Essentials: ADHD & How Anyone Can Improve Their Focus

Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health, and performance.

欢迎来到 Huberman Lab Essentials，在这里我们回顾过去的剧集，寻找针对心理健康、身体健康和表现的最有效、最可操作的基于科学的工具。

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）。

Now, just a quick reminder that any time 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。

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。

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。

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。

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。

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。

For instance, right now, you're hearing sound waves, you are seeing things, you are sensing things against your skin, but you are only paying attention to some of those.

例如，现在，你听到声波，你看到东西，你感觉到皮肤上的东西，但你只注意到其中的一些。

And the ones that you're paying attention to are your perceptions.

你所关注的是你的看法。

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.

你现在没有注意你的其他感官。

Okay?

好的？

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。

So attention and focus are more or less the same thing, but impulse control is something separate.

因此，注意力和专注力或多或少是同一回事，但冲动控制是不同的。

Because impulse control requires pushing out or putting the blinders on to sensory events in our environment.

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。

Yes, they are distractible.

是的，他们很容易分散注意力。

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.

他们有时也有高度的情绪化。

However, people with ADHD can have a hyperfocus, an incredible ability to focus on things that they really enjoy and 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，可以专注于他们真正喜欢和感兴趣的事情。

Now, this is a very important point because 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.

现在，这是非常重要的一点，因为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。

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。

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, and they often can focus very well if the consequences of not completing a task or not attending are severe enough.

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，并且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。

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。

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。

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，经常会受到干扰。

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保留在网上的能力，并在大脑中一遍又一遍地循环使用它，以便您可以在短期或短期内使用它。

A good example of this would be you meet somebody, they tell you their name, they give you their phone number verbally, and you have to walk back to your phone and enter it into your phone.

一个很好的例子是，您遇到某人，他们告诉您他们的名字，他们口头给您他们的电话号码，然后您必须走回手机并将其输入到您的手机中。

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。

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。

Okay, so we've more or less established the kind of menu of items that people with ADHD tend to have.

好的，我们或多或少已经建立了多动症患者倾向于拥有的菜单。

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。

Their severity can range from very intense to mild, but in general, it's challenges with attention and focus, challenges with impulse control.

它们的严重程度可以从非常强烈到轻微，但总的来说，这是对注意力和注意力的挑战，对冲动控制的挑战。

They get annoyed easily.

他们很容易生气。

They have kind of 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, and they have a hard time with anything that's mundane that they're not really interested in.

时间感知可能会出现问题，他们很难处理那些他们并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。

I'd like to take a quick break and acknowledge our sponsor, Eight Sleep.

我想稍微休息一下，并向我们的赞助商“八睡”表示感谢。

Eight Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity.

August Sleep 生产具有冷却、加热和睡眠跟踪功能的智能床垫套。

One of the best ways to ensure a great night's sleep is to make sure that the temperature of your sleeping environment is correct.

确保一夜好眠的最佳方法之一是确保睡眠环境的温度正确。

And that's because in order to fall and stay deeply asleep, your body temperature actually has to drop by about one to three degrees.

这是因为为了入睡并保持深度睡眠，您的体温实际上必须下降约一到三度。

And in order to wake up feeling refreshed and energized, your body temperature actually has to increase by about one to three degrees.

为了醒来时感觉神清气爽、精力充沛，您的体温实际上必须升高约一到三度。

Eight Sleep automatically regulates the temperature of your bed throughout the night, according to your unique needs.

八睡眠会根据您的独特需求自动调节整个晚上的床温。

I've been sleeping on an Eight Sleep mattress cover for over four years now, and it has completely transformed and improved the quality of my sleep.

我已经睡在八睡眠床垫罩上四年多了，它彻底改变并改善了我的睡眠质量。

Eight Sleep has just launched their latest model, the Pod 5, and the Pod 5 has several new important features.

八睡眠刚刚推出了他们的最新型号 Pod 5，Pod 5 有几个新的重要功能。

One of these new features is called Autopilot.

这些新功能之一称为自动驾驶仪。

Autopilot is an AI engine that learns your sleep patterns to adjust the temperature of your sleeping environment across different sleep stages.

Autopilot 是一款人工智能引擎，可以学习您的睡眠模式，以调整不同睡眠阶段的睡眠环境温度。

It also elevates your head if you're snoring, and it makes other shifts to optimize your sleep.

