TMS and the neural circuitry of courage resilience and survival with Dr Jonathan Downar

Jul 8, 2024 - neurocare group

New Episo

In a recent episode of neurocare academy's interview series, Dr. Trevor Brown meets with TMS expert Jonathan Downar, who is Associate Professor of Psychiatry at the University of Toronto. The two neuromodulation experts talk deeper about the neural underpinnings of resilience, survival, and their connection to effective depression treatments such as TMS. This is the second interview with Jonathan Downer in the ongoing series.

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Exploring the Neural Circuitry of Courage and Resilience

Downar provides fascinating insights on the neural mechanisms that govern courage, resilience, and survival. Central to this is the left dorsolateral prefrontal cortex, a region of the brain that plays a critical role in our ability to adapt and respond to challenges. Downar explains how this area is involved in the brain's executive functions, including decision-making, planning, and foraging behavior—a term he uses to describe our daily activities and problem-solving efforts.

The Role of TMS in Mental Health Treatment

TMS therapy emerges as a pivotal tool in supporting these neural functions. By targeting specific brain regions, TMS helps modulate neural activity, aiding patients in overcoming states of mental stagnation or "freeze." This therapy offers a non-invasive, medication-free alternative that aligns with the brain's natural processes, enhancing mental health and well-being.

Downar emphasizes the importance of viewing mental health through an evolutionary lens. Our neural circuitry, designed for survival, encompasses not only the fight-or-flight response but also freeze and foraging states. Understanding these can shed light on our mental health challenges and treatments.

They also discuss, in relation to mental health, how our ability to transition smoothly between different mental states, such as ‘foraging’ and ‘freeze’, significantly impacts our well-being. Prolonged periods in a ‘freeze’ state can hinder our capacity to function effectively, making it harder to achieve a balanced and productive life.

With the demands of modern life ‘trapping’ many people us in states of avoidance or freeze, leading to poor mental health, they discuss how TMS therapy can help "unstick" the brain, facilitating a return to more adaptive and productive states.

Downar also highlights the significance of social support and belonging in building resilience. He explains how the brain's executive mode, responsible for our day-to-day functioning, is bolstered by these social factors. The periaqueductal gray, a brain region involved in survival functions, also plays a role in cognitive control tasks, linking our survival instincts with our higher-order thinking processes.

Future Directions in TMS Research and Application

Looking ahead, Downar discusses the potential advancements in TMS therapy. Efforts are underway to improve accessibility and reduce costs, making TMS more widely available. Innovations include the development of smaller, portable TMS devices and the integration of neuroplasticity-enhancing medications to accelerate treatment outcomes.

Jonathan Downar's interview with Dr. Trevor Brown offers profound insights into the neural basis of courage, resilience, and the role of TMS in mental health treatment. By understanding and harnessing the brain's natural mechanisms, TMS provides a promising avenue for effective, holistic mental health care. This interview underscores the importance of flexibility in brain states, social support, and the ongoing evolution of TMS therapy in improving mental health outcomes globally.

About the series:

The neurocare group is a global network of experts in neuroscience, psychology, and engineering, with a mission to empower best practices and bring innovative and sustainable mental health techniques to more patients in need through our network of clinics. Through this interview series, the head of the neurocare Academy, Dr Trevor Brown, interviews leading minds in this field, to present the state of research and possibilities and effective models of care in mental health and cognitive performance. 

 If you are a patient looking for more information about these techniques or to find one of our clinics worldwide, visit

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Learn from the experts at neurocare Academy on our LMS ( neurocare Academy also offers in-person training and supervision in workshops throughout the world.

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