Essentials: Psychedelics & Neurostimulation for Brain Rewiring | Dr. Nolan Williams
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
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。
And now for my discussion with Dr. Nolan Williams.
现在我与诺兰·威廉姆斯博士进行讨论。
Thanks for joining today.
感谢您今天加入。
I'm really excited to have this conversation.
我真的很高兴能进行这次谈话。
I have a lot of questions about different compounds, psychedelics in particular.
我对不同的化合物，特别是致幻剂有很多疑问。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
But before we get into that discussion, I want to ask you about depression, broadly speaking.
但在我们开始讨论之前，我想从广义上问你关于抑郁症的问题。
Andrew Huberman:
安德鲁·休伯曼：
Sure.
当然。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
I heard you say in a wonderful talk that you gave that depression is perhaps the most debilitating condition worldwide.
我听到您在一次精彩的演讲中说，抑郁症可能是全世界最令人衰弱的疾病。
Yet, in contrast to other medical conditions like cancer, we actually have a fairly limited number of tools to approach depression, and yet the number of tools and the potency of those tools is growing.
然而，与癌症等其他疾病相比，我们治疗抑郁症的工具实际上数量相当有限，但工具的数量和这些工具的效力正在不断增长。
Andrew Huberman:
安德鲁·休伯曼：
Depression is the most disabling condition worldwide.
抑郁症是全世界最严重的致残疾病。
What's interesting about depression is it's both a risk factor for other illnesses, and it makes other medical and psychiatric illnesses worse.
抑郁症的有趣之处在于，它既是其他疾病的危险因素，又会使其他疾病和精神疾病恶化。
Right?
正确的？
So recently, the American Heart Association added depression as the fourth major risk factor for coronary artery disease.
最近，美国心脏协会将抑郁症列为冠状动脉疾病的第四大危险因素。
Right?
正确的？
So alongside the risk factors that we know, hypertension, high blood pressure, hyperlipidemia, high cholesterol, and diabetes, high blood sugar, those three have been on the list for a long time, and depression ended up being added to the list as the fourth one.
那么除了我们知道的危险因素之外，高血压、高血压、高血脂、高胆固醇，还有糖尿病、高血糖，这三个因素已经在名单上很久了，而抑郁症最终被列为第四个。
A lot of what we're doing in the lab actually is measuring brain-heart connections, and we can actually, with transcranial magnetic stimulation, a form of brain stimulation, we can actually decelerate the heart rate, and we can capture that heart rate deceleration over the mood regulatory regions.
我们在实验室所做的很多事情实际上是测量脑心连接，实际上，通过经颅磁刺激（一种大脑刺激形式），我们可以实际上降低心率，并且可以捕获情绪调节区域的心率减速。
And so actually a direct probe of that connection.
所以实际上是对这种联系的直接探测。
We've been very interested in a very particular clinical set of problems around the most severe and the most high acuity settings that folks with depression end up being in, and that's in emergency settings where they go into inpatient units.
我们对一系列非常特殊的临床问题非常感兴趣，这些问题围绕抑郁症患者最终所处的最严重和最严重的环境，即他们进入住院病房的紧急情况。
The field really hasn't developed a way of consistently being able to treat that problem, and folks end up getting the same standard oral antidepressants that they've been getting outpatient.
该领域确实还没有开发出一种能够持续治疗这个问题的方法，人们最终只能得到与门诊相同的标准口服抗抑郁药。
And I came to this because I've dual trained as a neurologist and psychiatrist, went back and forth between neurology and psychiatry.
我之所以来到这里，是因为我接受过神经科医生和精神病学家的双重培训，在神经病学和精神病学之间来回切换。
Saw that in neurology we have all of these ways of treating acute brain-based problems, and really wanted to emulate that in psychiatry and find ways to develop and engineer new brain-based solutions.
看到在神经学领域，我们有所有这些治疗急性大脑问题的方法，并且真的想在精神病学中效仿，并找到开发和设计新的基于大脑的解决方案的方法。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Many people out there probably think of the relationship between the heart and the mind as kind of woo or kind of a-
许多人可能认为心灵和思想之间的关系是一种求爱或一种——
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm
嗯嗯
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
a soft biology.
软生物学。
But here you're talking about an actual physical connection.
但这里你谈论的是实际的物理连接。
Andrew Huberman:
安德鲁·休伯曼：
Yep.
是的。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
What area of the brain is it?
它是大脑的哪个区域？
Andrew Huberman:
安德鲁·休伯曼：
The first place where the stimulation goes is called the dorsolateral prefrontal cortex.
刺激到达的第一个地方称为背外侧前额皮质。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
It's kind of the sense of control, kind of governor of the brain.
这是一种控制感，一种大脑的管理者。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Mm-hmm.
嗯嗯。
Andrew Huberman:
安德鲁·休伯曼：
And then what we know is that when you use a magnet, kind of what we call Faraday's law, this idea of using a magnetic pulse to induce an electrical current in electrically conducting substances.
然后我们知道的是，当你使用磁铁时，我们称之为法拉第定律，即使用磁脉冲在导电物质中感应出电流的想法。
So in this case, brain tissue, but not skull or scalp or any of that, or hair, you avoid all that, just the brain tissue.
所以在这种情况下，是脑组织，但不是头骨或头皮或任何其他东西，或头发，你可以避免所有这些，只是脑组织。
Then you have a direct depolarization of cortical neurons, the surface of the brain's neurons in this dorsolateral prefrontal.
然后，皮质神经元（位于背外侧前额叶的大脑表面神经元）发生直接去极化。
And if you do that in the actual scanner, which we can do, you can see that that distributes down into the anterior cingulate, and the insula, and the amygdala.
如果你在实际的扫描仪中做到这一点（我们可以做到），你可以看到它向下分布到前扣带回、岛叶和杏仁核。
And ultimately, the tract goes into something called the nucleus tractus solitarius, and ultimately into the vagus nerve into the heart.
最终，该束进入孤束核，并最终进入迷走神经，进入心脏。
So the heart very consistently seems to be the end organ of the dorsolateral prefrontal cortex.
因此，心脏似乎非常一致地是背外侧前额叶皮层的终末器官。
And if you do that over visual cortex, you don't get that, or motor cortex, you don't get any of those findings.
如果你在视觉皮层上这样做，你就得不到那个，或者在运动皮层上，你就得不到任何这些发现。
It's really specific to this kind of control region of the brain.
它确实是针对大脑的这种控制区域的。
And so yeah, it's our work.
是的，这是我们的工作。
Other folks' work, Martijn Arns in Europe, Netherlands work showing the same connections.
其他人的作品，Martijn Arns 在欧洲、荷兰的作品也显示出同样的联系。
I think it's been replicated like four or five times.
我认为它已经被复制了四五次。
Where I think TMS is really interesting, actually, we had a lot of patients who've told me, like, "My therapist told me that I wasn't trying hard enough in therapy." These are moderate or pretty severe depressed patients.
我认为 TMS 真的很有趣，事实上，我们有很多患者告诉我，比如，“我的治疗师告诉我，我在治疗方面做得不够努力。”这些是中度或相当严重的抑郁症患者。
And as soon as we get them well with the TMS approaches, kind of rapid five-day approach, and then the next week we come in and see them, and they'll say, "You know what I did all weekend is I looked at my therapy books, and now I can understand it." And so, I actually see TMS as a way of having kind of exogenous sorts of cognitive functions that in milder forms of depression, we can pull off with psychotherapy.
一旦我们用 TMS 方法（一种快速的五天方法）让他们康复，然后下周我们去看他们，他们会说，“你知道我整个周末都做了什么，我看了我的治疗书籍，现在我能理解它了。”因此，我实际上将 TMS 视为一种具有外源性认知功能的方式，在轻度抑郁症中，我们可以通过心理治疗来实现这种功能。
This idea of being able to kind of turn that prefrontal cortex on and have it govern these deeper regions.
这种想法能够打开前额皮质并让它控制这些更深的区域。
In depression, the deeper regions govern the prefrontal cortex.
在抑郁症中，较深层的区域控制着前额皮质。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
In one case, it's like the coach telling the player what to do.
