Traditionally, depression has been defined by symptoms like low mood, fatigue, slowed movement or speech, anxiety and loss of interest - but what if we look at it differently? Dr. Georg Northoff, senior scientist at The Royal is challenging the way we see depression.
Instead of focusing only on what people feel, Northoff examines how fast or slow the brain is operating. “People who are diagnosed with depression often report having sluggish thoughts and being unable to change their thought contents,” Northoff explained.
His work in “spatiotemporal psychiatry”, which looks at how the brain’s timing and patterns shape how we feel and experience the world, suggests that depression may stem from a brain that has become stuck in rigid, slowed patterns and could benefit from speed and rhythm.
In a healthy brain, emotional and cognitive states fluctuate. In depression, those fluctuations flatten. Thoughts linger. Emotions stick. Even physical movement can slow.
From checklists to biomarkers
Northoff’s shift in thinking has profound implications. If depression is partly about disrupted brain rhythms, then treatment can move beyond general approaches to precision-based interventions.
“By learning from patients in real time, research helps us refine care and bring forward treatments that are more targeted, more informed, and more effective—particularly for those who haven’t benefited from traditional options,” said Dr. Florence Dzierszinski, President and CEO, Research Institute, The Royal. “Dr. Northoff’s research is actively shaping the care patients receive today.”
Rather than relying solely on symptom checklists, Northoff’s team is developing “speed biomarkers,” which are objective measures of how the brain processes time. These markers could help clinicians distinguish depression from other conditions and tailor treatments accordingly.
This perspective offers helpful ways to better understand and support someone experiencing depression by:
- recognizing that slowness or emotional “stuckness” reflects brain function,
- encouraging rhythm-based supports like music, movement, or breathing, and
- developing personalized mental health therapies based on an individual's unique brain spatio-temporal signatures.
Case studies: When timing changes everything
The power of this approach becomes clear through real-life examples.
Snapshot
- Depression may involve disrupted brain speed and rhythm, not just mood.
- Personalized interventions, like music and focused breathing, can help "retune" the brain.
- Objective biomarkers could improve diagnosis and treatment precision.
- Empowering individuals with tools they can control can help with symptoms.
Client A
A woman with severe depression struggled to get moving each morning. She turned to fast-paced techno music, hoping it would energize her, but instead, it made her feel “aggressive and angry.”
By measuring her brain’s speed and perception, Northoff’s team curated a personalized playlist aligned with her brain’s natural tempo. The result? Music that gently activated her in a positive way helping her start her day more effectively.
Client B
A high-performing professional suffered from intense social anxiety, especially around public speaking.
Using personalized breathing techniques, the team identified her optimal slow breathing rate. Practicing for just a few minutes before presentations significantly reduced her anxiety.
A new perspective on mental illness
Northoff’s approach challenges us to think differently about depression; not as a fixed emotional state, but as a dynamic system that has fallen out of sync.
By focusing on timing, rhythm, and individualized care, Northoff’s work points toward a future where mental illness treatment is as precise and personalized as care for physical conditions.
About The Royal
The Royal is one of Canada’s foremost mental illness and addiction treatment, research, and education hospitals, dedicated to supporting individuals aged 16 and older who are living with complex mental illness and addiction. Since opening in 1910, The Royal has grown into a trusted resource for people across eastern and northern Ontario, western Quebec, and Nunavut.
With campuses in Ottawa and Brockville, and clinical teams working directly in homes and communities, The Royal delivers compassionate, evidence-informed care grounded in cutting-edge research, including through its partnership with the University of Ottawa and other academic and community partners. Its integrated model brings together care, research, education, and strategic partnerships to help build a future of recovery.
At The Royal, we separate the person from the illness, helping more people reclaim their lives.
Media contact
Alyssa Nader, Communications Specialist, The Royal, anader@theroyal.ca.
