My ultimate aim is to understand how people can regain control of their lives
Maybe you think you're not a go-getter and tough challenges are not for you. You hear yourself saying that taking the easy way out may be 'just part of my character'. 'In a way, it is, but deeper psychological processes are at play,' says Vassena. Engaging in difficult situations can be especially tough for individuals dealing with depression or anxiety disorders. Is giving up then still a part of your character, or could we do something about it? People can have different causes for mental symptoms. We must understand which part of the puzzle we are looking at to provide fitting care. 'Understanding the decision to cease or persist could bring us an essential perspective,' says Vassena.
Visualising the puzzle
When you have to choose between ceasing or persisting, the parts of the brain that make decisions run at full speed, considering all sorts of important factors. How much effort will it cost? What positive consequences can you count on? Are things actually under your control? 'I want to examine those parts at that critical moment because they can teach us much about a person's mental health.'
Decision stress?
We now know that the average brain weighs up in a matter of seconds whether the outcome of a decision will bring pleasure or annoyance, how likely you are to succeed, or how much effort the choice will cost you. 'These brain calculations are not always flawless,' says Vassena. For instance, people sometimes misjudge themselves or situations or choose the option where they experience short-term happiness after all. Think, for example, of not quitting your horrible job because it gives you a sense of safety every month.
Diving deeper
The underlying brain activity can vary enormously from person to person, and then knowledge about the average brain is no longer enough. 'We need to go into more depth to help people,' Vassena concludes. Vassena uses a mathematical model, focused ultrasound waves, and medication experiments to do this.
Digital twins
At this point, it is still almost impossible to see all choice processes in someone's brain at a glance, while someone only makes the decisive choice once to cease or persist. Vassena is, therefore, working on a computational model with which she can create a 'digital twin' of someone's brain. She uses fMRI to study brain activity during 'cease or persist' moments and integrates it into the mathematical model. 'With this model, we can predict whether someone gives up or perseveres and which underlying process this is due to', says Vassena. But she first has to uncover that underlying process. Some individuals may be more affected by the required effort, while others may be more sensitive to potential negative outcomes or uncertainty.
With this model, we can predict whether someone gives up or perseveres and which underlying process this is due to
Shake it up!
Vassena plans to use ultrasound waves to 'shake up' the deep brain regions that regulate our decisions, involving weighing pros and cons. This way, she will show which areas are crucial to supporting the ability to keep going when faced with challenging tasks. Vassena hopes to see which parts of the brain are most important for giving up or persevering.
Targeted medication
Finally, she is going to use three types of medication to try to influence the little substances in the brain that allow or block a particular choice: the so-called neurotransmitters like dopamine and serotonin. Thanks to the computational model results and ultrasound waves, Vassena hopes to see whether a patient would need more serotonin or dopamine. This is a significant improvement because we only use the usual procedure without customising the treatment based on the individual's needs. As a result, a treatment often has only a maximum 50% chance of success. Vassena wants to change that.
Computer games instead of an MRI scan
'My first dream is that thanks to this research, the treatment of mental disorders starts as early as the GP with a more personalised approach,' says Vassena. Imagine a scenario where patients at the doctor's office could engage in a computer game that displays the functioning of different parts of their brain without requiring an MRI scan. This game could provide insights into the balance of dopamine, noradrenaline, and serotonin levels. 'Also, think about the long waiting lists for psychological care; we could reduce these enormously if patients get the proper treatment immediately.’
Empowering the young with care prevention
'My second dream is for young people, similar to a dental check-up, to play such a computer game once in a while so that we can recognise whether someone is more vulnerable to depression or burnout to provide timely interventions possibly,' says Vassena. Every year, a significant number of students cave to the workload. Imagine adapting a curriculum to that in advance that would keep students happier and healthier.
My dream is for young people, similar to a dental check-up, to play such a computer game once in a while so that we can recognise whether someone is more vulnerable to depression or burnout
Follow your dreams
The choice to give up or persevere is enormously complex. With the COPE model, we will soon see which brain processes are working more or less well and respond appropriately almost instantly. Hopefully, you can quickly achieve your dreams and successfully pursue those tough challenges with peace of mind.
