ADHD & How Anyone Can Improve Their Focus
Andrew Huberman:
安德鲁·休伯曼：
Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.
欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。
Andrew Huberman:
安德鲁·休伯曼：
I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.
我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。
Today, we are going to talk all about attention deficit hyperactivity disorder, or ADHD.
今天，我们要谈谈注意力缺陷多动障碍（ADHD）。
We are also going to talk about normal levels of focus, what are normal levels of focus, and how all of us, whether or not we have ADHD or not, can improve our ability to focus, our ability to rule out distraction — it turns out those are two separate things — as well as remember information better.
我们还将讨论正常的注意力水平，什么是正常的注意力水平，以及我们所有人，无论是否患有注意力缺陷多动症，如何提高我们的专注能力、排除干扰的能力（事实证明这是两个不同的事情）以及如何更好地记住信息。
We are also going to talk about how we can learn to relax while focusing, which turns out to be a critical component of learning new information and for coming up with new creative ideas.
我们还将讨论如何在专注的同时学会放松，事实证明，这是学习新信息和提出新创意的关键组成部分。
Andrew Huberman:
安德鲁·休伯曼：
So whether or not you have ADHD or know someone who does, or if you're somebody who feels that they do not have ADHD, but would simply like to improve their ability to focus or to be more creative, this episode is definitely for you as well.
因此，无论您是否患有注意力缺陷多动症或认识患有注意力缺陷多动症的人，或者如果您认为自己没有注意力缺陷多动症，但只是想提高自己的专注能力或更具创造力，那么本集也绝对适合您。
We are going to talk about drug-based tools that are out there.
我们将讨论现有的基于药物的工具。
We are going to talk about behavioral tools.
我们将讨论行为工具。
We will talk about the role of diet and supplementation, and we will talk about new emerging brain machine interface devices, things like transcranial magnetic stimulation.
我们将讨论饮食和补充剂的作用，我们将讨论新兴的脑机接口设备，例如经颅磁刺激。
If you don't know what that is, don't worry, I will explain it to you.
如果你不知道那是什么，别担心，我会向你解释的。
These are noninvasive methods for rewiring your brain in order to make focusing more natural for you, and to teach you how to increase your depth of focus.
这些是重新连接大脑的非侵入性方法，使您能够更自然地集中注意力，并教您如何增加焦点深度。
Andrew Huberman:
安德鲁·休伯曼：
Now, just a quick reminder that anytime we discuss a psychiatric disorder, it's important that we remember that all of us have the temptation to self-diagnose or to diagnose others.
现在，快速提醒一下，每当我们讨论精神疾病时，重要的是我们要记住，我们所有人都有自我诊断或诊断他人的诱惑。
So as I list off some of the symptomology of ADHD, some of that symptomology might resonate with you.
因此，当我列出多动症的一些症状时，其中一些症状可能会引起您的共鸣。
You might think, "Oh, maybe I have ADHD," or you might decide that someone definitely has ADHD.
您可能会想，“哦，也许我患有多动症”，或者您可能会认为某人肯定患有多动症。
However, it is very important that you don't self-diagnose or diagnose somebody else.
然而，非常重要的是，您不要自我诊断或诊断他人。
The clear and real diagnosis of ADHD really should be carried out by a psychiatrist, a physician or a very well-trained clinical psychologist.
ADHD 的明确而真实的诊断确实应该由精神科医生、医生或训练有素的临床心理学家进行。
Andrew Huberman:
安德鲁·休伯曼：
There are clear criteria for what constitutes full-blown ADHD.
对于什么是全面的多动症，有明确的标准。
However, many of us have constellations of symptoms that make us somewhat like somebody with ADHD.
然而，我们中的许多人都有一系列症状，使我们有点像多动症患者。
If you're struggling with focus nowadays, as a lot of people are because of stress, because of smartphone use, which turns out can induce adult ADHD — we'll talk about that — well, then pay attention to the symptomology.
如果你现在很难集中注意力，就像很多人因为压力、因为智能手机的使用而困扰一样，事实证明这会诱发成人注意力缺陷多动症——我们会讨论这个——那么，那么请注意症状。
You may actually require professional treatment.
您实际上可能需要专业治疗。
You might not.
你可能不会。
Equally important is to remember that some of the terms that we cover, like impulse control and attention and concentration, are somewhat subjective, and they can change over time.
同样重要的是要记住，我们涵盖的一些术语，例如冲动控制、注意力和集中力，在某种程度上是主观的，并且会随着时间的推移而改变。
Andrew Huberman:
安德鲁·休伯曼：
Some times we have a better level of attention than others.
有时我们比其他人有更好的注意力。
Maybe it depends on how we slept, or other events going on in our life, or something that we're entirely unaware of.
也许这取决于我们的睡眠方式，或者我们生活中发生的其他事件，或者我们完全不知道的事情。
The important thing to remember is that we can all improve our attentional capacity.
重要的是要记住，我们都可以提高我们的注意力能力。
We can all rewire the circuits that make heightened levels of focus more accessible to us.
我们都可以重新连接电路，使我们更容易集中注意力。
We can do that through multiple types of interventions, and we are going to cover all those interventions today.
我们可以通过多种类型的干预措施来做到这一点，今天我们将介绍所有这些干预措施。
Andrew Huberman:
安德鲁·休伯曼：
Before we march into the material, I'd like to remind that this podcast is separate from my teaching and research roles at Stanford.
在我们开始讨论材料之前，我想提醒一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。
It is however, part of my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public.
然而，我的愿望和努力的一部分是将有关科学和科学相关工具的零成本消费者信息带给公众。
In keeping with that theme, I'd like to thank the sponsors of today's podcast.
为了与这个主题保持一致，我要感谢今天播客的赞助商。
Let's talk about ADHD, attention deficit hyperactivity disorder.
我们来谈谈注意力缺陷多动症（ADHD），即注意力缺陷多动障碍。
Let's also talk about focus and attention, and everybody's ability to focus and attend, not just people with ADHD.
我们还要谈谈专注力和注意力，以及每个人专注和参与的能力，而不仅仅是患有多动症的人。
Andrew Huberman:
安德鲁·休伯曼：
We are also going to talk about tools that would allow anyone, whether or not they have ADHD or not, to enhance their level of concentration and focus.
我们还将讨论可以让任何人（无论是否患有注意力缺陷多动症）提高注意力和注意力水平的工具。
Now, ADHD used to be called ADD, attention deficit disorder.
现在，ADHD过去被称为ADD，即注意力缺陷障碍。
We have record of ADD in the medical literature dating back to as early as 1904.
早在 1904 年，医学文献中就有 ADD 的记录。
Now, there's nothing special about 1904.
现在看来，1904 年并没有什么特别的。
That's just the first time that it showed up in the standard medical literature.
这只是它第一次出现在标准医学文献中。
We have to believe that ADD, which we now call ADHD, existed before 1904, and probably long before 1904.
我们必须相信ADD，也就是我们现在所说的ADHD，在1904年之前就已经存在，而且很可能早在1904年之前就已经存在了。
Why?
为什么？
Well, because it has a strong genetic component.
嗯，因为它有很强的遗传成分。
Andrew Huberman:
安德鲁·休伯曼：
If you have a close relative that has ADHD, there's a much higher probability that you will have ADHD, and that probability goes up depending on how closely related to that person you happen to be.
如果你有一个近亲患有注意力缺陷多动症，那么你患注意力缺陷多动症的可能性就会高得多，而且这种可能性的增加取决于你与那个人的关系有多密切。
So for instance, if you're an identical twin, and your twin has ADHD, there's a very high concordance, as we say, a very high probability that you will have ADHD, up to 75% chance.
举例来说，如果你是同卵双胞胎，而你的双胞胎患有 ADHD，那么就有非常高的一致性，正如我们所说，你患有 ADHD 的可能性非常高，高达 75% 的机会。
If you have a fraternal twin with ADHD, that number goes down a bit, in the 50% to 60% range, and so on.
如果你有一个患有多动症的异卵双胞胎，这个数字会稍微下降，在 50% 到 60% 的范围内，依此类推。
If you have a parent with ADHD, that number ranges anywhere from 10% to 25% likelihood that you will have ADHD.
如果您的父母患有多动症，那么您患有多动症的可能性为 10% 到 25%。
If you have two parents, and so on and so on; so there's a genetic component.
如果你有两个父母，等等；所以这是有遗传因素的。
Andrew Huberman:
安德鲁·休伯曼：
That genetic component, it turns out, relates directly to how specific neural circuits in the brain wire up, the chemicals they use and the way they use those chemicals — a topic that we are going to discuss in depth today.
事实证明，这种遗传成分与大脑中特定神经回路的连接方式、它们使用的化学物质以及它们使用这些化学物质的方式直接相关——这是我们今天要深入讨论的话题。
Now, if you have a close relative with ADHD, that does not mean that you are fated to have ADHD.
现在，如果你有一个近亲患有多动症，这并不意味着你注定会患有多动症。
If you happen to have ADHD, there are ways to overcome those symptoms of lack of attention, impulsivity and so on.
如果你恰好患有多动症，有一些方法可以克服注意力不集中、冲动等症状。
Another important point about ADHD is that it has nothing to do with intelligence, whether or not we're talking about intelligence measured by a standard IQ test, a rather controversial issue.
关于多动症的另一个重要点是，它与智力无关，无论我们是否在谈论通过标准智商测试测量的智力，这是一个相当有争议的问题。
Andrew Huberman:
安德鲁·休伯曼：
As many of you probably know, there are lots of forms of intelligence that a standard IQ test just wouldn't pick up.
你们中的许多人可能都知道，有很多形式的智力是标准智商测试无法检测到的。
Emotional intelligence, musical intelligence, spatial intelligence, all sorts of intelligences, none of them are related to ADHD.
情绪智力、音乐智力、空间智力，各种智力，都与多动症无关。
Being very high functioning doesn't make you more likely to have ADHD, and being ADHD doesn't necessarily mean that you have a low IQ.
功能非常高并不会让你更有可能患有注意力缺陷多动症，而注意力缺陷多动症并不一定意味着你智商低。
There are people with ADHD who have low IQs, people with ADHD with high IQs, people with ADHD with high emotional IQ or with low IQ in the emotional scale.
有些患有多动症的人智商低，有些患有多动症的人智商高，有些患有多动症的人情绪智商高，或者情绪智商低。
It's all over the place.
到处都是。
The important point is that your ability to attend and focus does not relate to how smart you are or your IQ of any type, not just a standard IQ.
重要的一点是，你的注意力和集中注意力的能力与你的聪明程度或任何类型的智商无关，而不仅仅是标准智商。
Andrew Huberman:
安德鲁·休伯曼：
The renaming of ADD to ADHD took place in the mid to late 1980s, when the psychiatric community and the psychological community started taking better notice of the fact that so-called hyperactive kids also had attentional issues.
ADD 更名为 ADHD 发生在 20 世纪 80 年代中后期，当时精神病学界和心理学界开始更好地注意到所谓的多动儿童也存在注意力问题这一事实。
This might seem obvious, but there's been extensive and ongoing revision of the criteria for designating a psychiatric disorder, and this is still an ongoing process even today.
这似乎是显而易见的，但精神疾病的认定标准一直在进行广泛且持续的修订，即使在今天，这仍然是一个持续的过程。
So in the mid '80s, we started hearing about ADHD, and then gradually that term ADD has been dropped away.
因此，在 80 年代中期，我们开始听说 ADHD，然后渐渐地，ADD 这个词就被抛弃了。
However, just the renaming of ADD to ADHD has led to much better diagnosis and detection of ADHD.
然而，仅仅将 ADD 更名为 ADHD 就可以更好地诊断和检测 ADHD。
Andrew Huberman:
安德鲁·休伯曼：
So right now, the current estimates are that about one in 10 children, and probably more, have ADHD.
因此，目前估计大约十分之一的儿童（甚至可能更多）患有多动症。
The current estimates are anywhere from 10%, one in 10, to as high as 12%.
目前的估计从 10%（十分之一）到高达 12% 不等。
Now, fortunately, about half of those will resolve with proper treatment, but the other half typically don't.
现在，幸运的是，其中大约一半可以通过适当的治疗得到解决，但另一半通常不会。
The other thing that we are seeing a lot nowadays is increased levels of ADHD in adults.
如今我们经常看到的另一件事是成人多动症水平的增加。
There are some question as to whether or not those adults had ADHD that went undetected during their childhood, or whether or not ADHD is now cropping up in adulthood due to the way that we are interacting with the world.
有一些问题是，这些成年人是否患有在童年时期未被发现的多动症，或者由于我们与世界互动的方式，多动症现在是否在成年后突然出现。
Andrew Huberman:
安德鲁·休伯曼：
In particular, smart phone use, the combination of email, text, real-world interactions, multiple apps and streams of media and social media all coming in at once, trying to manage life, all of the things that are going on are creating a cloud of pools on our attention.
特别是智能手机的使用，电子邮件、文本、现实世界互动、多种应用程序以及媒体流和社交媒体的结合，所有这些都同时出现，试图管理生活，所有正在发生的事情都在我们的注意力上形成了一个云池。
So, there is this question to whether or not we are creating ADHD in adults that never had ADHD prior to being an adult.
因此，问题是我们是否会在成年前从未患过 ADHD 的成年人中造成 ADHD。
Let's talk about attention.
我们来谈谈注意力。
First, let's just define what we mean by attention.
首先，让我们定义一下注意力的含义。
Out there in the scientific literature and in discussions about ADHD, we will hear things like attention and focus and concentration and impulse control.
在科学文献和有关多动症的讨论中，我们会听到诸如注意力、集中力、集中力和冲动控制之类的东西。
Andrew Huberman:
安德鲁·休伯曼：
For sake of today's discussion, attention, focus and concentration are essentially the same thing.
对于今天的讨论来说，注意力、焦点和专注本质上是同一件事。
We could split hairs, and the scientific literature does split hairs about these.
我们可能会吹毛求疵，而科学文献对此也确实吹毛求疵。
But if we want to understand the biology, and we want to have a straightforward conversation about ADHD, if I say attention or focus, I'm basically referring to the same thing, unless I specify otherwise.
但如果我们想了解生物学，并且我们想就 ADHD 进行直接对话，如果我说注意力或集中力，我基本上指的是同一件事，除非我另有说明。
So, people with ADHD have trouble holding their attention.
因此，患有多动症的人很难保持注意力。
What is attention?
什么是注意力？
Well, attention is perception.
嗯，注意力就是感知。
It's how we are perceiving the sensory world.
这就是我们感知感官世界的方式。
So just a little bit of Neurobiology 101: we are sensing things all the time.
神经生物学 101 的一点点：我们一直在感知事物。
Andrew Huberman:
安德鲁·休伯曼：
There's information coming into our nervous system all the time.
一直有信息进入我们的神经系统。
For instance, right now, you are hearing sound waves.
例如，现在，您听到声波。
You are seeing things.
你正在看到一些事情。
You are sensing things against your skin, but you are only paying attention to some of those, and the ones that you're paying attention to are your perceptions.
你正在感知皮肤上的事物，但你只关注其中的一些，而你所关注的是你的感知。
So if you hear my voice, you are perceiving my voice.
所以，如果你听到我的声音，你就是在感知我的声音。
You are not paying attention to your other senses at the moment, okay?
你现在没有注意你的其他感官，好吗？
You might even be outside in a breeze, and until I said that, you might not be perceiving that breeze, but your body was sensing it all along.
你甚至可能在外面微风中，直到我这么说之前，你可能没有感觉到微风，但你的身体一直在感知它。
Andrew Huberman:
安德鲁·休伯曼：
Attention and focus are more or less the same thing, but impulse control is something separate, because impulse control requires pushing out or putting the blinders on to sensory events in our environment.
注意力和集中力或多或少是同一件事，但冲动控制是不同的事情，因为冲动控制需要推出或遮盖我们环境中的感官事件。
It means lack of perception.
这意味着缺乏感知。
Impulse control is about limiting our perception.
冲动控制就是限制我们的感知。
People with ADHD have poor attention, and they have high levels of impulsivity.
患有多动症的人注意力不集中，而且很容易冲动。
They're easily distractible, but the way that shows up is very surprising.
他们很容易分散注意力，但出现的方式却非常令人惊讶。
You might think that people with ADHD just simply can't attend to anything, they really can't focus even if they really want to, but that's simply not the case.
您可能会认为患有多动症的人根本无法关注任何事情，即使他们真的想集中注意力，他们也确实无法集中注意力，但事实并非如此。
Andrew Huberman:
安德鲁·休伯曼：
People with ADHD, yes, they are distractible.
患有多动症的人，是的，他们很容易分心。
Yes, they are impulsive.
是的，他们很冲动。
Yes, they are easily annoyed by things happening in the room.
是的，他们很容易被房间里发生的事情惹恼。
They sometimes have a high level of emotionality as well, not always, but often.
他们有时也会情绪化，虽然并非总是如此，但经常如此。
However, people with ADHD can have a hyperfocus, an incredible ability to focus on things that they really enjoy or are intrigued by.
然而，患有注意力缺陷多动症的人可能具有高度专注力，一种令人难以置信的能力，能够专注于他们真正喜欢或感兴趣的事情。
Now, this is a very important point, because typically we think of somebody with ADHD as being really wild and hyperactive or having no ability whatsoever to sit still and attend.
现在，这是非常重要的一点，因为通常我们认为患有注意力缺陷多动症的人非常狂野和过度活跃，或者没有任何能力坐下来专注。
Andrew Huberman:
安德鲁·休伯曼：
While that phenotype, as we call it, that contour of behavior and cognition, can exist, many people, if not all people with ADHD, if you give them something they really love, like if the child loves video games, or if a child loves to draw, or if an adult loves a particular type of movie or a person very much, they will obtain laser focus without any effort.
虽然我们所说的这种行为和认知的轮廓是存在的，但很多人，如果不是所有患有多动症的人，如果你给他们真正喜欢的东西，比如孩子喜欢电子游戏，或者孩子喜欢画画，或者成年人非常喜欢某种类型的电影或一个人，他们将毫不费力地获得激光聚焦。
That tells us that people with ADHD have the capacity to attend, but they can't engage that attention for things that they don't really, really want to do.
这告诉我们，患有多动症的人有能力参加，但他们无法将注意力集中在他们并不真正想做的事情上。
As we all know, much of life, whether or not you're a child or an adult, involves doing a lot of things that we don't want to do.
众所周知，生活的大部分时间，无论你是孩子还是成年人，都会做很多我们不想做的事情。
Andrew Huberman:
安德鲁·休伯曼：
Much of our schooling involves doing things that we would prefer not to do and forcing ourselves to do it, to attend even though we are not super interested in what we are attending to.
我们的大部分学业都涉及做我们不愿意做的事情，并强迫自己去做，即使我们对自己正在做的事情不是很感兴趣，但还是要参加。
There are a couple other things that people with ADHD display quite often.
患有多动症的人还经常表现出其他一些东西。
One is challenges with time perception.
一是时间感知的挑战。
Now, time perception is a fascinating aspect of how our brain works.
现在，时间感知是我们大脑工作方式的一个令人着迷的方面。
Later, we're going to talk about time perception and how you can actually get better at time perception.
稍后，我们将讨论时间感知以及如何真正提高时间感知能力。
It's very likely that right now you are doing things that get in the way of optimal time perception, and I will tell you how to adjust your ability to measure time with your brain.
现在你很可能正在做的事情妨碍了最佳时间感知，我将告诉你如何调整你的大脑测量时间的能力。
Andrew Huberman:
安德鲁·休伯曼：
People with ADHD often run late.
患有多动症的人经常迟到。
They often procrastinate.
他们经常拖延。
But what's interesting and surprising is that if they are given a deadline, they actually can perceive time very well.
但有趣和令人惊讶的是，如果给他们一个最后期限，他们实际上可以很好地感知时间。
They often can focus very well if the consequences of not completing a task or not attending are severe enough.
如果未完成任务或不参加的后果足够严重，他们通常可以很好地集中注意力。
It's a little bit like the way that people with ADHD can really focus if they like something.
这有点像多动症患者如果喜欢某件事就能真正集中注意力。
Well, if they're scared enough about the consequences of not attending, oftentimes, not always, but oftentimes they can attend.
好吧，如果他们足够害怕不参加的后果，通常，不是总是，但很多时候他们可以参加。
If they're not really concerned about a deadline or a consequence, well, then they tend to lose track of time, and they tend to underestimate how long things will take.
如果他们并不真正关心最后期限或后果，那么他们往往会忘记时间，并且往往会低估事情需要多长时间。
Andrew Huberman:
安德鲁·休伯曼：
Now, many people do that, not just people with ADHD, but people with ADHD have challenges understanding how to line up the activities of their day in order to meet particular deadlines, even if it's just a simple thing like finishing one set of tasks before lunch.
现在，许多人都这样做，不仅是患有多动症的人，而且患有多动症的人在理解如何安排一天的活动以在特定的期限内完成时面临着挑战，即使这只是一件简单的事情，比如在午餐前完成一组任务。
Oftentimes, they will remember that lunch starts at noon, but somehow, they aren't able to fill the intervening time in a way that's productive, and they can obsess about the upcoming deadline, for instance.
通常，他们会记得午餐从中午开始，但不知何故，他们无法以富有成效的方式填补中间的时间，例如，他们可能会痴迷于即将到来的截止日期。
We will talk about how to remedy this.
我们将讨论如何解决这个问题。
In addition, their spatial organization skills are often subpar.
此外，他们的空间组织能力往往较差。
Not always, but often, you will find that somebody with ADHD uses what's called the pile system in order to organize things.
并不总是，但经常，你会发现患有多动症的人使用所谓的堆系统来组织事物。
Andrew Huberman:
安德鲁·休伯曼：
They will take many belongings, and this could be in the kitchen or in their bedroom or in their office or in any space, and they will start piling things up according to a categorization system that makes sense to them and only them.
他们会拿走许多物品，这可能是在厨房、卧室、办公室或任何空间，他们会开始根据对他们有意义且只有他们有意义的分类系统来堆放东西。
It doesn't really have any logical framework.
它实际上没有任何逻辑框架。
Now, many people use the pile system.
现在，很多人都使用桩系统。
And if you use the pile system, that doesn't mean that you have ADHD.
如果您使用桩系统，并不意味着您患有多动症。
In fact, if you're unpacking a house, or you've moved recently, or you've received a lot of presents recently, the pile system makes perfect sense to organize your space.
事实上，如果您正在拆开房子的包装，或者最近搬家，或者最近收到很多礼物，堆放系统非常适合整理您的空间。
Andrew Huberman:
安德鲁·休伯曼：
But people with ADHD tend to organize things according to the pile system all the time, and that pile system doesn't work for them.
但患有多动症的人总是倾向于按照堆积系统来组织事物，而堆积系统对他们不起作用。
That's the key distinction, that they use a filing system, and it's not really files, they're piling things up in a way that makes sense to them, but then it doesn't work for them in terms of what task they actually need to perform.
这是关键的区别，他们使用文件系统，这并不是真正的文件，他们以一种对他们有意义的方式堆积东西，但就他们实际需要执行的任务而言，这对他们不起作用。
They can't find things, or if anyone moves one thing, then it's very disruptive to their overall plan because their overall plan doesn't really work in the first place.
他们找不到东西，或者如果有人移动了一件东西，那么这会对他们的整体计划造成很大的破坏，因为他们的整体计划从一开始就不起作用。
That's a common phenotype as we call it.
这是我们所说的常见表型。
Andrew Huberman:
安德鲁·休伯曼：
A phenotype, by the way, is just an expression of a particular set of underlying genetic or psychological components, so we say the phenotype.
顺便说一句，表型只是一组特定的潜在遗传或心理成分的表达，所以我们说表型。
A phenotype could be brown hair and green eyes.
表型可能是棕色头发和绿色眼睛。
For me, a phenotype could also be that somebody uses the piling system.
对我来说，表型也可能是某人使用打桩系统。
The other thing that people with ADHD have real trouble with is so-called working memory.
患有多动症的人真正遇到的另一件事是所谓的工作记忆。
Now, you might think that people with ADHD would have really poor memories, but in fact, that's not the case.
现在，您可能认为患有多动症的人记忆力很差，但事实上，情况并非如此。
People with ADHD often can have a terrific memory for past events.
患有多动症的人通常对过去的事情有很好的记忆力。
They can remember upcoming events quite well.
他们可以很好地记住即将发生的事件。
Their memory is clearly working.
他们的记忆力显然在发挥作用。
Andrew Huberman:
安德鲁·休伯曼：
However, one aspect of memory, in particular, that we call working memory, is often disrupted.
然而，记忆的一个方面，特别是我们所说的工作记忆，经常受到干扰。
Working memory is the ability to keep specific information online to recycle it in your brain over and over again so that you can use it in the immediate or short term.
工作记忆是一种将特定信息在线保存并在大脑中反复循环使用的能力，以便您可以立即或短期使用它。
A good example of this would be you meet somebody.
一个很好的例子就是你遇到某人。
They tell you their name.
他们告诉你他们的名字。
They give you their phone number verbally, and you have to walk back to your phone, and enter it into your phone.
他们口头给你他们的电话号码，你必须走回你的手机，并将其输入你的手机。
People without ADHD might have to put some effort into it.
没有多动症的人可能需要付出一些努力。
It might feel like a bit of a struggle, but typically, they would be able to recite that phone number in their mind over and over, and then put it into their phone.
这可能感觉有点困难，但通常情况下，他们能够在脑海中一遍又一遍地背诵该电话号码，然后将其输入手机中。
Andrew Huberman:
安德鲁·休伯曼：
People with ADHD tend to lose the ability, or lack the ability to remember things that they just need to keep online for anywhere from 10 seconds to a minute or two.
患有多动症的人往往会失去或缺乏记住那些他们只需要在网上停留 10 秒到一两分钟的事情的能力。
So a string of numbers like 643-781, for most people, would be pretty easy, 643-781, 643-781.
因此，对于大多数人来说，像 643-781 这样的一串数字非常简单，643-781、643-781。
You could probably remember that a minute from now without writing it down.
你可能一分钟后就能记住这一点，而无需写下来。
But if you add one more number to that 643-7813, it gets tougher.
但如果你在 643-7813 的基础上再添加一个数字，事情就会变得更加困难。
There's a reason why phone numbers typically have seven digits in them.