在一种情况下，这就像教练告诉球员该做什么。
Andrew Huberman:
安德鲁·休伯曼：
Exactly.
正是如此。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And in the other case, like a player telling the coach what to do, and you-
在另一种情况下，就像一名球员告诉教练该做什么，而你-
Andrew Huberman:
安德鲁·休伯曼：
That's right
没错
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
you restore order to the game.
你恢复了游戏秩序。
Andrew Huberman:
安德鲁·休伯曼：
You restore order to the game.
你恢复了游戏秩序。
And what it looks like is depression is a bunch of kind of spontaneous content that's semi-volitional, that's being kind of generated out of this conflict detection system, the cingulate.
看起来抑郁症是一种半自愿的自发内容，是由冲突检测系统（扣带回）产生的。
In depression, it looks like the left dorsolateral does not sufficiently clamp down on it.
在抑郁症中，左背外侧似乎没有足够的压力。
And what therapy appears to do is to kind of restore that.
治疗似乎要做的就是恢复这种状态。
What we see with TMS over that region is that we just exogenously do the same sort of thing.
我们通过 TMS 在该区域看到的是，我们只是外源性地做同样的事情。
We restore the governance of the left dorsolateral over the cingulate area, and that is correlated with treatment improvement.
我们恢复了扣带回左侧背外侧的控制，这与治疗的改善相关。
So the degree in which you can re- Time re-regulate in time the left dorsolateral over the cingulate, the more of an antidepressant effect you have.
因此，您可以及时重新调节扣带回左侧背外侧的程度，您的抗抑郁效果就越大。
TMS is almost like exercise for the brain.
TMS 几乎就像大脑的锻炼。
You're kind of exercising this region over and over again with a physiologically relevant signal and kind of turning that system on.
您可以通过生理相关信号一遍又一遍地锻炼该区域，并打开该系统。
And what's interesting for this show is we had a couple of folks, probably five or six folks that have actually told me this, where if they remit early enough in the week, we have this very dense stimulation approach where we can stimulate people really rapidly over a five-day block.
这个节目的有趣之处在于，我们有几个人，可能有五六个人实际上告诉了我这一点，如果他们在一周内足够早地汇款，我们就有这种非常密集的刺激方法，我们可以在五天的时间内真正快速地刺激人们。
By Wednesday, they're totally zero down on the depression scales, even better than most people walking around, really no anxiety, no depression or anything.
到周三，他们的抑郁量表完全为零，甚至比大多数人都好，真的没有焦虑，没有抑郁或任何东西。
By Thursday, the first guy that told me this, he came in and he said, "I was driving back to my hotel and I decided to go to the beach and I just sat there and I was totally present in the present moment for an hour." And he's like, "I read about this in my mindfulness books, but I experienced it last night and I've never experienced anything like this before." And I was like, "Hmm, that's interesting," but kind of wasn't sure.
到周四，第一个告诉我这件事的人进来了，他说：“我正开车回酒店，我决定去海滩，我就坐在那里，在一个小时里我完全沉浸在当下。”他说，“我在正念书籍中读到过这一点，但我昨晚经历过，我以前从未经历过这样的事情。”我当时想，“嗯，这很有趣，”但有点不确定。
And then I didn't tell obviously any more patients about that.
然后我显然没有告诉更多的病人这件事。
And then about five over the last couple of years, when they remit early in the week, by the end of the week, they're going to the beach and they're totally having what people describe as a pretty mindful, present moment sort of experience, which is really interesting what that is.
然后，在过去的几年里，大约有五年，当他们在本周早些时候汇款时，到周末，他们会去海滩，他们完全享受人们所说的一种非常用心的、当下的体验，这真的很有趣。
I don't have full on scientific data to tell you, but it's an interesting anecdote that folks, when you push them through this point of feeling kind of clinically well, that some people end up reporting this additional set of features.
我没有完整的科学数据可以告诉你，但这是一个有趣的轶事，当你让人们感觉临床上感觉良好时，有些人最终会报告这组额外的功能。
So
所以
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
I'd like to take a quick break and acknowledge our sponsor, Function.
我想稍微休息一下并感谢我们的赞助商 Function。
Function provides over 160 advanced lab tests to give you a clear snapshot of your bodily health.
功能提供超过 160 项高级实验室测试，让您清晰了解自己的身体健康状况。
This snapshot gives you insights into your heart health, your hormone health, autoimmune function, nutrient levels, and much more.
通过此快照，您可以深入了解心脏健康状况、激素健康状况、自身免疫功能、营养水平等。
They've also recently added access to advanced MRI and CT scans.
他们最近还增加了先进的 MRI 和 CT 扫描的访问权限。
Function not only provides testing of over 160 biomarkers key to your physical and mental health, it also analyzes these results and provides recommendations for improving your health from top doctors.
Function 不仅提供对您身心健康至关重要的 160 多种生物标记物的测试，还分析这些结果并提供顶级医生改善您健康的建议。
For example, in a recent test with Function, I learned that some of my blood lipids were slightly out of range.
例如，在最近的一次 Function 测试中，我发现我的一些血脂稍微超出了范围。
As a result, I decided to start supplementing with nattokinase, which can naturally help reduce LDL cholesterol, and it did.
因此，我决定开始补充纳豆激酶，它自然可以帮助降低低密度脂蛋白胆固醇，而且确实如此。
In a follow-up test, I could confirm that this strategy worked.
在后续测试中，我可以确认这个策略是有效的。
My blood lipids are now back exactly where I want them.
我的血脂现在完全回到了我想要的水平。
Comprehensive lab testing of the sort that Function offers is just so important for health.
Function 提供的全面实验室测试对于健康非常重要。
How else are you going to know what's going on under the hood?
否则你怎么知道幕后发生了什么？
And while I've been doing blood work for years, it used to be time-consuming, complicated, and expensive.
虽然我从事血液检查已有多年，但它过去非常耗时、复杂且昂贵。
In fact, I used to spend thousands of dollars per year trying to get this kind of data, and the data, frankly, were not all that good.
事实上，我曾经每年花费数千美元试图获得此类数据，但坦率地说，这些数据并不那么好。
But now with Function, it's extremely easy and affordable.
但现在有了 Function，它变得非常简单且经济实惠。
A Function membership is only a dollar a day, $365 a year.
Function 会员每天仅需 1 美元，每年 365 美元。
And if you think about the information it provides and the health challenges it helps you avoid and the proactive things that it can do for you to enhance your health, I truly look at it as a savings.
如果您考虑一下它提供的信息、它可以帮助您避免的健康挑战以及它可以为您增强健康所做的积极主动的事情，我确实将其视为一种节省。
To learn more, visit functionhealth.com/huberman and use the code Huberman for a $50 credit towards your membership.
要了解更多信息，请访问 functionhealth.com/huberman 并使用代码 Huberman 获得 50 美元的会员积分。
Again, that's functionhealth.com/huberman.
同样，这是 functionhealth.com/huberman。
I want to make sure that before we dive into ketamine and psilocybin, that we do touch on SSRIs, selective serotonin reuptake inhibitors, because we can't really have a discussion about depression without talking about SSRIs.
我想确保，在我们深入探讨氯胺酮和裸盖菇素之前，我们确实会涉及 SSRIs（选择性血清素再摄取抑制剂），因为如果不谈论 SSRIs，我们就无法真正讨论抑郁症。
My understanding is that the SSRIs are powerfully effective for certain forms of obsessive compulsive disorder and may also be effective for treatment of depression.
我的理解是，SSRIs 对某些形式的强迫症非常有效，也可能对治疗抑郁症有效。
Is that right?
是这样吗？
And how should we think about SSRIs?
我们应该如何看待 SSRIs？
Are they useful?
它们有用吗？
Are they not useful?
它们没有用吗？
Andrew Huberman:
安德鲁·休伯曼：
SSRIs clearly work.
SSRIs 显然有效。
Many meta-analyses kind of proving that out.
