The Science of Feeling Stuck

Why do some people feel trapped in sadness, while others lose their sense of motivation and purpose? In this episode of Road to Resilience, host Stephen Calabria speaks with Dr. Martijn Figee about the brain science behind depression, resilience, and emotional recovery.

A leader in the study of deep brain stimulation and psychiatric neuromodulation, Dr. Figee explains how different brain circuits govern mood, reward, stress, and motivation—and how understanding those systems may reshape the future of mental health care. Along the way, he offers practical insights into mindfulness, behavioral activation, social connection, and the everyday habits that help keep the brain healthy and resilient.

Stephen Calabria: [00:00:00] From the Mount Sinai Health System in New York City, this is Road to Resilience, a podcast about facing adversity. I'm your host, Stephen Calabria, Mount Sinai's director of podcasting.

On this episode, we welcome Martijn Figee, MD, PhD. Dr. Figee is a professor of psychiatry, neurosurgery, neurology, and neuroscience at the Icahn School of Medicine at Mount Sinai.

His work focuses on the psychiatric use and study of neuromodulation, particularly deep brain stimulation, and the role of reward and mood circuits in neuropsychiatric disorders like depression and OCD.

Dr. Figee walks us through what neuromodulation even is, where the neuroscience is taking us, and how we can apply the lessons we've learned about deep d- deep brain stimulation to our own lives. We're honored to welcome Dr. Martijn Figee to the show.

Dr. Martijn Figee, [00:01:00] welcome to Road to Resilience.

Martijn Figee: Pleasure to be here.

Stephen Calabria: Can you introduce yourself and your work at the Nash Family Center for Advanced Circuit Therapeutics?

Martijn Figee: So I'm a psychiatrist, and a professor in psychiatry and neurosurgery, and that's because I'm working on the cusp of psychiatry and brain interventions, trying to treat people with psychiatric problems through brain interventions, including surgical brain interventions.

So I work with the Department of Neurology and Neurosurgery to treat different conditions, either n- either through modulation of the brain from outside or through implants.

Stephen Calabria: Now, we'll get into that word modulation in a little bit, but your research focuses on reward and mood circuits in the brain. How would you describe these circuits in simple terms for our audience?

Full Episode Transcript

Stephen Calabria: [00:00:00] From the Mount Sinai Health System in New York City, this is Road to Resilience, a podcast about facing adversity. I'm your host, Stephen Calabria, Mount Sinai's director of podcasting.

On this episode, we welcome Martijn Figee, MD, PhD. Dr. Figee is a professor of psychiatry, neurosurgery, neurology, and neuroscience at the Icahn School of Medicine at Mount Sinai.

Dr. Martijn Figee, [00:01:00] welcome to Road to Resilience.

Martijn Figee: Pleasure to be here.

Stephen Calabria: Can you introduce yourself and your work at the Nash Family Center for Advanced Circuit Therapeutics?

Martijn Figee: So I'm a psychiatrist, and a professor in psychiatry and neurosurgery, and that's because I'm working on the cusp of psychiatry and brain interventions, trying to treat people with psychiatric problems through brain interventions, including surgical brain interventions.

So I work with the Department of Neurology and Neurosurgery to treat different conditions, either n- either through modulation of the brain from outside or through implants.

Stephen Calabria: Now, we'll get into that word modulation in a little bit, but your research focuses on reward and mood circuits in the brain. How would you describe these circuits in simple terms for our audience?

Martijn Figee: So if [00:02:00] it comes to mood, there are actually... the interesting thing about deep brain stimulation, which is for us, the most interesting and most direct- intervention into the brain because you're implanting brains with millimeter precision leads at a certain spot, and then you turn on the leads to correct local brain activity, and you'll see changes, sometimes very dramatic, unlike you've ever seen in psychiatry before.

Also very rapid, unlike ever seen before with medications or therapy where things change much slower and much more much more broadly. So here, if you intervene into the brain with these very precise leads, you get a very nice and interesting new insight into, for example, mood circuits.