电话号码通常包含七位数字是有原因的。
Of course, there's an area code.
当然，还有区号。
But remembering information that strings out longer than seven numbers or a sentence or two, that's challenging for most people.
但记住超过七个数字或一两个句子的信息对大多数人来说都是一个挑战。
People with ADHD have severe challenges, even with much smaller batches of information over even much smaller batches of time.
患有注意力缺陷多动症的人面临着严峻的挑战，即使在更短的时间内处理更少量的信息。
Andrew Huberman:
安德鲁·休伯曼：
Deficits in working memory are also something that we see in people who have frontal temporal dementia, so damage to the frontal lobes, or age-related cognitive decline.
我们在患有额颞叶痴呆、额叶受损或与年龄相关的认知能力下降的人中也发现了工作记忆缺陷。
It will come as no surprise that later when we discuss treatments, supplements and other tools for ADHD, that many of those treatments, supplements and tools for ADHD are similar to the ones that work for age-related cognitive decline.
毫不奇怪，当我们稍后讨论多动症的治疗、补充剂和其他工具时，许多多动症的治疗、补充剂和工具与治疗与年龄相关的认知衰退的药物类似。
We've more or less established a menu of items that people with ADHD tend to have.
我们或多或少地建立了一个多动症患者倾向于拥有的项目菜单。
Some have all of them.
有些拥有所有这些。
Some have just a subset of them.
有些只有其中的一个子集。
Andrew Huberman:
安德鲁·休伯曼：
Their severity can range from very intense to mild.
它们的严重程度可以从非常强烈到轻微。
But in general, it's challenges with attention and focus, challenges with impulse control.
但总的来说，这是注意力和注意力的挑战，是冲动控制的挑战。
They get annoyed easily.
他们很容易生气。
They have an impulsivity.
他们有一种冲动。
They can't stay on task.
他们无法继续执行任务。
Time perception can be off.
时间感知可能会关闭。
They use the piling system or a system that doesn't work well for them in order to organize their things in physical space, and they have a hard time with anything that's mundane that they're not really interested in.
他们使用堆积系统或不适合他们的系统来在物理空间中组织他们的东西，并且他们很难处理任何他们不真正感兴趣的平凡事物。
But again, I just want to highlight that people with ADHD are able to obtain heightened levels of focus, even hyperfocus, for things that are exciting to them and that they really want to engage in.
但我想再次强调的是，患有注意力缺陷多动症的人能够对令他们兴奋且真正想要参与的事情获得高度的注意力，甚至是过度注意力。
Andrew Huberman:
安德鲁·休伯曼：
Now, you have the contour of what ADHD is.
现在，您已经了解了多动症的轮廓。
If you're somebody who doesn't have ADHD, you should also be asking yourself, "Which aspects of ADHD are similar to things I've experienced before?" Because what we know about the healthy brain is that there's also a range of abilities to focus.
如果你没有多动症，你也应该问自己，“多动症的哪些方面与我以前经历过的事情相似？”因为我们对健康大脑的了解是，它还具有一系列集中注意力的能力。
Some people focus very well on any task.
有些人对任何任务都非常专注。
You give them a task.
你给他们一个任务。
They can just laser in on that task.
他们可以直接完成这项任务。
Other people, they have to fight an internal battle.
其他人，则要打一场内部斗争。
They have to convince themselves that it's important or interesting.
他们必须说服自己这很重要或很有趣。
They have to incentivize themselves internally.
他们必须在内部激励自己。
Andrew Huberman:
安德鲁·休伯曼：
Other people — doesn't matter.
其他人——并不重要。
They could be bored to tears with the information, but they can do it just because they are "very disciplined people." We tend to admire those people.
他们可能会对这些信息感到无聊得流泪，但他们能做到这一点只是因为他们是“非常自律的人”。我们倾向于钦佩这些人。
But as you'll see a little bit later, it's not clear that that's the best way to run your attentional system.
但正如您稍后会看到的，目前尚不清楚这是否是运行注意力系统的最佳方式。
There might be something to this business of having heightened levels of attention for the things that you are most interested or excited by.
对于你最感兴趣或最兴奋的事情，你可能会更加关注。
Let's drill into this issue of why people with ADHD actually can focus very intensely on things that they enjoy and are curious about.
让我们深入探讨一下为什么患有多动症的人实际上可以非常专注于他们喜欢和好奇的事情。
Andrew Huberman:
安德鲁·休伯曼：
Now, enjoyment and curiosity are psychological terms.
现在，享受和好奇心是心理学术语。
They're not even really psychological terms.
它们甚至不是真正的心理学术语。
They're just the way that we describe our human experience of liking things, wanting to know more about them.
它们只是我们描述人类喜欢事物、想要更多地了解它们的经历的方式。
But from a neurobiological perspective, they have a very clear identity and signature, and that's dopamine.
但从神经生物学的角度来看，它们有一个非常明确的身份和特征，那就是多巴胺。
Dopamine is released from neurons.
多巴胺从神经元中释放出来。
It's what we call a neuromodulator.
这就是我们所说的神经调节剂。
As a neuromodulator, it changes the activity of the circuits in the brain such that certain circuits are more active than others.
作为一种神经调节剂，它改变大脑中回路的活动，使某些回路比其他回路更活跃。
Andrew Huberman:
安德鲁·休伯曼：
In particular, dopamine creates a heightened state of focus.
特别是，多巴胺可以提高注意力。
It tends to contract our visual world, and it tends to make us pay attention to things that are outside and beyond the confines of our skin.
它往往会收缩我们的视觉世界，并且往往会让我们关注皮肤之外的事物。
That's what we call exteroception.
这就是我们所说的外感受。
Dopamine also tends to put us in a state of motivation and wanting things outside the confines of our skin.
多巴胺也会让我们处于一种动力状态，想要超越我们皮肤范围的事物。
So whether or not we're pursuing something physical in our world, or whether or not we're pursuing information in our outside world, dopamine is largely responsible for our ability and our drive to do that, but dopamine, as a neuromodulator, is also involved in changing the way that we perceive the world.
因此，无论我们是否在世界中追求物质，或者是否在外部世界追求信息，多巴胺在很大程度上决定了我们的能力和动力，但多巴胺作为一种神经调节剂，也参与改变我们感知世界的方式。
Andrew Huberman:
安德鲁·休伯曼：
So as I mentioned earlier, you have all these senses coming in, and you can only perceive some of them because you're only paying attention to some of them.
正如我之前提到的，你拥有所有这些感官，但你只能感知其中的一些，因为你只关注其中的一些。
Dopamine, when it's released in our brain, tends to turn on areas of our brain that narrow our visual focus and our auditory focus.
当多巴胺在我们的大脑中释放时，它往往会激活我们大脑的区域，从而缩小我们的视觉焦点和听觉焦点。
It creates a cone of auditory attention that's very narrow.
它创造了一个非常狭窄的听觉注意力锥体。
It creates a tunnel of visual attention that's very narrow.
它创造了一条非常狭窄的视觉注意力隧道。
Whereas when we have less dopamine, we tend to view the entire world.
然而，当我们的多巴胺较少时，我们倾向于看整个世界。
We tend to see the whole scene that we are in.
我们倾向于看到我们所处的整个场景。
We tend to hear everything all at once.
我们倾向于同时听到所有内容。
Andrew Huberman:
安德鲁·休伯曼：
So as I describe this, hopefully you're already starting to see and understand how having dopamine release can allow a person, whether or not they have ADHD or not, to direct their attention to particular things in their environment.
因此，正如我所描述的那样，希望您已经开始看到并理解多巴胺的释放如何让一个人（无论是否患有多动症）将注意力转移到环境中的特定事物上。
Now, what we're doing is we're moving away from attention as this vague, ambiguous term, and we're giving it a neurochemical identity, dopamine.
现在，我们正在做的是，我们正在摆脱注意力这个模糊的、模棱两可的术语，我们给它一个神经化学特性：多巴胺。
We are giving it a neural circuit identity.
我们给它一个神经回路标识。
Just to put a little bit of flavor and detail on which neural circuits those are, I wanted to discuss two general types of neural circuits that dopamine tends to enhance.
为了对这些神经回路进行一些介绍和细节，我想讨论多巴胺倾向于增强的两种一般类型的神经回路。
Andrew Huberman:
安德鲁·休伯曼：
Let's talk neural circuits.
我们来谈谈神经回路。
For those of you that love hearing neuroscience nomenclature, you're going to eat this part up.
对于那些喜欢听神经科学术语的人来说，你将会吃掉这一部分。
For those of you that don't like a lot of names of brain areas, I invite you to tune out or just try and grab the top contour of this.
对于那些不喜欢太多大脑区域名称的人，我邀请您放弃或尝试抓住其顶部轮廓。
I will describe it in pretty general terms, but I will give some detail, because I know there are some of you out there who really want to dig deeper into what the exact structures and connectivities are.
我会用相当笼统的术语来描述它，但我会给出一些细节，因为我知道你们中的一些人确实想更深入地了解确切的结构和连接是什么。
There are two main types of circuits that we need to think about with respect to ADHD, attention, and dopamine.
关于注意力缺陷多动症，我们需要考虑两种主要类型的回路：注意力和多巴胺。
The first one is called the default mode network.
第一个称为默认模式网络。
Andrew Huberman:
安德鲁·休伯曼：
The default mode network is the network of brain areas in your brain, in my brain, and in everybody's brain that is active when we're not doing anything, when we're just sitting there idle at rest.
默认模式网络是你的大脑、我的大脑以及每个人的大脑中的大脑区域网络，当我们不做任何事情时，当我们只是闲着休息时，它就会处于活动状态。
Now, it's very hard to not think about anything, but when you're not engaged in any type of specific task, so you're not driving.
现在，很难不去想任何事情，但是当你没有从事任何类型的特定任务时，所以你就不会开车。
You're not playing a video game.
你不是在玩电子游戏。
You're not trying to study.
你不是在努力学习。
You're not trying to listen.
你并没有试图去听。
You're just sitting there letting your brain go wherever it wants to go.
你只是坐在那里，让你的大脑去任何它想去的地方。
Your default mode network underlies that state of mind.
您的默认模式网络是这种心态的基础。
Andrew Huberman:
安德鲁·休伯曼：
The other set of circuits that we're going to think about and talk about with respect to ADHD are the task networks, the networks of the brain that make you goal oriented, or that are at least trying to make you goal oriented.
我们将要考虑和讨论的关于多动症的另一组回路是任务网络，即使你以目标为导向的大脑网络，或者至少试图让你以目标为导向的大脑网络。
Those are a completely different set of brain areas.
这些是一组完全不同的大脑区域。
However, the default mode network and these task networks are communicating with one another, and they're doing that in very interesting ways.
然而，默认模式网络和这些任务网络正在相互通信，并且它们以非常有趣的方式进行通信。
So first, I want to describe how these two sets of brain areas, the default mode network and the task networks, normally interact.
首先，我想描述这两组大脑区域（默认模式网络和任务网络）通常如何相互作用。
A little bit of naming here.
这里稍微命名一下。
Again, feel free to ignore it if you don't want this level of detail, but the default mode network includes an area called the dorsolateral prefrontal cortex.
同样，如果您不需要这种详细程度，请随意忽略它，但默认模式网络包括一个称为背外侧前额皮质的区域。
Andrew Huberman:
安德鲁·休伯曼：
Frontal cortex, no surprise, is in the front.
毫不奇怪，额叶皮层位于前面。
You have a dorsal, the top, and side, lateral part, dorsolateral prefrontal cortex.
你有背侧、顶部、侧面、外侧部分、背外侧前额叶皮质。
You got one on each side of your brain.
你的大脑两侧各有一个。
Then you have a brain area called the posterior cingulate cortex.
然后你有一个称为后扣带皮层的大脑区域。
Then you have an area called the lateral parietal lobe.
然后有一个区域称为侧顶叶。
Again, you don't need to remember these names, but these are three brain areas that normally are synchronized in their activity.
同样，您不需要记住这些名称，但这三个大脑区域的活动通常是同步的。
So when one of these areas is active in a typical person, the other areas would be active as well.
因此，当一个人的这些区域之一活跃时，其他区域也会活跃。
So, it's a little bit like a symphony or a band, a three-piece band.
所以，它有点像交响乐或乐队，三人乐队。
Andrew Huberman:
安德鲁·休伯曼：
It's like drums, guitar and bass.
就像鼓、吉他和贝斯一样。
They're playing together.
他们在一起玩。
That's how it is in a typical person.
典型的人就是这样。
A person with ADHD, or even a person who has subclinical ADHD, or in any human being who hasn't slept well, what you find is the default mode network is not synchronized.
患有注意力缺陷多动症的人，甚至患有亚临床注意力缺陷多动症的人，或者任何睡眠质量不佳的人，您会发现默认模式网络不同步。
These brain areas are just not playing well together.
这些大脑区域不能很好地协同工作。
Now, the task networks include a different set of structures.
现在，任务网络包含一组不同的结构。
It still involves the prefrontal cortex, but it's a different part of the prefrontal cortex.
它仍然涉及前额叶皮层，但它是前额叶皮层的不同部分。
It tends to be the medial prefrontal cortex.
它往往是内侧前额叶皮层。
There are some other brain areas that the medial prefrontal cortex is communicating to all the time, mainly to suppress impulses.
内侧前额叶皮层一直在与其他一些大脑区域进行通信，主要是为了抑制冲动。
Andrew Huberman:
安德鲁·休伯曼：
It's shutting down the desire to stand up or to scratch the side of your cheek or your nose if you're trying not to do that.
如果你不想站起来，或者抓挠脸颊或鼻子，它就会阻止你这样做。
Anytime you're restricting your behavior, these task-directed networks are very active.
每当你限制自己的行为时，这些任务导向的网络就会非常活跃。
Now, normally in a person without ADHD, the task networks and the default mode networks are going in seesaw fashion.
现在，通常在没有多动症的人中，任务网络和默认模式网络会以跷跷板的方式进行。
They are actually what we call anticorrelated.
它们实际上就是我们所说的反相关。
It's not just that they are not correlated, they are actually opposing one another.
它们不仅不相关，而且实际上是相互对立的。
They are anticorrelated.
它们是反相关的。
In a person with ADHD, the default mode networks and the task networks are actually more coordinated.
对于患有多动症的人来说，默认模式网络和任务网络实际上更加协调。
Andrew Huberman:
安德鲁·休伯曼：
That might come as surprising.
这可能会让人感到惊讶。
I think that we all have this tendency to jump to conclusion and assume that somebody who doesn't have an easy time paying attention, or has ADHD, that their brain must be completely incoherent, that it's not working well, because everything's out of whack.
我认为我们都有这样的倾向，即得出结论，认为那些注意力不集中的人，或者患有注意力缺陷多动症的人，他们的大脑一定是完全不连贯的，工作得不好，因为一切都不正常。
But there's something interesting about people with ADHD whereby the task networks and the default mode networks are actually working together in a way that's correlated, and that is what's abnormal.
但患有多动症的人有一些有趣的事情，即任务网络和默认模式网络实际上以一种相关的方式一起工作，这就是不正常的地方。
This would be like the guitar, bass and the drums playing together in a way where the bass isn't keeping the back beat, and the drums aren't keeping the back beat that they're playing together.
这就像吉他、贝斯和鼓一起演奏，贝斯不保持伴奏，鼓也不保持他们一起演奏的伴奏。
Andrew Huberman:
安德鲁·休伯曼：
They're all playing the melodies and harmonies in a way that just doesn't sound right.
他们都以一种听起来不正确的方式演奏旋律和和声。
That's what's going on in the brain of somebody with ADHD.
这就是多动症患者大脑中正在发生的事情。
We can now confidently say, based on brain imaging studies, that when somebody gets better when they're treated for ADHD, or when they age out of ADHD, as sometimes is the case, that the default mode networks and the task networks tend to become anticorrelated again.
现在，根据脑成像研究，我们可以自信地说，当某人接受多动症治疗后情况有所好转时，或者当他们随着年龄的增长不再多动症时（有时就是这种情况），默认模式网络和任务网络往往会再次变得反相关。
That's the underlying neurobiology, but you'll notice that I didn't mention dopamine at all.
这是基本的神经生物学，但你会注意到我根本没有提到多巴胺。
What dopamine is doing in this context is dopamine is acting like a conductor.
多巴胺在这种情况下的作用是充当导体。
Dopamine is saying, "This circuit should be active, then that circuit should be active.
多巴胺在说：“这个回路应该活跃，那么那个回路也应该活跃。
It should be default mode network, and then when the default mode network is not active, then it should be the task network," so it's really acting as a conductor, saying, "You go now.
它应该是默认模式网络，然后当默认模式网络未激活时，它应该是任务网络，”所以它实际上充当指挥，说，“你现在走。
You go now.
你现在就走吧。
You go now.
你现在就走吧。
You go." In ADHD, there's something about the dopamine system that is not allowing it to conduct these networks and make sure that they stay, what the engineers or physicists or mathematicians would say, out of phase, to be anticorrelated.
你走吧。”在多动症中，多巴胺系统存在某种原因，不允许它传导这些网络并确保它们留下来，工程师、物理学家或数学家会说，异相，反相关。
Out of phase and anticorrelated, essentially the same thing, at least for purposes of this discussion.
异相和反相关本质上是同一件事，至少就本次讨论而言是如此。
Andrew Huberman:
安德鲁·休伯曼：
That raises two questions.
这就提出了两个问题。
Could it be that dopamine is not at sufficiently high levels, or could it be that dopamine is just doing it all wrong?
是否是多巴胺的水平不够高，或者多巴胺只是做错了事情？
In other words, is there no conductor or is the conductor playing with, like, little tiny toothpicks, and so the instruments can't see what they're supposed to do?
换句话说，是不是没有指挥，或者指挥在玩小牙签之类的东西，所以乐器看不到它们应该做什么？
They can't get the instruction, because it's just not loud enough so to speak.
他们无法得到指示，因为声音不够大声。
Could it be that the information is getting out, but the information that's getting out is wrong?
难道是信息传出去了，但是传出去的信息是错误的？
The conductor is there, but the conductor isn't very good at conducting.
导体在那里，但是导体的导电能力不是很好。
Andrew Huberman:
安德鲁·休伯曼：
Now, we can gain insight into how this system works and fails, and how to treat it, by looking at some of the current and previous treatments for ADHD, as well as some of the recreational drugs that people with ADHD tend to pursue and like.
现在，通过研究当前和以前的一些多动症治疗方法，以及多动症患者倾向于追求和喜欢的一些娱乐性药物，我们可以深入了解该系统如何工作和失败，以及如何治疗它。
Now, I'm certainly not a proponent of people with ADHD taking drugs recreationally.
现在，我当然不支持多动症患者为了消遣而吸毒。
That's not what this is about.
这不是重点。
But if you look at their drug-seeking behavior, and you couple that drug-seeking behavior to their desire to remedy their attention deficit, you start gaining some really interesting insight into how dopamine is regulating these circuits in normal circumstances and in people with ADHD.
但是，如果你观察他们的寻求药物行为，并将这种寻求药物行为与他们纠正注意力缺陷的愿望结合起来，你就会开始获得一些非常有趣的见解，了解多巴胺在正常情况下和多动症患者中如何调节这些回路。
Andrew Huberman:
安德鲁·休伯曼：
What exactly is going on with the dopamine system in people with ADHD, and what's going on with the dopamine system in people that have terrific levels of attention for any task?
多动症患者的多巴胺系统究竟发生了什么，以及对任何任务都高度关注的人的多巴胺系统到底发生了什么？
Well, in the year 2015, an important paper came out.
那么2015年，一篇重要的论文出来了。
The first author is Spencer.
第一作者是斯宾塞。
It came out in a journal called Biological Psychiatry.
它发表在一本名为《生物精神病学》的杂志上。
It formalized the so-called low dopamine hypothesis of ADHD.
它正式确立了所谓的多动症低多巴胺假说。
The idea that dopamine was somehow involved or not at the appropriate levels in people with ADHD had been around for a pretty long time.
多动症患者体内多巴胺以某种方式参与或未达到适当水平的观点已经存在了相当长的时间。
But, a formal proposition of the low dopamine hypothesis led to some really important experiments and understanding of what goes wrong in ADHD.
但是，低多巴胺假说的正式提出导致了一些非常重要的实验和对多动症问题的理解。
Andrew Huberman:
安德鲁·休伯曼：
It turns out that if dopamine levels are too low, in particular circuits in the brain, that it leads to unnecessary firing of neurons in the brain that are unrelated to the task that one is trying to do, and that is unrelated to the information that one is trying to focus on.
事实证明，如果多巴胺水平太低，特别是大脑中的回路，就会导致大脑中不必要的神经元放电，这些神经元与人们试图完成的任务无关，也与人们试图关注的信息无关。
So if you think back before, you've got this default mode network and a task-related network, and they need to be in this concert of anticorrelation.
因此，如果你回想一下之前，你已经有了这个默认模式网络和一个与任务相关的网络，它们需要处于反相关的协调中。
In ADHD, they're firing together.
在多动症中，他们一起射击。
Well, the problem seems to be that when dopamine is low, certain neurons are firing when they shouldn't be.
好吧，问题似乎是，当多巴胺水平较低时，某些神经元会在不应该的情况下放电。
This is like a band, right?
这就像一个乐队，对吧？
We'll go back to our band.
我们会回到我们的乐队。
That's a guitar, a bass and a person playing the drums.
那是一把吉他、一把贝斯和一个打鼓的人。
It's as if one of those, or several of those instruments are playing notes when they shouldn't be playing, right?
就好像其中之一或其中几个乐器在不应该演奏的时候演奏音符，对吗？
Andrew Huberman:
安德鲁·休伯曼：
The pauses in music are just as important as the actual playing of notes.
音乐中的停顿与音符的实际演奏同样重要。
When dopamine is too low, neurons fire more than they should in these networks that govern attention.
当多巴胺过低时，控制注意力的网络中的神经元会过度放电。
This is the so-called low dopamine hypothesis.
这就是所谓的低多巴胺假说。
If you start looking anecdotally at what people with ADHD have done for decades, not just recently since the low dopamine hypothesis has been proposed, but what they were doing in the 1950s and in the 1940s and in the 1960s, what you find is that they tend to use recreational drugs or they tend to indulge in nondrug stimulants, so things like drinking six cups of coffee, or quadruple espressos, or when it was more prominent, smoking a half a pack of cigarettes and drinking four cups of coffee a day, or if the person had access to it, using cocaine as a recreational drug, or amphetamine as a recreational drug.
如果你开始观察患有多动症的人几十年来所做的事情，不仅是自提出低多巴胺假说以来最近，而且是他们在 20 世纪 50 年代、1940 年代和 1960 年代所做的事情，你会发现他们倾向于使用娱乐性药物或倾向于沉迷于非药物兴奋剂，例如喝六杯咖啡或四杯浓缩咖啡，或者更突出的是吸烟每天吸半包香烟并喝四杯咖啡，或者如果该人有机会使用可卡因作为娱乐性药物，或使用安非他明作为娱乐性药物。
Andrew Huberman:
安德鲁·休伯曼：
All of those substances that I just described, in particular cocaine and amphetamine, but also coffee and cigarettes, increase levels of multiple neurotransmitters, but all have the quality of increasing levels of dopamine in the brain, and in particular in the regions of the brain that regulate attention, and these task-related and default mode networks.
我刚才描述的所有这些物质，特别是可卡因和安非他明，还有咖啡和香烟，都会增加多种神经递质的水平，但都具有增加大脑中多巴胺水平的性质，特别是在大脑中调节注意力的区域，以及这些与任务相关和默认模式网络。
Now, young children, fortunately, don't have access to those kinds of stimulants most of the time.
幸运的是，现在年幼的孩子大多数时候都无法接触到这些兴奋剂。
Those stimulants all have high potential for abuse in adults, so we will talk about the potential for abuse in a few minutes.
这些兴奋剂在成年人中都有很高的滥用可能性，因此我们将在几分钟内讨论滥用的可能性。
But if you look at children, even very young children with ADHD, they show things like preference for sugary foods, which also act as dopamine-inducing stimulants.
但如果你观察儿童，即使是患有注意力缺陷多动症的幼儿，他们也会表现出对含糖食物的偏爱，而这些食物也会产生多巴胺兴奋剂。
Andrew Huberman:
安德鲁·休伯曼：
Now, of course, once they get access to soda pop and coffee and tea, they start to indulge in those more than other people.
当然，现在，一旦他们能够喝到汽水、咖啡和茶，他们就会开始比其他人更沉迷于这些。
For a long time, it was thought that children with ADHD consumed too many sugary foods, or drank too much soda, or adults with ADHD would take recreational drugs like methamphetamine or cocaine, or would drink coffee to excess or smoke cigarettes to excess, because they had poor levels of attention, and because they couldn't make good decisions.
长期以来，人们认为患有注意力缺陷多动症的儿童食用了太多含糖食物，或者喝了太多苏打水，或者患有注意力缺陷多动症的成年人会服用甲基苯丙胺或可卡因等娱乐性药物，或者过量喝咖啡或过量吸烟，因为他们注意力不集中，而且无法做出正确的决定。
They were too impulsive, and so forth.
他们太冲动了等等。
Andrew Huberman:
安德鲁·休伯曼：
While that certainly could be the case, knowing what we now know about dopamine and the fact that having enough dopamine is required in order to coordinate these neural circuits that allow for focus and quality decision-making, an equally valid idea is that these children and these adults are actually trying to self-medicate by pursuing these compounds, right?
虽然情况确实可能如此，但了解我们现在对多巴胺的了解，以及需要有足够的多巴胺来协调这些神经回路，从而实现集中注意力和高质量决策的事实，一个同样有效的想法是，这些儿童和这些成年人实际上是在尝试通过追求这些化合物来进行自我治疗，对吗？
Things like cocaine lead to huge increases in dopamine.
可卡因等物质会导致多巴胺大量增加。
Well, what happens when somebody with ADHD takes that drug?
那么，当多动症患者服用这种药物时会发生什么？
It turns out they actually obtain heightened levels of focus.
事实证明，他们实际上获得了更高的注意力。
Their ability to focus on things other than things they absolutely care intensely about goes up.
他们专注于自己绝对关心的事情以外的事情的能力得到了提高。
Likewise, children who-
同样，孩子们——
Andrew Huberman:
安德鲁·休伯曼：
-about goes up.