许多荟萃分析都证明了这一点。
That in a subpopulation of individuals, they achieve great benefit for depression, for obsessive compulsive disorder, for generalized anxiety disorder, panic, all of these things you can see an improvement in those symptoms with what we call SSRIs or selective serotonin reuptake inhibitors.
在一个亚群中，他们对抑郁症、强迫症、广泛性焦虑症、恐慌症，以及所有这些症状，都可以通过我们所说的 SSRIs 或选择性血清素再摄取抑制剂得到改善。
The issue is that they don't work immediately.
问题是它们不会立即起作用。
So they don't work the same day you start taking them, and that suggests that probably it's not exactly the serotonin being in there that's directly driving it, that it's much more likely that it may have some brain plasticity effects.
因此，它们在您开始服用的当天就不会起作用，这表明可能并不完全是其中的血清素直接驱动它，更有可能的是它可能对大脑可塑性产生一些影响。
There's not a deficit of serotonin.
没有血清素缺乏。
You're not born with what people call a chemical imbalance, and psychiatry's known this.
你并不是生来就患有人们所说的化学失衡，精神病学也知道这一点。
This is not actually new information to anybody.
这对任何人来说实际上都不是新信息。
It's kind of a rehashing of a bunch of information we've known for a while now, but in the lay press, it's kind of hit in a way that it didn't seem to grab attention before with previous publications.
这是对我们已经知道了一段时间的一堆信息的重新整理，但在外行媒体上，它以一种以前的出版物似乎没有引起注意的方式受到了打击。
But this idea that this chemical imbalance idea is wrong, I really think that part's important because I think that what I'll call psychiatry 1.0, this kind of idea of Freud and psychotherapy in its origins , it was a lot around your family and those experiences and psychotherapy kind of going in and correcting or helping you to figure out or you being able to see or people hear you so that you can eventually come to the conclusion of certain cognitions that aren't helping you.
但这种化学不平衡的想法是错误的，我真的认为这部分很重要，因为我认为我称之为精神病学1.0，这种弗洛伊德和心理治疗的想法起源于你的家庭，这些经历和心理治疗会介入并纠正或帮助你弄清楚，或者你能够看到或人们听到你的声音，这样你最终可以得出某些对你没有帮助的认知的结论。
Things like the schizophrenogenic mother and all of that, that was a concept at some point.
像患有精神分裂症的母亲之类的事情，这在某种程度上是一个概念。
And so we've transitioned from that to for a long time, the chemical imbalance, which I'll call psychiatry 2.0, this idea that there's something chemically missing.
因此，很长一段时间以来，我们已经从化学失衡过渡到化学失衡，我将其称为精神病学 2.0，即化学物质缺失的想法。
The trouble there for a patient is that it's sending a message of there's something missing with me, whether it be my experiences I had no control over when I was a child or a chemical in my brain.
对于病人来说，麻烦在于它传递出一种信息，表明我缺少某些东西，无论是我小时候无法控制的经历，还是我大脑中的化学物质。
What I think is really powerful with TMS and a lovely even powerful with the psychedelic story is it's saying something different TMS works and there's no serotonin coming in or out of the brain, right?
我认为 TMS 真正强大的地方，以及迷幻故事的可爱甚至强大之处在于，它说明了 TMS 的作用不同，并且没有血清素进出大脑，对吗？
And we're doing a rapid form of TMS that works in one to five days.
我们正在开发一种快速 TMS，只需一到五天就可以发挥作用。
It's very unlikely that there's some long-term kind of upregulation of serotonin that's driving that.
不太可能是某种长期的血清素上调导致了这种情况。
So our work actually kind of pushes back on this serotonin hypothesis as being kind of the center of depression because it says, look, we're not giving anybody any serotonin.
因此，我们的工作实际上有点反驳了血清素假说，认为它是抑郁症的中心，因为它说，看，我们不会给任何人任何血清素。
We're simply turning these brain regions on, and we're focused on the circuitry, and that's Psychiatry 3.0.
我们只是打开这些大脑区域，我们专注于电路，这就是精神病学 3.0。
It's not just like neuromodulation.
这不仅仅是神经调节。
Neuromodulations are a really nice use case for Psychiatry 3.0 because it's a way to focally and directly perturb brain regions in whatever modality you're using.
神经调节是精神病学 3.0 的一个非常好的用例，因为它是一种以任何方式集中、直接扰乱大脑区域的方法。
But there are a lot of groups that are actually doing neuroimaging before and after, and they're able to see circuit-level changes for something like psilocybin or ketamine long after the drug is gone, suggesting in those same brain regions converge.
但有很多小组实际上在前后进行了神经影像学检查，他们能够在药物消失后很久看到裸盖菇素或氯胺酮等药物的回路水平变化，这表明这些相同的大脑区域会聚合。
So the subgenual default mode network connection that we see is changing with our Stanford neuromodulation therapy technique.
因此，我们看到的膝下默认模式网络连接正在随着我们的斯坦福神经调节治疗技术而改变。
It's that same set of brain regions that ketamine and psilocybin seem to act on these connections between brain networks that seem to shift.
氯胺酮和裸盖菇素似乎作用于大脑网络之间的这些连接的同一组大脑区域似乎发生了变化。
And so it refocuses the story on something that's highly correctable, and it's basically electrophysiology.
因此，它将故事的焦点重新集中在高度可纠正的事物上，这基本上是电生理学。
And it's basically kind of recalibrating a circuit that is recalibratable instead of I have something missing or I have some set of experiences early in life that are going to forever trap me in these psychiatric diagnoses.
这基本上是一种重新校准可重新校准的电路，而不是我缺少某些东西，或者我在生命早期有一些经历，这些经历将永远让我陷入这些精神病诊断中。
And so it kind of challenges that idea, and I think that's what's so powerful about Psychiatry 3.0, this idea of focusing on the circuit because it gets us into thinking about psychiatry and psychiatric illnesses as something that are recoverable.
所以它在某种程度上挑战了这个想法，我认为这就是精神病学 3.0 的强大之处，这种专注于回路的想法因为它让我们开始思考精神病学和精神疾病是可以康复的。
People can get better.
人们可以变得更好。
We've seen with our TMS techniques, we've seen it with some of the psychedelic work that we've done, where people are actually in normal levels of mood for sustained periods of time or-
我们已经通过 TMS 技术看到了这一点，我们已经通过我们所做的一些迷幻工作看到了这一点，人们实际上在持续一段时间内处于正常的情绪水平，或者-
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Within five days
五天内
Andrew Huberman:
安德鲁·休伯曼：
...
...
within five or less days.
五天内或更短的时间内。
And in the case of the psychedelics, within a few days.
就迷幻药而言，几天之内。
So we can get people out of these states.
这样我们就可以让人们离开这些州。
They're totally well.
他们很好。
There's no drug in their system at that point.
那时他们的系统中没有药物。
In the case of psychedelics, there was never a drug in their system in the case of TMS.
就迷幻剂而言，在 TMS 的情况下，他们的系统中从来没有药物。
And it just tells us that it's fixable.
它只是告诉我们它是可以修复的。
It's just like an arrhythmia in the heart.
就像心脏出现心律失常一样。
It's like a broken leg.
就像断了腿一样。
We can go in and do something, and we can get somebody better.
我们可以进去做点什么，我们可以让某人变得更好。
Then I think what's empowering and what a lot of patients have told me is they say, some people will relapse and need more stimulation or need more psychedelics or whatever it is, but they'll tell me, "I don't fear that I'm chronically broken.
然后我认为什么是赋予力量的，很多病人告诉我的是他们说，有些人会复发，需要更多刺激或需要更多迷幻药或其他什么，但他们会告诉我，“我不担心我长期崩溃。
I don't fear that the chemical imbalance is still imbalanced.
我不担心化学不平衡仍然不平衡。
I don't fear that these things that I couldn't control in my childhood are going to be there and drive this problem forever." And I think that's what's so powerful about this.
我不担心我童年时无法控制的这些事情会继续存在并永远导致这个问题。”我认为这就是它的强大之处。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And that brings me to this question about psychedelics and frankly, the altered thinking and perception that occurs in high-dose psilocybin-
这让我想到了关于迷幻药的问题，坦率地说，高剂量裸盖菇素会改变思维和感知——
Andrew Huberman:
安德鲁·休伯曼：
Yeah
是啊
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
clinical sessions.