And then you become familiar with the fact and this, it also aligns with other studies, that mood is actually a [00:03:00] difficult construct. It so mood circuits and mood in itself basically contain affect, which is how you feel.

And people with a mood problem, they feel negative in general. Of course, they can also feel overly positive if they have a bipolar or manic mood problem. But basically they either... they can feel negative.

But the other issue that, that's very prominently present in depression or in mood problems is anhedonia, which is not necessarily affect. That's your ability to motivate and get up and achieve your goals. And now these two have different circuits.

So the mood circuit is basically a circuit that is involved in regulating a negative affect. Of course, it includes the amygdala. It includes this region that we call area 25, which is also where we do DBS, which is involved in sadness and in grief.

It goes up when people go through [00:04:00] grief and loss. And it has, of course, a function, 'cause that puts you into a more reflective state where you don't move too much, you think a lot, and you try to process because your brain signals something negative is happening or has happened.

You try to process that negative thing until that circuit basically goes down again, and you can continue with your life. So that's the mood, the classic mood circuit where a negative affect is i- is involved. It's area 25. It's the amygdala.

It's also the insula, which is a part of the brain where you can basically translate negative things to how your body feels, right? Your body starts to slow down, but you also, your body starts to feel stressed, and you feel your heart go, going up.

So those are all intertwined. And then the anhedonia circuit the motivation circuit- Which is that other part of mood disorders, that's more a reward circuit.

And now you're talking about structures like the [00:05:00] brain stem where dopamine is being produced, going to the nucleus accumbens, which is one of the reward centers in the brain, going all the way up to the prefrontal cortex where you regulate motivation.

And mood problems or depression can have dysfunctions in, in, in both circuits or either of the two. But it will give you a slightly different mood problem. And the reason I'm emphasizing this is because the way we treat currently at Sinai mood problems is by manipulating or modulating that negative mood circuit.

But there's also groups including my o- my old group in Amsterdam where I was trained, where we would go after the reward circuit. And those are two different approaches for different phenotypes or aspects of mood problems.

And this is not just relevant for mood, becau- but this is relevant also for addiction, obsessive compulsive disorder, [00:06:00] schizophrenia. All of those conditions, they have aspects of either motivational or mood dysregulation.

Stephen Calabria: Now, before we get into the specific research, could you tell us what originally drew you to study the brain's reward and mood systems, particularly in the context of psychiatric disorders?

Martijn Figee: I think I was, to be honest, right now I'm studying negative mood and motivation. Initially, I was mostly interested in motivation, right? When I was young, I wanted to really become a psychiatrist and go into medical school because I wanted to understand and learn what motivates people, right? It's a very broad question.

And at that time, this was the late nine- late '80s when I started medical school, that was mostly psychoanalytically driven where I wanted to become basically a psychoanalysist to basically [00:07:00] learn why people were having motivational problems and how, of course, to change that.

Now, during medical school, and specifically during my psychiatry residency, and now we're talking late '90s, early 2000s, biological psychiatry emerged, which was new, right? Freud had these beautiful ideas of why we limit ourselves and why we aren't motivated for things that we wanna achieve in life.

But he also always said- this should be studied in the brain, right? There's o- there's obviously a brain correlate for these theoretical constructs that I have, which are actually still pretty accurate if you think about them.

And he didn't have access to the brain, al- although he was also a neurologist and he would very much liked to. So then when I became a psychiatrist, during my training imaging took off, like neuroimaging, where you could place people in a scanner and measure activity in different brain circuits.

And that's actually something [00:08:00] that kind of switched my, you could say, motivation to study motivation, because now I had access to, to actually brain mechanisms of motivation, which is, if you're trained as a doctor, a little more attractive than just studying psychology, right?

Because, that's ultimately what medicine is about, that you wanna understand the organ and the biological mechanism of disease, including motivational problems. So we st- I started in schizophrenia.

I started my PhD in studying the reward circuitry in schizophrenia. And mind you, schizophrenia, part of schizophrenia is negative symptoms, where people are apathetic and they have difficulties getting up from bed.