-大约上升。
Likewise, children who consume anything that increases their levels of dopamine, if those children have ADHD, they tend to be calmer.
同样，食用任何会增加多巴胺水平的孩子，如果这些孩子患有注意力缺陷多动症，他们往往会更加平静。
They tend to be able to focus more.
他们往往能够更加集中注意力。
Now, this is very different than children who do not have ADHD.
现在，这与没有多动症的孩子有很大不同。
When they consume too much sugar, they tend to become super hyperactive.
当他们摄入过多的糖时，他们往往会变得超级活跃。
When they consume any kind of stimulant, they tend to go wild and run around like crazy.
当他们服用任何一种兴奋剂时，他们都会变得疯狂并疯狂地奔跑。
I actually have an anecdote about this just to illustrate it.
其实我有一个关于这个的轶事只是为了说明这一点。
I have a friend, he has two children that are now in their teens and twenties, but when they were little, one time I brought them some chocolate just as a gift when I showed up at their house, and within 30 minutes the kids were running around like crazy.
我有一个朋友，他有两个孩子，现在已经十几岁、二十多岁了，但当他们还小的时候，有一次我去他们家时，给他们带了一些巧克力作为礼物，不到30分钟，孩子们就疯狂地跑来跑去。
I mean, they were pretty high energy kids, but they were going bonkers.
我的意思是，他们都是精力充沛的孩子，但他们却变得疯狂。
And that's actually when the mother, my friend at the time and fortunately still now, looked at the chocolate and realized that it was chocolate with espresso beans in it.
事实上，就在那时，我的母亲，我当时的朋友，幸运的是现在仍然如此，看着巧克力，意识到这是含有浓缩咖啡豆的巧克力。
It was like dark chocolate espresso beans.
它就像黑巧克力浓缩咖啡豆。
Andrew Huberman:
安德鲁·休伯曼：
So I was really at fault there.
所以我确实有错。
You don't want to give kids dark chocolate with espresso beans, but what you're really seeing, that hyperactivity, that is dopamine.
你不想给孩子们黑巧克力和浓缩咖啡豆，但你真正看到的是，过度活跃，那就是多巴胺。
Okay?
好的？
It's the sugar, combined with the caffeine, in this case, combined with a few other compounds that exist in chocolate that really increase our levels of alertness and our tendency to want to move around a lot.
在这种情况下，糖与咖啡因的结合，以及巧克力中存在的其他一些化合物的结合，真正提高了我们的警觉程度和我们想要四处走动的倾向。
Okay.
好的。
So, dopamine, and low levels of dopamine, apparently are what's wrong in people with ADHD.
因此，多巴胺和低水平的多巴胺显然是多动症患者的问题所在。
That dopamine hypothesis is what led to the idea that treating people, children and adults included, with dopaminergic compounds would somehow increase their ability to focus.
多巴胺假说导致了这样一种想法：用多巴胺能化合物治疗人类（包括儿童和成人）可以在某种程度上提高他们的注意力集中能力。
And if you look at the major drugs that were developed and now marketed by pharmaceutical companies for the treatment of ADHD, those drugs have names like Ritalin.
如果你看看制药公司开发和销售的用于治疗多动症的主要药物，这些药物的名称如利他林。
Nowadays.
如今。
It's typically things like Adderall, modafinil, and some of the other derivatives.
通常是阿得拉、莫达非尼和其他一些衍生物。
Andrew Huberman:
安德鲁·休伯曼：
They all serve to increase levels of dopamine, in particular, dopamine in the networks that control task-directed behavior, and that coordinate the default mode network and these task-related networks.
它们都有助于增加多巴胺的水平，特别是控制任务导向行为的网络中的多巴胺，以及协调默认模式网络和这些任务相关网络的多巴胺。
So, many of you have probably heard of Ritalin.
所以，你们很多人可能听说过利他林。
Ritalin is a prescription stimulant that is prescribed for ADHD, as well as for narcolepsy.
利他林是一种处方兴奋剂，用于治疗多动症和嗜睡症。
Narcolepsy is a condition which people tend to fall asleep during the daytime quite a lot.
发作性睡病是一种人们在白天经常入睡的疾病。
It's excessive daytime sleepiness, not due to lack of sleep at night, but also tend to fall asleep when they get excited, if they're really emotionally excited or about to eat, or any other kind of activity that would normally get somebody really aroused and alert, people with narcolepsy tend to fall asleep or they tend to become what's called cataplectic.
这是白天过度嗜睡，不是因为晚上睡眠不足，而是在兴奋时容易入睡，如果他们真的情绪激动或要吃东西，或者任何其他通常会使人真正兴奋和警觉的活动，患有发作性睡病的人往往会入睡，或者他们往往会变得所谓的猝倒症。
They tend to just sort of go limp in the muscles.
他们的肌肉往往会变得无力。
So it's this invasion of sleep into the daytime.
所以这就是睡眠对白天的入侵。
Andrew Huberman:
安德鲁·休伯曼：
It's dysregulated by emotion.
它因情绪而失调。
You can imagine why a stimulant, something that would wake you up, make you very alert, focused and motivated would be a good treatment for narcolepsy.
你可以想象为什么兴奋剂，一种可以叫醒你，让你非常警觉、专注和积极主动的东西，会是治疗发作性睡病的一种很好的方法。
Adderall also is used to treat ADHD and to treat narcolepsy.
阿得拉还用于治疗多动症和发作性睡病。
Things like modafinil also used to treat ADHD and narcolepsy.
像莫达非尼这样的药物也用于治疗多动症和嗜睡症。
So you're sensing a theme here.
所以你在这里感受到了一个主题。
So what are the differences and similarities between these drugs, and what can that tell us about ADHD?
那么这些药物之间有什么区别和相似之处？这可以告诉我们关于多动症的什么信息？
Well, Ritalin was one of the first-generation drugs that was prescribed for ADHD in order to deal head on with this dopamine hypothesis, this idea that in ADHD, dopamine levels are too low.
利他林是治疗多动症的第一代药物之一，旨在解决多巴胺假说，即在多动症中，多巴胺水平过低。
Nowadays, Adderall is the more typically prescribed drug for ADHD.
如今，阿德拉（Adderall）是治疗多动症（ADHD）更常用的处方药。
That has to do with some of the so-called pharmacokinetics, the rate at which those drugs enter the system and how long they last in the system.
这与一些所谓的药代动力学有关，即这些药物进入系统的速率以及它们在系统中的持续时间。
So for instance, Ritalin was a drug that was packaged into various time-release formulas, whereas initially, Adderall was only released in a form that had a very short life.
例如，利他林是一种被包装成各种缓释配方的药物，而最初，阿得拉仅以寿命非常短的形式释放。
Andrew Huberman:
安德鲁·休伯曼：
So meaning that it wasn't in the bloodstream very long and didn't affect the brain for very long.
这意味着它在血液中停留的时间并不长，也不会影响大脑很长时间。
And so the dosages could be controlled in a more typical way.
因此可以以更典型的方式控制剂量。
Without going into a lot of tangential detail, as you all know, at different times of day, you tend to be more or less alert.
众所周知，在一天中的不同时间，您往往会或多或少地保持警觉，无需深入探讨太多无关细节。
So a long sustained-release drug, while that might sound like a really terrific thing, if that drug is having an effect of making you more alert and it's released across very many hours of your day, there might be periods of your day when you feel too alert, periods of your day when you feel just right, and periods of your day when you wished that you were more alert.
因此，一种长效缓释药物，虽然听起来确实是一件很棒的事情，但如果该药物具有使您更加警觉的效果，并且它在一天中的很多小时内释放，那么您可能会在一天中的某些时段感到过于警觉，在一天中的某些时段感觉恰到好处，以及在一天中的某些时段您希望自己更加警觉。
These are some of the pharmacokinetics — kinetics, meaning movement — of the different compounds within the bloodstream and brain that you could imagine in a very real way would impact whether or not someone would feel really good on one of these drugs, or whether or not they would feel too anxious or too sleepy, and so on.
这些是血液和大脑中不同化合物的一些药代动力学（动力学，意思是运动），您可以以非常真实的方式想象它们会影响某人对这些药物中的一种是否感觉良好，或者他们是否会感到太焦虑或太困，等等。
Andrew Huberman:
安德鲁·休伯曼：
Let's take a step back for a second and just ask, what are these drugs?
让我们退后一步，问一下，这些药物是什么？
We know they increased dopamine, but what are they really?
我们知道它们会增加多巴胺，但它们到底是什么？
Well Ritalin, also called methylphenidate, is very similar to amphetamine — speed, or what's typically called speed in the street drug nomenclature.
利他林，也称为哌醋甲酯，与安非他明非常相似——速度，或者街头毒品术语中通常所说的速度。
Adderall, which goes by various other names, so Adderall, Adderall XR, Mydayis, things like that.
Adderall，它有各种其他名称，如 Adderall、Adderall XR、Mydayis 等。
Adderall is basically a combination of amphetamine and dextroamphetamine.
Adderall 基本上是苯丙胺和右旋苯丙胺的组合。
Now, some of you probably realize this, that Adderall is amphetamine, but I'm guessing that there are a good number of you out there, perhaps even parents and kids, that don't realize that these drugs like cocaine and amphetamine, methamphetamine, which are incredibly dangerous and incredibly habit-forming and have high potential for abuse, well, the pharmaceutical versions of those are exactly what are used to treat ADHD.
现在，你们中的一些人可能意识到这一点，Adderall 是安非他明，但我猜你们中有很多人，甚至可能是父母和孩子，都没有意识到这些药物，如可卡因、安非他明、甲基安非他明，它们非常危险，令人难以置信地形成习惯，并且具有很高的滥用潜力，那么，这些药物的药物版本正是用于治疗多动症的。
Now, they're not exactly like cocaine or methamphetamine, but they are structurally and chemically very similar, and their net effect in the brain and body is essentially the same, which is to increase dopamine, primarily, but also to increase levels of a neuromodul
现在，它们并不完全像可卡因或甲基苯丙胺，但它们在结构和化学上非常相似，它们在大脑和身体中的净效应本质上是相同的，主要是增加多巴胺，但也增加神经调节的水平
Andrew Huberman:
安德鲁·休伯曼：
ator called epinephrine or norepinephrine, also called noradrenaline and adrenaline — those names are the same — and to some extent to increase levels of serotonin in the brain and blood, but not so much serotonin.
一种叫做肾上腺素或去甲肾上腺素的药物，也称为去甲肾上腺素和肾上腺素——这些名字是相同的——在一定程度上可以增加大脑和血液中血清素的水平，但不会增加那么多血清素。
That's just kind of a small smidgen of effect.
这只是一点点的影响。
Okay, so dopamine way up, norepinephrine and adrenaline way up.
好的，多巴胺、去甲肾上腺素和肾上腺素都会上升。
So that's motivation, drive, focus and energy, and to some extent a little bit of serotonin, which is really more about feeling calm and relaxed, and you could imagine why that would be a good balancing effect for dopamine and norepinephrine.
所以这就是动机、驱动力、专注力和能量，在某种程度上还有一点血清素，这实际上更多的是让人感觉平静和放松，你可以想象为什么这对多巴胺和去甲肾上腺素有很好的平衡作用。
So what I'm essentially saying is that the drugs that are used to treat ADHD are stimulants, and they look very much like, in fact nearly identical to, some of the so-called street drug stimulants that we all hear are so terrible.
所以我本质上想说的是，用于治疗多动症的药物是兴奋剂，它们看起来非常像，实际上几乎相同，一些我们都听说过的所谓街头毒品兴奋剂非常可怕。
However, I do want to emphasize that at the appropriate dosages, and working with a quality psychiatrist or neurologist or family physician, does have to be a board-certified MD that prescribes these things, many people with ADHD achieve excellent relief with these drugs.
然而，我确实想强调，在适当的剂量下，并且与高质量的精神科医生或神经科医生或家庭医生合作，确实必须是经过委员会认证的医学博士开出这些药物，许多多动症患者通过这些药物获得了极好的缓解。
Not all of them, but many of them do, especially if these treatments are started early in life.
不是全部，但很多人都会这样做，特别是如果这些治疗是在生命早期开始的话。
So now knowing what these drugs are, I want to raise the question of why prescribe these drugs?
现在知道了这些药物是什么，我想提出一个问题：为什么开这些药物？
I mean, everyone has to make a decision for themselves or for their child as to whether or not they're going to take these things or not.
我的意思是，每个人都必须为自己或他们的孩子做出是否要接受这些东西的决定。
I also want to acknowledge that many people out there, many, many people out there, are taking these drugs even though they have not been clinically diagnosed with ADHD.
我还想承认，很多人正在服用这些药物，即使他们尚未被临床诊断为多动症。
When I say these drugs, I'm specifically referring to Ritalin and Adderall and modafinil, but more typically it's Adderall.
当我说这些药物时，我特指利他林、阿得拉和莫达非尼，但更典型的是阿得拉。
Okay?
好的？
People using cocaine and amphetamine for recreational purposes, that's a completely different beast, and it is indeed a beast, and it's something that I strongly discourage.
人们为了娱乐目的而使用可卡因和安非他明，这是一种完全不同的野兽，它确实是一种野兽，这是我强烈反对的事情。
However, I'm aware that up to 25% of college students, and perhaps as many as 35% of all individuals between the ages of 17 and 30, are taking Adderall on a regular or semiregular basis in order to work, in order to study and in order to function and focus in their daily life, even though they have not been diagnosed with ADHD.
然而，我知道，高达 25% 的大学生，或许在 17 岁至 30 岁之间的所有人中，有多达 35% 的人正在定期或半定期服用阿得拉，以便工作、学习以及日常生活中的正常运转和注意力集中，即使他们尚未被诊断出患有 ADHD。
Andrew Huberman:
安德鲁·休伯曼：
There's a whole black market for this.
这有一个完整的黑市。
They're getting it from people with prescriptions.
他们从有处方的人那里得到它。
I'm not here to pass judgment.
我来这里不是为了做出判断。
I just want to emphasize how these drugs work, some of the things that they do to enhance cognition and focus that actually serve the brain well in certain individuals, and how they can be very detrimental in other individuals.
我只是想强调这些药物是如何发挥作用的，它们可以增强认知和注意力，实际上对某些人的大脑有很好的作用，以及它们如何对其他人非常有害。
I sort of blew right past it, but the fact that in upwards of 25% of young people are taking things like Adderall despite not having a clinical diagnosis of ADHD, well, that's a ridiculously high number.
我有点忽略了这一点，但事实是，尽管没有临床诊断出多动症，但仍有超过 25% 的年轻人正在服用阿得拉之类的药物，这个数字高得离谱。
A few years ago, it was estimated that Adderall use and Ritalin use without diagnosis of ADHD was second in incident only to cannabis.
几年前，据估计，在未诊断出多动症的情况下使用阿得拉和利他林是仅次于大麻的第二大事件。
But actually, now the consumption of Adderall without prescription is higher than the consumption of cannabis in that age group.
但实际上，现在该年龄段非处方阿得拉的消费量高于大麻的消费量。
So what that means is that there's a lot of stimulant use in that age group, and there are a lot of adults also using and abusing stimulants in order to gain focus.
所以这意味着这个年龄段有很多兴奋剂的使用，而且很多成年人也使用和滥用兴奋剂来获得注意力。
Andrew Huberman:
安德鲁·休伯曼：
Now, we could have a whole discussion about whether or not life is becoming more demanding, whether or not the need for focus is excessive, and that's why people are doing that.
现在，我们可以全面讨论生活是否变得更加苛刻，是否需要过度集中注意力，这就是人们这样做的原因。
Frankly, it's an interesting discussion, but it's not one that would deliver us to any answers.
坦率地说，这是一场有趣的讨论，但它不会给我们带来任何答案。
Rather, I'd like to focus on the ways that people now, and people have always been self-medicating to increase focus, right?
相反，我想关注人们现在以及人们一直以来通过自我治疗来提高注意力的方式，对吗？
Caffeine, which I indulge some, I don't think to excess, has long been used as a stimulant to increase dopamine, increase norepinephrine, increase focus and energy.
我喜欢喝咖啡因，但我认为并不过分，它长期以来一直被用作增加多巴胺、去甲肾上腺素、增加注意力和能量的兴奋剂。
And in addition to that, it works through the so-called cyclic AMP phosphodiesterase pathway.
除此之外，它还通过所谓的环 AMP 磷酸二酯酶途径发挥作用。
Remember, anytime you see, you hear an A-S-E.
请记住，无论何时您看到，您都会听到 A-S-E。
that's an enzyme.
那是一种酶。
Phosphodiesterase is involved in the conversion of things like cyclic AMP into energy for cells and so forth.
磷酸二酯酶参与将环磷酸腺苷等物质转化为细胞能量等。
Basically, coffee gives you energy, it makes you feel good, and it increases focus because of the circuits that it engages in the brain.
基本上，咖啡可以给你能量，让你感觉良好，并且由于它参与大脑回路而提高注意力。
Andrew Huberman:
安德鲁·休伯曼：
People have been taking caffeine, and continue to take caffeine, for ages.
人们多年来一直在服用咖啡因，并将继续服用咖啡因。
People also used to smoke cigarettes, nicotine, in order to gain focus.
人们还习惯吸食尼古丁香烟，以获取注意力。
Nowadays, that's less common because of the concerns, quite valid concerns, about lung cancer from smoking.
如今，这种情况已经不那么常见了，因为人们对吸烟导致肺癌的担忧非常合理。
But there's a lot of vaping out there.
但那里有很多电子烟。
There are a lot of people now consuming nicotine, which is the active substance in cigarettes, and in most nicotine vapes, that stimulates the brain to be more focused and more alert.
现在有很多人消费尼古丁，尼古丁是香烟和大多数尼古丁电子烟中的活性物质，可以刺激大脑更加集中注意力和更加警觉。
So the idea of taking stimulants, of consuming things or smoking things in order to increase alertness is not a new idea.
因此，通过服用兴奋剂、吃东西或抽烟来提高警觉性的想法并不是什么新想法。
It's just that in ADHD, it's surprising that these things would work, right?
只是在多动症中，这些东西竟然能起作用，真是令人惊讶，对吧？
I mean, if the problem is attention deficit hyperactivity disorder, what we're really talking about here, or children that are prescribed a drug that ought to be a stimulant, it ought to make them hyper hyperactive, and rather than doing that, it actually somehow serves to calm them a bit, or at least allow them to focus.
我的意思是，如果问题是注意力缺陷多动障碍，我们在这里真正讨论的是什么，或者给孩子开了一种应该是兴奋剂的药物，那么它应该让他们变得过度活跃，而不是这样做，它实际上以某种方式让他们平静一点，或者至少让他们集中注意力。
Here's the reason.
原因如下。
Children have a brain that's very plastic, meaning it can remodel itself and change in response to experience very, very quickly compared to adults.
儿童的大脑具有很强的可塑性，这意味着与成人相比，儿童的大脑可以非常非常快地重塑自身并根据经历做出改变。
Taking stimulants as a child, if you are a child diagnosed with ADHD, allows that forebrain task-related network to come online, to be active at the appropriate times.
如果你是一个被诊断患有多动症的孩子，小时候服用兴奋剂可以让前脑任务相关网络上线，在适当的时间活跃起来。
And because those children are young, it allows those children to learn what focus is and to sort of follow or enter that tunnel of focus.
因为这些孩子还小，所以它可以让他们了解什么是焦点，并遵循或进入焦点隧道。
Now, by taking a drug, it's creating focus artificially.
现在，通过服用药物，它可以人为地创造注意力。
It's not creating focus because they're super interested in something.
这并不是因为他们对某件事超级感兴趣而创造焦点。
It's chemically inducing a state of focus.
它通过化学方式诱导一种专注状态。
And let's face it, a lot of childhood and school and becoming a functional adult is about learning how to focus even though you don't want to do something.
让我们面对现实吧，很多童年和学校以及成为一个正常的成年人都是为了学习如何集中注意力，即使你不想做某事。
Andrew Huberman:
安德鲁·休伯曼：
In fact, when I was in college, I had this little trick that may or may not work for some of you, which is if I couldn't focus on the material I was trying to learn, I would delude myself into thinking that it was the most interesting thing in the world.
事实上，当我上大学时，我有一个小技巧，可能对你们中的一些人有用，也可能不起作用，那就是如果我不能专注于我想要学习的材料，我会欺骗自己，认为这是世界上最有趣的事情。
I would just kind of lie to myself and tell myself, "Okay, this ...
我只是对自己撒谎并告诉自己，“好吧，这......
," I won't mention the subjects; "I absolutely love this." I would tell myself that I loved it, and I noticed that just that selective or deliberate engagement of that desire-to-know circuit, whatever that is in my brain, no doubt involves dopamine, allowed me to focus and remember the information.
，”我就不提科目了； “我非常喜欢这个。”我会告诉自己我喜欢它，而且我注意到，只要有选择地或有意地参与那个渴望知道的回路，无论我大脑中的是什么，毫无疑问都涉及多巴胺，让我能够集中注意力并记住信息。
And somewhat surprisingly, or perhaps not surprisingly, I would often fall in love with the information.
有点令人惊讶的是，或者也许并不令人惊讶的是，我经常会爱上这些信息。
I'd find that that was my favorite class.
我发现那是我最喜欢的课。
It was what I wanted to learn the most.
这是我最想学的。
Andrew Huberman:
安德鲁·休伯曼：
So, that's one way you can do it artificially.
所以，这是一种可以人工完成的方法。
But kids with ADHD, they can't do that, right?
但是患有多动症的孩子，他们不能这样做，对吧？
They're told to sit still and they end up getting up 11 times.
他们被告知要安静地坐着，但最终他们站起来了 11 次。
They are told that they can't speak out in class or that they have to remain in their seats for 10 minutes, and they just, despite their best effort, they simply cannot do it.
他们被告知不能在课堂上发言，或者必须在座位上停留 10 分钟，尽管他们尽了最大努力，但他们就是做不到。
They're highly distractible.
他们非常容易分散注意力。
So what are we to make of this whole picture?
那么我们该如何理解这整个图景呢？
That we need more dopamine, but these kids with ADHD, they're getting their dopamine by way of a drug, which is for all the world amphetamines, right?
我们需要更多的多巴胺，但是这些患有多动症的孩子，他们通过药物获取多巴胺，这对全世界来说都是安非他明，对吗？
It's speed.
这是速度。
That's really what it is.
确实是这样。
What are the long-term consequences?
长期后果是什么？
What are the short-term consequences?
短期后果是什么？
And what should we make of people taking these drugs without a clinical need?
对于那些在没有临床需要的情况下服用这些药物的人，我们该怎么办？
What are the consequences there?
那里会产生什么后果？
Andrew Huberman:
安德鲁·休伯曼：
Well, in order to get to some of those answers, I went to one of my colleagues.
嗯，为了得到其中一些答案，我去找了我的一位同事。
This is a colleague that I've actually known for a very long time.
这是我实际上认识很长时间的同事。
I was their teaching assistant when they were an undergraduate.
当他们还是本科生时，我是他们的助教。
They went on to get an MD, a medical degree, as well as a PhD and have become a pediatric neurologist that specializes in the treatment of epilepsy and ADHD in kids of all ages, from age three to 21.
他们随后获得了医学博士学位、医学学位和博士学位，并成为一名儿科神经科医生，专门治疗 3 岁至 21 岁各年龄段儿童的癫痫和多动症。
That's the age range, pretty broad age range, and has extensive knowledge in this.
这就是年龄范围，相当广泛的年龄范围，并且在这方面有广泛的知识。
And what makes them particularly interesting, for sake of this discussion, is that they have a child, a young boy who's now showing signs of ADHD, and they are on the threshold of trying to decide whether or not they will prescribe Adderall or something similar.
为了这次讨论，让他们特别有趣的是，他们有一个孩子，一个小男孩，现在表现出多动症的迹象，他们正准备决定是否开阿得拉或类似的药物。
Andrew Huberman:
安德鲁·休伯曼：
So we had a discussion about this, and prior to learning that their child may have ADHD, I asked the following questions.
所以我们对此进行了讨论，在得知他们的孩子可能患有多动症之前，我问了以下问题。
First of all, I asked, What do you think about giving young kids amphetamine?
首先，我问，你对给小孩子服用安非他明有何看法？
And their answer was, on the face of it it seems crazy, but provided that the lowest possible dose is used and that that dosage is modulated as they grow older and developed those powers of attention, their observation was that they've seen more kids benefit than not benefit from that.
他们的答案是，从表面上看这似乎很疯狂，但如果使用尽可能低的剂量，并且随着年龄的增长和注意力的发展而调整剂量，他们的观察结果是，他们看到更多的孩子从中受益，而不是没有受益。
Now, I'm certainly not saying what people should do.
现在，我当然不是在说人们应该做什么。
You obviously have to go to a doctor because as I always say, I'm not a doctor.
显然你必须去看医生，因为正如我常说的，我不是医生。
I don't prescribe anything.
我不开任何处方。
I'm a professor, so I profess things.
我是一名教授，所以我有自己的专业。
And here I'm professing that you talk to your doctor if you're considering giving Ritalin or Adderall or any type of stimulant to your child.
我在此声明，如果您正在考虑给您的孩子服用利他林或阿得拉或任何类型的兴奋剂，请咨询您的医生。
Of course, what could be more important than the health of your child?
当然，还有什么比孩子的健康更重要的呢？
Andrew Huberman:
安德鲁·休伯曼：
But it was a very interesting answer, because typically we hear, yes, medicate, or don't medicate.
但这是一个非常有趣的答案，因为我们通常会听到，是的，用药或不用药。
Rarely do we hear that the medication should be adjusted across the lifespan and in any particular kind of way.
我们很少听说药物应该在整个生命周期中以任何特定的方式进行调整。
Now, the fact that this person, this now friend of mine and colleague of mine, has so much expertise in the way that the brain works and is considering putting their child on such medication, I said, "You know, why wouldn't you wait until your kid reaches puberty?"
现在，这个人，现在是我的朋友和同事，在大脑工作方式方面拥有如此多的专业知识，并且正在考虑让他们的孩子接受这种药物治疗，我说，“你知道，你为什么不等到你的孩子进入青春期呢？”
Andrew Huberman:
安德鲁·休伯曼：
I mean, we know that in boys and in girls there are increases in testosterone and estrogen during puberty that dramatically change the way that the body appears.
