canada community, with its One Brain Approach, and you that is accelerating breakthroughs to improve brain health for all people in Canada. 

Dr. Georg Northoff at the University of Ottawa Institute of Mental Health Research at The Royal leads a team that was awarded a $950,000 Brain Canada Platform Support Grant in 2024 for the Brain Imaging Centre Advanced Multi-modal Neuroimaging Platform for Psychiatry (BIC-AMPP). The grant was made possible with the financial support of Health Canada (through the Canada Brain Research Fund, an innovative partnership between the Government of Canada (through Health Canada) and Brain Canada) with financial support from the Royal Ottawa Foundation for Mental Health.