So that was the part that we were studying. And indeed, we found that reward circuit was not activated as much as healthy controls, for example, when you give them monetary rewards.

And then and this was near the end of my psychiatry training the first patients with obsessive [00:09:00] compulsive disorder in the world were implanted with DBS leads. So now we were... and they, and those were actually close to the reward circuit, to the nucleus accumbens.

And it helped. This was just three patients done in Leuven which is very close to Amsterdam. And this was amazing, fascinating. So now we had a, an interventional tool to basically change reward activity and see if that could be helpful.

First, we tried it in obsessive compulsive disorder. It did help for more or less half of the people. And then we also, not surprisingly of course, saw that when we modulated that nucleus accumbens reward structure with electricity, with implants, that also, of course, their moods changed, their mood improved.

So we started also doing it in depression, which was, of course, also successful, again, in half of the people, which kind of suggests that it may h- help for people with a primary motivational issue, but not necessarily a mood issue, right?

[00:10:00] But that's something that we didn't really know back then yet. We just saw that it helped in, in, in some, but not other people. And then I moved to- New York. This was eight years ago, so making a big step.

And here I came into contact with Helen Mayberg, and she's an expert in the mood circuits. She's always been studying and modulating with implants the mood circuit.

So now we work together. We're c- we're seeing, we're ki- we're trying to come up with with metrics of mood versus motivation or reward circuit dysfunction so that you can basically tell your patient, "You need a, an intervention for mood. You need an intervention for motivation," which by now is something no psychiatrist really does.

We lump them all together and we call it all depression. Depression is, if you think about it, a very vague term. It means you're low, but low in what? Low in mood, low in motivation, low in energy, all of the above.

Those are, [00:11:00] to just name three, already different circuits, right? And then there's even things like anxiety and stress. I could go on, but depression in itself is a fascinating concept, but it's unfortunately also a very broad concept with different brain structures.

Stephen Calabria: And because of the broadness, it's hard to differentiate oftentimes between someone who just feels sad and someone who is suffering from clinical depression, but at a circuit level, what's going on in the brain when someone feels stuck or unable to feel pleasure?

Martijn Figee: So again it, it's important first to identify if they're stuck because they can't feel pleasure or motivation, their reward circuit is hypoactivated and hypoconnected, or they are just incredibly sad and negative.

They feel like they're going through grief and loss, but there's not really grief or loss going on. Or even if there was initially, the system doesn't switch off, so they stay [00:12:00] in that sad, grieving, immobile state even though there's nothing to process.

So that's actually two forms of stuckness. One is something is in your way, negativity. The other is you miss positivity, you miss drive. And the problem is if those patients come to you as a psychiatrist, they can just, as you say, they can just, their basic complaint is, "I'm stuck. I feel depressed."

But it's hard for a psychiatrist to understand where they are stuck, so you have to basically ask, "Are you stuck because negativity's in your way, or are you stuck because you miss, miss positiv- positivity?"

Now I'm putting it very simplistically, but even those simple questions are hard to answer for a patient because the challenging thing of psychiatry is that you gotta, you're basically asking the patient to verbalize their own biological dysfunctions which we never- do i- in most other medical disease.

Because, and even if we do, it's just a little easier to [00:13:00] describe or report a tremor than something vague as like why am I stuck? Why can't I achieve? Like again, that's why Freud came up with these beautiful theories because it's very complicated and hard. A- and so we, we gotta probably also just find metrics and work close to those where we can basically directly interrogate those systems, right?

And so the patient shouldn't be bothered by trying to verbalize these very complex internal state. We're just gonna, we're just gonna look for you and see where you're most likely dysfunctional.

Stephen Calabria: And to that point, those kinds of interventions, neuromodulation techniques like deep brain stimulation, how do those approaches interact with reward and mood circuits?

Martijn Figee: So again, depending on where you place them, you can place them directly in the reward system, like the nucleus accumbens or the medium forebrain bundle, and there they're supposed to boost dopamine and motivation in people that have a primary motivational problem.