临床会议。
Many people do report improvements in trauma-related symptomology and depression, as I understand it-
据我了解，许多人确实报告了与创伤相关的症状和抑郁症的改善——
Andrew Huberman:
安德鲁·休伯曼：
Yeah
是啊
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
from my read of the clinical trials after taking psilocybin, because during those sessions, something comes to mind spontaneously.
从我读到的服用裸盖菇素后的临床试验来看，因为在这些疗程中，我会自发地想到一些事情。
They will report, for instance, a new way of seeing the old problem.
例如，他们会报告看待老问题的新方法。
Andrew Huberman:
安德鲁·休伯曼：
That's right.
没错。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And the old problem could be the voice that they're no good, nothing will ever work out, or could be even more subtle than that.
老问题可能是他们的声音说他们不好，什么都不会解决，或者可能比这更微妙。
Why do you think the brain would ever hold on to rules that don't serve us well?
你认为为什么大脑会坚持那些对我们不利的规则？
Andrew Huberman:
安德鲁·休伯曼：
I think it's an evolutionary neurobiology answer.
我认为这是进化神经生物学的答案。
I think that we end up being a result of probably a lot of biology that's not that useful in the modern era.
我认为我们最终可能成为许多生物学的结果，而这些生物学在现代并不那么有用。
And I think in the brain for, let's say PTSD.
我认为在大脑中，比如说创伤后应激障碍（PTSD）。
A lot of veterans come back, and they experience these PTSD symptoms, and they're not at all useful back home.
很多退伍军人回来后，都会经历这些创伤后应激障碍症状，但这些症状回到家后一点用处都没有。
They hear some loud noise, and all of a sudden, they're behind a car or they're behind a...
他们听到一些巨响，突然之间，他们就在一辆汽车后面，或者在...
I've heard of folks jump and run behind a trash can or whatever in the middle of San Francisco when they hear a loud noise.
我听说在旧金山市中心，人们听到巨响时会跳到垃圾桶或其他什么地方后面。
But if you put them back in the battlefield-
但如果你把他们放回战场——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Highly adaptive
适应性强
Andrew Huberman:
安德鲁·休伯曼：
...
...
that's highly adaptive.
这是高度适应性的。
We hold onto those things from, I think, an evolutionary neurobiology standpoint.
我认为，我们从进化神经生物学的角度坚持这些东西。
But what seems to, for whatever reason, kind of alleviate that are these substances, some new, like MDMA, some that have been around for thousands of years, like psilocybin, seem to have a therapeutic effect that seems to be pretty long-lasting for these phenomenon.
但无论出于什么原因，这些物质似乎能缓解这种情况，有些是新的，如摇头丸，有些是已经存在了数千年的物质，如裸盖菇素，似乎对这些现象有相当持久的治疗作用。
And so it's just curious.
所以这只是好奇。
It's curious that in the absence of that, these things will keep going on and on.
奇怪的是，如果没有这一点，这些事情就会继续发生。
But in the presence of that exposure, then all of a sudden you see a resolution of the problem.
但在这种曝光的存在下，你会突然看到问题的解决方案。
And we have some work now.
我们现在有一些工作。
We're treating folks with Navy SEALs.
我们正在用海豹突击队来治疗人们。
The anecdotes that we're getting are folks are coming back, and they're saying these set of PTSD symptoms are finally gone.
我们得到的轶事是人们回来了，他们说这些 PTSD 症状终于消失了。
And so this idea that for whatever reason, going into what's probably a highly plastic state and re-experience memories, and then as you know, reconsolidating it in that state, for whatever reason, may drive a therapeutic effect.
因此，无论出于何种原因，进入可能高度可塑的状态并重新体验记忆，然后如您所知，无论出于何种原因，在该状态下重新巩固它，都可能会产生治疗效果。
My business is to find treatments that help people, and so I'm much more pragmatic about it.
我的工作是寻找对人们有帮助的治疗方法，所以我对此更加务实。
If this sort of thing, which has a lot of cultural baggage, but if this sort of thing ultimately ends up being therapeutic, if we can design trials that convince me and others that it is, then we should absolutely use it.
如果这种事情有很多文化包袱，但如果这种事情最终具有治疗作用，如果我们能够设计试验来让我和其他人相信它确实如此，那么我们绝对应该使用它。
And if it doesn't, then we clearly shouldn't use it.
如果没有，那么我们显然不应该使用它。
The work that's been done so far, the first psilocybin trial, the first MDMA trial was published in Nature Medicine recently.
迄今为止所做的工作，第一个裸盖菇素试验，第一个 MDMA 试验最近发表在《自然医学》上。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
And what do those generally say?
这些通常怎么说？
Let's start with psilocybin and MDMA.
让我们从裸盖菇素和摇头丸开始。
Andrew Huberman:
安德鲁·休伯曼：
So MDMA appears to, in one to a few MDMA sessions, have an anti-PTSD effect that seems to be outside of the kind of standard assumed levels of PTSD improvement that you can observe in individuals with this level of PTSD.
因此，在一到几次 MDMA 疗程中，MDMA 似乎具有抗 PTSD 效果，这种效果似乎超出了您可以在具有这种 PTSD 水平的个体中观察到的 PTSD 改善的标准假设水平。
Right?
正确的？
So-
所以——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
So does that mean that for people that have trauma, who do a-- and again, we're talking about in a clinical setting.
那么，这是否意味着对于遭受创伤的人来说，我们在临床环境中再次讨论。
They take one or two doses of MDMA.
他们服用一剂或两剂 MDMA。
I think the standard MAPS dose is 150 to 175 milligrams.
我认为标准 MAPS 剂量是 150 至 175 毫克。
Again, doing this with a physician, et cetera, controlled clinical trial, legal.
再次强调，与医生等一起进行对照临床试验是合法的。
Andrew Huberman:
安德鲁·休伯曼：
Exactly.
正是如此。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
They do it once or twice, and broadly speaking, what percentage of people who had trauma report feeling significant relief from their trauma afterward?
他们会这样做一两次，从广义上讲，有多少比例的遭受创伤的人表示在事后感到创伤得到了显着缓解？
Andrew Huberman:
安德鲁·休伯曼：
It's about two-thirds of people had a clinically significant change in their PTSD symptoms.
大约三分之二的人的创伤后应激障碍症状出现了临床上的显着变化。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
That's impressive.
这令人印象深刻。
And how long-lasting was that?
那持续多久了？
Andrew Huberman:
安德鲁·休伯曼：
It appears to last for a while.
看来还要持续一段时间。
In the earlier trials where they followed people out, it seemed to last for kind of in the years range for some people.
在他们跟踪人们的早期试验中，对于某些人来说，这种情况似乎持续了几年。
And so it's pretty compelling.
所以它非常引人注目。
And contrast that with ketamine, which only, on average, lasts about a week and a half for a single infusion, so it's a much shorter-
与氯胺酮相比，氯胺酮一次输注平均只能持续大约一周半，所以它的时间要短得多——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
So they have to get repeated infusions of ketamine every 10 days or so?
那么他们必须每 10 天左右重复输注氯胺酮吗？
Andrew Huberman:
安德鲁·休伯曼：
For some people, or they end up getting a bunch of doses for a couple of weeks, and then for some people, that seems to last a while.
对于某些人来说，或者他们最终会在几周内接受大量剂量，然后对于某些人来说，这似乎会持续一段时间。
That's where I think the psilocybin story for depression and the MDMA story for PTSD seem more interesting to me.
这就是我认为裸盖菇素治疗抑郁症的故事和摇头丸治疗创伤后应激障碍的故事对我来说更有趣的地方。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
So for psilocybin, what is the rough percentages on-- And this would be relief not from trauma, but from depression.
那么对于裸盖菇素来说，大概的百分比是多少——这不是缓解创伤，而是缓解抑郁。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, exactly.