如果您打鼾，它还会抬高您的头部，并进行其他转换以优化您的睡眠。

The base on the Pod 5 also has an integrated speaker that syncs to the Eight Sleep app and can play audio to support relaxation and recovery.

Pod 5 的底座还配有一个集成扬声器，可与八睡眠应用程序同步，并可以播放音频以支持放松和恢复。

The audio catalog includes several NSDR, Non-Sleep Deep Rest scripts, that I worked on with Eight Sleep to record.

音频目录包括几个 NSDR、非睡眠深度休息脚本，是我与“八睡眠”一起录制的。

NSDR can help offset some of the negative effects of slight sleep deprivation, and NSDR gets you better at falling back asleep should you wake up in the middle of the night.

NSDR 可以帮助抵消轻微睡眠不足的一些负面影响，并且 NSDR 可以让您在半夜醒来时更好地重新入睡。

It's an extremely powerful tool that anyone can benefit from the first time and every time.

这是一个极其强大的工具，任何人第一次和每次都可以从中受益。

If you'd like to try Eight Sleep, go to eightsleep.com/huberman to get up to $350 off the new Pod 5.

如果您想尝试八睡眠，请访问八睡眠.com/huberman，新款 Pod 5 最高可享受 350 美元优惠。

Eight Sleep ships to many countries worldwide, including Mexico and the UAE.

八号睡眠船运往世界各地的许多国家，包括墨西哥和阿联酋。

Again, that's eightsleep.com/huberman to save up to $350.

同样，访问八睡眠.com/huberman 最多可节省 350 美元。

So 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.

因此，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。

Now, enjoyment and curiosity, they're just the way that we describe our human experience of liking things, wanting to know more about them.

现在，享受和好奇心，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, and in particular, dopamine creates a heightened state of focus.

这就是我们所说的神经调节剂，特别是多巴胺可以创造高度的注意力状态。

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。

It's what we call exteroception.

这就是我们所说的外感受。

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。

So it creates a cone of auditory attention that's very narrow.

所以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。

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。

All right?

好的？

So now what we're doing is we're moving away from attention as this kind of vague, ambiguous term, and we're giving it a neurochemical identity, dopamine, and we are giving it a neural circuit identity.

所以现在我们正在做的是，我们正在摆脱注意力这种模糊的、模棱两可的术语，我们给它一个神经化学特性，多巴胺，我们给它一个神经回路特性。

And just to put a little bit of flavor and detail on which neural circuits those are, I want 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。

The first one is called the default mode network.

第一个称为默认模式网络。

The default mode network is the network of brain areas in your brain and 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和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。

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, and those are a completely different set of brain areas.

我们要考虑和讨论的关于多动症的另一组回路是任务网络，即让你以目标为导向的大脑网络，它们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。

Frontal cortex, no surprises, in the front, and you have a dorsal, the top, and side, lateral part.

毫无疑问，额叶皮层位于前面，并且有背侧、顶部和侧部。

Dorsolateral prefrontal cortex.

背外侧前额皮质。

And 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。

And 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。

And in 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.

对于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。

Okay?

好的？

Tends to be the medial prefrontal cortex.

往往是内侧前额叶皮层。

And 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。

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。

Okay?

好的？

Now, normally, in a person without ADHD, the task networks and the default mode networks are going in a seesaw fashion.

现在，通常情况下，对于没有多动症的人来说，任务网络和默认模式网络会以跷跷板的方式运行。

They are actually what we call anti-correlated.

它们实际上就是我们所说的反相关。

In a person with ADHD, they actually tend to be more correlated.

对于患有多动症的人来说，它们实际上往往更具相关性。

The default mode networks and the task networks are actually more coordinated.

默认模式网络和任务网络实际上更加协调。

And 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 anti-correlated 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或随着年龄的增长而不再多动症（有时就是这种情况）时，默认模式网络和任务网络往往会再次变得反相关。

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, "If this circuit should be active, then that circuit should be active.

多巴胺在说：“如果这个回路应该活跃，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." And 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 anti-correlated.

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。”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保持不变，正如工程师、物理学家或数学家所说，异相是反相关的。

So what exactly is going on with the dopamine system in people with ADHD?

那么多动症患者的多巴胺系统究竟发生了什么？

And what's going on with the dopamine system in people that have terrific levels of attention for any task?

对于任何任务都高度关注的人的多巴胺系统发生了什么？

Well, in the year 2015, an important paper came out, and it formalized the so-called low dopamine hypothesis of ADHD.