[00:14:00] This is something that we've done in the past, and it seems to work. Again, for some people, not for others, because probably they- they're stuck somewhere else. Now, if you do the same in the negative affect circuit, which is what we currently do in Sinai you can actually interrupt the hyperactivity in that system that signals sadness.

So you can basically tune down the sadness so that people can feel motivated and rewarded again because there's nothing in their way anymore, unless they're also affected in that reward circuit.

So this is where it's so important to know your target. But either way, you have, with neuromodulation with deep brain stimulation, you have the ability to very precisely choose your target and then modulate that target.

That's not the limiting factor. We can be extremely precise. The limiting factor is that we need to understand someone's depression and where they should be implanted, where they are primarily [00:15:00] dysfunctional. That's still the challenge.

Stephen Calabria: And I imagine too, it's a lot easier, to your point earlier about treating other parts of the body, it's a lot easier to treat perhaps something like a toe or a hand- Yeah ... as opposed to something as complete, as incredibly complex as the brain.

Martijn Figee: Exactly. Or even the brain when it involves the toe or the hand, right? Because that's what my neurology colleagues do, where I also work closely with here at Sinai. So we work with movement disorder specialists, and they use deep brain stimulation all the time.

But they target motor circuits, and the beauty is if they- If they change parameters or look for the optimal parameters, they can just objectively see someone's tremor go down, right? Or they become less stiff or less slow. That's just something you can even quantify.

And so they watch videos all the time, whereas we [00:16:00] ask questions and questions and skills. Neurologists typically, they're very accustomed to just looking at the person because that's your objective way to really see if something is better.

And if you see a patient with tremor in the operation room, we wake them up and we test if we are at the right spot. And we can literally see that by just waking them up and see the tremor stop.

So it's much it's much more objectifiable than you're right going after mood and then different aspects of mood.

But we're close we're close and we're closer. And deep brain stimulation is a very useful tool to basically separate the brain into different circuits because you have what we call a causal model.

You can change a specific circuit and see what happens and ask and watch what, what happens with the patient, with the person.

And we video record them while they're going through these changes. And we see very fascinating changes in their facial [00:17:00] expression and in the way they relate to the world. So there, there's a lot of things that we're learning now, which kind of re- reconceptualize psychiatry as a field because we're, all of a sudden we're becoming more brain scientists.

Stephen Calabria: For someone without a medical background who still wants to apply these sorts of lessons in a practical way, how might understanding our reward and mood circuits help them better manage everyday challenges like stress or lack of motivation?

Martijn Figee: Now it's important to mention that stress can affect either of these circuits. So stress can lead to feeling negative which is the negative affect circuit or the salient circuit.

Usually that's also accompanied by ruminations like worrying, when you start to you feel negative so you wanna understand why you feel negative, so you start to have negative thoughts, and you start to [00:18:00] worry.

This is a network called the default mode network. So those network, the negative salience network, the default mode network, they go up, you ruminate, you feel negative, and that makes you just less motivated to do things, right?

Because something is in your way. The other circuit, again, the motivational reward circuit, there it's not so much that you feel negative or you worry all the time, although that may of course be the more secondary effect.

But it's whatever you try, you feel there's no drive, there's no energy, there's no push. You miss your old push your old drive, and you stay in bed too much. Or you don't feel purpose or joy with whatever you do.

So I think it's important if you have a motivational problem that you try and understand, i- is there something in my way? Do I just feel too negative, or am I too worried about things? Am I anxious? Am I worried?

Am I feeling negative all the time, or am I primarily lacking drive or energy? And so you can [00:19:00] self-diagnose yourself in that way. If you're mostly bothered by negativity and anxiety and ruminations you could probably use an antidepressant a classic serotonergic antidepressant, because we know that's really where that circuit is involved.

Of course, you could also benefit from cognitive behavioral therapy where you try to down-regulate your own negativity. You could use things like transcranial magnetic stimulation, which is also neuromodulation, but it's not invasive.