我的意思是，我们知道男孩和女孩在青春期睾酮和雌激素会增加，这会极大地改变身体的外观。
But also that dramatically change the way that the brain functions.
但这也极大地改变了大脑的运作方式。
In particular, we know this: that puberty triggers the activation of so-called frontotemporal task-related executive functioning.
特别是，我们知道：青春期会触发所谓的额颞叶任务相关执行功能的激活。
That's just fancy science-speak for being able to focus, being able to direct your attention, being able to control your impulses.
这只是一种奇特的科学说法，指的是能够集中注意力，能够引导你的注意力，能够控制你的冲动。
Look at a small child, or look at a puppy, and then look at an older child, or look at a dog.
看看一个小孩，或者看看一只小狗，然后看看一个大一点的孩子，或者看看一只狗。
Very different levels, patterns of spontaneous behavior.
自发行为的水平和模式截然不同。
Young children move around a lot, I don't want to say shifty because that makes it sound like they're up to something bad, which they might be, but they don't have to be up to something bad.
年幼的孩子经常四处走动，我不想说他们狡猾，因为这听起来像是他们在做坏事，但他们不一定要做坏事。
They fidget a lot.
他们很烦躁。
So do puppies.
小狗也一样。
Everything's a stimulus.
一切都是刺激。
As animals and humans get older, they learn how to control their behavior and sit still, listen and focus even if they don't want to.
随着动物和人类年龄的增长，即使他们不愿意，他们也会学会如何控制自己的行为，安静地坐着，倾听和集中注意力。
Andrew Huberman:
安德鲁·休伯曼：
So giving a drug that allows a child to access that stillness early on, it's thought will allow them to maintain that ability as time goes on.
因此，人们认为，给予孩子一种让孩子尽早获得这种平静的药物，可以让他们随着时间的推移保持这种能力。
But I decided to push a little bit further.
但我决定更进一步。
I said, "Well, why would you do it now as opposed to during puberty or after puberty?" And their answer was very specific, and I think very important.
我说：“那么，你为什么要现在做，而不是在青春期或青春期之后呢？”他们的回答非常具体，我认为非常重要。
What they said was, "Look, neuroplasticity is greatest in childhood and tapers off after about age 25.
他们说的是，“看，神经可塑性在童年时期最强，在 25 岁左右逐渐减弱。
But neuroplasticity from age three until age 12 or 13 is exceedingly high." And they're right.
但从 3 岁到 12 岁或 13 岁的神经可塑性非常高。”他们是对的。
Andrew Huberman:
安德鲁·休伯曼：
When you sit back and you look at the literature on neuroplasticity, you'd say childhood plasticity and young adult plasticity is much greater than adult plasticity.
当你坐下来看看有关神经可塑性的文献时，你会说童年的可塑性和年轻人的可塑性比成人的可塑性大得多。
But that early childhood plasticity is far and away the period in which you can reshape the brain at an accelerated rate.
但童年早期的可塑性无疑是加速重塑大脑的时期。
So this lines up really well with the clinical literature — not surprisingly, they're a clinician — that early treatment is key.
因此，这与临床文献非常吻合——毫不奇怪，他们是一名临床医生——早期治疗是关键。
If you have the opportunity to work with a quality physician and treat these things early, these drugs can allow these frontal circuits, these task-related circuits, to achieve their appropriate levels of functioning and for kids to learn how to focus in a variety of different contexts.
如果您有机会与优质医生合作并尽早治疗这些问题，这些药物可以让这些额叶回路、这些与任务相关的回路达到适当的功能水平，并让孩子们学习如何在各种不同的环境中集中注意力。
Now, is that the only thing that they should be doing?
现在，这是他们唯一应该做的事情吗？
Of course not.
当然不是。
Andrew Huberman:
安德鲁·休伯曼：
So, the next question I asked was, "What should we make of all this diet-related stuff, right?" I've heard before that the so-called elimination diet, or ingesting no sugars, or no dairy, or no gluten, that all of these things have been purported to improve symptoms of ADHD.
所以，我问的下一个问题是，“我们应该如何看待所有这些与饮食相关的东西，对吗？”我以前听说过所谓的消除饮食，或者不摄入糖，不吃奶制品，不吃麸质，所有这些都据称可以改善多动症的症状。
And people and parents with ADHD go to fanatic lengths to try and find the exact foods that are causing problems and the exact foods that the kids can eat in order to try and get their brain wired up right, and correctly, and to avoid lifelong ADHD.
患有多动症的人和父母会不遗余力地尝试找到导致问题的确切食物以及孩子们可以吃的确切食物，以便尝试让他们的大脑正确、正确地连接，并避免终身多动症。
And their answer was really interesting.
他们的回答真的很有趣。
But before I tell you their answer, I want to tell you the studies and the data related to this question of whether or not food and the constellation of foods that one avoids and will eat has anything to do with our levels of attention.
但在我告诉你他们的答案之前，我想告诉你与这个问题相关的研究和数据，即人们避免和会吃的食物和一系列食物是否与我们的注意力水平有关。
And in particular, whether or not that can be used as a leverage point to treat ADHD.
特别是，这是否可以作为治疗多动症的杠杆点。
Andrew Huberman:
安德鲁·休伯曼：
So you can imagine the challenges of exploring the role of diet and nutrition in any study, but especially in a study on ADHD.
因此，您可以想象在任何研究中探索饮食和营养的作用所面临的挑战，尤其是在多动症研究中。
Why?
为什么？
Well, because as I mentioned before, children with ADHD, and it turns out adults with ADHD, tend to pursue sugary foods or any types of food that increase their levels of dopamine.
嗯，因为正如我之前提到的，患有多动症的儿童，以及患有多动症的成年人，倾向于追求含糖食物或任何类型的会增加多巴胺水平的食物。
They are naturally drawn to those foods, whether or not they realize it or not, presumably, as a way to try and treat their lack of focus and impulsivity.
他们自然而然地被这些食物所吸引，无论他们是否意识到，大概是为了尝试治疗他们缺乏注意力和冲动的一种方式。
So in this study that I'm about to share with you, there was no drug treatment.
因此，在我即将与大家分享的这项研究中，没有进行药物治疗。
It was just a study manipulating diet and involved a hundred children, 50 in the so-called elimination diet group, the special diet where certain foods were eliminated, and 50 in the so-called control group.
这只是一项控制饮食的研究，涉及 100 名儿童，其中 50 名属于所谓的消除饮食组，即消除某些食物的特殊饮食组，50 名属于所谓的对照组。
However, being a well-designed randomized controlled trial, the study also included a crossover, meaning where the kids would serve as their own control or control group at a certain portion of the study.
然而，作为一项精心设计的随机对照试验，该研究还包括交叉，这意味着孩子们将在研究的某个部分作为自己的对照组或对照组。
So they would be in one group where they eliminated certain foods, and then after a period of time in the study, they would swap to the other group.
因此，他们会在一组中消除某些食物，然后在研究一段时间后，他们会交换到另一组。
This is a powerful way to design a study for reasons that you can imagine, because you start to eliminate changes and effects due to individual differences.
这是一种设计研究的强大方法，其原因是你可以想象的，因为你开始消除由于个体差异而产生的变化和影响。
Andrew Huberman:
安德鲁·休伯曼：
In any case, a hundred children total, 50 in each group at any one period in time, and the effects that they observed were extremely dramatic.
无论如何，在任何一个时间段，总共有 100 名儿童，每组 50 名，他们观察到的效果非常显着。
In the world of statistics and analysis of scientific data, we talk about P values, probability values.
在科学数据的统计和分析领域，我们谈论 P 值、概率值。
What's the likelihood that something could happen according to chance?
某件事偶然发生的可能性有多大？
And typically the cutoff would be something like p less than .05.
通常，截止值类似于 p 小于 0.05。
That's less than .05 chance, essentially, of the effect being due to chance.
从本质上讲，这种效应是由于偶然而产生的概率小于 0.05。
However, in this study, every single one of the effects is p less than .0001.
然而，在这项研究中，每一个效应的 p 均小于 0.0001。
Very, very infinitesimally small probability that the effects observed could be due to chance.
观察到的影响是偶然的可能性非常非常小。
So what were these effects?
那么这些影响是什么呢？
These effects were enhanced ability to focus, less impulsivity, even less tendency to move when trying to sit still.
这些效果包括增强专注能力、减少冲动，甚至在试图静坐时减少移动的倾向。
So everything from mental focus to the ability to control their bodies improved when they were in the elimination diet group.
因此，当他们处于消除饮食组时，从精神集中到控制身体的能力等各个方面都得到了改善。
Andrew Huberman:
安德鲁·休伯曼：
What was eliminated?
什么被淘汰了？
Well, the elimination diet in this particular study was a so-called oligoantigenic diet.
嗯，这项特定研究中的消除饮食是所谓的寡抗原饮食。
It was a diet in which each kid took a test to determine which foods they had antibodies for, meaning that they were mildly allergic to.
在这种饮食方式中，每个孩子都会进行测试，以确定他们对哪些食物有抗体，这意味着他们对哪些食物有轻微过敏。
Now, in this study, it was very important that the kids not be extremely allergic to any food because as I mentioned before, they actually served as a control at one point in the study where they were eating all sorts of foods, including foods that they had mild allergies to.
现在，在这项研究中，非常重要的是孩子们不要对任何食物极度过敏，因为正如我之前提到的，他们实际上在研究中的某个时刻充当了对照，他们吃各种各样的食物，包括他们有轻微过敏的食物。
So basically what this study said was that eliminating foods to which children have allergies can dramatically improve their symptoms of ADHD.
所以基本上这项研究所说的是，消除儿童过敏的食物可以显着改善他们的多动症症状。
And this study, not surprisingly because it was published in such a high-quality journal, Lancet, et cetera, large number of subjects, set the world on fire.
而这项研究，并不奇怪，因为它发表在柳叶刀等如此高质量的期刊上，大量的科目，引起了世界的关注。
People were extremely excited about these results, because here, in the absence of any drug treatment, there was a significant improvement in ADHD symptoms observed.
人们对这些结果感到非常兴奋，因为在这里，在没有任何药物治疗的情况下，观察到多动症症状有显着改善。
And then came the criticisms.
然后是批评。
Andrew Huberman:
安德鲁·休伯曼：
So, many papers were published after this, specifically dealing with reanalysis of these data.
因此，此后发表了许多论文，专门涉及对这些数据的重新分析。
And I want to be fair in saying that the data in the paper look good, but there are criticisms of the overall structural design in the study.
我想公平地说，论文中的数据看起来不错，但研究中的整体结构设计存在批评。
I don't want to go into all the details exactly, because it gets really nuanced about some of the statistics in the way that one examines these types of data.
我不想详细讨论所有细节，因为在检查这些类型的数据时，某些统计数据会变得非常微妙。
But there was skepticism.
但也有人持怀疑态度。
And in science, skepticism is healthy, especially when making decisions about whether or not to treat or feed children one food or another or give them one drug or another.
在科学上，怀疑是健康的，尤其是在决定是否给儿童治疗或喂养一种或另一种食物或给他们一种或另一种药物时。
Now I want to return to the story of my friend who is a pediatric neurologist and treats ADHD and has a child who is on the precipice of perhaps starting to take drugs for the treatment of ADHD.
现在我想回到我朋友的故事，他是一名儿科神经科医生，治疗多动症，并且有一个孩子正处于可能开始服用治疗多动症药物的边缘。
Andrew Huberman:
安德鲁·休伯曼：
I asked the simple question, "Do you see an effect of diet?" Meaning when parents control the diet of their children, does it make a positive or negative or no difference in terms of the way that the kids respond to ADHD drugs like Ritalin and Adderall or whether or not it can help them avoid treating with those drugs entirely?
我问了一个简单的问题：“你看到饮食的影响吗？”这意味着当父母控制孩子的饮食时，这对孩子对利他林和阿得拉等多动症药物的反应方式是否有积极或消极或没有影响，或者是否可以帮助他们完全避免使用这些药物治疗？
And her response was very straightforward.
而她的回答也非常直接。
She said, "Elimination of simple sugars has a dramatic and positive effect." She's observed that over and over and over again in many dozens if not hundreds of patients.
她说：“消除单糖具有显着且积极的效果。”她在数十名甚至数百名患者身上一遍又一遍地观察到这一点。
Okay?
好的？
Now that's not a peer-reviewed study, that's a statement that I'm conveying to you anecdotally, but it's a highly, highly informed one.
这不是一项经过同行评审的研究，而是我以轶事方式向您传达的一项声明，但它是一项内容非常丰富的研究。
I said, "What about these elimination diets?" She said, and I found other sources to support this, that these oligoantigenic diets are controversial.
我说：“这些消除饮食怎么样？”她说，这些寡抗原饮食是有争议的，我找到了其他来源来支持这一点。
There are many people who really believe in identifying all the things that you're allergic to and making sure that you and, especially, your kids avoid those foods.
有很多人确实相信找出您过敏的所有食物，并确保您，尤其是您的孩子避免这些食物。
Andrew Huberman:
安德鲁·休伯曼：
However, there's another camp that's starting to emerge in the peer-reviewed scientific literature showing that when kids are not exposed to certain foods, in particular nuts and things of that sort, they develop allergies to those foods and then when exposed to them later, they cause real problems.
然而，同行评审的科学文献中开始出现另一个阵营，表明当孩子们没有接触某些食物，特别是坚果和类似的东西时，他们会对这些食物产生过敏，然后再接触这些食物时，就会造成真正的问题。
So there's a whole galaxy of discussion and controversy, and outright fighting, about allergies and kids, and whether or not the oligoantigenic diet is the appropriate one.
因此，关于过敏和儿童，以及寡抗原饮食是否合适，存在着一系列的讨论和争议，以及彻底的争论。
However, out of the four neurologists and psychiatrists that I spoke to about ADHD in preparation for this, every single one said children with ADHD, as much as possible, should be encouraged to avoid high sugar and simple sugar foods of most kinds.
然而，在我为此做准备时采访的四位神经科医生和精神病学家中，每个人都表示，应鼓励患有多动症的儿童尽可能避免大多数种类的高糖和单糖食物。
And if they can find particular foods that exacerbate their symptoms, obviously eliminating those foods is beneficial, and the foods that exacerbate their symptoms change over time.
如果他们能找到加剧症状的特定食物，显然消除这些食物是有益的，而且加剧症状的食物会随着时间的推移而改变。
So I don't like giving a complicated answer, but I also don't like giving an incomplete answer.
所以我不喜欢给出复杂的答案，但我也不喜欢给出不完整的答案。
Andrew Huberman:
安德鲁·休伯曼：
What this tells me is that children, and especially young children, who have ADHD should probably not eat much sugar, in particular simple sugars.
这告诉我，患有多动症的儿童，尤其是幼儿，可能不应该吃太多糖，尤其是单糖。
In addition to that, exploring whether or not they have existing allergies to foods they already consume might be a good idea.
除此之外，探索他们是否对已经食用的食物过敏可能是个好主意。
At least that's what this paper, the Pelsser et al.
至少 Pelsser 等人的这篇论文就是这样的。
Lancet paper, seems to speak to.
柳叶刀纸，似乎在说话。
And I should mention that that paper was published in 2011.
我应该提一下，那篇论文发表于 2011 年。
Since then, there have been many dozens of studies exploring the same thing as well as meta-analysis of all those data.
从那时起，已有数十项研究探索同一事物并对所有这些数据进行荟萃分析。
And it does appear that diet can have a highly significant role in eliminating or at least reducing the symptoms of ADHD, so much so that some of the children are able to not take medication at all or eventually wean themselves off medication as young adults and as adults.
饮食似乎确实可以在消除或至少减轻多动症的症状方面发挥非常重要的作用，以至于一些孩子能够完全不服药，或者最终在年轻时和成年后戒掉药物。
One interesting question is whether or not adults should modify their diet in order to increase their levels of focus if they're already having normal levels of focus but would like more, or would like to reduce existing adult ADHD.
一个有趣的问题是，如果成年人已经具有正常的注意力水平但想要更多，或者想要减少现有的成人多动症，是否应该改变他们的饮食以提高注意力水平。
Andrew Huberman:
安德鲁·休伯曼：
That's an interesting and even more controversial topic.
这是一个有趣且更具争议性的话题。
It brings us right into the realm of what are called omega-3 fatty acids.
它把我们带入了 omega-3 脂肪酸的领域。
I've talked many times on this podcast about the known benefits of omega-3 fatty acids.
我在这个播客中多次谈论过 omega-3 脂肪酸的已知益处。
In particular, getting one-gram, 1000 milligrams, or more, even as much as 2000 milligrams each day of the so-called EPA component of omega-3 fatty acids, known to have antidepressant effects, mood elevating effects, known to have important effects protecting the cardiovascular system.
特别是，每天摄入 1 克、1000 毫克或更多，甚至多达 2000 毫克的 omega-3 脂肪酸中所谓的 EPA 成分，已知它具有抗抑郁作用、提升情绪的作用，还具有保护心血管系统的重要作用。
Andrew Huberman:
安德鲁·休伯曼：
I think it's now clear that the immune system also benefits, that omega-3 fatty acids that include a gram or more of EPAs are very beneficial.
我认为现在很清楚，免疫系统也会受益，含有 1 克或更多 EPA 的 omega-3 脂肪酸非常有益。
Typically, that's done through fish oil.
通常，这是通过鱼油完成的。
Liquid fish oil is going to be the most cost-efficient.
液体鱼油将是最具成本效益的。
But there are capsule forms, for those of you that don't like fish oil, you can ingest this through other means.
但也有胶囊形式，对于那些不喜欢鱼油的人来说，可以通过其他方式摄入。
You can get it from certain algaes, or krill, et cetera.
您可以从某些藻类或磷虾等中获取它。
You have to make it compatible with your particular diet, whether or not you're vegan or vegetarian or omnivore, et cetera.
你必须让它与你的特定饮食相适应，无论你是素食主义者、素食主义者还是杂食动物等等。
Omega-3s have been shown to have all these positive health benefits.
Omega-3 已被证明具有所有这些积极的健康益处。
Do they have positive effects on focus and attention?
它们对注意力有积极影响吗？
And the answer is you can find studies that support that statement, and the effects are significant, but the effects are modest.
答案是你可以找到支持这一说法的研究，而且效果显着，但效果不大。
You can also find studies that show no effect.
您还可以找到显示没有效果的研究。
However, much like with omega-3s and antidepressants, whereby ingestion of omega-3 fatty acids of a gram or more of EPA per day allows people with major depression to get away with taking lower doses of antidepressant medication.
然而，就像 omega-3 和抗抑郁药一样，每天摄入 1 克或更多 EPA 的 omega-3 脂肪酸可以让重度抑郁症患者无需服用较低剂量的抗抑郁药物。
It does seem that ingestion of omega-3 fatty acids in, adults, that include EPAs of a thousand milligrams or more can allow adults with ADHD or mild attention deficit issues to function well on lower doses of medication, and in rare cases to eliminate medication entirely.
成人摄入 omega-3 脂肪酸（包括 1000 毫克或更多的 EPA）似乎确实可以使患有注意力缺陷多动症或轻度注意力缺陷问题的成年人在服用较低剂量的药物时表现良好，在极少数情况下甚至可以完全消除药物治疗。
Andrew Huberman:
安德鲁·休伯曼：
So what this says is, once again, that the omega-3 fatty acids are beneficial.
这再次表明 omega-3 脂肪酸是有益的。
Will they cure or eliminate ADHD?
他们会治愈或消除多动症吗？
I think it's safe to say no. They are playing a supportive, or what we call a modulatory, role.
我认为可以安全地说“不”。他们扮演着支持性的角色，或者我们所说的调节性的角色。
Just like good sleep plays a supportive and modulatory role for essentially everything.
就像良好的睡眠对一切事物都起着支持和调节作用一样。
Your immune system, your ability to think, your ability to regulate your emotion; it's modulating that process.
你的免疫系统、你的思考能力、你调节情绪的能力；它正在调节这个过程。
This component of modulation is extremely important to highlight, and I think I want to spend a moment on it because this is especially important in the context of ADHD and all the information that's out there.
调制的这个组成部分非常重要，需要强调，我想我想花点时间在它上面，因为这在 ADHD 和所有现有信息的背景下尤其重要。
There are biological processes that are mediated by particular compounds, like dopamine.
有些生物过程是由特定化合物介导的，例如多巴胺。
So for instance, the ability to feel motivated, to attend, to focus is mediated by the circuits in the brain that release dopamine.
例如，感到有动力、专注、专注的能力是由大脑中释放多巴胺的回路介导的。
However, attention is also modulated by how rested you are.
然而，注意力也会受到休息程度的影响。
Andrew Huberman:
安德鲁·休伯曼：
If you want to eliminate your ability to think well at all, just stay up for two nights and don't sleep at all, right?
如果你想完全消除你的思考能力，就熬两个晚上，根本不睡觉，对吗？
If you do that, you will have modulated the circuits in your brain that respond to various things, and you will be highly distractible.
如果你这样做，你就会调节大脑中对各种事物做出反应的电路，并且你会很容易分心。
You will be highly emotional.
你会非常情绪化。
You will feel like garbage.
你会觉得自己像个垃圾。
But that doesn't mean that sleep mediates focus and attention.
但这并不意味着睡眠可以调节注意力。
It modulates it indirectly.
它间接地调节它。
Likewise, I think these omega-3 fatty acids, in particular the EPAs, which are so beneficial for mood and apparently also for attention, they don't directly mediate attention and mood.
同样，我认为这些 omega-3 脂肪酸，尤其是 EPA，对情绪非常有益，显然也对注意力有益，但它们并不直接调节注意力和情绪。
What they do is they modulate those circuits, they make dopamine more available.
他们所做的就是调节这些回路，让多巴胺更容易被利用。
They make whatever dopamine is available more likely to bind to the various receptors that are present on neurons and so forth.
它们使任何可用的多巴胺更有可能与神经元等上存在的各种受体结合。
Andrew Huberman:
安德鲁·休伯曼：
And I think this is very important because, likewise, diet and any discussion about nutrition has to include this framework of is the diet — the elimination diet, or whether or not it's some other diet or esoteric diet, ketogenic diet — is it modulating or mediating a process?
我认为这非常重要，因为同样，饮食和任何有关营养的讨论都必须包括饮食的框架 - 消除饮食，或者是否是其他饮食或深奥的饮食，生酮饮食 - 它是否调节或介导一个过程？
And most likely in the context of ADHD, it's modulating that process.
最有可能的是在多动症的背景下，它正在调节这个过程。
So if the ADHD is mild or if it's caught early enough, or if it's in conjunction with pharmacology with a prescription treatment, well then it might help guide the child or adult to a better place of being able to focus.
因此，如果注意力缺陷多动症很轻微，或者发现得足够早，或者与药理学和处方治疗相结合，那么它可能有助于引导儿童或成人更好地集中注意力。
But it's not going to be the switch that flips everything.
但这不会成为翻转一切的开关。
Now, that does not mean that consuming the wrong foods, sugary foods or foods that you happen to be allergic to is a good idea.
现在，这并不意味着食用错误的食物、含糖食物或您碰巧过敏的食物是一个好主意。
It will still be detrimental.
这仍然会是有害的。
So I hope that conceptual framework helps, because if you go online, if you're somebody with ADHD or not, you are going to be bombarded with the ADHD diet.
所以我希望这个概念框架能有所帮助，因为如果你上网，无论你是否患有多动症，你都会受到多动症饮食的轰炸。
The oligoantigenic diet.
寡抗原饮食。
The "eliminate this supplement, that EPA," and I think it's very important to understand whether or not you're talking about something mediating a process or modulating a process.
“消除这种补充剂，即 EPA”，我认为了解您是否在谈论某种介导过程或调节过程的东西非常重要。
Andrew Huberman:
安德鲁·休伯曼：
Now, drugs like Ritalin, drugs like Adderall, they are tapping into the circuitries and the neurochemistries that mediate attention and focus.
现在，像利他林这样的药物，像阿得拉这样的药物，它们正在利用调节注意力和注意力的电路和神经化学物质。
They are not the only alternatives, or the only choices rather, for treatment of these circuits and enhancement of the circuits for focus.
它们不是治疗这些回路和增强聚焦回路的唯一替代方案，或者说唯一的选择。
I'm going to talk about other alternatives and some behavioral alternatives that are not very well-known, but are very, very effective, in a few minutes.
我将在几分钟内讨论其他替代方案和一些不太为人所知但非常非常有效的行为替代方案。
But I really want to make this clear distinction between modulation and mediation because it's vital for anyone that's trying to modulate or mediate anything within their own brain.
但我真的想在调节和调解之间做出明确的区分，因为这对于任何试图调节或调解自己大脑内任何事物的人来说都是至关重要的。
If any of you are interested in this oligoantigenic diet as it relates to ADHD, and you want to explore a more recent study besides that classic 2011 Lancet study that's rather controversial, there's a paper that was published in Frontiers in Psychiatry just last year, 2020.
如果你们中有人对这种与 ADHD 相关的寡抗原饮食感兴趣，并且除了 2011 年《柳叶刀》颇具争议的经典研究之外，您还想探索一项更新的研究，那么去年（2020 年）《精神病学前沿》上发表了一篇论文。
The title of the paper is "Oligoantigenic diet improves children's ADHD rating scale scores reliably in added video-rating." The added video-rating is just that they're using an additional measure of focus and attention.
这篇论文的标题是“寡抗原饮食在附加视频评分中可靠地提高了儿童多动症评分量表得分”。增加的视频评级只是他们使用了额外的焦点和注意力衡量标准。
Again, that's Frontiers in Psychiatry, 2020.
再说一遍，这是 2020 年精神病学前沿。
I'll put a link to it in the caption, and that's a more recent study for you to peruse.
我将在标题中放置一个链接，这是一项更新的研究供您仔细阅读。
Andrew Huberman:
安德鲁·休伯曼：
So we've talked about the neural circuits of focus and the chemistry of focus, but we haven't talked yet about what would make us better at focusing and what focusing better really is.
我们已经讨论了聚焦的神经回路和聚焦的化学原理，但我们还没有讨论什么能让我们更好地聚焦以及更好地聚焦到底是什么。
So let's take a step back and think about how we focus and how to get better at focus.
因此，让我们退一步思考一下我们如何集中注意力以及如何更好地集中注意力。
And I'm going to share with you a tool for which there are terrific research data that will allow you in a single session to enhance your ability to focus, in theory, forever.
