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The Default Mode Network.

The air tightened when she walked into the room, her breathing was faster than it should of been, not laboured just fast, and as she sat I could see a fine tremor in her hands whilst her fingers constantly fidgeted in her lap playing out the tune of her anxiety.

It was this anxiety that had driven her to see her doctor today, her sleep was fretful, her concentration was poor, she was getting annoyed with people around her and recently she had been getting full blown panic attacks, the last of which necessitated a trip to the Emergency Department by ambulance.

In the Hospital all of her tests; namely ECGs, D-Dimers, Troponins, a Chest XR and Arterial Blood Gasses had systematically proved that her ‘attack’ was not a heart attack, nor a dysrhythmia, nor a pulmonary embolus, or a whole manner of bad conditions that could have presented with similar symptoms. 

“It can’t be a panic attack I wasn’t doing anything stressful” she said.

With this phrase she had inadvertently hit the proverbial nail on the head, because where the problem and a possible solution lay was in her ‘Default Mode Network‘.

The Default Mode Network (DMN) refers to the parts of the brain that are active during our ‘default’ or inactive state, in these areas of the brain the neurones fire when we are busy doing nothing, the purpose and the function of this activity is thought to be that during these time of inactivity the brain starts to review, replay, remember and to plan future actions.

As man evolved the so did our DMN because this came better planning thus producing better behaviour especially in difficult situations, this in turn gave us an improved survival response in a challenging environment. It has been postulated that the Default Mode Network is the circuit of the brain which produces spontaneous thoughts, it is the part that causes the mind to wander thus enabling more creative thinking.

The trouble is the Default Mode Network can over do it, left to it’s own devices it can get stuck replaying negative memories, it can drive you crazy as you ruminate over negative thoughts and experiences and it’s creative element can think up worse case scenarios as you surround yourself in a world of panic wallowing in catastrophes that will never really happen.

So it’s of no surprise that the DMN has been shown to be overactive in a whole range of psychiatric conditions including anxiety, Depression, ADHD, PTSD, and Chronic Pain, an overactive DMN may not always be the cause of these conditions although that certainly doesn’t mean that we can’t look to how the DMN can be turned down to help with treatment.

The part of the brain that we use when the brain is active is called the Task Positive Network (TPN), when we are doing something the TPN lights up and the DMN reduces it’s activity.

There’s a condition called a ‘flow state’ this is when you are totally engrossed in the ‘doing’ of a semi-complex task, in a flow state the TPN is totally engaged and the DMN has effectively switched itself off, and you don’t have to reach a flow state or one of total concentration to know that sometimes keeping busy is the only way to take your mind off your worries.

This brings us onto what is called the ‘anxiety paradox’, where the mind is more likely to relax if you are doing something (when the TPN is more predominant and the DMN switches off) rather when you are doing nothing (when the DMN starts to become overactive).

As well as staying busy we can also train our brains to turn down our Default Mode Network, Cognitive Based Mindfulness Therapy (CBMT) is the current scientific names for what is fundamentally a form of meditative practice. In recent years medical research has repeatedly shown that the minds of people who practice meditation become wired differently, meditative practice turns down the DMN, the TPN is engaged and awareness is brought from the past or the future and back into the present, and this is how mindfulness can help to turn down an overactive DMN and the negative moods and feelings that ruminate from it.

Add to the mix cognitive therapies like CBT and NLP where thought patterns can be trained to become healthier even to the extent that the thoughts that do arise in your inactive mind tend to be more positive and resourceful then we can start to have a glimpse of a possible solution for this patient and for others suffering from a whole range on conditions that plague modern society.

Perhaps not everyone is open to the thought of starting meditative practice or seeing a therapist, most people are however open to simple lifestyle advice and stress management techniques. Some patients want a quick solution clinicians commonly prescribe drugs to treat anxiety, to sedate or re-balance the brain, to try and turn down the brain’s activity.

There is real objective evidence shown on fMRI scans that the activity in the Default Mode Network is effected by subjective thought and meditative practice, research has also shown that cognitive therapies are proved to be just as effective as antidepressants in some people with conditions such as anxiety and depression, and it’s no wonder that focus, concentration and overall stress levels are improved when the DMN behaves itself and the patient starts to re-engage their TPN, and get themselves out to do the things they used to enjoy.

Now take a few minutes to ask yourself what happens when you are doing nothing, where does your mind wander and where do your day dreams take you to? because perhaps you could benefit from a better functioning Default Mode Network.