You can just go to a doctor's offers and... office and get five minutes of stimulation of that circuit. That could be helpful. And that's about it. If you have a reward circuit problem, and you feel like motivation and drive is your primary issue, you probably need more what we call dopaminergic or noradrenergic medications.

Those are also antidepressant, but they have a slightly different mechanism, right? Because they help you with drive and goal-directed [00:20:00] actions. You could still also use transcranial magnetic stimulation, TMS, but you're gonna probably have to target different circuits.

Not every center knows how to get there, but it's definitely possible. The other important thing is if you're thinking about therapy, maybe more than just down-regulating negative moods and worries- You probably should do something that we call behavioral activation, where you miss the drive to go, so the natural inclination is to stay in bed and just stay still because it's all so hard and effortful.

But you should actually push yourself, right? When people say, "just get up and go," it's of course always easier said than done, but that may be especially important if you have a reward circuit problem.

But behavior activation is not just get up and go, right? It's really structuring your day or your week in such a way that you can minimally push yourself through that initial lack of drive.

Because the interesting thing with the reward system is if you get going, if you're over that first hump, which is [00:21:00] very dopaminergic, right? You're low in dopamine, so it's very hard to get into that groove.

Once you're into that groove, it's actually gonna make you feel better. So you need something to push yourself, like a trainer or a schedule, something that makes you get up even though you don't want it or you don't feel it because it's there. It's waiting for you.

Stephen Calabria: To that point, the unused pull-up bar in my apartment is not necessarily evidence of depression. It could just be evidence of laziness or procrastination. Where do you draw the line between laziness and procrastination, and symptoms of depression?

Martijn Figee: Yeah I don't... that's also in part a, a subjective question. Do you feel that it's a limitation, it is not yourself? Are you missing the goals that you wanna achieve, right? That, again, even in the time of Freud, that was the definition of a problem, where if you can't achieve the goals that you [00:22:00] like to achieve or want to achieve then there's a problem, right?

Whatever that is. If you're okay with being lazy, then you're okay, right? You don't have a problem. But if it's not what you want and what you like, then you have a problem. And with depression, with true depression, that sep- separation is usually quite a bit clearer because they clearly can't get to work or be in relationships or even see people.

So the basics of life, work, social interactions, sometimes even food and sex, they're all down, right? So it, it's a little more exaggerated than than yeah, not wanting to work out.

Stephen Calabria: Sure. And you've touched on what is the next question. How does lifestyle, things like sleep, diet, social connection, or physical activity influence the brain's reward and mood systems?

Martijn Figee: Yeah, it tremendously, right? Again, if it's broken, you're gonna have to work hard and very [00:23:00] gradual- gradually push yourself up to higher levels of activation to get there because you won't be able to get there right away.

So you shouldn't compare yourself with healthy individuals, right? You should gradually basically push your limits of activities.

That's why I always emphasize use a schedule so you can evaluate what you've done over the week and how you could feed that towards the next week, and maybe take it up a little notch or take it down a little no- notch if it was too much, right?

That's not something you should do too spontaneously. You should really register it. But then the other important thing about the reward circuit, it's hugely implicated. It's hugely negatively affected by things like stress, overweight, drugs inflammation, which are basically all intertwined, right?

Overweight and stress, they cause or they are associated with [00:24:00] inflammation. So do drugs. So all of those factors can hugely negatively impact the reward system. So it's important to eat healthy.

Some people say keto like at least avoid things that can cause inflammation, things that are processed or high of sugar, and also alcohol and drugs. Make sure you lose overweight because overweight is a huge downer of the reward system.

So that's very important. Make sure you stay healthy and without inflammation. If you're inflamed, sure, your reward system will go down, right? If you have COVID or the flu, you'll feel completely unrewarded, right?

But then of course, that's a state that should dissipate once it's over. But again, some people feel like chronically inflamed, and if that's true, you should have a checkup. But regardless, you should think about your lifestyle. [00:25:00]

Stephen Calabria: Are there simple mental exercises or strategies that people can use to, quote, "tune" their reward circuits in healthy ways, like how we might exercise our muscles, our physical muscles?