是的，完全正确。
So in open label studies, it's closer to half to two-thirds of people end up getting better, depending upon their level of treatment resistance.
因此，在开放标签研究中，接近一半到三分之二的人最终会好转，具体取决于他们的治疗抵抗程度。
In the blinded trials, it was more like a third or so of people.
在盲法试验中，大约有三分之一左右的人。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
I'd like to take a quick break and acknowledge our sponsor, BetterHelp.
我想稍微休息一下并感谢我们的赞助商 BetterHelp。
BetterHelp offers professional therapy with a licensed therapist carried out entirely online.
BetterHelp 提供由持证治疗师完全在线进行的专业治疗。
Now, I've been doing therapy for a long time, and I can tell you that it's a lot like physical workouts.
现在，我已经做了很长时间的治疗，我可以告诉你，这很像体育锻炼。
There are times when I want to do it, and there are times when I don't want to do it.
有想做的时候，也有不想做的时候。
But whenever I finish a therapy session, I come away feeling better, and I have specific actionable items that hadn't occurred to me, that when I implement, improve various aspects of my life.
但每当我完成治疗课程时，我都会感觉更好，并且我有一些我没有想到的具体可操作的项目，当我实施这些项目时，可以改善我生活的各个方面。
The data tell us that there are just so many benefits that come through effective therapy.
数据告诉我们，有效的治疗可以带来很多好处。
And effective therapy involves having a good rapport with your therapist, getting insights from them and with them, and coming away with specific actionable tools that you can apply outside of therapy.
有效的治疗包括与治疗师保持良好的关系，从他们那里获得见解并与他们一起获得见解，并得出可以在治疗之外应用的具体可行的工具。
With BetterHelp, they make it very easy to find an expert therapist who can help provide those benefits that come through effective therapy.
通过 BetterHelp，他们可以很容易地找到一位专家治疗师，他可以帮助提供通过有效治疗带来的好处。
They have a short questionnaire to help match you to a therapist.
他们有一份简短的调查问卷来帮助您与治疗师匹配。
And while BetterHelp has an industry-leading match rate, if you aren't happy with your match, you can switch to a different therapist at any time.
虽然 BetterHelp 拥有行业领先的匹配率，但如果您对匹配不满意，您可以随时更换为其他治疗师。
Also, because BetterHelp is done entirely online, it's extremely efficient.
此外，由于 BetterHelp 完全在线完成，因此效率极高。
There's no driving to a therapist's office, looking for parking, or anything like that.
无需开车去治疗师办公室、寻找停车位或类似的事情。
You simply log on and do your session wherever you happen to be.
无论您身在何处，您只需登录并进行会话即可。
If you would like to try BetterHelp, go to betterhelp.com/huberman to get 10% off your first month.
如果您想尝试 BetterHelp，请访问 betterhelp.com/huberman，第一个月可享受 10% 的折扣。
Again, that's betterhelp.com/huberman.
再说一次，这是 betterhelp.com/huberman。
Since you mentioned psilocybin, let's talk a little bit about the neurochemistry of psilocybin.
既然你提到了裸盖菇素，我们就来谈谈裸盖菇素的神经化学。
What's going on when one takes psilocybin, and why is it interesting in light of depression?
当一个人服用裸盖菇素时会发生什么？鉴于抑郁症，它为什么有趣？
Andrew Huberman:
安德鲁·休伯曼：
Yeah, definitely.
是的，绝对是。
So David Nutt and Robin Carhart-Harris's work around neuroimaging psychedelics are kind of some of the first folks to do that work.
因此，大卫·纳特（David Nutt）和罗宾·卡哈特-哈里斯（Robin Carhart-Harris）关于神经影像迷幻药的研究是最早从事这项工作的人之一。
And to their great surprise, they thought there was going to be an increase in activity on psychedelics, and what they found is the opposite, right?
令他们大吃一惊的是，他们认为迷幻药的活动将会增加，但他们发现事实恰恰相反，对吗？
There's kind of an overall decrease in the level of activity in the brain with psychedelics.
迷幻药会导致大脑活动水平总体下降。
But they've also looked at connectivity, and there's this kind of small world, large world connectivity that you think about.
但他们也研究了连通性，你会想到这种小世界、大世界的连通性。
And so small world meaning there's kind of a much more kind of focused kind of cortical function or subcortical function or whatever it is.
如此小的世界意味着存在一种更加集中的皮质功能或皮质下功能或其他任何功能。
And what you see is a difference in that level of engagement and of brain regions.
你看到的是参与程度和大脑区域的差异。
So the connectivity, kind of global connectivity kind of increases.
因此，全球连通性有所增加。
And so it's interesting.
这很有趣。
I think to kind of have a convergent theory on this, it's still to be determined.
我认为对此有一个趋同的理论，仍有待确定。
There's still a lot of work, I think, that needs to be done.
我认为还有很多工作需要完成。
But it's certainly suggestive that there's pretty profound changes in brain activity and brain connectivity after.
但这肯定表明，之后大脑活动和大脑连接发生了相当深刻的变化。
And what we've found to be really interesting is the antidepressant effects of psilocybin have a particular connectivity change that we also see with our TMS approaches, right?
我们发现真正有趣的是裸盖菇素的抗抑郁作用具有特定的连接性变化，我们在 TMS 方法中也看到了这一点，对吗？
And it's this connectivity between the subgenual anterior cingulate and the default mode network.
这就是膝下前扣带回和默认模式网络之间的连接。
And so when we do this effective Stanford neuromodulation therapy stimulation, we see a downregulation, the connectivity between the negatively valenced mood state in the case of depressed individuals, and the self-representation of the brain.
因此，当我们进行这种有效的斯坦福神经调节疗法刺激时，我们会看到下调，即抑郁症患者的负价情绪状态与大脑的自我表征之间的联系。
And you see that same connectivity change occur post psilocybin, suggesting there's a convergent mechanism.
您会看到裸盖菇素后发生了相同的连接变化，表明存在收敛机制。
And it makes sense, right?
这是有道理的，对吧？
You've kind of got an over-connected, negatively valenced system, conflict system, that's kind of attached onto the self-representation, and people feel stuck, right?
你有一个过度联系、负价的系统、冲突系统，它有点依附于自我表征，人们感到被困住了，对吧？
And then when you do whatever you do that's effective, it unpairs those two systems.
然后，当你做任何有效的事情时，它就会取消这两个系统的配对。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
I want to ask you about ibogaine.
我想问你关于伊博加因的事。
Is it legal in the US as a clinical tool?
作为临床工具在美国合法吗？
Who's using it, and for what purposes?
谁在使用它，用途是什么？
Andrew Huberman:
安德鲁·休伯曼：
Ibogaine is one of the alkaloids that you can extract from an iboga tree Root bark that's typically growing in the country of Gabon, Africa.
伊博加因是一种生物碱，可以从伊博加树根皮中提取，该树通常生长在非洲加蓬国家。
So what individuals taking ibogaine will say is that open eyes, they don't see anything, but closed eyes, they'll go back through and re-experience earlier life memories, and they will be able to experience it from a place of empathy, not only for themselves, but from others, and kind of a detached empathy and being able to see this as almost a third party, even though they were there.
因此，服用伊博加因的人会说，睁开眼睛，他们看不到任何东西，但闭上眼睛，他们会回顾并重新体验早年的生活记忆，他们将能够从同理心的地方体验它，不仅是对自己，而且是对他人，一种超然的同理心，能够将其视为几乎第三方，即使他们在那里。
Ibogaine is in no way a recreational substance.
伊博加因绝不是一种娱乐物质。
You're essentially having this, what they call a life review.
你本质上是在进行这个，他们称之为人生回顾。
They also call it 10 years of psychotherapy in a night.
他们也称之为一夜心理治疗十年。
So these are the terminology that people talk about.
这些就是人们谈论的术语。
The issue-
问题是——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
How long does it last?
持续多久？
Is it truly one night?
真的是一晚吗？
Andrew Huberman:
安德鲁·休伯曼：
Depending upon how fast you metabolize it, sometimes 24, sometimes 36 hours.