我将与您分享一个工具，该工具有大量的研究数据，可以让您在一次会议中增强您理论上永远专注的能力。
What I'm about to read you is from an excellent book that I recommend if any of you are interested in neuroscience and things like meditation and default mode networks and things of that sort.
我要给你们读的内容来自一本优秀的书，如果你们中有人对神经科学以及冥想、默认模式网络等感兴趣的话，我会推荐这本书。
The book is called "Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body." And no, I'm not going to try and convince you to meditate.
这本书的名字是《改变的特质：科学揭示冥想如何改变你的思想、大脑和身体》。不，我不会试图说服你冥想。
Andrew Huberman:
安德鲁·休伯曼：
I'm going to share with you a small passage in the book that relates some research data related to focus that are very important.
我将与您分享书中的一小段内容，其中涉及一些与焦点相关的非常重要的研究数据。
If you want to meditate, that's your choice.
如果你想冥想，那是你的选择。
That's a separate matter.
那是另一回事了。
This is a book by Daniel Goleman and Richard Davidson, and I should just mention that Goleman is a well-known author.
这是丹尼尔·戈尔曼和理查德·戴维森的书，我只想提一下戈尔曼是一位著名的作家。
He's written books on emotional intelligence and so forth.
他写过有关情商等方面的书籍。
Richard Davidson is also a PhD.
理查德·戴维森也是一名博士学位。
He's a professor of psychology and psychiatry, and that he's at University of Wisconsin-Madison.
他是威斯康星大学麦迪逊分校的心理学和精神病学教授。
He's done terrific work on brain states and modulation of brain states and so forth.
他在大脑状态和大脑状态调节等方面做了出色的工作。
Andrew Huberman:
安德鲁·休伯曼：
...
...
and modulation of brain states and so forth.
以及大脑状态的调节等等。
What we're about to talk about is when attention works and when attention falters, and what we are specifically going to talk about are what are called attentional blinks.
我们要讨论的是注意力何时发挥作用以及何时注意力减弱，而我们特别要讨论的是所谓的注意力瞬脱。
Not actual eye blinks, we're going to talk about that in a few minutes, but we're going to talk about attentional blinks.
不是真正的眨眼，我们将在几分钟内讨论这个问题，但我们将讨论注意力眨眼。
I'm paraphrasing here, because Goleman and Davidson wrote about this so beautifully, I'd rather paraphrase from them than try and just make up a new way to say it that is less interesting or less good, but I want to credit them.
我在这里转述，因为戈尔曼和戴维森对此写得非常漂亮，我宁愿转述他们的观点，也不愿尝试创造一种不太有趣或不太好的新方式来表达它，但我想相信他们。
Attentional blinks are really easy to understand if you think about a Where's Waldo task.
如果您考虑“沃尔多在哪里”任务，那么注意眨眼就很容易理解。
You know this task, Where's Waldo, where there are a bunch of people and objects and things in a picture, and somewhere in there is Waldo with the striped hat and the glasses, and kind of a skinny dude, and you have to find Waldo.
你知道这个任务，《沃尔多在哪里》，图片中有一堆人和物体和事物，其中某个地方有戴着条纹帽子和眼镜的沃尔多，他是一个骨瘦如柴的家伙，你必须找到沃尔多。
Andrew Huberman:
安德鲁·休伯曼：
And so it's a visual search, and it's visual search for an object that has distinct features but is embedded in this ocean of other things that could easily be confused as Waldo.
所以这是一种视觉搜索，它是对一个具有独特特征但嵌入在其他事物海洋中的物体的视觉搜索，这些物体很容易被误认为是沃尔多。
So you tend to look, look, look, look, look, look, look, look, look, and then you find Waldo.
所以你倾向于看，看，看，看，看，看，看，看，看，然后你找到了威利。
Kids can do this, they enjoy doing this.
孩子们可以这样做，他们喜欢这样做。
Adults may or may not enjoy it but they can do it too.
成年人可能喜欢也可能不喜欢它，但他们也可以这样做。
They find Waldo.
他们找到了沃尔多。
When you find Waldo, or when you search for a target in some other visual search task, at that moment your nervous system celebrates a little bit, and it celebrates through the release of neurochemicals that make you feel good.
当你找到 Waldo 时，或者当你在其他视觉搜索任务中寻找目标时，此时你的神经系统会稍微庆祝一下，它会通过释放让你感觉良好的神经化学物质来庆祝。
You found it, and you pause.
你找到了它，然后你停了下来。
Now the pause is interesting, because when you pause, what we know from many experiments is that in that moment of pause and mild celebration, however mild, you are not able to see another Waldo sitting right next to it.
现在暂停很有趣，因为当你暂停时，我们从许多实验中知道，在暂停和温和庆祝的那一刻，无论多么温和，你都看不到另一个沃尔多坐在旁边。
Andrew Huberman:
安德鲁·休伯曼：
So what this means is in attending to something, in searching and in identifying a visual target, your attention blinked.
所以这意味着在关注某件事、搜索和识别视觉目标时，你的注意力会眨眼。
It shut off for a second.
它关闭了一秒钟。
And there's a more formal and more laboratory-type way that we look at this.
我们有一种更正式、更实验室式的方式来看待这个问题。
The more typical way to do this is to give someone a string of letters or a string of numbers, and beforehand you tell them, "Be on the lookout for the letters R and Z.
更典型的方法是给某人一串字母或一串数字，然后事先告诉他们，“留意字母 R 和 Z。
Okay?
好吧？
You're just going to watch this string of numbers go by, and there will be a letter R in there, and there will be a letter Z in there, and try and spot them both." And what you find is when you present that string of numbers, and then they see the R, they see the R, they register it consciously, and they tend to miss the Z, just like in the Waldo-type example.
你只要观察这串数字的经过，就会发现其中有一个字母 R，还有一个字母 Z，然后尝试找出它们。”你会发现，当你呈现那串数字，然后他们看到 R，他们看到 R，他们有意识地记录下来，他们往往会错过 Z，就像 Waldo 类型的例子一样。
Andrew Huberman:
安德鲁·休伯曼：
Now, of course the numbers are going by pretty quickly, but they can spot the R.
当然，现在数字过得很快，但他们可以发现 R。
They could also spot the Z if you told them beforehand, "Just spot the Z." And the numbers are moving through at the same rate in both conditions, so what that means is that in every case, you are capable of seeing the R or the Z.
如果您事先告诉他们“只要找到 Z”，他们也可以找到 Z。在这两种情况下，数字以相同的速率移动，因此这意味着在每种情况下，您都能够看到 R 或 Z。
It's when you try and see both that seeing the first one prevents you from seeing the second one.
当你试图同时看到两者时，看到第一个就会阻止你看到第二个。
It's what we call an attentional blink.
这就是我们所说的注意力眨眼。
We do this all the time, and people with ADHD tend to have many more attentional blinks than people that don't, and this is true for children and for adults.
我们一直这样做，患有注意力缺陷多动症的人往往比没有注意力缺陷的人有更多的注意力眨眼，对于儿童和成人来说都是如此。
This is an important point, so important that I want to emphasize it twice in case you attentionally blinked.
这是很重要的一点，非常重要，我想强调两次，以免你注意眨眼。
If you see something that you're looking for or you're very interested in something, you are definitely missing other information, in part because you're overfocusing on something.
如果您看到了您正在寻找的东西或者您对某件事非常感兴趣，那么您肯定会错过其他信息，部分原因是您过度关注某件事。
Andrew Huberman:
安德鲁·休伯曼：
And this leads to a very interesting hypothesis about what might go wrong in ADHD, where we've always thought that they cannot focus, and yet we know they can focus on things they care very much about.
这导致了一个非常有趣的假设，关于多动症可能会出现什么问题，我们一直认为他们无法集中注意力，但我们知道他们可以专注于他们非常关心的事情。
Well maybe, just maybe, they are experiencing more attentional blinks than people who do not have ADHD, and indeed there are data now to support the possibility that that's actually what's happening.
好吧，也许，只是也许，他们比没有多动症的人经历了更多的注意力眨眼，而且现在确实有数据支持这种可能性，这实际上正在发生。
And that should be exciting to anyone that has ADHD.
对于患有多动症的人来说，这应该是令人兴奋的。
It should also be exciting to anyone that cares about increasing their focus and their ability to attend.
对于任何关心提高注意力和参与能力的人来说，这也应该是令人兴奋的。
Andrew Huberman:
安德鲁·休伯曼：
What this is saying is that these circuits that underlie focus and our ability to attend and our ability to eliminate distraction, they aren't just failing to focus.
这就是说，这些回路是我们集中注意力、注意力集中的能力和消除干扰能力的基础，但它们不仅仅是无法集中注意力。
That's just a semantic way of describing the outcome.
这只是描述结果的语义方式。
They are overfocusing on certain things and thereby missing other things, and so our distractibility, or the distractibility of somebody with ADHD, could exist because they are overfocusing on certain elements, and they are there therefore missing other elements that they should be attending to.
他们过度关注某些事情，从而错过了其他事情，因此我们的注意力分散，或者患有注意力缺陷多动症的人的注意力分散，可能会因为他们过度关注某些元素而存在，因此他们错过了他们应该关注的其他元素。
Andrew Huberman:
安德鲁·休伯曼：
So what they really need is this property that we call open monitoring.
所以他们真正需要的是我们称之为开放监控的属性。
Now, open monitoring is something that's described in the book that I just referred to, and that typically is associated with people who have done a lot of meditation, so-called Vipassana meditation, or have spent a lot of time learning how to do what's called open gaze visual analysis and open gaze thinking, but there's a simpler version of this that allows us to bypass all that.
现在，开放式监控是我刚才提到的书中描述的东西，通常与进行了大量冥想（所谓的内观冥想）的人相关，或者花了很多时间学习如何进行所谓的开放式凝视视觉分析和开放式凝视思考，但有一个更简单的版本可以让我们绕过所有这些。
First of all, your visual system has two modes of processing.
首先，你的视觉系统有两种处理模式。
It can be highly focused, a soda-straw view, so looking for the R in this string of numbers in the example that I just gave.
它可以是高度集中的、苏打吸管视图，因此在我刚刚给出的示例中的这串数字中寻找 R。
Or if you're very excited about something, you're in that soda-straw view of the world, and you're missing other things.
或者，如果你对某件事非常兴奋，那么你就会陷入苏打稻草般的世界观，而错过其他事情。
Okay?
好的？
That's high levels of attention.
这是高度关注。
However, there's also a property of your visual system that allows you to dilate your gaze, to be in so-called panoramic vision.
然而，视觉系统还有一个特性可以让您扩大视线，形成所谓的全景视觉。
Andrew Huberman:
安德鲁·休伯曼：
Panoramic vision is something you can do right now, no matter where you are, and I can do it right now.
全景视觉是你现在就可以做到的事情，无论你在哪里，我现在就能做到。
You won't know that I'm doing it, but even though I'm still looking directly at you, I'm consciously dilating my gaze so that I can see the ceiling, the floor, and the walls all around me.
你不会知道我在这么做，但尽管我仍然直视着你，但我有意识地扩大了我的视线，这样我就可以看到我周围的天花板、地板和墙壁。
That panoramic vision is actually mediated by a separate stream or set of neural circuits going from the eye into the brain, and it's a stream or set of circuits that isn't just wide angle view.
全景视觉实际上是由从眼睛到大脑的独立流或一组神经回路介导的，而且它不仅仅是广角视图。
It also is better at processing things in time.
它也更擅长及时处理事情。
Its frame rate is higher.
其帧率较高。
So you've seen slow motion video and you've seen standard video.
所以您已经看过慢动作视频，也看过标准视频。
Slow motion video gives you that slow motion look because it's a higher frame rate, you're thin slicing time.
慢动作视频给你带来慢动作的感觉，因为它的帧速率更高，你的切片时间很短。
Okay?
好的？
You can use panoramic vision to access the state that we call open monitoring.
你可以使用全景视觉来进入我们所说的开放式监控的状态。
Andrew Huberman:
安德鲁·休伯曼：
When people do that, they are able to attend to and recognize multiple targets within this string of numbers.
当人们这样做时，他们能够关注并识别这串数字中的多个目标。
They can see the R, and they can see the Z and they can see additional things.
他们可以看到 R，他们可以看到 Z，他们可以看到其他东西。
So this is something that can be trained up and people can practice, whether or not they have ADHD or not.
所以这是可以训练的东西，人们可以练习，无论他们是否患有多动症。
What it involves is learning how to dilate your gaze consciously.
它涉及的是学习如何有意识地扩大你的目光。
That's actually quite easy for most people.
这对大多数人来说实际上很容易。
Whether or not you wear corrective lenses or contacts or not, you can consciously go into open gaze and then you can contract your field of view as well.
无论您是否佩戴矫正镜片或隐形眼镜，您都可以有意识地睁开眼睛，然后您也可以缩小视野。
Andrew Huberman:
安德鲁·休伯曼：
There have also been studies done where people were taught to think in a particular way for a very short period of time, and that forever changed their ability to limit or reduce the number of these attentional blanks.
还进行了一些研究，教人们在很短的时间内以特定的方式思考，这永远改变了他们限制或减少这些注意力空白数量的能力。
There are now published accounts in the literature of a simple practice done for about 15 minutes where subjects were asked to just sit quietly, eyes closed, and do what is sort of akin to meditation, but to not direct their mind into any particular state or place, but simply to think about their breathing and to focus on their so-called interoception, focus on how their body feels, if their mind drifted to bring it back — okay, so it's basically meditation — for about 15 minutes.
现在文献中公开了一种持续约 15 分钟的简单练习，受试者被要求安静地坐着，闭上眼睛，做一些类似于冥想的事情，但不要将他们的思想引导到任何特定的状态或地方，而是简单地思考他们的呼吸并专注于他们所谓的内感受，专注于他们的身体感觉，如果他们的思想漂移将其带回来 - 好吧，所以这基本上是冥想 - 大约 15 分钟。
Andrew Huberman:
安德鲁·休伯曼：
That might not seem like a significant or unusual practice, or that it would have any impact at all, but remarkably, just doing that once for 17 minutes significantly reduced the number of attentional blinks that people would carry out, in other words their focus got better, in a near permanent way without any additional training.
这似乎不是一个重要或不寻常的做法，或者根本不会产生任何影响，但值得注意的是，仅仅这样做一次持续 17 分钟就显着减少了人们进行注意力眨眼的次数，换句话说，他们的注意力变得更好，几乎是永久性的，无需任何额外的训练。
There's something about that practice of reducing the amount of visual information coming in and learning to pay attention to one's internal state, what we call interoception, that allowed them an awareness such that when they needed to look for visual targets, when they needed to focus on multiple things in sequence, they didn't experience the same number of attentional blinks.
减少进入的视觉信息量并学习关注一个人的内部状态（我们称之为内感受）的做法可以让他们有一种意识，这样当他们需要寻找视觉目标时，当他们需要按顺序关注多个事物时，他们不会经历相同次数的注意眨眼。
And I should mention, not incidentally, as people age and their working memory gets worse and their ability to focus gets worse, the number of attentional blinks that they carry out goes up.
我应该提到，并非偶然，随着人们年龄的增长，他们的工作记忆变得更差，他们的注意力集中能力也变得更差，他们进行注意力眨眼的次数就会增加。
Andrew Huberman:
安德鲁·休伯曼：
And there are now studies exploring whether or not this simple meditation-like practice of 15 to 20 minutes or so, of sitting and just quietly resting and paying attention to one's breathing and internal state, can also offset some of that age-related, what is called, cognitive decline.
现在有研究探索这种简单的类似冥想的练习（15到20分钟左右），即坐下来安静地休息并注意自己的呼吸和内部状态，是否也可以抵消一些与年龄相关的所谓认知能力下降。
So what these data tell mean is that regardless of whether or not you're a child or you're an adult, whether or not you have ADHD or not, whether or not you're experiencing age-related cognitive decline or you would simply like to avoid age-related cognitive decline, a simple practice of taking 17 minutes, sitting and paying attention to your internal state, just interocepting, registering your breathing, registering the contact of your skin with whatever surface you're on, can forever rewire your brain to be able to attend better, and possibly even offset some of that age-related attentional drift.
因此，这些数据表明，无论你是儿童还是成年人，无论你是否患有注意力缺陷多动症，无论你是否正在经历与年龄相关的认知能力下降，或者你只是想避免与年龄相关的认知能力下降，一个简单的练习，花 17 分钟，坐下来关注你的内部状态，只是内感受，记录你的呼吸，记录你的皮肤与你所在的任何表面的接触，可以永远重新连接你的大脑，以便能够参与其中更好，甚至可能抵消一些与年龄相关的注意力漂移。
Andrew Huberman:
安德鲁·休伯曼：
Now, I don't expect anyone to start meditating regularly.
现在，我不期望任何人开始定期冥想。
I don't expect anyone to do anything they don't want to do, but I think most of us could handle one meditation session of 17 minutes or so.
我不期望任何人做任何他们不想做的事情，但我认为我们大多数人都可以进行一次 17 分钟左右的冥想课程。
And so if ever there was a tool that stood to rewire our attentional circuitry in a powerful way, this seems to be it.
因此，如果有一种工具能够以强大的方式重新连接我们的注意力回路，那么它似乎就是它了。
And in addition, the ability to engage in panoramic vision, to dilate our gaze, this so-called open monitoring that allows the brain to function in a way that it can detect more information faster, that's a powerful tool as well, and the beauty of that tool is that it works the first time, and it works every time.
此外，参与全景视觉、扩大视野的能力，这种所谓的开放式监控，可以让大脑以更快地检测到更多信息的方式发挥作用，这也是一个强大的工具，而该工具的美妙之处在于它第一次起作用，并且每次都起作用。
Now, how exactly it works is a little bit unclear.
现在，它到底是如何运作的还不清楚。
Is it, for instance, orchestrating this synchrony or asynchrony between the default mode network and the task-related networks?
例如，它是在默认模式网络和任务相关网络之间协调同步还是异步吗？
We don't know.
我们不知道。
Andrew Huberman:
安德鲁·休伯曼：
Those studies have not yet been carried out.
这些研究尚未进行。
Nonetheless, the effects are significant, they are long lasting, and they appear to exist after just one session of this quiet 17-minute interoception, which to me makes it seem like a very worthwhile thing to do for everybody.
尽管如此，效果是显着的，它们是持久的，而且它们似乎在这个安静的 17 分钟内感的一个疗程后就存在了，在我看来，这对每个人来说都是一件非常值得做的事情。
So we just talked about attentional blinks, which are essentially blinks of thinking.
所以我们刚刚讨论了注意力眨眼，这本质上是思维眨眼。
It's your mind shutting off for a moment and missing information.
这是你的思维暂时关闭并错过了信息。
Now let's talk about actual blinks, the sort that you do with your eyelids.
现在我们来谈谈实际的眨眼，就像你用眼睑所做的那样。
Now this might come across as somewhat obvious, but you can do fast, what are called spontaneous blinks, and they're always coordinated between the two eyes, or you can do long blinks, like when you go to sleep at night you do one very long blink.
现在这可能看起来有些明显，但你可以快速地眨眼，即所谓的自发眨眼，并且它们总是在两只眼睛之间协调，或者你可以做长时间的眨眼，就像当你晚上睡觉时，你会做一次很长时间的眨眼。
And I'm not being facetious.
我并不是在开玩笑。
When you go to sleep at night, you are shutting your eyelids, and you are limiting the amount of information coming in, and your perception of time starts to drift as you go into sleep.
当你晚上睡觉时，你会闭上眼皮，限制传入的信息量，当你入睡时，你对时间的感知开始漂移。
Andrew Huberman:
安德鲁·休伯曼：
Your perception of time changes from very fast at one moment to very slow, meaning the frame rate at which you are analyzing information, dreaming, et cetera, is variable when you are in sleep.
您对时间的感知会从某一时刻的非常快变为非常慢，这意味着您在睡眠时分析信息、做梦等的帧速率是可变的。
Sometimes it's very fast, meaning you experience things in slow motion, sometimes it's very fast.
有时它非常快，这意味着您以慢动作体验事物，有时它非常快。
In waking too, your experience of time can sometimes be very fast, sometimes be very slow.
同样，在醒着的时候，你所经历的时间有时会非常快，有时会非常慢。
Typically, the more alert you are, the higher the frame rate, you're thin slicing your experience.
通常，您越警觉，帧速率越高，您的体验就会变得越薄。
You've probably had this happen.
你可能遇到过这种情况。
If you're ever very stressed and you're waiting for something or somebody, it seems like it takes forever, because your frame rate is higher, you're analyzing time more finely.
如果你压力很大，正在等待某事或某个人，那么这似乎要花很长时间，因为你的帧速率更高，你可以更精细地分析时间。
Conversely, if you are very relaxed or even sleepy, you wake up and you have to think about all the things you have to do, it will seem like the world is going by very, very fast and that you are moving very slow.
相反，如果你非常放松，甚至昏昏欲睡，当你醒来时，你必须思考你必须做的所有事情，看起来世界过得非常非常快，而你却进展得很慢。
Andrew Huberman:
安德鲁·休伯曼：
Time is going at the same rate, but your perception of time is what's changed.
时间以同样的速度流逝，但你对时间的感知发生了变化。
Believe it or not, your perception of time is also changed on a rapid basis, moment-to-moment basis, by how often you blink.
不管你相信与否，你对时间的感知也会随着你眨眼的频率而迅速、每时每刻地改变。
This is a well-established literature in the world of neuroscience, that unlike the literature and claims about blinking and sociopathy which have no basis, the science of blinking as it relates to time perception has some very good data to support it.
这是神经科学领域公认的文献，与没有根据的关于眨眼和反社会的文献和主张不同，眨眼与时间感知相关的科学有一些非常好的数据来支持。
I want to just emphasize one study in particular, which is quite appropriately titled, "Time dilates after spontaneous blinking." This is a paper that was published in current biology.
我想特别强调一项研究，其标题非常恰当：“自发眨眼后时间会扩张”。这是一篇发表在《当代生物学》上的论文。
The first author is Terhune, T-E-R-H-U-N-E.
第一作者是 Terhune, T-E-R-H-U-N-E。
It's a wonderful paper.
这是一篇很棒的论文。
They examine the relationship between fluctuations in timing and blinking.
他们检查时间波动和眨眼之间的关系。
And to make a long story short, what they found is that right after blinks, we reset our perception of time.
长话短说，他们发现眨眼之后，我们就会重置对时间的感知。
Okay?
好的？
Andrew Huberman:
安德鲁·休伯曼：
So blinks in that sense are a little bit like the curtain coming down on a scene between scenes in a play, or takes in a movie.
因此，从这个意义上来说，眨眼有点像戏剧或电影中场景之间的幕布落下。
You know, when they clap the clap thing, they start it, "Take!" What do they say?
你知道，当他们拍拍手的时候，他们就开始说：“拿！”他们怎么说？
"Action." And then at the end, they do the thing and they click it down and they say, "It's a take." That's one take.
“行动。”最后，他们做了这件事，然后点击它，然后说：“这是一个镜头。”这是一件事。
When you blink, it's a take.
当你眨眼的时候，就是一个镜头。
Okay?
好的？
Now what's interesting, and will immediately make sense to you as to why this is important, is that the rate of blinking is controlled by dopamine.
现在有趣的是，眨眼的频率是由多巴胺控制的，并且您会立即明白为什么这很重要。
So what this means is that dopamine is controlling attention, blinks relate to attention and focus, and therefore the dopamine and blinking system is one way that you constantly modulate and update your perception of time, and fortunately, it's also one that you can control.
所以这意味着多巴胺正在控制注意力，眨眼与注意力和焦点有关，因此多巴胺和眨眼系统是你不断调节和更新时间感知的一种方式，幸运的是，它也是你可以控制的一种方式。
So the basic takeaway of this study was that blinking controls time perception, but also that levels of dopamine can alter your sense of time, and, stay with me here, and that blinking and dopamine are inextricably linked.
因此，这项研究的基本结论是，眨眼控制时间感知，而且多巴胺水平可以改变你的时间感，并且，请听我说，眨眼和多巴胺有着千丝万缕的联系。
They are working together to control your attention.
他们共同努力控制你的注意力。
Andrew Huberman:
安德鲁·休伯曼：
When dopamine levels go up, people tend to overestimate how long something lasted.
当多巴胺水平升高时，人们往往会高估某件事持续的时间。
Why?
为什么？
Because they are processing time more finely.
因为他们对时间的处理更加精细。
It's slow motion mode.
这是慢动作模式。
When dopamine levels are lower, they tend to underestimate time intervals.
当多巴胺水平较低时，他们往往会低估时间间隔。
Let's remember back to the very beginning of the episode.
让我们回想一下本集的开头。
What's going on in people with ADHD?
患有多动症的人会发生什么？
They are not good at managing their time.
他们不善于管理自己的时间。
They tend to run late, or they're disorganized.
他们往往会迟到，或者组织混乱。
They are not just disorganized in space, meaning in the physical space around them, they're disorganized in time.
它们不仅在空间上（即在它们周围的物理空间）上杂乱无章，而且在时间上也杂乱无章。
Their dopamine is low, we know that as well.
他们的多巴胺水平较低，我们也知道这一点。
And so they are underestimating time intervals, and so it makes perfect sense that they would be late.
所以他们低估了时间间隔，所以他们迟到是完全有道理的。
It makes perfect sense that they would lose track of time or the ability to focus.
他们会忘记时间或无法集中注意力，这是完全有道理的。
Andrew Huberman:
安德鲁·休伯曼：
This is really exciting, because what it means is that children with ADHD, adults with ADHD, or people with normal levels of focus that want to improve their ability to focus, can do so through a training that involves learning how often to blink and when, and how to keep their visual focus on a given target.
这真的很令人兴奋，因为这意味着患有注意力缺陷多动症的儿童、患有注意力缺陷多动症的成年人，或者注意力水平正常但想要提高注意力的人，可以通过训练来做到这一点，其中包括学习眨眼的频率和时间，以及如何将视觉焦点保持在给定目标上。
And it turns out this study has actually been done.