Martijn Figee: Absolutely. So the negative affect circuit and also the default mode network circuits, right? Those two circuits involved in negativity and worries or ruminations which again, can really lower your motivation and your reward system, but in a, in an indirect way.

Those are, can be tuned by like cognitive- behavioral therapy, but also something that's of course very en vogue these days by mindfulness practices. Because again, what happens if the brain is overly negative is you start to attend that negativity.

'Cause you wanna understand it and you wanna make it go away, so you start to, to ki- obsess with the negativity. And that, of course gets you in a loop, in a very negative loop.

So [00:26:00] mindfulness, like focusing on basically a more acceptance mode of yourself a- and how you feel and where you are, is a very effective way of kind of down-regulating specifically that, that default mode network.

Similar to other things that are very popular these days psychedelics or alcohol or any drug for that matter.

But of course, drugs and alcohol, even though they can very much help with down-regulating that system and basically getting you out of that negative internal state, they do so in a very inefficient way, and you become easily addicted and after you've used drugs, whether it's cannabis or a glass of alcohol, you'll go through a little bit of wi- withdrawal, which will actually jack up that system.

So it's a very inefficient... People often think, "I use for stress regulation," like i- "I smoke a little bit of weed," or, "I use a little bit of alcohol," that's all fine, but it will make your circuit go up and down, and it will [00:27:00] probably limit some of the necessary learning that you could do with more natural techniques like mindfulness or yoga or meditation, if you're really disciplined.

The reward system itself, again, it's mostly behavioral. Make sure you push yourself in a very structured way. And make sure that you also, again, do things mindful. So it doesn't help if you just go out and make that walk because you feel you need to make that 10 minutes walk because that's the way you scheduled it.

But also make sure that while you walk, that you stop yourself from ruminating or from focusing on the fact that it doesn't feel rewarding. Just take it in and be there in a mindful way.

Smell the air. Look at the sun. Even if it's not rewarding, just take it in. And also very importantly, make sure you schedule as many as you can social activities, interactions.

Because with social interactions, it's much harder to withdraw into that internal state. You gotta- almost gotta focus on what's in front [00:28:00] of you, which is a healthy strategy to to boost the rewards circuit.

Stephen Calabria: So it sounds like one of the biggest differences between these sorts of problems and other, quote, "physical parts of the body," is that patients have to take a more active role in these sorts of things.

They have to actively focus on being better, being more constructive with their thoughts and with their feelings as opposed to, again, let's say they had a foot problem and they can just ignore it and it will get better.

Martijn Figee: I don't think that's completely true because if you have a foot problem, it needs to probably be fixed, right? But still you need to train, right? Because otherwise, you'll never be completely healthy. And this is similar. You need to fix the brain.

You need to try first self, but if the brain is broken, you cannot do it, and you need mental help. You need a [00:29:00] psychiatrist, and the psychiatrist hopefully will find out where you're broken and treat you with, for example, negative mood medications like antidepressants or more dopaminergic medications, or will refer you to a therapist that can help you train.

But regardless, once that kind of primary problem is fixed, you still need to, yes, be an active participant to to rehab basically. But that's similar with any medical medical problem. Once the organ is fixed, you need to get back in shape basically.

Stephen Calabria: Looking ahead, what are the most promising directions for research into mood and reward circuits that might impact clinical care in the next five to 10 years?

Martijn Figee: So we're close to biotyping someone's depression. We and others. So basically for example, with a scan, which is of course the most obvious tool, like a functional brain scan, but also [00:30:00] a structural scan, looking at the state of your circuit, how active are you, how broken are you in mood versus reward circuit, and how can we use that information to learn where you need an intervention.

That and also because you don't necessarily wanna, maybe place everybody in a expensive scanner, although why not, right? There's so many expensive medical tests. I think in psychiatry we're a little modest using those tools.