取决于你代谢的速度，有时是 24 小时，有时是 36 小时。
Sometimes it can be shorter, but it is a long time.
有时可以更短，但时间却很长。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Wow.
哇。
Andrew Huberman:
安德鲁·休伯曼：
It's a very long time.
这是很长一段时间了。
So it's definitely the longest acting psychedelic substance I know of.
所以它绝对是我所知道的作用时间最长的迷幻物质。
And so, we have, over the last couple of years, been able to do this first in human kind of full neurobiological, clinical neurocognitive evaluation of what ibogaine is doing.
因此，在过去的几年里，我们首次能够对伊博加因的作用进行人类全面的神经生物学、临床神经认知评估。
In this case, in special operations, special forces individuals, former Navy SEALs, former Army Rangers, that kind of crew of folks, and look at the pre-post changes that their experience to be able to totally quantitate all of that.
在这种情况下，在特种作战中，特种部队人员、前海豹突击队、前陆军游骑兵等人员，通过观察他们经历的前后变化，能够完全量化所有这些。
And so we've been able to capture all the clinical scales, depression scales, PTSD scales, all that standard stuff.
因此，我们已经能够捕获所有临床量表、抑郁量表、创伤后应激障碍量表以及所有标准内容。
Neurocognitive batteries, so how does your executive function work specifically?
神经认知电池，那么你的执行功能具体是如何运作的呢？
How does your verbal memory, all of that.
你的言语记忆如何，所有这些。
And then neuroimaging and EEG.
然后是神经影像学和脑电图。
So this will be the first human study of ibogaine for those.
因此，这将是针对伊博加因的首次人体研究。
And the reason why is because ibogaine's both seemingly the most potent and seemingly, to me at least, most powerful psychedelic, but the one that has the most risk too, because it has a cardiac effect.
原因是伊博加因看起来既是最有效的，至少对我来说也是最强大的迷幻剂，但也是风险最大的一种，因为它具有心脏作用。
It seems to be that you can screen people out that have risk off of their electrocardiogram and reduce the risk quite a bit, and that's what we all did.
似乎你可以通过心电图筛选出有风险的人，并大大降低风险，这就是我们所有人所做的。
But that's why people haven't really studied it as much.
但这就是为什么人们还没有真正研究过它。
In addition, there's nobody goes to rave on ibogaine.
此外，没有人对伊博加因赞不绝口。
There's no recreation at all with this.
这根本没有任何娱乐可言。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
It's not fun.
这并不好玩。
Andrew Huberman:
安德鲁·休伯曼：
People say that it's relieving, but it's hard work.
人们说这很轻松，但其实很辛苦。
Because yeah, you're re-examining things.
因为是的，你正在重新审视事情。
So then we see these folks after, and I'll tell you, we haven't fully analyzed the data yet, but I'll tell you that from what my folks are telling me, it's pretty dramatic.
然后我们会看到这些人，我会告诉你，我们还没有完全分析数据，但我会告诉你，从我的家人告诉我的情况来看，这是相当戏剧性的。
People come back, and they're doing a lot better.
人们回来了，他们的表现好多了。
Soldiers experience something called moral injury, where maybe they accidentally blew something up and it had a kid in it or something like that.
士兵们会经历一种叫做道德伤害的事情，也许他们不小心炸毁了某个东西，而里面有一个孩子或类似的东西。
If they're in Afghanistan or Iraq, maybe a child died on accident or maybe a civilian died or whatever it was.
如果他们在阿富汗或伊拉克，可能有一个孩子死于意外，或者可能有一个平民死亡，或者其他什么原因。
And they suffer these moral injuries as part of the job, and it's almost one of the kind of vocational risks.
作为工作的一部分，他们遭受这些道德伤害，这几乎是一种职业风险。
They come back and say that they've forgiven themselves.
他们回来后说他们已经原谅了自己。
Which is huge.
这是巨大的。
And part of that is being able to see themself in a different light and having empathy finally for themself and being able to kind of have that experience of forgiving.
其中一部分是能够以不同的眼光看待自己，最终对自己产生同理心，并能够获得宽恕的体验。
And so there's this kind of Timothy Leary kind of sociocultural construct that ends up being overlaid over psychedelics.
因此，蒂莫西·利里（Timothy Leary）的这种社会文化建构最终被迷幻剂所覆盖。
And what I think is that if you rid yourself of all of those preconceived notions of what it is and isn't and the counterculture movement, all that stuff that neither of us were ever involved in, neither of us ever partake in, as kind of straight scientists looking at this.
我的想法是，如果你摆脱所有那些关于它是什么和不是什么的先入为主的观念，以及反主流文化运动，所有这些我们俩都没有参与过的东西，我们都没有参与过，作为一种直接的科学家来看待这个问题。
If you can kind of rid yourself of all those sociocultural constructions and then reexamine this, if we just discovered these today, we would say that these sorts of drugs are a huge breakthrough in psychiatry because they allow for us to do a lot of the sorts of things we've been thinking about with SSRIs, with psychotherapy, but kind of combined.
如果你能摆脱所有这些社会文化结构，然后重新审视这一点，如果我们今天才发现这些，我们会说这类药物是精神病学的巨大突破，因为它们使我们能够做很多我们一直在考虑的 SSRIs 和心理治疗的事情，但有点结合。
Psychotherapy plus drugs in a substance that kind of allows you to reexamine these things.
心理治疗加上某种物质中的药物可以让你重新审视这些事情。
And so it's interesting.
这很有趣。
There's a lot to do to try to figure out if that's true.
要弄清楚这是否属实，还有很多工作要做。
And I can say that as it stands right now, we don't know if that statement is true.
我可以说，就目前情况而言，我们不知道这种说法是否属实。
There's a lot more work that needs to happen for that statement to be proven to be true.
要证明该声明的真实性，还需要做更多的工作。
But the hypothesis is, if it is true, then it's very likely that this will be seen as a breakthrough because it allows you to do these sorts of things that you can't do with normal waking consciousness.
但假设是，如果这是真的，那么这很可能会被视为一个突破，因为它允许你做这些在正常清醒意识下无法做的事情。
But also why we have to really think about this and these drugs can't be recreational drugs.
但也是为什么我们必须真正考虑这一点，这些药物不能是娱乐性药物。
They really shouldn't be recreational drugs.
它们确实不应该是消遣性药物。
They're really too powerful to be used in the context of recreation because they can put you into these states.
它们确实太强大了，无法在娱乐环境中使用，因为它们可以让你进入这些状态。
And this generation of psychedelic researchers are really clear about that.
这一代迷幻研究人员对此非常清楚。
I think the '60s folks were not clear about that, and they felt like there was this whole kind of cultural thing that was going on there.
我认为 60 年代的人们对此并不清楚，他们觉得那里正在发生这种文化事件。
But I think this cohort of individuals really understands that in order to really make this happen, we have to understand that if you need a prescription for an SSRI, which doesn't change your consciousness a whole lot, and we were very worried about that, and the doctor has to evaluate you for that every week.
但我认为这群人真正明白，为了真正实现这一目标，我们必须明白，如果你需要 SSRI 处方，这不会完全改变你的意识，我们对此非常担心，医生必须每周对你进行评估。
That the idea that some of these substances would go outside of very strict medical supervision is kind of preposterous, actually.
事实上，认为其中一些物质会不受非常严格的医疗监督的想法有点荒谬。
It's kind of a dumb moment, I think, for all of medicine to say, "Look, if we're going to do this right, we've got to do it in such a way that's so protected, that's so safe that we make sure people know These things are not recreational, and they're really for the pure purposes of really powerfully changing cognition for a while and letting people have these, what seem to be, relatively therapeutic states.
我认为，对于所有医学界来说，这是一个愚蠢的时刻，“听着，如果我们要做正确的事情，我们就必须以一种如此受保护、如此安全的方式来做这件事，我们要确保人们知道这些东西不是娱乐性的，它们的纯粹目的是在一段时间内真正有力地改变认知，让人们拥有这些看似相对治疗的状态。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Tell me about ayahuasca, and as a plant, is it useful for the same sorts of conditions that we've talked about thus far?