事实证明这项研究确实已经完成了。
There's a study, again I'll link to this study, entitled "Improvement of attention in elementary school students through fixation focus training activity." And I won't go through all the details, but what they found was a short period of focusing on a visual target allowed these school children to greatly enhance their ability to focus on other types of information, and a significant component of the effect was due to the way that they were controlling the shutters on their eyes, their eyelids, and controlling their blinks.
有一项研究，我再次链接到这项研究，题为“通过固视焦点训练活动提高小学生的注意力”。我不会详细介绍所有细节，但他们发现，短时间内专注于视觉目标可以使这些学童极大地增强他们专注于其他类型信息的能力，而这种效果的一个重要组成部分是由于他们控制眼睛、眼睑和眨眼的方式。
Andrew Huberman:
安德鲁·休伯曼：
So what they did in this study is they had these kids focus their visual attention on some object that was relatively close, like their hand, for a minute or so, which actually takes some effort if you try and do that.
所以他们在这项研究中所做的是让这些孩子将视觉注意力集中在一些相对较近的物体上，比如他们的手，持续一分钟左右，如果你尝试这样做，这实际上需要一些努力。
They were allowed to blink.
他们被允许眨眼。
However, it's known from other work that if people can consciously override the desire to blink, at least to the point where they feel like they have to or else their eyes will dry out, that actually can increase attention even further.
然而，从其他研究中得知，如果人们能够有意识地抑制眨眼的欲望，至少达到他们觉得必须这样做的程度，否则他们的眼睛会变干，这实际上可以进一步提高注意力。
And they had conditions where they would look at a point further across the room, and even further across the room.
他们有条件可以观察房间更远的地方，甚至房间更远的地方。
Andrew Huberman:
安德鲁·休伯曼：
It only took a few minutes each day to do this, 30 seconds in one condition, or maybe a minute, and then at another station of looking a little bit further out and a little bit further out.
每天只需要几分钟就能做到这一点，在一种情况下需要 30 秒，或者可能是一分钟，然后在另一个站观察得更远一点，再更远一点。
However, there was an important feature of this study that is definitely worth mentioning, which is before they did this visual focus task or training, they did a series of physical movements with the kids so that the kids could sort of eliminate or move out some of their desire to move and would thereby enhance their ability to sit still.
不过，这项研究有一个重要的特点绝对值得一提，那就是在进行视觉聚焦任务或训练之前，他们与孩子们进行了一系列的身体运动，这样孩子们就可以消除或消除一些移动的欲望，从而增强他们静坐的能力。
Now it's long been known that kids need a recess, they need time to run around and play and roll around and do whatever it is that they do in order to be able to sit still at all.
现在人们早就知道孩子们需要休息，他们需要时间跑来跑去、玩耍、打滚，做任何他们所做的事情，以便能够安静地坐着。
Andrew Huberman:
安德鲁·休伯曼：
Adults probably need this too, frankly, but kids need it more, because the circuits in the brain that control reflexive movements, and as we say kind of rhythmic, undulating behavior and things like that, that's an active suppression, and kids have less of that circuitry built up until they hit about age 15 or 16.
坦率地说，成年人可能也需要这个，但孩子们更需要它，因为大脑中控制反射性运动的回路，正如我们所说的有节奏的、起伏的行为和类似的东西，这是一种主动抑制，而孩子们在 15 岁或 16 岁左右之前，建立的这种回路较少。
So they had the kids move around a bit and then do this focus training.
所以他们让孩子们稍微活动一下，然后进行集中训练。
That brings me to another treatment that's actively used nowadays in schools for kids with ADHD, but also is starting to be used by many kids, and by parents in order to keep their kids focusing and not going crazy in the car or not acting out in general, and that's the prevalence of these so-called fidgeter toys, or things that kids can do actively and repetitively in order to move out some of their underlying reverberatory activity in their nervous system.
这让我想到了另一种治疗方法，这种治疗方法现在在学校里为患有多动症的孩子积极使用，但也开始被许多孩子和家长使用，以让孩子集中注意力，不要在车里发疯或一般不表现出来，这就是这些所谓的烦躁玩具的流行，或者孩子们可以积极和重复地做的事情，以消除他们神经系统中一些潜在的反射活动。
Andrew Huberman:
安德鲁·休伯曼：
So what you will find is that some kids with ADHD are now given a rubber band on their desk, literally a rubber band that's attached to their desk, and they're able to pull on it, even snap it against the desk.
所以你会发现，一些患有注意力缺陷多动症的孩子现在在他们的桌子上放了一根橡皮筋，实际上是一根固定在桌子上的橡皮筋，他们可以拉动它，甚至可以将它扣在桌子上。
If I had done that when I was a kid, I think my teachers would have thrown me out of class, but I think it's great that they're allowing them to do this now, as a way of moving some of their physical energy out, or engage their physical energy rather, as opposed to trying to sit statue still all the time and attend.
如果我小时候这样做，我想我的老师会把我赶出课堂，但我认为他们现在允许他们这样做很好，作为一种转移他们的一些体力的方式，或者更确切地说是利用他们的体力，而不是试图一直坐着不动地上课。
And it turns out that does enhance these children's ability to focus mentally when they have some physical activity to attend to, and it turns out it also can work for adults.
事实证明，这确实可以增强这些孩子在进行一些体力活动时集中注意力的能力，而且它也适用于成年人。
I'll share with you a related anecdote, because it illustrates the underlying mechanism.
我将与您分享一个相关的轶事，因为它说明了基本机制。
I've had the great privilege of being able to do a number of surgeries, brain surgeries, during my career.
在我的职业生涯中，我非常荣幸能够进行多次脑部手术。
Andrew Huberman:
安德鲁·休伯曼：
So one thing you find when you do brain surgeries is that the brain's pretty small, regardless of the species that you're working on, and you're in there and you're trying to do something very specific, and the more you try and hold your hands really steady, the more they want to shake.
因此，当你进行脑部手术时，你会发现一件事是，无论你正在研究什么物种，大脑都非常小，而你在里面，你试图做一些非常具体的事情，而你越是试图保持双手真正稳定，他们就越想摇晃。
All right?
好的？
So it's not natural for any of our limbs to sit perfectly still.
因此，我们的任何四肢完全静止不动都是不自然的。
Depending on how much coffee you've had, how well-rested you are, and your sort of baseline level of autonomic arousal, some of you may find that you can hold out your hand absolutely rock solid, others will shake a little bit more.
根据你喝了多少咖啡、休息得有多好，以及你的自主神经唤醒的基线水平，有些人可能会发现你可以绝对坚如磐石地伸出你的手，而另一些人会摇晃得更多一些。
Doesn't mean you're nervous if you're shaking, doesn't mean you're calm if you're still.
如果你在发抖，并不意味着你很紧张；如果你保持静止，并不意味着你很平静。
What it relates to is the amount of what we call premotor activity, the number of commands to move that are being sent through the system, and that's what I mean by reverberatory activity.
它所涉及的是我们所说的运动前活动的数量，即通过系统发送的移动命令的数量，这就是我所说的反射活动。
Andrew Huberman:
安德鲁·休伯曼：
And it does seem that kids with ADHD and adults with ADHD have a lot of reverberatory activity in their nervous system, and so that's that constant desire to move, it's hard for them to sit still, and therefore it's hard for them to attend, to harness their attention.
患有多动症的孩子和患有多动症的成年人确实在他们的神经系统中有很多反射活动，所以这就是持续不断的运动欲望，他们很难安静地坐着，因此他们很难集中注意力，很难利用他们的注意力。
When you do a surgery and you find that your hands are shaking, what you learn from your mentors, which I did, and what works extremely well, whether or not you're doing a surgery or not, is that you simply tap your foot or you bounce your knee a little bit, which you might think would make your hand shake even more, but provided that it's subtle, what it does is it is actually shuttles some of the activity from those premotor circuits to elsewhere in the body, and then you're able to sit much more still with your hand.
当你做手术时，你发现你的手在颤抖，你从你的导师那里学到了什么，无论你是否做手术，效果都非常好，就是你只需轻拍你的脚或稍微弹动你的膝盖，你可能认为这会让你的手颤抖得更厉害，但只要它是微妙的，它的作用实际上是将一些活动从这些前运动回路转移到身体的其他地方，然后你就可以坐得更安静了手。
Andrew Huberman:
安德鲁·休伯曼：
You're able to perform the surgery with much more precision.
您能够更精确地进行手术。
You are able to write with much better handwriting.
你可以写出更好的字。
And for those of you who engage in public speaking, if you're ever too nervous, that's why pacing while you public speak helps if you're nervous.
对于那些从事公开演讲的人来说，如果您过于紧张，这就是为什么在公开演讲时调整节奏会在您紧张时有所帮助。
That's why bouncing your knee behind the podium works as well.
这就是为什么在讲台后面弹起膝盖也有效。
That's why nodding your head and gesticulating can help.
这就是为什么点头和打手势会有所帮助。
It's not a matter of "moving energy out of the body," that doesn't actually happen.
这不是“将能量移出身体”的问题，这实际上并没有发生。
What it is you're engaging those premotor circuits that are sending through commands.
你正在参与那些通过命令发送的前运动电路。
It's like trying to stuff a bunch of stuff through a funnel, and it creates this tension, so you're giving it an outlet for the neural circuitry to be able to move something so that you can keep other components of your body and your mental attention engaged and locked onto something, what we call focus.
这就像试图将一堆东西塞进漏斗，它会产生这种张力，所以你给它一个神经回路能够移动某些东西的出口，这样你就可以保持身体的其他部分和你的精神注意力集中并锁定在某些东西上，这就是我们所说的焦点。
Andrew Huberman:
安德鲁·休伯曼：
One thing related to this whole business of blinking and focus, and training yourself to focus and not blinking, et cetera, is that most all of the drugs, Ritalin, Adderall, and recreational drugs that increase dopamine, even coffee and tea and other forms of caffeine, they tend to make us blink less.
与眨眼和集中注意力以及训练自己集中注意力而不眨眼等等相关的一件事是，大多数药物，利他林，阿得拉和增加多巴胺的娱乐性药物，甚至咖啡和茶以及其他形式的咖啡因，它们往往会让我们减少眨眼。
And when we get tired, we tend to blink more.
当我们感到疲倦时，我们往往会眨眼更多。
Now, this is sort of a duh, right?
现在，这有点废话，对吧？
But being wide-eyed with excitement or fear, or with your eyes barely being able to keep them open, now it should make perfect sense that these shutters on the front of your eyes, they aren't just there for winking, and they aren't just there for cosmetic purposes.
但是，当你因兴奋或恐惧而睁大眼睛，或者你的眼睛几乎无法睁开时，现在你眼前的这些百叶窗应该完全有道理了，它们不仅仅是为了眨眼，它们不仅仅是为了美容目的。
Andrew Huberman:
安德鲁·休伯曼：
They are there to regulate the amount of information going into your nervous system, and they're there to regulate how long you are bringing information into your nervous system, and in what bins.
它们的作用是调节进入你的神经系统的信息量，它们的作用是调节你将信息带入神经系统的时间和信息的存储箱。
How widely or finely you are binning time is set by how often you blink, and how widely or specifically you are grabbing attention from the visual world is set by whether or not you're viewing things very specifically, like a crosshair or through a soda-straw view, like this, or whether or not you are in this panoramic sort of whole environment mode, this kind of fish-eye lens or wide-angle lens mode.
你的分箱时间有多宽或多细取决于你眨眼的频率，而你从视觉世界中吸引注意力的范围有多广或具体取决于你是否非常具体地观察事物，比如十字准线或通过苏打吸管视图，像这样，或者你是否处于这种全景的整个环境模式，这种鱼眼镜头或广角镜头模式。
Andrew Huberman:
安德鲁·休伯曼：
And in fairness to the pharmacology and the circuitry, while dopamine and heightened levels of alertness and excitement tend to make us blink less and attend more, there's actually a study that's looked at the other neurochemical systems and drugs and how those relate to blinking, and so this will all be obvious by the title of the paper I'm about to share with you.
公平地对待药理学和电路，虽然多巴胺和提高的警觉性和兴奋水平往往会使我们眨眼次数减少并注意更多，但实际上有一项研究着眼于其他神经化学系统和药物以及它们与眨眼的关系，因此从我即将与您分享的论文标题中可以看出这一点。
This is a paper entitled, "Decreased spontaneous eye blink rates in chronic cannabis users: Evidence for striatal cannabinoid-dopamine interactions."
这是一篇题为“慢性大麻使用者自发眨眼率降低：纹状体大麻素-多巴胺相互作用的证据”的论文。
Andrew Huberman:
安德鲁·休伯曼：
Okay, I'm not going to go into all the details here, but one thing that is somewhat surprising is that many people with ADHD use or abuse cannabis.
好吧，我不打算在这里详细介绍所有细节，但令人惊讶的一件事是许多患有多动症的人使用或滥用大麻。
You might think, "Well, why would they do that, because I thought that an increase in dopamine is actually what's going to lead to heightened levels of attention, and that's what these people and children crave." Well, it turns out that cannabis also increases dopamine transmission in the brain, but because of the other chemicals it increases, namely serotonin and some components of the cannabinoid and opioid system, it creates that kind of alert but mellow feel.
你可能会想，“好吧，他们为什么要这么做，因为我认为多巴胺的增加实际上会导致注意力水平的提高，而这正是这些人和孩子所渴望的。”事实证明，大麻也会增加大脑中的多巴胺传输，但由于它增加了其他化学物质，即血清素以及大麻素和阿片类药物系统的一些成分，它会产生那种警觉但柔和的感觉。
Andrew Huberman:
安德鲁·休伯曼：
And again, here I'm not a proponent of this.
再说一次，我不是这个的支持者。
I personally am not a THC or cannabis user, it's just not my thing.
我个人不是四氢大麻酚或大麻使用者，这不是我的事。
And obviously, it's illegal some places, and so you have to determine that for yourself.
显然，有些地方这是非法的，所以你必须自己确定。
It does have medical purposes and in some places it is legal.
它确实具有医疗目的，并且在某些地方是合法的。
But THC increases dopamine and increases neurochemicals that can also create a state of calm, so it's that sort of middle ground.
但四氢大麻酚会增加多巴胺并增加神经化学物质，这也可以创造一种平静的状态，所以这是一种中间立场。
And this paper has a beautiful demonstration whereby not just while people are using cannabis, but depending on how long they've been using cannabis across their lifespan, the rates of eye blinking change.
这篇论文有一个精彩的演示，不仅在人们使用大麻时，而且根据他们在一生中使用大麻的时间长短，眨眼的频率也会发生变化。
So if you look at the number of years that people have been using cannabis on a regular basis, either weekly or up to daily, what you find is that, for people that have not been using cannabis at all or have only been using it for about two years, their rates of eye blinks are much higher than people who have been using it chronically for 10 years.
因此，如果你看看人们定期（每周或每天）使用大麻的年数，你会发现，对于根本没有使用大麻或只使用大麻约两年的人来说，他们眨眼的频率比长期使用大麻 10 年的人要高得多。
Andrew Huberman:
安德鲁·休伯曼：
In other words, people who have been using cannabis for 10 years don't blink very often at all.
换句话说，吸食大麻十年的人根本不经常眨眼。
Now, cannabis has well-known effects in depleting memory, but it does seem to engage the focus and blinking system in a way that increases focus.
现在，大麻在消耗记忆方面具有众所周知的作用，但它似乎确实以增加注意力的方式参与焦点和眨眼系统。
So basically what I'm saying is marijuana seems to increase people's focus, but then they can't remember what they were focusing on.
所以基本上我想说的是，大麻似乎可以增加人们的注意力，但随后他们就不记得自己在关注什么。
Something I'd like to discuss just briefly is the so-called interoceptive awareness that's present in people with ADHD, both children and adults.
我想简单讨论的是多动症患者（无论是儿童还是成人）中存在的所谓内感受意识。
Interoceptive awareness is one's sense of one's own internal state, heartbeat, breathing, contact of skin with a given surface, et cetera.
内感受意识是一个人对自己的内部状态、心跳、呼吸、皮肤与给定表面的接触等的感觉。
For a long time there was this hypothesis, this idea that people with ADHD were just not in touch with how they felt, that somehow they weren't registering all the stuff that was going on inside them, changes in heart rate and so forth, and so they were behaving in a way that was dysregulated, or appeared dysregulated, and that if they could just learn to attend to their internal state better, that somehow they would function better in the world.
很长一段时间以来，人们一直有这样的假设，认为患有多动症的人只是不了解自己的感受，不知何故，他们没有记录体内发生的所有事情，心率的变化等等，因此他们的行为方式失调，或者看起来失调，如果他们能够学会更好地关注自己的内部状态，那么他们在世界上的表现就会更好。
Andrew Huberman:
安德鲁·休伯曼：
Now, before we described a process, literally a 17-minute interceptive exercise, that does seem to lead to improvements in one's ability to focus for a longer period of time.
现在，在我们描述一个过程之前，实际上是一个 17 分钟的拦截练习，这似乎确实可以提高一个人长时间集中注意力的能力。
However, it's very unlikely that that was due to increasing interoceptive awareness per se.
然而，这不太可能是由于内感受意识本身的增强所致。
It probably wasn't because people gain a much heightened or improved ability to understand what's going on internally.
这可能并不是因为人们了解内部发生的事情的能力得到了提高或提高。
In fact, you can imagine how that might actually prevent one's ability to pay attention to things in the outside world.
事实上，你可以想象这实际上可能会妨碍一个人关注外部世界的能力。
So while there is benefit to just sitting there and being in stillness, as they say, or focusing on one's breathing and internal state for sake of then accessing information in the external world, a really nice study called, "Interoceptive awareness in attention deficit hyperactivity disorder," explored whether or not interceptive awareness was different in people with ADHD, or did not have ADHD.
因此，虽然正如他们所说，坐在那里保持静止，或者专注于自己的呼吸和内部状态，然后获取外部世界的信息是有好处的，但一项非常好的研究，名为“注意缺陷多动障碍中的内感受意识”，探讨了患有多动症或没有多动症的人的内感受意识是否不同。
Andrew Huberman:
安德鲁·休伯曼：
And the findings were essentially that there's no difference, that people with ADHD, children and adults, they are aware of what's going on inside them just as much as anyone else is.
研究结果本质上是没有区别的，患有多动症的人，无论是儿童还是成人，他们都像其他人一样了解自己内心发生的事情。
And the typical measure of interoceptive awareness is one's ability to count their own heartbeats.
内感受意识的典型衡量标准是一个人计算自己心跳的能力。
This is actually challenging for some individuals and very easy for other individuals, regardless of their attentional capacity.
这对于某些人来说实际上是具有挑战性的，而对于其他人来说却很容易，无论他们的注意力能力如何。
Some people just can really feel their heartbeat without taking their pulse.
有些人不需要量脉搏就能真正感觉到自己的心跳。
Other people cannot.
其他人不能。
And these studies are pretty straightforward to do.
这些研究做起来非常简单。
You ask people to sit there and to count their heartbeats, and then you are monitoring their heartbeats, and you get to gauge how accurate they are.
你让人们坐在那里，数他们的心跳，然后你监测他们的心跳，然后你就可以衡量它们的准确性。
Andrew Huberman:
安德鲁·休伯曼：
So it's important to understand that people with ADHD are in touch with how they feel.
因此，重要的是要了解患有多动症的人会影响自己的感受。
It's really a question of whether or not they can take the demands that are placed upon them and enter a cognitive state, a mental state, that allows them to access the information they need to access.
这实际上是一个问题，即他们是否能够接受施加在他们身上的要求并进入一种认知状态、一种精神状态，从而允许他们访问他们需要访问的信息。
In other words, whether or not they can focus.
换句话说，就是能否集中注意力。
But it is absolutely wrong to think that the child that's getting up 11 times during a short six-minute interaction at the table, or whether or not a child who somehow has to venture off every moment, or a coworker of yours who's an adult who's constantly fidgeting or moving things around, that somehow they are unaware, that they are oblivious.
但如果你认为在餐桌上短暂的六分钟互动中起身 11 次的孩子，或者无论是一个每时每刻都必须冒险离开的孩子，还是你的一个成年人的同事，他总是坐立不安或移动东西，他们不知何故没有意识到，他们没有意识到，这是绝对错误的。
Andrew Huberman:
安德鲁·休伯曼：
They're not oblivious to how they feel.
他们并没有忘记自己的感受。
Chances are they are very challenged in the situations that they're in, and they're doing everything they can to try and regulate their attention.
他们很可能在所处的情况下面临很大的挑战，并且他们正在尽一切努力尝试调节自己的注意力。
So I think it's an important study to highlight because it really underscores the fact that something else is going on, and that something else has everything to do with this ability to coordinate these task-directed networks and to coordinate that in the proper way with that default mode network.
所以我认为这是一项值得强调的重要研究，因为它确实强调了这样一个事实：其他事情正在发生，而其他事情与协调这些任务导向网络并以正确的方式与默认模式网络进行协调的能力有关。
Andrew Huberman:
安德鲁·休伯曼：
And that is a process, as you now know, that's regulated exquisitely by certain neurochemicals, and in particular the neurochemicals dopamine, norepinephrine and serotonin.
正如您现在所知，这个过程受到某些神经化学物质的精确调节，特别是神经化学物质多巴胺、去甲肾上腺素和血清素。
And a fourth one I'd like to throw into the mix which is acetylcholine, which is very vital for cognitive focus.
我想添加第四个，那就是乙酰胆碱，它对于认知焦点非常重要。
So now I want to switch back to talking about some of the drugs that are typically used to access those systems, prescription drugs, and I want to talk about some of the new and emerging nonprescription approaches to increasing the levels of dopamine, acetylcholine and serotonin in the brain using various supplement-type compounds, because several of them are showing really remarkable efficacy in excellent peer-reviewed studies.
所以现在我想转回谈论一些通常用于进入这些系统的药物，处方药，我想谈谈一些新兴的非处方方法，使用各种补充剂类型的化合物来增加大脑中的多巴胺、乙酰胆碱和血清素的水平，因为其中一些在优秀的同行评审研究中显示出真正显着的功效。
Andrew Huberman:
安德鲁·休伯曼：
So before moving to some of the newer atypical compounds and things sold over the counter, I'd like to just briefly return to the classic drugs that are used to treat ADHD.
因此，在转向一些较新的非典型化合物和非处方药之前，我想简单地回顾一下用于治疗多动症的经典药物。
These are the ones I mentioned earlier, methylphenidate, also called Ritalin; modafinil; armodafinil is another one and Adderall.
这些就是我之前提到的哌醋甲酯，也叫利他林；莫达非尼；阿莫达非尼是另一种，还有阿得拉。
Again, all of these work by increasing levels of dopamine and norepinephrine.
同样，所有这些都是通过增加多巴胺和去甲肾上腺素的水平来发挥作用的。
Typically, they are taken orally in pill form, or sometimes in capsule form.
通常，它们以药丸形式口服，有时以胶囊形式服用。
The dosages that are appropriate vary according to severity of the condition, for a given person, and the age of the person.
适当的剂量根据特定人的病情严重程度和年龄而变化。
This is a complicated landscape for each individual.
对于每个人来说，这都是一个复杂的局面。
They have to figure out the pharmacology that's best for them.
他们必须找出最适合他们的药理学。
Some individuals are even layering long or timed release Ritalin with Adderall in smaller doses.
有些人甚至将长效或定时释放的利他林与小剂量的阿得拉分层服用。
It can get quite complex, or it can be quite straightforward.
它可以变得非常复杂，也可以非常简单。
Andrew Huberman:
安德鲁·休伯曼：
If you are really interested in these drugs and how they work, and you'd like to get a glance at a table of all the results from all the studies, of which there are now hundreds, there's an excellent review about these drugs and their use, and their comparison to similarly structured drugs, in particular MDMA and cocaine and amphetamine, meaning street amphetamine, to really illustrate the similarities of action and some of the problems associated with long-term use.
如果您真的对这些药物及其作用原理感兴趣，并且您想浏览一下所有研究的所有结果表格（目前已有数百项研究），这里有一篇关于这些药物及其用途的精彩评论，以及它们与类似结构药物（特别是摇头丸、可卡因和安非他明，即街头安非他明）的比较，以真正说明作用的相似性以及与长期使用相关的一些问题。
I don't expect you to read this article in full.
我不希望您完整地阅读这篇文章。
I'm here so that you don't have to go read these articles, but in case you want a ton of information, the paper is Esposito et al, Frontiers in Biosciences.
我在这里是为了让您不必阅读这些文章，但如果您需要大量信息，这篇论文是 Esposito 等人的《生物科学前沿》。
It's an excellent, excellent review of the entire literature.
这是对整个文献的精彩评论。
It is quite long, I can put a link to that study in our caption, and it essentially describes all the studies that have been done, peer reviewed and published, and it refers to these drugs in an interesting way.
它很长，我可以在我们的标题中添加该研究的链接，它基本上描述了所有已经完成、同行评审和发表的研究，并且它以一种有趣的方式提到了这些药物。
Andrew Huberman:
安德鲁·休伯曼：
It doesn't just refer to these drugs as for treatment of ADHD.
它不仅仅指这些药物用于治疗多动症。
It actually refers to them using language that ordinarily I'm not very fond of but I'll agree to here, which is so-called smart drugs or nootropics.
它实际上指的是他们使用通常我不太喜欢的语言，但我在这里同意，这就是所谓的智能药物或促智药。
It also covers caffeine, which again, as I mentioned earlier, increases dopamine, norepinephrine and, to some extent, serotonin.
它还包括咖啡因，正如我之前提到的，咖啡因会增加多巴胺、去甲肾上腺素，并在某种程度上增加血清素。
But what I like about this review so much is that in putting these drugs of abuse, methamphetamine and cocaine, right alongside these drugs like Ritalin and Adderall, and also caffeine, we start to realize that the distinction between drugs of abuse and the distinction between drugs of treatment is actually a very fine and sometimes even a blurry line.
但我对这篇评论非常喜欢的是，将这些滥用药物、甲基苯丙胺和可卡因与利他林、阿得拉和咖啡因等药物放在一起，我们开始意识到，滥用药物和治疗药物之间的区别实际上是一条非常精细的界限，有时甚至是一条模糊的界限。
Andrew Huberman:
安德鲁·休伯曼：
And in thinking about whether or not one wants to use these prescription — I want to emphasize prescription, not drugs of abuse, but prescription drugs — for treatment of one's own attentional capacity, I think it is important to understand the extent to which they all carry more or less the same side effects.