2015 年，一篇重要的论文发表了，它正式提出了所谓的 ADHD 低多巴胺假说。

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，如果大脑中特定回路中的多巴胺水平太低，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 kind of concert of anti-correlation.

因此，如果你回想一下，你已经有了这个默认模式网络和一个与任务相关的网络，它们需要处于这种反相关的协调中。

And in ADHD, they're firing together.

而在多动症中，他们是一起开火的。

Well, the problem seems to be that when dopamine is low, neurons fire more than they should in these networks that govern attention.

好吧，问题似乎是，当多巴胺水平较低时，这些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。

And if you start looking anecdotally at what people with ADHD have done for decades, what you find is that they tend to use recreational drugs, or they tend to indulge in non-drug stimulants.

如果你开始观察多动症患者几十年来的所作所为，你会发现他们倾向于使用娱乐性药物，或者倾向于沉迷于非药物兴奋剂。

So things like smoking a half a pack of cigarettes and drinking four cups of coffee a day.

比如每天抽半包烟、喝四杯咖啡。

Or if the person had access to it, using cocaine as a recreational drug or amphetamine as a recreational drug.

或者，如果该人有机会获得它，则使用可卡因作为娱乐药物或安非他明作为娱乐药物。

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以及这些任务相关和默认模式网络的区域。

Now, young children fortunately don't have access to those kinds of stimulants most of the time.

现在，幸运的是，幼儿大多数时候都无法接触到这些兴奋剂。

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。

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，人们认为患有多动症的儿童食用了太多的含糖食物或喝了太多的苏打水，或者患有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，或者会过量喝咖啡或过量吸烟，因为他们注意力不集中并且无法做出正确的决定。

They were too impulsive and so forth.

他们太冲动等等。

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.

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。

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 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。

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, it's typically things like Adderall, Modafinil, and some of the other derivatives.

如今，它通常是阿得拉、莫达非尼和其他一些衍生物。

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并协调默认模式网络和这些任务相关网络的网络中的多巴胺。

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 increase 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、速度或街头毒品命名中通常所说的速度非常相似。

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 neuromodulator called epinephrine or norepinephrine, also called noradrenaline and adrenaline.

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，即主要增加多巴胺，但也增加称为肾上腺素或去甲肾上腺素（也称为去甲肾上腺素和肾上腺素）的神经调节剂的水平。

Those names are the same.

这些名字是一样的。

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，事实上，它们看起来非常像，事实上，与我们都听说过的一些所谓的街头毒品兴奋剂几乎相同。

However, I do want to emphasize that at the appropriate dosages and working with a quality psychiatrist or neurologist or family physician, it does have to be a board-certified MD that prescribes these things.

然而，我确实想强调，在适当的剂量下，并与优质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处方。

Many people with ADHD achieve excellent relief with these drugs.

许多多动症患者通过这些药物得到了很好的缓解。

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。

I'd like to take a quick break and acknowledge our sponsor, Joovv.

我想稍微休息一下并感谢我们的赞助商 Joovv。

Joovv makes medical-grade red light therapy devices.

Joovv 生产医疗级红光治疗设备。

Now, if there's one thing that I have consistently emphasized on this podcast, it's the incredible impact that light can have on our biology.

现在，如果我在这个播客中一直强调一件事，那就是光对我们的生物学产生的令人难以置信的影响。

Now, in addition to sunlight, red light and near-infrared light have been shown to have positive effects on improving numerous aspects of cellular and organ health, including faster muscle recovery, improved skin health and wound healing, improvements in acne, meaning reductions in acne, reduced pain and inflammation, improved mitochondrial function, and even improving visual function itself.

现在，除了阳光之外，红光和近红外光已被证明对改善细胞和器官健康的许多方面具有积极作用，包括更快的肌肉恢复、改善皮肤健康和伤口愈合、改善痤疮，这意味着减少痤疮、减轻疼痛和炎症、改善线粒体功能，甚至改善视觉功能本身。

What sets Joovv lights apart and why they're my preferred red light therapy device is that they use clinically proven wavelengths, meaning specific wavelengths of red light and near-infrared light in specific combinations to trigger the optimal cellular adaptations.

Joovv 灯的与众不同之处以及它们成为我首选红光治疗设备的原因在于它们使用经过临床验证的波长，这意味着特定波长的红光和近红外光以特定的组合来触发最佳的细胞适应。

Personally, I use the Joovv whole body panel about three to four times per week, typically in the morning, but sometimes in the afternoon, and I use the Joovv handheld light both at home and when I travel.