告诉我关于死藤水的事，作为一种植物，它对我们迄今为止讨论过的同类疾病有用吗？
And if you could perhaps tell me a little bit also about the Brazilian prisoner study.
如果您能告诉我一些关于巴西囚犯研究的信息吗？
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Definitely.
绝对是。
Ayahuasca is another psychedelic.
死藤水是另一种迷幻剂。
It's used as a sacrament in Brazil and in Peru and Ecuador and Colombia, so a lot of the South American countries.
它在巴西、秘鲁、厄瓜多尔和哥伦比亚以及许多南美国家被用作圣礼。
And what they do is they combine two plants together, where one plant of the two plant combination would effectively do nothing, but the two plant combination together is capable of producing this very profound psychedelic effect.
他们所做的是将两种植物结合在一起，两种植物组合中的一种植物实际上什么也不做，但是两种植物组合在一起能够产生这种非常深刻的迷幻效果。
And what's really kind of curious is that there are, as I understand it, 10 to 20,000 plant species in the Amazon, and somehow somebody-
真正令人好奇的是，据我了解，亚马逊地区有 10 到 20,000 种植物，而且不知何故有人——
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Someone tried them all.
有人尝试了所有这些。
Andrew Huberman:
安德鲁·休伯曼：
...
...
combined these two plants together in certain proportionality and cooked this for five, 10 hours to the point where you cook out the dimethyltryptamine out of one of the plants and cook out the reversible monoamine oxidase inhibitor out of the other plant.
将这两种植物按一定比例混合在一起，煮五到十个小时，直到从其中一种植物中煮出二甲基色胺，从另一种植物中煮出可逆单胺氧化酶抑制剂。
It's such a way that the reversible monoamine oxidase inhibitor prevents the GI breakdown of the dimethyltryptamine in such a way that it's then allowed to cross the blood-brain barrier and get into the brain.
通过这种方式，可逆单胺氧化酶抑制剂可以防止二甲基色胺在胃肠道中分解，从而使其穿过血脑屏障并进入大脑。
And if you didn't add the reversible monoamine oxidase inhibitor plant-derived into this combination, then it would never cross the brain.
如果你没有将植物来源的可逆单胺氧化酶抑制剂添加到这种组合中，那么它永远不会穿过大脑。
If you put people on a standard psychiatry-prescribed monoamine oxidase inhibitor that wasn't reversible, you'd throw them into serotonin syndrome, right?
如果你让人们服用标准的精神病学规定的不可逆的单胺氧化酶抑制剂，你就会让他们陷入血清素综合症，对吗？
So this kind of sweet spot that somehow ayahuasca practitioners have found of being able to get DMT into the brain from an oral source with this combination of a monoamine oxidase inhibitor is curious.
因此，死藤水练习者以某种方式发现能够将 DMT 与单胺氧化酶抑制剂的组合从口服来源进入大脑的这种最佳点令人好奇。
And so that substance has been explored as an antidepressant agent, and some studies have looked at that.
因此，这种物质已被探索作为抗抑郁剂，一些研究也对此进行了研究。
It also seems to be very safe.
看起来也很安全。
There's a psychiatrist down at UCLA Harbor who's done a lot of work with this, where he's looked at children even that have been exposed to small doses of ayahuasca as kind of a sacrament within Amazonian tribes and found no neurocognitive effects, no neurocognitive effects in adults, and so it appears to be safe.
加州大学洛杉矶分校港分校的一位精神病学家在这方面做了很多工作，他观察了那些接触过小剂量死藤水（亚马逊部落中的一种圣礼）的儿童，结果发现没有神经认知影响，成年人也没有神经认知影响，所以它似乎是安全的。
It's kind of part and brought into various religions, including kind of merged with Catholicism in South America, which is kind of very interesting.
它是不同宗教的一部分，包括与南美天主教的融合，这非常有趣。
And so, in some sects of Catholicism in Brazil, it's used as sacrament during religious ceremonies.
因此，在巴西天主教的一些教派中，它在宗教仪式中被用作圣礼。
And so it became interesting to Brazilian researchers as to whether or not they could affect recidivism rates for prisoners in Brazilian prisons, right?
因此，巴西研究人员对它们是否会影响巴西监狱中囚犯的累犯率变得很感兴趣，对吗？
So they gave half of the prisoners some sort of inert substance and half of the prisoners an ayahuasca session.
因此，他们给一半的囚犯注射了某种惰性物质，给一半的囚犯注射了死藤水。
And the recidivism rate or the return to prison rate in the ayahuasca-exposed individuals was statistically significantly lower than the recidivism rate in the control group, suggesting that whatever is going on there seems to have an effect on whatever drives criminal behavior, whatever criminal behavior that happened to be.
而且，接触死藤水的人的累犯率或重返监狱率在统计上显着低于对照组的累犯率，这表明那里发生的任何事情似乎都会对驱动犯罪行为的因素产生影响，无论发生的犯罪行为是什么。
And I don't have the details on the exact nature of the crime.
我不知道犯罪的具体性质的细节。
I am also in no way saying that we should just be giving psychedelics to folks in prison and all of that.
我也绝不是说我们应该给监狱里的人服用迷幻药等等。
I think that is a very edgy thing to do and probably not something that anybody should try.
我认为这是一件非常前卫的事情，可能不适合任何人尝试。
But it does kind of bring up this curious question of what is it about that that would drive people to change those behaviors, and why do people make those behavioral decisions?
但它确实提出了一个奇怪的问题：是什么促使人们改变这些行为，以及为什么人们会做出这些行为决定？
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
As many of you know, I've been taking AG1 for nearly 15 years now.
你们很多人都知道，我服用 AG1 已有近 15 年了。
I discovered it way back in 2012, long before I had a podcast, and I've been taking it every day since.
我早在 2012 年就发现了它，那时我还没有播客，从那时起我就每天都在听它。
AG1 is, to my knowledge, the highest quality and most comprehensive of the foundational nutritional supplements on the market.
据我所知，AG1 是市场上质量最高、最全面的基础营养补充剂。
It combines vitamins, minerals, prebiotics, probiotics, and adaptogens into a single scoop that's easy to drink and tastes great.
它将维生素、矿物质、益生元、益生菌和适应原结合到一勺中，易于饮用且味道极佳。
It's designed to support things like gut health, immune health, and overall energy, and it does so by helping to fill any gaps that you might have in your daily nutrition.
它旨在支持肠道健康、免疫健康和整体能量等，并通过帮助填补您日常营养中可能存在的任何缺口来实现这一目标。
And of course, we should all eat high-quality whole foods, but most of us are probably not getting enough prebiotics, vitamins, and minerals, and AG1 ensures that those gaps are filled.
当然，我们都应该吃高质量的天然食品，但我们大多数人可能没有摄入足够的益生元、维生素和矿物质，而 AG1 可确保填补这些空白。
If you'd like to try AG1, you can go to drinkag1.com/huberman to get a special offer.
如果您想尝试 AG1，可以访问 Drinkag1.com/huberman 以获得特别优惠。
For a limited time, AG1 is giving away a week's supply of AGZ, which is their sleep supplement, and a free bottle of vitamin D3+K2 with your subscription.
在有限的时间内，AG1 将赠送一周的 AGZ（这是他们的睡眠补充剂），以及一瓶免费的维生素 D3+K2。
AGZ is something that I helped design.
AGZ是我帮忙设计的。
It tastes great, and it's the only sleep supplement I take.
味道很好，也是我唯一服用的睡眠补充剂。
It has a collection of different things in it that has dramatically improved my sleep, both my slow-wave deep sleep and my rapid eye movement sleep, and I absolutely love it.
它里面有一系列不同的东西，极大地改善了我的睡眠，包括我的慢波深度睡眠和快速眼动睡眠，我非常喜欢它。
Again, that's drinkag1.com/huberman to get a week's supply of AGZ and a bottle of D3+K2 with your subscription.
再次强调，通过 Drinkag1.com/huberman 订阅即可获得一周的 AGZ 和一瓶 D3+K2。
Before we wrap, I do want to give you the opportunity to talk about the SAINT study.