在考虑一个人是否想要使用这些处方——我想强调处方，不是滥用药物，而是处方药——来治疗自己的注意力能力时，我认为重要的是要了解它们在多大程度上都或多或少地带来相同的副作用。
The one exception being caffeine.
唯一的例外是咖啡因。
Caffeine's side effects can be anxiety if you ingest too much of it, insomnia if you drink it too late in the day, but typically it will not cause the major side effects of the other drugs, such as high propensity for addiction and abuse.
如果摄入过多，咖啡因的副作用可能是焦虑，如果一天太晚喝咖啡因，可能会导致失眠，但通常它不会引起其他药物的主要副作用，例如高度成瘾和滥用的倾向。
Amphetamines of any kind, as well as cocaine, can cause sexual side effects because they're vasoconstrictors, so men have trouble achieving erection.
任何种类的安非他明以及可卡因都会引起性副作用，因为它们是血管收缩剂，因此男性难以勃起。
There can often be the intense desire or libido for sex but an inability to actually perform, so that's an issue with any kind of stimulant.
通常，人们可能对性有强烈的渴望或性欲，但无法实际执行，所以这是任何兴奋剂的问题。
Andrew Huberman:
安德鲁·休伯曼：
So these drugs are not without their consequences.
因此，这些药物并非没有后果。
In addition, and here I'd lump caffeine back into the mix, in addition they almost all carry cardiac effects, right?
此外，在这里我将咖啡因重新加入到混合物中，此外它们几乎都具有心脏作用，对吗？
They increase heart rate, but they also have effects on constriction of blood vessels and arteries and veins and so forth in ways that can create cardiovascular problems.
它们会增加心率，但也会导致血管、动脉和静脉等收缩，从而导致心血管问题。
Now, caffeine is a bit of a complicated one.
现在，咖啡因有点复杂。
I talked about this on a podcast long ago, but I'll just remind you that it turns out that if you are caffeine adapted, in other words if you are used to drinking caffeine, then the ingestion of caffeine most often will cause vasodilation, it will actually allow more blood flow through.
我很久以前在播客上谈到过这个问题，但我只是提醒你，事实证明，如果你适应咖啡因，换句话说，如果你习惯喝咖啡因，那么摄入咖啡因最常会引起血管舒张，它实际上会让更多的血液流过。
However, if you are not caffeine adapted, it will cause vasoconstriction due to an increased stress response.
然而，如果您不适应咖啡因，则会因压力反应增加而导致血管收缩。
So if you're familiar with caffeine, caffeine can actually have a little bit more of a relaxation response, although if you drink enough of it will make you amped up.
因此，如果您熟悉咖啡因，咖啡因实际上可以产生更多的放松反应，尽管如果您喝足够的咖啡因会让您兴奋。
These other drugs almost always lead to vasoconstriction, increased-
这些其他药物几乎总是会导致血管收缩，增加-
Andrew Huberman:
安德鲁·休伯曼：
Drugs almost always lead to vasoconstriction, increased heart rate, dilation of the pupils, less blinking, heightened levels of attention, which looks very much like stress.
药物几乎总是会导致血管收缩、心率加快、瞳孔放大、眨眼次数减少、注意力高度集中，这些看起来很像压力。
And at its extremes looks very much like the effects of street drugs like cocaine and amphetamine.
其极端情况看起来非常像可卡因和安非他明等街头毒品的影响。
Because of the large amounts of dopamine that released in the brain, people tend to crave that state over and over, and yet with each subsequent use are able to get less and less of that euphoric feeling, or that really, really focused feeling.
由于大脑中释放大量的多巴胺，人们往往会一遍又一遍地渴望这种状态，但随着每次使用，这种欣快感或真正专注的感觉会越来越少。
So one thing that's being explored quite extensively now in the treatment of ADHD are drug schedules.
因此，目前在治疗多动症方面正在广泛探索的一件事是药物治疗方案。
Whether or not people should take Adderall every day or every other day.
人们是否应该每天或每隔一天服用阿得拉。
Whether or not they should take it only every once in a while.
他们是否应该偶尔服用一次。
Whether or not young children can take it just a few times and engage in behavioral training of the sort that I talked about before, where they're doing, maybe it's a 17-minute meditation-type exercise, but more likely it would be the movement followed by the visual focusing, because that's only done for 20 or 30 or 60 seconds.
无论幼儿是否可以接受几次，并进行我之前谈到的那种行为训练，他们正在做的事情，也许是17分钟的冥想式练习，但更可能是运动后进行视觉聚焦，因为这只进行20或30或60秒。
Andrew Huberman:
安德鲁·休伯曼：
Why would you do that?
你为什么要这么做？
Well, in a chemically enhanced state, your brain is more plastic.
嗯，在化学增强状态下，你的大脑更具可塑性。
The circuits are able to modify and learn better.
电路能够更好地修改和学习。
That's the optimal time to engage in focus in a very deliberate way.
这是以非常审慎的方式集中注意力的最佳时间。
So just taking a drug and expecting focus to just work at any point and being able to turn focus on and off at will, that's an unrealistic expectation.
因此，仅仅服用药物并期望注意力在任何时候都能发挥作用，并且能够随意打开和关闭注意力，这是一个不切实际的期望。
Right?
正确的？
More likely the best use of things like Adderall, modafinil, armodafinil, and Ritalin is going to be to combine those treatments with behavioral exercises that actively engage the very circuits that you're trying to train up and enhance.
更有可能的是，阿得拉、莫达非尼、阿莫达非尼和利他林等药物的最佳用途是将这些治疗与行为练习结合起来，积极参与您想要训练和增强的回路。
And then perhaps, I want to highlight perhaps, tapering off those drugs so that then one can use those circuits without any need for chemical intervention.
然后，也许，我想强调一下，逐渐减少这些药物，这样人们就可以使用这些电路，而不需要任何化学干预。
So despite any controversy that might be out there, I think it's fair to say that the consumption of omega-3 fatty acids can positively modulate the systems for attention and focus.
因此，尽管存在任何争议，但我认为可以公平地说，食用 omega-3 脂肪酸可以积极调节注意力和注意力系统。
Andrew Huberman:
安德鲁·休伯曼：
So then the question becomes how much EPA?
那么问题就变成了多少EPA？
How much DHA?
DHA 含量是多少？
Does that differ for what's helpful for depression, et cetera?
这对于治疗抑郁症等有帮助吗？
And actually it does differ.
事实上它确实有所不同。
In reviewing the studies for this, it appears that a threshold level of 300 milligrams of DHA turns out to be an important inflection point.
回顾这方面的研究，300 毫克 DHA 的阈值水平似乎是一个重要的拐点。
So typically, fish oils or other sources of omega-3s will have DHA and EPA.
因此，鱼油或其他 omega-3 来源通常含有 DHA 和 EPA。
And typically it's the EPA that's harder to get at sufficient levels.
通常，EPA 更难达到足够的水平。
Meaning you have to take quite a lot of fish oil in order to get above that 1000 milligram or 2000 milligram threshold to improve mood and other functions.
这意味着您必须服用大量鱼油才能超过 1000 毫克或 2000 毫克阈值，以改善情绪和其他功能。
But for sake of attention, there are 10 studies that have explored this in detail.
但为了引起注意，有 10 项研究对此进行了详细探讨。
And while the EPA component is important, the most convincing studies point to the fact that getting above 300 milligrams per day of DHA is really where you start to see the attentional effects.
虽然 EPA 成分很重要，但最令人信服的研究指出，每天摄入超过 300 毫克的 DHA 才真正开始看到注意力效应。
Andrew Huberman:
安德鲁·休伯曼：
Now, fortunately, if you're getting sufficient EPA, for sake of mood and other biological functions, almost without question, you're getting 300 milligrams or more of DHA.
现在，幸运的是，如果您为了情绪和其他生物功能而获得了足够的 EPA，那么几乎毫无疑问，您将获得 300 毫克或更多的 DHA。
So that usually checks that box just fine.
所以通常勾选那个框就可以了。
What's interesting is that there's another compound, phosphatidylserine, that has been explored for its capacity to improve the symptoms of ADHD.
有趣的是，还有另一种化合物，磷脂酰丝氨酸，已因其改善多动症症状的能力而被探索。
Again, I don't think this is in a direct way, but rather in a modulatory way.
再说一遍，我认为这不是直接的方式，而是一种调节的方式。
But it appears that phosphatidylserine, taken for two months, for 200 milligrams per day,` was able to reduce the symptoms of ADHD in children.
但每天服用 200 毫克磷脂酰丝氨酸两个月似乎能够减轻儿童多动症的症状。
It has not been looked at in adults yet.
尚未在成人中进行研究。
At least as far as I know, but that this effect was greatly enhanced by the consumption of omega-3 fatty acids.
至少据我所知，食用 omega-3 脂肪酸可以大大增强这种效果。
So now we're starting to see synergistic effects of omega-3 fatty acids and phosphatidylserine.
现在我们开始看到 omega-3 脂肪酸和磷脂酰丝氨酸的协同作用。
Again, that was 200 milligrams per day.
同样，每天摄入 200 毫克。
Andrew Huberman:
安德鲁·休伯曼：
This is something that sold over the counter in capsule form, at least in the U.S. There were two studies.
这是在柜台上以胶囊形式出售的东西，至少在美国是这样。有两项研究。
Both were double-blind studies, carried out for anywhere from one to six months on both boys and girls.
两项研究都是双盲研究，对男孩和女孩都进行了一到六个月不等的研究。
And it really was boys and girls, not men and women.
确实是男孩和女孩，而不是男人和女人。
This was kids age one to six or seven to twelve.
这是一岁到六岁或七岁到十二岁的孩子。
And it was a fairly large number of subjects.
而且科目数量相当多。
So 147 subjects in one case and 36 in the other.
因此，一种情况下有 147 名受试者，另一种情况下有 36 名受试者。
The takeaway is that getting sufficient levels of EPAs, in particularly this 300 milligram threshold of DHA.
结论是获得足够水平的 EPA，特别是 300 毫克的 DHA 阈值。
Plus, if you are interested in it and it's right for you, 200 milligrams of phosphatidylserine, can be an important augment for improving the symptoms of ADHD.
另外，如果您对此感兴趣并且它适合您，200 毫克磷脂酰丝氨酸可以成为改善 ADHD 症状的重要增强剂。
You'll also find literature out there and many claims about so-called ginkgo biloba, which has been shown to have minor effects in improving the symptoms of ADHD.
您还可以找到有关所谓银杏叶的文献和许多说法，银杏叶已被证明对改善多动症症状有轻微作用。
Andrew Huberman:
安德鲁·休伯曼：
Not nearly as effective as Ritalin and Adderall.
不如利他林和阿德拉有效。
Gingko biloba is not appropriate for many people.
银杏叶不适合很多人。
I am one such person.
我就是这样的人之一。
I don't have ADHD, but when I've taken gingko, even at very low doses, I get absolutely splitting headaches.
我没有多动症，但当我服用银杏时，即使剂量非常低，我也会感到头痛欲裂。
Some people do not experience those headaches, but it's known to have very potent vasoconstrictive and vasodilating properties that vary.
有些人不会经历这些头痛，但众所周知，它具有非常有效的血管收缩和血管舒张特性，且特性各不相同。
Depending on when you took the compound.
取决于您服用该化合物的时间。
So for those of you that are exploring gingko biloba, and you will see a lot of claims about gingko biloba for attention and ADHD, definitely take the vasodilation, vasoconstriction headache issue into consideration.
因此，对于那些正在探索银杏叶的人来说，您会看到很多关于银杏叶用于注意力和多动症的说法，一定要考虑到血管舒张、血管收缩性头痛问题。
Andrew Huberman:
安德鲁·休伯曼：
So I'd like to talk about the drug modafinil, and the closely related drug armodafinil.
所以我想谈谈药物莫达非尼，以及密切相关的药物阿莫达非尼。
That's A-R-modafinil.
那是A-R-莫达非尼。
Because modafinil and armodafinil are gaining popularity out there both for treatment of ADHD and narcolepsy, but also for communities of people that are trying to stay awake long periods of time.
因为莫达非尼和阿莫达非尼在治疗多动症和发作性睡病方面越来越受欢迎，而且也受到那些试图长时间保持清醒的人群的欢迎。
Andrew Huberman:
安德鲁·休伯曼：
So it's actively used in the military, by first responders, it's gaining popularity on college campuses and people are using it more and more as an alternative to Adderall and Ritalin and excessive amounts of coffee.
因此，它在军队中被急救人员积极使用，在大学校园中越来越受欢迎，人们越来越多地使用它作为阿得拉和利他林以及过量咖啡的替代品。
It does increase focus, and to a dramatic extent.
它确实增加了注意力，而且达到了戏剧性的程度。
Modafinil typically was very expensive.
莫达非尼通常非常昂贵。
I don't know if it's still this expensive, but when one has a prescription for it, it could still cost as much as eight or nine hundred dollars, or even a thousand dollars a month.
我不知道是不是还这么贵，但是如果有处方的话，一个月也可能要八九百块钱，甚至上千块钱。
Armodafinil is a far less expensive version that's chemically slightly different than Modafinil.
阿莫达非尼是一种便宜得多的版本，其化学成分与莫达非尼略有不同。
Regardless of price, people are taking modafinil and armodafinil.
无论价格如何，人们都在服用莫达非尼和阿莫达非尼。
I want to emphasize that unlike Ritalin and Adderall, modafinil and armodafinil are weak dopamine reuptake inhibitors, and that's how they lead to increases in dopamine.
我想强调的是，与利他林和阿得拉不同，莫达非尼和阿莫达非尼是弱多巴胺再摄取抑制剂，这就是它们导致多巴胺增加的原因。
So, whereas Ritalin and Adderall, amphetamine and cocaine lead to big increases in dopamine, also through reuptake mechanisms, and so forth.
因此，利他林和阿得拉、安非他明和可卡因也会通过再摄取机制等导致多巴胺大幅增加。
Modafinil is a weaker dopamine reuptake stimulator.
莫达非尼是一种较弱的多巴胺再摄取刺激剂。
Andrew Huberman:
安德鲁·休伯曼：
And so what that means is that it leaves more dopamine around to be active at the synapse, the gaps between neurons.
所以这意味着它会留下更多的多巴胺在突触（神经元之间的间隙）处活跃。
However, it also activates other systems.
然而，它也会激活其他系统。
It acts on the orexin system, which is actually a peptide that we talked about in the episode on hunger.
它作用于食欲素系统，这实际上是我们在饥饿剧集中谈到的一种肽。
Because it regulates hunger and appetite.
因为它可以调节饥饿和食欲。
And it regulates sleepiness and feelings of sleepiness.
它可以调节睡意和睡意。
In fact the orexin, also called hypocretin system, the orexin hypocretin system, is what's disrupted in narcolepsy.
事实上，食欲素，也称为下丘脑分泌素系统，食欲素下丘脑分泌素系统，是在发作性睡病中被破坏的。
That was the important discovery of my colleagues Emmanuel Mignot and Seiji Nishino at Stanford some years ago.
这是几年前我在斯坦福大学的同事 Emmanuel Mignot 和 Seiji Nishino 的重要发现。
They identified the biological basis of narcolepsy, and it's a disruption in this orexin hypocretin system.
他们确定了发作性睡病的生物学基础，这是食欲素下丘脑分泌素系统的破坏。
And modafinil is one of the primary treatments for narcolepsy.
莫达非尼是发作性睡病的主要治疗方法之一。
It also has these other effects on the dopamine system and on the norepinephrine system.
它还对多巴胺系统和去甲肾上腺素系统有这些其他影响。
Even though it doesn't lead to quite as intense levels of dopamine and arousal and focus, it does have the property of raising levels of attention and focus, and that's why people are using it.
尽管它不会产生那么强烈的多巴胺、兴奋和注意力水平，但它确实具有提高注意力和注意力水平的特性，这就是人们使用它的原因。
Andrew Huberman:
安德鲁·休伯曼：
So it's a somewhat milder form of Adderall.
所以它是一种温和的阿得拉形式。
Armodafinil, for some people, works as well as modafinil — and as I mentioned before, it's much lower cost — for other people it doesn't.
对于某些人来说，阿莫达非尼的作用与莫达非尼一样好——正如我之前提到的，它的成本要低得多——但对其他人来说则不然。
I have an experience, meaning I do have an experience that I'll share with you with armodafinil.
我有一个经验，这意味着我确实有一个与阿莫达非尼分享的经验。
A few years ago, I was suffering from jet lag really terribly, and I was traveling overseas.
几年前，我因时差的困扰而出国旅行。
I went to a meeting to give a talk.
我去参加一个会议并发表演讲。
I took half of the prescribed dose of armodafinil.
我服用了阿莫达非尼处方剂量的一半。
It was prescribed to me.
这是给我开的。
I took that half dose and I gave my lecture, and then I stayed around to answer questions.
我服用了一半的剂量并进行了演讲，然后我留下来回答问题。
And then four hours later, a friend of mine came up to me and said, "You've been talking for four and a half hours, and there are only a few people still here." Luckily, there were still a few people, it would be a lot weirder if the room was completely empty since it wasn't being recorded.
然后四个小时后，我的一个朋友走过来对我说：“你已经讲了四个半小时了，这里只剩下几个人了。”幸好还有几个人，如果房间里空无一人那就更奇怪了，因为没有被记录。
Andrew Huberman:
安德鲁·休伯曼：
So I have firsthand knowledge of the sorts of cognitive effects that it can create.
因此，我对它可以产生的各种认知效果有第一手的了解。
I personally would not want to be in that state for sake of studying or learning or for doing this podcast, for instance.
例如，我个人不想为了学习或做这个播客而处于那种状态。
And I can honestly say, that today all I've ingested is some coffee and some yerba maté tea and some water.
我可以诚实地说，今天我只喝了一些咖啡、一些马黛茶和一些水。
I'm not on any of the compounds that I've described during the course of today's episode.
我没有使用我在今天的节目中描述的任何化合物。
Andrew Huberman:
安德鲁·休伯曼：
You might ask why I took half the recommended dose of armodafinil, and the reason is that I'm somebody who's fairly hypersensitive to medication of any kind.
您可能会问为什么我服用了推荐剂量的一半的阿莫达非尼，原因是我是一个对任何药物都相当过敏的人。
What you find if you look in the literature is that about 5% of people are hyper, hypersensitive to medication.
如果你查阅文献，你会发现大约 5% 的人对药物过度敏感。
They require far lower doses of any medication than other people in order to experience the same effects.
他们需要比其他人低得多的药物剂量才能获得相同的效果。
I'm somebody that I think is sort of modest hyper, if that's sort of an oxymoronic statement, but modest hypersensitivity to medication.
我认为我是一个适度的过敏症患者，如果这是一种矛盾的说法，但对药物的适度过敏症。
Andrew Huberman:
安德鲁·休伯曼：
So I've almost always been able to get by on taking less of whatever was prescribed for me and feel just fine, or in this case to feel like it was still too much.
因此，我几乎总是能够减少服用为我开出的处方药，并感觉良好，或者在这种情况下，感觉仍然太多了。
It turned out that the right dose of armodafinil for me was zero milligrams.
事实证明，阿莫达非尼对我来说的正确剂量是零毫克。
Andrew Huberman:
安德鲁·休伯曼：
Now you may notice that I haven't talked much about acetylcholine.
现在您可能注意到我没有过多谈论乙酰胆碱。
Acetylcholine is a neurotransmitter that at the neuron-to-muscle connections, the so-called neuromuscular junctions, is involved in generating muscular contractions of all kinds for all movements.
乙酰胆碱是一种神经递质，在神经元与肌肉的连接处，即所谓的神经肌肉接头处，参与产生所有运动的各种肌肉收缩。
Acetylcholine is also released from two sites in the brain.
乙酰胆碱也从大脑的两个部位释放。
So a little bit of nomenclature here.
这里有一点术语。
Again, feel free to ignore the nomenclature, but there is a collection of neurons in your brain stem that send projections forward, kind of like a sprinkler system that's very diffuse, to release acetylcholine.
再次强调，请随意忽略术语，但您的脑干中有一组神经元会向前发送投射，有点像非常分散的喷水系统，以释放乙酰胆碱。
And those neurons reside in an area or a structure that's called the pedunculopontine nucleus, the PPN.
这些神经元位于一个称为桥脚核（PPN）的区域或结构中。
Andrew Huberman:
安德鲁·休伯曼：
And then there's a separate collection of neurons in the basal forebrain called, unimaginatively, nucleus basalis, the nucleus at the base.
然后，基底前脑中有一个单独的神经元集合，毫无想象力地称为基底核，即底部的核。
And they also hose the brain with acetylcholine, but in a much more specific way.
他们还向大脑注入乙酰胆碱，但方式更为具体。
So one is sort of like a sprinkler system, and the other one is more like a fire hose to a particular location.
因此，一个有点像喷水灭火系统，另一个更像是通往特定位置的消防水龙带。
And those two sources of acetylcholine collaborate to activate particular locations in the brain and really bring about a tremendous degree of focus to whatever is happening at those particular synapses.
这两种乙酰胆碱来源共同激活大脑中的特定位置，并真正使人们高度关注这些特定突触发生的事情。
So it could be a focus on visual information or auditory information.
所以它可能关注视觉信息或听觉信息。
If you're listening closely to what I'm saying right now, you just heard "closely" step out from the rest of my sentence.
如果你正在仔细听我现在所说的话，你就会听到我句子的其余部分中出现了“密切”一词。
No doubt there was acetylcholine released at the sites in your brain where the neurons that represent your recognition of the word "closely" occurred.
毫无疑问，你大脑中代表你对“密切”一词的识别的神经元的部位会释放乙酰胆碱。
Andrew Huberman:
安德鲁·休伯曼：
Okay, so now you have an example and you have an understanding and hopefully a picture in your mind of how all this is working.
好的，现在您有了一个示例，并且您已经了解了所有这些是如何工作的，并且希望您能在脑海中描绘出一幅图景。
Not surprisingly then, drugs that increase cholinergic or acetylcholine transmission will increase focus and cognition.
毫不奇怪，增加胆碱能或乙酰胆碱传输的药物将增强注意力和认知能力。
One such compound is so called Alpha-GPC.
其中一种化合物称为 Alpha-GPC。
Which is a form of choline and increases acetylcholine transmission.
它是胆碱的一种形式，可以增加乙酰胆碱的传输。
Dosages as high as 1200 milligrams per day, which is a very high dosage, spread out, typically it's 300 or 400 milligrams, spread out throughout the day, have been shown to offset some of the effects of age-related cognitive decline, improve cognitive functioning in people that don't have age-related cognitive decline.
每天高达 1200 毫克的剂量，这是一个非常高的剂量，通常是 300 或 400 毫克，全天分散，已被证明可以抵消与年龄相关的认知衰退的一些影响，改善没有与年龄相关的认知衰退的人的认知功能。
That's a very high dose.
这是一个非常高的剂量。
Typically, when people are using Alpha-GPC to study or to enhance learning of any kind, they will take somewhere between 300 and 600 milligrams.
通常，当人们使用 Alpha-GPC 进行学习或增强任何类型的学习时，他们会服用 300 到 600 毫克之间的量。
That's more typical.
这个就比较典型了
Again, you have to check with your doctor.
再次强调，您必须咨询您的医生。
You have to decide if the safety margins are appropriate for you.
您必须决定安全裕度是否适合您。
Obviously, you'd want to check that out.
显然，您想检查一下。
But Alpha-GPC is effective in creating more focus by way of this cholinergic system.
但 Alpha-GPC 可以通过这种胆碱能系统有效地创造更多注意力。
Andrew Huberman:
安德鲁·休伯曼：
It stimulates acetylcholine release from both of those locations.
它刺激乙酰胆碱从这两个位置释放。
The PPN in the back of the brain and nucleus basalis in the front of the brain.
PPN 位于大脑后部，基底核位于大脑前部。
There are two other over-the-counter compounds that are in active use out there for treatment of ADHD and in use for simply trying to improve focus.
还有另外两种非处方化合物正在积极用于治疗多动症，并用于简单地提高注意力。
And the first one is L-tyrosine, it's an amino acid that acts as a precursor to the neuromodulator dopamine.
第一个是 L-酪氨酸，它是一种氨基酸，是神经调节剂多巴胺的前体。
And now, knowing everything you know about dopamine attention and the circuits involved, it should come as no surprise as to why people are exploring the use of L-tyrosine for that purpose.
现在，了解了有关多巴胺注意力及其相关回路的一切知识后，人们为什么会探索使用 L-酪氨酸来实现这一目的就不足为奇了。
L-tyrosine does lead to increases in dopamine.
L-酪氨酸确实会导致多巴胺增加。
They are fairly long-lived, and L-tyrosine can improve one's ability to focus.
它们的寿命相当长，L-酪氨酸可以提高人的注意力集中能力。
However, the dosaging can be very tricky to dial in.
然而，调整剂量可能非常棘手。
Sometimes it makes people feel too euphoric, or too jittery, or too alert, that they are then unable to focus well.
有时它会让人们感到过于欣快、过于紧张或过于警觉，从而无法集中注意力。
Andrew Huberman:
安德鲁·休伯曼：
So the dosage ranges are huge.
所以剂量范围很大。
You see evidence for a hundred milligrams all the way up to 1200 milligrams.
您可以看到 100 毫克一直到 1200 毫克的证据。
It's something that really should be approached with caution.
这确实应该谨慎对待。
Especially for people that have any kind of underlying psychiatric or mood disorder, because dysregulation of the dopamine system is central to many of the mood disorders, such as depression, but also especially mania, mania bipolar disorder, schizophrenia, things of that sort.
特别是对于患有任何潜在精神或情绪障碍的人来说，因为多巴胺系统的失调是许多情绪障碍的核心，例如抑郁症，而且尤其是躁狂症、躁狂双相情感障碍、精神分裂症等。
So it's something that really should be approached with caution.
所以这确实应该谨慎对待。
Nonetheless, in exploring what's out there, and even some studies online that were done, either animal studies or human studies, it's clear that L-tyrosine is being explored for that purpose.
尽管如此，在探索现有的情况，甚至在网上进行的一些研究（无论是动物研究还是人体研究）中，很明显，L-酪氨酸正在为此目的进行探索。
As is PEA and phenylethylamine, which is essentially PEA, but some related compounds.