就我个人而言，我每周大约使用 Joovv 全身面板三到四次，通常是在早上，但有时在下午，我在家和旅行时都会使用 Joovv 手持灯。

If you'd like to try Joovv, you can go to Joovv, spelled J-O-O-V-V, .com/huberman.

如果您想尝试 Joovv，可以访问 Joovv，拼写为 J-O-O-V-V，.com/huberman。

Joovv is offering an exclusive discount to all Huberman Lab listeners with up to $400 off select Joovv products.

Joovv 向所有 Huberman Lab 听众提供独家折扣，精选 Joovv 产品最高可享受 400 美元的折扣。

Again, that's Joovv, J-O-O-V-V, .com/huberman to get up to $400 off.

同样，Joovv、J-O-O-V-V、.com/huberman 可享受高达 400 美元的折扣。

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？

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。

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.

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，对于全世界来说，这种药物就是安非他明。

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？

Well, in order to get to some of those answers, I went to one of my colleagues, a pediatric neurologist that specializes in the treatment of epilepsy and ADHD in kids of all ages, from age three to 21.

嗯，为了找到其中一些答案，我去找了我的一位同事，他是一位儿科神经科医生，专门治疗 3 岁到 21 岁各年龄段儿童的癫痫和多动症。

I asked the following questions.

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，您对给小孩子服用安非他明有何看法？

Provided that the lowest possible dose is used and that dosage is modulated as they grow older and develop those powers of attention, their observation was that they've seen more kids benefit than not benefit from that.

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，而不是受益。

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, "Why wouldn't you wait until your kid reaches puberty?" 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, but also that dramatically change the way that the brain functions.

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，“你为什么不等到你的孩子进入青春期呢？”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，同时也会极大地改变大脑的功能。

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.

这只是奇特的科学说法，能够集中注意力，能够引导你的注意力，能够控制你的冲动。

And their answer was very specific and I think very important.

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, but neuroplasticity from age three until age 12 or 13 is exceedingly high.

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，但从 3 岁到 12 岁或 13 岁的神经可塑性非常高。

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." 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.

如果你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。”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 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, not actual eye blinks.

我们要讨论的是注意力何时发挥作用以及注意力何时减弱，而我们具体要讨论的是所谓的注意力眨眼，而不是真正的眨眼。

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，而在其中的某个地方，沃尔多戴着条纹帽子、戴着眼镜，是个瘦瘦的家伙，你必须找到沃尔多。

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.

所以你倾向于看。

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 或在其他视觉搜索任务中寻找目标时，在那一刻，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。

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。

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 over-focusing 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。

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.

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。

And indeed, there are data now to support the possibility that that's actually what's happening.

事实上，现在有数据支持这确实正在发生的可能性。

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。

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.

它可以是高度集中的、苏打稻草视图。

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，可以让您将目光扩大到所谓的全景视觉。

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, it also is better at processing things in time.

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，它是一个流或一组神经回路，不仅是广角视图，而且还能够更好地及时处理事物。

Its frame rate is higher.

其帧率较高。

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。

When people do that, they are able to attend to and recognize multiple targets.

当人们这样做时，他们能够关注并识别多个目标。

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。

You can consciously go into open gaze, and then you can contract your field of view as well.

你可以有意识地开放凝视，然后你也可以收缩你的视野。

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。

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。

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改变。

I want to just emphasize one study in particular, which is quite appropriately titled Time Dilates After Spontaneous Blinking.

我想特别强调一项研究，其标题为“自发眨眼后时间扩张”，非常恰当。

They examined the relationship between fluctuations in timing and blinking, and to make a long story short, what they found is that right after blinks, we reset our perception of time.

他们研究了时间波动和眨眼之间的关系，长话短说，他们发现眨眼之后，我们就重置了对时间的感知。

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，您会立即明白为什么这很重要，因为眨眼的频率是由多巴胺控制的。

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.

所以这意味着多巴胺控制注意力，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。

And fortunately, it's also one that you can control.

幸运的是，这也是您可以控制的。

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。

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 are disorganized.

他们往往会迟到，或者组织混乱。

Their dopamine is low.

他们的多巴胺水平较低。

We know that as well.

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。

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.

这确实令人兴奋，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注意力正常的人如果想要提高自己的注意力能力，可以通过训练来实现这一目标，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, entitled Improvement of Attention in Elementary School Students through Fixation Focus Training Activity.