But you should probably also, this is also something we're close to, learn from, for example, facial analysis and the way people behave and relate to life. What are behavioral phenotypes or readouts of those circuit dysfunctions we can see things in the eyes, we can see things in how people walk and behave, or not walk and behave, and we can see very [00:31:00] interesting things in the words they use.

And those are things that are increasingly taken seriously in psychiatry, where people are asked to record themselves on their iPhone on a daily basis, and then we're using all sorts of AI and machine learning tools to to to learn from...

To basically develop more dynamic, more naturalistic digital ph- phenotypes rather than just asking the patient to verbalize their own symptoms. This is a very promising path forward, very promising.

Stephen Calabria: What advice do you have for someone who wants to understand their own brain health better?

Martijn Figee: I would go to a psychiatrist first. A psychiatrist is still handicapped, like Freud, with not having a great X-ray of the brain like so many other medical doctors have. And we can, of course, always make a scan, and people often ask for a scan, but it unfortunately doesn't really tell [00:32:00] you too much. It's a little more complicated than that.

Ultimately we will but not quite there yet. But at least the psychiatrist, because he's so used, he or she is so used to not having those tools, they're at least very very skilled in asking the right questions, so to almost dream up or imagine which brain circuits are most likely involved, and what is the state of health of your brain.

But I think as a general rule of thumb, to always try and and use the techniques that I just explained, whether it's mindfulness, yoga, meditation, or behavioral activation when you schedule structured activities.

If you feel stuck despite those efforts and despite therapy, you gotta see a psychiatrist, and you probably need tools to to improve your brain health, whether that's medication or neuromodulation.

Stephen Calabria: Has your research changed the way you think about [00:33:00] your own mood, motivation, and resilience?

Martijn Figee: My own, huh? Interesting. Yeah, absolutely. I think it's knowing about these systems is extremely helpful. If you find yourself in this kind of worrying internal state where you're not even noticing what's going on around, you can so it's reassuring to know, okay, that's my default mode network at play, right?

I gotta tune that down, 'cause that's not what it's supposed to do. It's only supposed to be that way when there's something alarming or stressful to go through. So let's just focus on other system that can basically re orient myself to the outside world.

Or maybe there is something negative going on that I actually need to attend, right? Sometimes it's also a healthy signal, right? Okay, just go with the pain. There's probably something my brain is telling me.

Either way, it- it's helpful, right? 'Cause it makes you a little bit more of an active participant of your brain, rather than just [00:34:00] going through whatever state your brain throws you in.

Stephen Calabria: Finally, what's one message you hope every listener takes away from today's conversation about the brain and resilience?

Martijn Figee: The brain is extremely important in resilience. Don't underestimate the brain. Don't think you're weak or a loser or can't do it. Everybody has resilience, but it's something you need to train.

Like any other organ, right? If you wanna grow muscles or energy, endurance, you gotta just train. So be active in training your brain and your brain health. And again, if you feel it's not getting you to what you achieve or what you want, don't be ashamed and look for help.

It's the, I an unhealthy brain is just a little more subtle and sometimes subjective than [00:35:00] an unhealthy liver or anything else, right? But it doesn't make it less unhealthy. And then that's I wanna advocate for an emancipation of the brain.

We should take our brain serious, and if it doesn't go according to plan, train harder or just seek help, mental help.

Stephen Calabria: That was it for my questions. Was there anything else you wanted to say?

Martijn Figee: No. Thank you. This was really a very engaging interview. Thanks.

Stephen Calabria: Dr. Martijn Figee, thank you so much for being on Road to Resilience.

Thanks again to Dr. Martijn Figee for his time and expertise. That's all for this episode of Road to Resilience. If you enjoyed it, please rate, review, and subscribe to our podcast on your favorite podcast platform.

Want to get in touch with the show or suggest an idea for a future episode? Email us at podcasts@mountsinai.org.

Road to Resilience is a production of the Mount Sinai Health System. It's produced by me, Stephen Calabria, and our executive producer, Lucia Lee.

From all of us [00:36:00] here at Mount Sinai, thanks for listening, and we'll catch you next time. And don't neglect that pull-up bar.