PEA 和苯乙胺也是如此，苯乙胺本质上是 PEA，但有一些相关的化合物。
So there's a whole class of dopaminergic or dopamine-stimulating supplements that people are using to try and get their dopamine levels up.
因此，人们正在使用一整类多巴胺能或多巴胺刺激补充剂来尝试提高多巴胺水平。
Andrew Huberman:
安德鲁·休伯曼：
And again, it's a kind of a fine line between too little, enough and too much.
再说一次，这是太少、足够和太多之间的微妙界限。
If you want to get the literature on those two compounds there, I will refer to this great website, examine.com.
如果您想获得有关这两种化合物的文献，我会参考这个很棒的网站，exspect.com。
Just as it sounds, and you can put in L-tyrosine or PEA and you can get the details on that.
正如听起来的那样，您可以添加 L-酪氨酸或 PEA，然后您可以获得有关的详细信息。
But I highly recommend also going to their section on ADHD to see how those particular compounds relate specifically to ADHD and cognitive focus.
但我强烈建议您也去他们关于多动症的部分，看看这些特定的化合物如何与多动症和认知焦点具体相关。
And last but not least, in terms of these different compounds.
最后但并非最不重要的一点是，就这些不同的化合物而言。
I do want to mention the racetams.
我确实想提一下racetams。
These are somewhat esoteric and probably most of you haven't heard about them, but some of you probably know a lot about them, and they are becoming more popular.
这些有些深奥，可能大多数人都没有听说过，但有些人可能对它们了解很多，而且它们正变得越来越流行。
They go by names like Noopept, and things of that sort.
它们的名字有“Noopept”之类的。
The racetams are illegal in certain countries.
消旋体在某些国家是非法的。
They are gray market in other countries, and they're sold over the counter in this country, in the U.S.
它们在其他国家是灰色市场，在美国是在柜台出售的。
Andrew Huberman:
安德鲁·休伯曼：
So they have different margins for safety.
所以他们有不同的安全边际。
You definitely need to consult your doctor, especially if you have ADHD.
您绝对需要咨询您的医生，特别是如果您患有多动症。
But Noopept has been shown, when taken at 10 milligrams twice daily, can be more effective than some of the other racetams.
但事实证明，每天两次服用 10 毫克的 Noopept 比其他一些消旋药更有效。
What is Noopept?
什么是 Noopept？
Noopept taps into the cholinergic system, the acetylcholine system, in ways very similar to Alpha-GPC, but seems to have a slightly higher affinity for some of the receptors involved and can lead to those heightened states of cognitive capacity.
Noopept 以与 Alpha-GPC 非常相似的方式进入胆碱能系统（乙酰胆碱系统），但似乎对某些相关受体具有稍高的亲和力，并且可以导致认知能力的增强。
And there are these studies, one in particular, comparative studies of Noopept and piracetam and the treatment of patients with mild cognitive disorders and brain disease of vascular and traumatic origin.
还有这些研究，特别是 Noopept 和吡拉西坦的比较研究，以及治疗患有轻度认知障碍和血管及创伤性脑部疾病的患者的研究。
That's a mouthful.
那是一口。
What this study basically points to is the fact that people who are experiencing some degree of inability to focus, due to prior concussion or some vascular event, a stroke or ischemia of any kind.
这项研究基本上指出的是，由于先前的脑震荡或某些血管事件、中风或任何类型的缺血，人们正在经历某种程度的注意力不集中的情况。
Because neurons need blood, when the blood supply is cut off to neurons or when there's a bleed in the brain subsequent to that, often there are challenges in maintaining focus.
由于神经元需要血液，当神经元的血液供应被切断或随后大脑出血时，保持注意力通常会遇到挑战。
Andrew Huberman:
安德鲁·休伯曼：
This is very common for people that have done sports where there's a lot of running into each other with your head, like rugby, football, hockey and so forth.
对于从事过经常用头碰撞的运动的人来说，这种情况很常见，例如橄榄球、足球、曲棍球等。
But also people who have experienced head blows, or often overlooked is the fact that most traumatic head injury is not actually from sports, even football.
但经历过头部撞击的人或者经常忽视的事实是，大多数头部创伤实际上并不是来自运动，甚至是足球。
It's from things like construction work ,from high impact work of that kind.
它来自诸如建筑工作之类的高影响工作。
So there does seem to be some efficacy of Noopept and piracetam and things like it.
所以 Noopept 和吡拉西坦之类的东西似乎确实有一些功效。
It's an emerging area, and as I mentioned, in the U.S., these things are sold over-the-counter.
这是一个新兴领域，正如我提到的，在美国，这些东西都是在柜台出售的。
Again, you have to figure out if it's right for you, but they are beginning to show some promise.
同样，您必须弄清楚它是否适合您，但它们已经开始显示出一些希望。
And I'm intrigued by them because of the way that they tap into the cholinergic system, which is both directly involved in focus and the ability to focus, but is also important for things related to age-related cognitive decline.
我对它们很感兴趣，因为它们利用胆碱能系统的方式，胆碱能系统既直接涉及注意力和集中注意力的能力，而且对于与年龄相关的认知衰退相关的事情也很重要。
Andrew Huberman:
安德鲁·休伯曼：
So a decline in cholinergic transmission or acetylcholine, as we call it, in the brain, is one of the things associated with cognitive decline.
因此，大脑中胆碱能传递或乙酰胆碱（我们称之为乙酰胆碱）的下降是与认知能力下降相关的因素之一。
And it does seem that increasing cholinergic transmission can offset some of that cognitive decline and perhaps even more so in conditions such as vascular damage or concussion to the brain.
增加胆碱能传递似乎确实可以抵消部分认知能力下降，在血管损伤或脑震荡等情况下可能更是如此。
Andrew Huberman:
安德鲁·休伯曼：
If you're interested in atypical treatments for ADHD compounds to improve focus and related themes, and you like reading about this stuff, there's an excellent review article that I can refer you to.
如果您对 ADHD 化合物的非典型治疗方法感兴趣，以提高注意力和相关主题，并且您喜欢阅读这些内容，那么我可以向您推荐一篇出色的评论文章。
It's by Ahn et al, A-H-N.
作者是 Ahn 等人，A-H-N。
It was published in 2016, so it's a little bit behind the times, although it's surprisingly comprehensive, given that, which lines up all the various drugs that I've discussed, racetams and Adderall and Ritalin and various forms of dopaminergic agents and cholinergic agents.
它于 2016 年出版，所以它有点落后于时代，尽管它的全面性令人惊讶，因为它列出了我讨论过的所有各种药物，消旋剂、阿得拉和利他林以及各种形式的多巴胺能药物和胆碱能药物。
Spells out whether or not they are sold over-the-counter or by prescription and really lines them up and all their effects, their drawbacks, et cetera.
详细说明它们是非处方药还是处方药出售，并真正将它们及其所有效果、缺点等等排列起来。
Andrew Huberman:
安德鲁·休伯曼：
I'll refer you to that study.
我将向您推荐该研究。
It's available in its full-length form online for free.
它的完整版本可在网上免费获取。
It's Ahn et al.
这是安等人。
The journal is Neural Plasticity, Neural Plasticity, 2016; should be very easy to find if you put those keywords in.
该杂志是Neural Plasticity，神经可塑性，2016年；如果你输入这些关键词，应该很容易找到。
And while it is a review, it is a very comprehensive review.
虽然这是一篇评论，但它是一篇非常全面的评论。
And if you're really into this stuff, and you also want to learn a thing or two about how these things interact with neurofeedback, et cetera, there's some information in there as well.
如果您真的很喜欢这些东西，并且您还想了解一两件事关于这些东西如何与神经反馈相互作用等，那么那里也有一些信息。
I know I've already covered a lot of information, but there is one more category of technology for the treatment of ADHD and for enhancement of focus in anyone, that I would like to emphasize.
我知道我已经介绍了很多信息，但我想强调的是，还有一类用于治疗注意力缺陷多动症和增强任何人注意力的技术。
And that's transcranial magnetic stimulation.
这就是经颅磁刺激。
Transcranial magnetic stimulation, also called TMS, is achieving increasing popularity nowadays for the treatment of all sorts of neurologic conditions and psychiatric conditions.
经颅磁刺激，也称为 TMS，如今在治疗各种神经系统疾病和精神疾病方面越来越受欢迎。
It is a noninvasive tool.
它是一种非侵入性工具。
Andrew Huberman:
安德鲁·休伯曼：
It involves taking a coil, it's a device with a coil that's placed over particular locations in the brain, and then sends magnetic stimulation into the brain.
它涉及到一个线圈，这是一个带有线圈的设备，放置在大脑的特定位置，然后将磁刺激发送到大脑中。
It can actually pass through the skull without having to drill through the skull.
它实际上可以穿过颅骨，而不需要钻穿颅骨。
And nowadays can be used to both lower the amount of activity, or increase the amount of activity in specific brain areas.
如今，可用于降低特定大脑区域的活动量或增加特定大脑区域的活动量。
It's spatial precision is not remarkable.
它的空间精度并不显着。
That doesn't mean it's not of use, but it is not a super fine-grain tool.
这并不意味着它没有用，但它不是一个超细粒度的工具。
Okay?
好的？
It's not a cannon, but it's also not a needle.
它不是大炮，但也不是针。
It is somewhere in between.
它介于两者之间。
It can direct the activity of particular brain regions at particular depths.
它可以指导特定深度特定大脑区域的活动。
And as I mentioned, it can increase or decrease that activity.
正如我所提到的，它可以增加或减少该活动。
So for instance, I've had a TMS coil placed on my head, not for therapeutic purposes.
举例来说，我在头上放置了一个 TMS 线圈，但不是出于治疗目的。
Even if it was I wouldn't tell you, but rather just for, well, I'm a neuroscientist and I worked in a lab with one, for entertainment, exploratory, purposes.
即使是这样，我也不会告诉你，只是因为，嗯，我是一名神经科学家，我在一个实验室里工作过，出于娱乐、探索等目的。
Andrew Huberman:
安德鲁·休伯曼：
Please don't do this at home.
请不要在家里这样做。
It was placed over my motor cortex, which generates voluntary action.
它被放置在我的运动皮层上，该皮层产生自愿动作。
And it was a coil that at that time could only inhibit neurons.
而且当时它是一个只能抑制神经元的线圈。
And so what I was doing is I was moving objects around on a table just like I am now.
所以我所做的就是像现在一样在桌子上移动物体。
It was actually a pencil, not a pen, and I was tapping the pencil and then the TMS coil was turned on.
它实际上是一支铅笔，而不是钢笔，我敲击铅笔，然后 TMS 线圈打开。
And for the life of me, I could not move that pencil.
在我的一生中，我无法移动那支铅笔。
Okay?
好的？
Because it was inhibiting my upper motor neurons in the portion of my cortex that controls voluntary activity.
因为它抑制了我大脑皮层控制自主活动部分的上运动神经元。
As soon as the coil was turned off, I could return to tapping the pencil again.
一旦线圈关闭，我就可以再次敲击铅笔。
Nowadays, it's possible to stimulate motor cortex ,or any area of the brain, with some degree of precision.
如今，可以在一定程度上精确地刺激运动皮层或大脑的任何区域。
That could create the impulse to move without actually making the decision to move.
这可能会产生搬家的冲动，但实际上并没有做出搬家的决定。
Andrew Huberman:
安德鲁·休伯曼：
So you can literally engage certain neural circuits and therefore behaviors, and certain thought and emotional patterns, by way of transcranial magnetic stimulation.
因此，您实际上可以通过经颅磁刺激来参与某些神经回路，从而参与某些行为，以及某些思想和情绪模式。
This has far reaching and vast implications, as you can probably imagine.
正如您可能想象的那样，这具有深远而广泛的影响。
In discussing ADHD with a colleague that uses TMS, what they are doing is they are taking the TMS coil to children and adults that have ADHD.
在与使用 TMS 的同事讨论 ADHD 时，他们正在做的是将 TMS 线圈带到患有 ADHD 的儿童和成人身上。
And they're using it to stimulate the portions of the prefrontal cortex, that we talked about earlier, that engage task-directed focused states.
他们用它来刺激我们之前讨论过的前额皮质部分，这些部分涉及任务导向的聚焦状态。
So rather than using a drug that generally increases dopamine and some of the other chemicals involved, they're using directed TMS stimulation of these circuits.
因此，他们没有使用通常会增加多巴胺和其他一些化学物质的药物，而是使用定向 TMS 刺激这些回路。
And fortunately, I was quite relieved to hear this, they're combining that with a focused learning task.
幸运的是，听到这个消息我感到很欣慰，他们正在将其与重点学习任务结合起来。
So they're literally teaching the brain to learn in a noninvasive way, no drug at all.
所以他们实际上是在教大脑以非侵入性的方式学习，根本不需要药物。
And right now there are experiments, clinical trials going on comparing TMS of this sort to the drug treatments of this sort that we described earlier that engage these circuits through pharmacologic mechanisms.
目前正在进行一些实验和临床试验，将这种 TMS 与我们之前描述的通过药理机制参与这些回路的药物治疗进行比较。
Andrew Huberman:
安德鲁·休伯曼：
So very exciting times for TMS, very exciting times for pharmacology related to ADHD and for enhancing focus in general.
对于 TMS 来说，这是非常激动人心的时刻，对于与 ADHD 相关的药理学以及总体上增强注意力来说，也是非常激动人心的时刻。
And when I say "very exciting times,' I mean no drug is perfect, but the constellation of drugs that's out there is getting much larger.
当我说“非常激动人心的时代”时，我的意思是没有一种药物是完美的，但现有的药物种类正在变得越来越多。
But because they tap into different aspects of their circuitry, I do think that we are well on our way to identifying the ideal combinations of drug treatments, technological treatments and behavioral paradigms for increasing focus in both children and adults with ADHD.
但由于它们利用了神经回路的不同方面，我确实认为我们正在努力确定药物治疗、技术治疗和行为模式的理想组合，以提高对患有多动症的儿童和成人的关注。
And as a final, final point, I also want to mention something about technologies that are making it harder for all of us to focus, regardless of whether or not we have preexisting ADHD or not.
作为最后一点，我还想提一下有关技术的一些事情，这些技术使我们所有人都更难集中注意力，无论我们是否患有多动症。
You can probably guess where this is going.
您大概可以猜到这是怎么回事。
Everybody nowadays seems to have a smartphone.
如今似乎每个人都拥有智能手机。
I'm sure there are a few individuals out there that don't have a smartphone.
我确信有一些人没有智能手机。
Andrew Huberman:
安德鲁·休伯曼：
Nonetheless, most people have them.
尽管如此，大多数人都拥有它们。
Most kids want one as soon as they can get them, and they are small.
大多数孩子一拿到手就想要一个，而且它们还很小。
They grab our attention entirely.
他们完全吸引了我们的注意力。
But within that small box of attention, there are millions of attentional windows scrolling by.
但在这个小小的注意力盒子里，有数以百万计的注意力窗口在滚动。
Right?
对吗？
So just because it's one device that we look at does not mean that we are focused.
因此，仅仅因为它是我们关注的一款设备并不意味着我们是专注的。
We are focused on our phone.
我们专注于我们的手机。
But because of the way in which context switches up so fast within the phone, it's thought that the brain is struggling now to leave that rapid turnover of context.
但由于手机中上下文切换的速度如此之快，人们认为大脑现在正在努力摆脱上下文的快速切换。
Right?
对吗？
Many, many shows, many, many Instagram pages, many, many Twitter feeds, many, many websites.
很多很多节目、很多很多 Instagram 页面、很多很多 Twitter 信息、很多很多网站。
Basically, the whole world, at least in virtual format, is available within that small box.
基本上，整个世界，至少以虚拟的形式，都可以在那个小盒子里找到。
Unlike any other technology humans have ever dealt with before.
与人类以前处理过的任何其他技术不同。
Even though there are trillions, infinite number of bits of information in the actual physical world, your attentional window, that aperture of constriction, and dilating that visual window is the way in which you cope with all that overwhelming information typically.
尽管现实物理世界中有数万亿、无限数量的信息，但你的注意力窗口、收缩孔径和扩大视觉窗口是你处理所有压倒性信息的典型方式。
Andrew Huberman:
安德鲁·休伯曼：
Well within the phone, your visual aperture is set to a given width.
在手机内部，您的视觉孔径被设置为给定的宽度。
It's about this big typically.
一般都是这么大。
The phones seem to be getting bigger, but nonetheless, it's about that big.
手机似乎变得越来越大，但尽管如此，它也差不多那么大了。
And within there, your attentional window is grabbing at near infinite number of bits of information, colors, movies.
在那里，你的注意力窗口正在捕捉近乎无限数量的信息、颜色、电影。
If a picture is worth a thousand words, a movie is worth a billion pictures.
如果一张图片抵得上一千个字，那么一部电影抵得上十亿张图片。
That brain loves visual motion.
那个大脑喜欢视觉运动。
And so the question is, does that sort of interaction on a regular basis lead to deficits in the types of attention that we need in order to perform well in work and school relationships, et cetera?
所以问题是，这种定期互动是否会导致我们在工作和学校关系等方面表现良好所需的注意力不足？
And the short answer is yes.
简短的回答是肯定的。
It does appear so.
看起来确实如此。
We are inducing a sort of ADHD.
我们正在诱发一种多动症。
And while the studies on this are ongoing, because prominent use of smartphones really took off right around 2010 and we're only in 2021, longstanding studies take time, which is essentially to say the same thing as longstanding.
虽然这方面的研究正在进行中，但由于智能手机的广泛使用在 2010 年左右才真正开始流行，而我们现在才到 2021 年，因此长期研究需要时间，这本质上与长期研究是一样的。
Andrew Huberman:
安德鲁·休伯曼：
There are some studies, and one in particular that I'd like to highlight.
有一些研究，我想特别强调其中一项。
One was actually carried out pretty early in 2014.
其中一项实际上早在 2014 年就进行了。
This is a study that explored smartphone use, at the time, they called it "mobile phone use," but smartphone use and inattention, difficulties in attending, in 7,102 adolescents.
这是一项探讨智能手机使用情况的研究，当时他们称之为“手机使用”，但智能手机的使用和注意力不集中、注意力不集中，在 7,102 名青少年中进行。
So this is a huge study, a population-based cross-sectional study, and you will be probably surprised and somewhat dismayed to hear that in order to avoid this decrease in attentional capacity, adolescents needed to use their smartphone for less than 60 minutes per day in order to stay focused and centered on their other tasks.
因此，这是一项规模庞大的研究，一项基于人群的横断面研究，您可能会感到惊讶，甚至有些沮丧，因为为了避免注意力能力下降，青少年需要每天使用智能手机的时间少于 60 分钟，才能保持专注并专注于其他任务。
Otherwise, they started to really run into significant issues.
否则，他们就会开始真正遇到重大问题。
So 60 minutes is not much.
所以60分钟并不算多。
I have a feeling that most young people are using their phone more than 60 minutes per day.
我有一种感觉，大多数年轻人每天使用手机的时间超过 60 分钟。
I know I am.
我知道我是。
I think for adults the number is probably higher.
我认为对于成年人来说这个数字可能更高。
Andrew Huberman:
安德鲁·休伯曼：
Meaning if you're an adult, I could, I'm going to just extrapolate from what I read in this study.
这意味着如果你是成年人，我可以，我将根据我在这项研究中读到的内容进行推断。
It seems that probably two hours a day on the phone would be the upper limit beyond which you would probably experience pretty severe attentional deficits.
每天打电话两小时似乎是上限，超过这个上限，你可能会经历相当严重的注意力缺陷。
I am a big fan of Cal Newport, who wrote the book "Deep Work." He's also written the excellent book "A World Without Email." I've never met him, but I'm a huge admirer of his work.
我是卡尔·纽波特的忠实粉丝，他写了《深度工作》一书。他还写了一本优秀的书《没有电子邮件的世界》。我从未见过他，但我非常崇拜他的作品。
And I will paraphrase something that he said far more eloquently than I ever could.
我将用比我更雄辩的方式来解释他所说的一些话。
Which is that the brain does not do well with constant context switching.
也就是说，大脑不能很好地适应不断的上下文切换。
Meaning it can do it, but it diminishes our capacity to do meaningful work of any other kind.
这意味着它可以做到这一点，但它削弱了我们做任何其他类型的有意义的工作的能力。
And so Cal, as I understand — he's a computer science professor at Georgetown, by the way — is very structured and very disciplined in his avoidance of cell phone use.
因此，据我所知，卡尔——顺便说一句，他是乔治城大学的计算机科学教授——在避免使用手机方面非常有条理、非常自律。
Andrew Huberman:
安德鲁·休伯曼：
I think we're all striving to do that.
我想我们都在努力做到这一点。
I'm not here to tell you what to do, but I think whether or not you have ADHD or not, if you're an adolescent, limiting your smartphone use to 60 minutes per day or less, and if you are an adult to two hours per day or less, is going to be among the very best ways to maintain.
我不是来告诉你该怎么做，但我认为，无论你是否患有多动症，如果你是青少年，将智能手机的使用时间限制在每天 60 分钟或更少，如果你是成年人，每天使用智能手机的时间限制在两小时或更少，这将是最好的维持方法之一。
Just to maintain your ability to focus at whatever level you can now.
只是为了保持你现在能够集中注意力的能力。
And as I always say, most of the things that we get recognized for in life, success in life, in every endeavor, whether or not it's school, relationships, sport, creative works of any kind, are always proportional to the amount of focus that we can bring that activity.
正如我常说的，我们在生活中获得认可的大多数事情、生活中的成功、每项努力，无论是学校、人际关系、体育、任何类型的创意作品，总是与我们可以为这项活动带来的关注程度成正比。
It is important to rest, of course, to get proper sleep.
当然，为了获得适当的睡眠，休息很重要。
But I stand behind that statement, and I leave you with that study about attention and cell phones and how cell phones are indeed eroding our attentional capacities.
但我支持这一说法，我留给你们的是关于注意力和手机的研究，以及手机如何确实侵蚀我们的注意力能力。
Andrew Huberman:
安德鲁·休伯曼：
So I realize I covered a lot of information about ADHD and the biology of focus and how to get better at focusing.
所以我意识到我涵盖了很多关于多动症、注意力生物学以及如何更好地集中注意力的信息。
We talked about the behavioral and psychological phenotypes of ADHD.
我们讨论了多动症的行为和心理表型。
We talked about the underlying neural circuitry.
我们讨论了底层的神经回路。
We also talked about the neurochemistry, and we talked about the various prescription drug treatments that are aimed at that neurochemistry and aimed at increasing focus in children and adults with ADHD.
我们还讨论了神经化学，我们讨论了针对神经化学的各种处方药治疗，旨在提高对患有多动症的儿童和成人的关注。
We also talked about over-the-counter compounds, the role of particular types of diets and elimination diets.
我们还讨论了非处方化合物、特定类型饮食和消除饮食的作用。
And we talked about interactions between these various features in dictating outcomes for ADHD and enhancing focus in general.
我们讨论了这些不同特征之间的相互作用，以决定多动症的结果和增强注意力。
We also talked a little bit about emerging neuro technologies and how certain technologies like the smartphone are no doubt hindering our ability to focus and put us at greater risk of developing ADHD at all ages.
我们还讨论了一些新兴的神经技术，以及智能手机等某些技术无疑会阻碍我们集中注意力的能力，并使我们在所有年龄段都面临更大的患注意力缺陷多动症的风险。
I do acknowledge the irony and, somewhat, the contradiction of doing a two-hour-plus episode on ADHD if indeed people who are watching this have challenges with attention.
我确实承认，如果观看此节目的人确实在注意力方面遇到了挑战，那么制作一个关于多动症的两个多小时的剧集具有讽刺意味，并且在某种程度上是矛盾的。
I want to emphasize that this podcast, like all of our podcast episodes are time stamped for a specific reason.
我想强调的是，这个播客就像我们所有的播客剧集一样，都因特定原因而带有时间戳。
They are designed to be digested in whatever batch one chooses.
它们被设计成可以在选择的任何批次中被消化。
Right?
对吗？
You don't have to watch or listen to the entire thing all at once.
您不必同时观看或收听整个内容。
However, if you've gotten to this point in the podcast, I want to thank you.
但是，如果您已经在播客中了解到这一点，我想感谢您。
I do hope that you've learned a lot about this condition.
我确实希望您已经对这种情况有了更多的了解。
I hope you've also learned a lot about your own capacity to focus and things that you can do to enhance your focus.
我希望您还了解了很多有关自己集中注意力的能力以及可以采取哪些措施来增强注意力的知识。
Andrew Huberman:
安德鲁·休伯曼：
We even talked about a tool that takes just one 17-minute session to enhance your ability to focus thereafter, presumably forever.
我们甚至讨论了一种工具，只需一次 17 分钟的会议即可增强您此后（可能是永远）集中注意力的能力。
If you're enjoying this podcast and you're learning from it, please subscribe to our YouTube channel.
如果您喜欢这个播客并从中学习，请订阅我们的 YouTube 频道。
That really helps us.
这确实对我们有帮助。
In addition, in the comment section on YouTube, you can leave us suggestions for future podcast guests and suggestions for future podcast topics that we may have not covered, or that you'd like to see covered in the future.
此外，在 YouTube 的评论部分，您可以向我们留下对未来播客嘉宾的建议，以及对我们可能未涵盖或您希望将来涵盖的未来播客主题的建议。
Andrew Huberman:
安德鲁·休伯曼：
In addition, please subscribe to the podcast on Apple and Spotify.
此外，请订阅 Apple 和 Spotify 上的播客。
And on Apple, you have the opportunity to leave us a comment and up to a five-star review.
在 Apple 上，您有机会给我们留下评论，最高可达五星级评价。
In addition, please check out the sponsors mentioned at the beginning of the podcast.
此外，请查看播客开头提到的赞助商。
That's a terrific way to support us.
这是支持我们的好方法。
And for those of you that would like to support research on stress, neurobiology and human performance, you can go to hubermanlab.stanford.edu and there you can make a tax-deductible donation for research on neurobiology in my laboratory.
对于那些想要支持压力、神经生物学和人类表现研究的人，您可以访问 hubermanlab.stanford.edu，在那里您可以为我实验室的神经生物学研究提供免税捐款。
And finally, I want to thank you for your time and your attention.
最后，我要感谢您的时间和关注。
And as always, thank you for your interest in science.
一如既往，感谢您对科学的兴趣。