事实证明，这项研究确实已经完成，题为“通过固视焦点训练活动提高小学生的注意力”。

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 schoolchildren to greatly enhance their ability to focus on other types of information.

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让这些学童大大增强他们专注于其他类型信息的能力。

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.

这种效应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。

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。

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 30 秒，或者可能一分钟，然后在另一个站，看得更远一点，再远一点。

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 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.

现在你应该明白，这些百叶窗位于你眼睛的前面，它们不仅仅是为了眨眼，而且它们不仅仅是为了美观的目的。

They are there to regulate the amount of information going into your nervous system, and they are 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 fisheye 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像这样的苏打吸管视图，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。

I'd like to take a quick break and acknowledge our sponsor, AG1.

我想稍微休息一下并感谢我们的赞助商 AG1。

AG1 is a vitamin mineral probiotic drink that also includes prebiotics and adaptogens.

AG1 是一种维生素矿物质益生菌饮料，还包含益生元和适应原。

As somebody who's been involved in research science for almost three decades and in health and fitness for equally as long, I'm constantly looking for the best tools to improve my mental health, physical health, and performance.

作为一个从事科学研究近三十年以及同样长期从事健康和健身工作的人，我一直在寻找最好的工具来改善我的心理健康、身体健康和表现。

I discovered AG1 back in 2012, long before I ever had a podcast, and I've been taking it every day since.

我早在 2012 年就发现了 AG1，那时我还没有播客，从那时起我就每天都在服用它。

I find it improves all aspects of my health, my energy, my focus, and I simply feel much better when I take it.

我发现它改善了我的健康、精力、注意力的各个方面，而且服用它后我感觉好多了。

AG1 uses the highest quality ingredients in the right combinations, and they're constantly improving their formulas without increasing the cost.

AG1 使用最优质的成分进行正确的组合，并且在不增加成本的情况下不断改进其配方。

In fact, AG1 just launched their latest formula upgrade.

事实上，AG1刚刚推出了他们最新的配方升级。

This next-gen formula is based on exciting new research on the effects of probiotics on the gut microbiome, and it now includes several clinically studied probiotic strains shown to support both digestive health and immune system health, as well as to improve bowel regularity and to reduce bloating.

这种下一代配方基于关于益生菌对肠道微生物组影响的令人兴奋的新研究，它现在包含几种经过临床研究的益生菌菌株，这些益生菌菌株显示出支持消化健康和免疫系统健康，以及改善肠道规律性和减少腹胀。

Whenever I'm asked if I could take just one supplement, what that supplement would be, I always say AG1.

每当我被问到是否可以只服用一种补充剂时，我总是说 AG1。

If you'd like to try AG1, you can go to drinkag1.com/huberman.

如果您想尝试 AG1，可以访问 Drinkag1.com/huberman。

For a limited time, AG1 is giving away a free one-month supply of omega-3 fish oil, along with a bottle of vitamin D3 plus K2.

AG1 限时免费赠送一个月的 omega-3 鱼油，以及一瓶维生素 D3 加 K2。

As I've highlighted before on this podcast, omega-3 fish oil and vitamin D3 K2 have been shown to help with everything from mood and brain health, to heart health, to healthy hormone status, and much more.

正如我之前在此播客中强调的那样，omega-3 鱼油和维生素 D3 K2 已被证明对改善情绪和大脑健康、心脏健康、健康激素状态等各个方面都有帮助。

Again, that's drinkag1.com/huberman to get a free one-month supply of omega-3 fish oil, plus a bottle of vitamin D3 plus K2 with your subscription.

再次强调，您可以通过 Drinkag1.com/huberman 获得一个月的免费 omega-3 鱼油，以及一瓶维生素 D3 和 K2。

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 non-prescription 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药，使用各种补充剂类型的化合物来增加大脑中多巴胺、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。

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.

这些是我之前提到的，哌醋甲酯，也称为利他林，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。

I think it is important to understand the extent to which they all carry more or less the same side effects, such as high propensity for addiction and abuse.

我认为重要的是要了解它们在多大程度上都具有或多或少相同的副作用，例如成瘾和滥用的高倾向。

Amphetamines of any kind, as well as cocaine, can cause sexual side effects because they're vasoconstrictors.

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。

So these drugs are not without their consequences.

因此，这些药物并非没有后果。

In addition, they almost all carry cardiac effects, right?

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。

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.

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。

So then the question becomes, how much EPA, how much DHA?

那么问题来了，多少EPA，多少DHA？

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, and typically it's the EPA that's harder to get at sufficient levels, meaning you have to take quite a lot of fish oil in order to get above that 1,000 milligram or 2,000 milligram threshold to improve mood and other functions.

因此，通常情况下，鱼油或其他 omega-3 来源都含有 DHA 和 EPA，而 EPA 的含量通常较难获得足够的水平，这意味着您必须服用大量鱼油才能达到 1,000 毫克或 2,000 毫克的阈值，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, 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.

但为了提高注意力，有 10 项研究对此进行了详细探讨，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 才是真正开始看到注意力效果的地方。

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足够的 EPA，那么几乎毫无疑问，您将获得 300 毫克或更多的 DHA。

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。

Phosphatidylserine taken for two months for 200 milligrams per day was able to reduce the symptoms of ADHD in children.

每天服用 200 毫克磷脂酰丝氨酸两个月，能够减轻儿童 ADHD 的症状。

It has not been looked at in adults yet, 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，尚未在成人中进行过研究，但食用 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。

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和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越来越受欢迎，不仅用于治疗多动症和发作性睡病，而且还适用于试图长时间保持清醒的人群。

So it's actively used in the military, by first responders.

因此，它在军队中被急救人员积极使用。

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.

它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德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，并且达到了戏剧性的程度。

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。

Now, you may notice that I haven't talked much about acetylcholine.

现在，您可能会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，参与产生各种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。

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, and those neurons reside in an area or a structure that's called the pedunculopontine nucleus, the PPN.

你的脑干中有一组神经元向前发送投射，有点像一个非常分散的喷水系统，以释放乙酰胆碱，这些神经元驻留在一个称为桥脚核（PPN）的区域或结构中。

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 now you have an example and you have an understanding and hopefully a picture in your mind of how all this is working.

现在你有了一个例子，你已经有了理解，并且希望你的脑海中能够描绘出这一切是如何运作的。

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, which is a form of choline and increases acetylcholine transmission.

其中一种化合物就是所谓的 α-GPC，它是胆碱的一种形式，可以增加乙酰胆碱的传输。

Dosages as high as 1,200 milligrams per day, which is a very high dosage, 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 1,200 毫克的剂量（这是一个非常高的剂量，通常为全天 300 或 400 毫克）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。

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 至 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。

And there are some over-the-counter compounds that are in active use out there for treatment of ADHD and in use for simply trying to improve focus.

还有一些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。

L-tyrosine, it's an amino acid that acts as a precursor to the neuromodulator dopamine.

L-酪氨酸是一种氨基酸，是神经调节剂多巴胺的前体。

The dosaging can be very tricky to dial in.

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。

So the dosage ranges are huge.

所以剂量范围很大。

You see evidence for 100 milligrams all the way up to 1,200 milligrams.

您会看到 100 毫克一直到 1,200 毫克的证据。

It's something that really should be approached with caution, 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.

这确实应该谨慎对待，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，但尤其是躁狂症、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。

Everybody nowadays seems to have a smartphone.

如今似乎每个人都拥有智能手机。

They grab our attention entirely, but within that small box of attention, there are millions of attentional windows scrolling by.

它们完全吸引了我们的注意力，但在这个小注意力盒子里，有数百万个注意力窗口滚动。

Right?

正确的？

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, 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.

我们专注于手机，但由于手机内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。

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通常是你应对所有压倒性信息的方式。

Well, within the phone, your visual aperture is set to a given width, and within there, your attentional window is grabbing a near infinite number of bits of information, colors, movies.

好吧，在手机内，你的视觉孔径被设置为给定的宽度，在其中，你的注意力窗口正在抓取几乎无限数量的信息、颜色、电影。

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。

We are inducing a sort of ADHD.

我们正在诱发一种多动症。

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 your ability to focus at whatever level you can now.

我不是来告诉你该怎么做，但我认为，无论你是否患有 ADHD，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 2 小时或更少，这将是保持你现在能集中注意力的能力的最佳方法之一。

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, but I stand behind that statement, and I leave you with that about attention and cell phones and how cell phones are indeed eroding our attentional capacities.

当然，为了获得适当的睡眠，休息很重要，但我支持这一说法，我留给你们关于注意力和手机的问题，以及手机确实如何侵蚀我们的注意力能力。

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。