在结束之前，我确实想给您一个机会来谈谈 SAINT 研究。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
SAINT, or what we're calling it SNT now.
SAINT，或者我们现在所说的 SNT。
Stanford Accelerated Intelligent Neuromodulation Therapy, or now what we're calling Stanford Neuromodulation Therapy.
斯坦福加速智能神经调节疗法，或者现在我们所说的斯坦福神经调节疗法。
The idea there is that TMS is a device that delivers a treatment.
TMS 的想法是一种提供治疗的设备。
And the treatment is the protocol, and the protocol is the stimulation parameter set in a specific brain region for a specific condition, whether it be transcranial magnetic stimulation or transcranial direct current stimulation or deep brain stimulation like what Casey Halpern talked about.
而治疗就是方案，方案就是针对特定条件在特定大脑区域设置的刺激参数，无论是经颅磁刺激还是经颅直流电刺激或像凯西·哈尔彭（Casey Halpern）谈到的深部脑刺激。
In all of those cases, the device itself is a physical layer conduit of a stimulation protocol that's therapeutic for a given condition in a given brain region.
在所有这些情况下，该设备本身都是刺激方案的物理层管道，可对给定大脑区域的给定条件进行治疗。
We decided, gosh, this problem I talked about at the beginning of the show where you have this problem that we don't have a treatment for people who are in these high acuity psychiatric emergency states.
我们决定，天哪，我在节目开始时谈到的这个问题，我们没有为处于这些高度严重的精神紧急状态的人提供治疗。
This idea that we're going to engineer a treatment where we can reorganize the stimulation approach in time to be much more efficient by utilizing something called space learning theory.
这个想法是，我们将设计一种治疗方法，通过利用空间学习理论，我们可以及时重组刺激方法，使其更加有效。
And so you probably know about the space learning theory.
所以你可能知道空间学习理论。
So the idea for the viewers is if I'm cramming for a test, what I do is I write out 60 note cards and I read each one for a minute until I get to the first note card again, and that's about an hour later.
所以观众的想法是，如果我为了考试而临时抱佛脚，我会写下 60 张记事卡，然后每张读一分钟，直到再次读到第一张记事卡，大约一个小时后。
That's space learning theory.
这就是空间学习理论。
It's this idea that you need to see it about every hour to an hour and a half, and that optimizes learning.
正是这个想法，你需要大约每小时到一个半小时看一次，这可以优化学习。
What we found was is that the old way of doing TMS, this idea of just doing it once a day, every day, five days a week for six weeks, didn't utilize the space learning theory.
我们发现，进行 TMS 的旧方法，即每天一次、每天一次、每周五天、持续六周的想法，并没有利用空间学习理论。
It's like studying for a month or two just a little bit once a day.
这就像学习一两个月，每天学习一点点。
You remember some of that stuff, but it's not as potent as that week where you're kind of cramming.
你记得其中一些东西，但它不如你临时抱佛脚那一周那么有效。
And what we realized is that if we could reorganize the stimulation in times, that we took the whole six-week course, we actually figured out a way to do it in a day.
我们意识到，如果我们能够及时重新组织刺激，我们完成了整个六周的课程，我们实际上就找到了一种在一天内完成的方法。
And then what we also figured out is that people were underdosing TMS because if you just keep going after six weeks out to month three, four, five, more and more people got better.
然后我们还发现，人们服用 TMS 的剂量不足，因为如果你在六周后继续坚持到第三、四、五个月，越来越多的人会好起来。
So we figured out it's not just one day.
所以我们发现这不仅仅是一天。
We're going to give five times the normal dose.
我们将给予正常剂量的五倍。
We're going to give seven and a half months worth in five days using space learning theory.
我们将利用空间学习理论在五天内提供七个半月的时间。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
So every hour?
那么每小时？
Andrew Huberman:
安德鲁·休伯曼：
Every hour for 10 hours.
每小时一次，持续10小时。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
For five days.
为期五天。
Andrew Huberman:
安德鲁·休伯曼：
For five days.
为期五天。
So it's a 50-hour block.
所以这是一个 50 小时的区块。
It's 90 minutes of actual stimulation, but spread out through the day in the same way of learning.
这是 90 分钟的实际刺激，但以相同的学习方式分散在一天中。
What we've found is that folks will within one to five days, in more cases than not, and depending upon if you're looking at this open label or in trials, somewhere between 60% and 90% of the time, they will go into full-on remission in the sense they're totally normal from a mood standpoint at the end of this.
我们发现，人们会在一到五天内，在更多的情况下，并且取决于你是否正在考虑这个开放标签或在试验中，大约在 60% 到 90% 的时间里，他们会进入完全缓解，从某种意义上说，从情绪的角度来看，他们在结束时是完全正常的。
And like I said, with variable durability.
就像我说的，具有可变的耐用性。
So that's the part we have to figure out now about dosing and how to keep people well.
这就是我们现在必须弄清楚的有关剂量以及如何保持人们健康的部分。
But for some people, we've had four years of remission, a year of remission, and it's really that cramming of the test.
但对于某些人来说，我们已经缓解了四年，缓解了一年，这确实是临时抱佛脚的测试。
It's really that idea that you're laying in that information in the exact right spot, and the signal is a simple signal, but it's a profound one, which is turn on, stay on, remember to stay on.
这确实是这样的想法，即您将信息放置在正确的位置，并且该信号是一个简单的信号，但它是一个深刻的信号，即打开，保持打开，记住保持打开。
That idea that you're sending this memory signal into the brain and you're doing it in such a way that you're telling the system, you're kind of taking it out of your own hippocampus's hand as you're sending the same signal the hippocampus normally signals out.
这个想法是，你将这个记忆信号发送到大脑中，并且你以这样一种方式来做，你告诉系统，你将它从你自己的海马体手中夺走，因为你发送的信号与海马体通常发出的信号相同。
Now you're sending that signal into the prefrontal cortex and kind of utilizing the brain's own communication style to get it to get out of the state.
现在，您将该信号发送到前额皮质，并利用大脑自身的通信方式使其摆脱该状态。
And what's very cool about this is that people when they kind of exit out of that, they end up saying they don't have any side effects from it, and they feel back to normal.
最酷的是，当人们退出这种状态时，他们最终会说他们没有任何副作用，并且感觉恢复了正常。
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
Thank you so much for taking us on this incredible voyage through the neurocircuitry underlying certain aspects of depression, the coverage of the different types of depression, the various therapeutic compounds, how they work.
非常感谢您带我们踏上这段令人难以置信的旅程，了解抑郁症某些方面的神经回路、不同类型抑郁症的覆盖范围、各种治疗化合物及其作用原理。
We've talked about a lot of things today, and you've shared so much knowledge.
今天我们讨论了很多事情，你也分享了很多知识。
And even as I say that, I very much want to have you back to talk about-
即使我这么说，我也非常想让你回来谈谈——
Andrew Huberman:
安德鲁·休伯曼：
Oh, cool
哦，酷
Dr. Nolan Williams:
诺兰·威廉姆斯博士：
...
...
many other things as well that we didn't have time to cover.
还有许多其他我们没有时间讨论的事情。
But to take the time to sit down with us and share all this knowledge that really is in service to mental health and humans feeling better and in fact, avoiding often suicidal depression.
但花时间与我们坐下来分享所有这些真正有助于心理健康和人类感觉更好的知识，事实上，避免经常自杀的抑郁症。
It's just incredible work and incredible generosity, and just thank you so much.
这是令人难以置信的工作和令人难以置信的慷慨，非常感谢你们。
Andrew Huberman:
安德鲁·休伯曼：
Absolutely.
绝对的。
Thank you.
谢谢你。
Speaker 3:
演讲者3：
Do you hear that?
你听到了吗？
That sound, right?
那个声音，对吗？
That means that summer's officially here.
这意味着夏天正式到来了。
It means that grown adults just sprint into the street for a frozen dessert shaped like a cartoon.
这意味着成年人只需跑到街上去吃卡通形状的冷冻甜点。
But this summer, Mint Mobile has a better treat.
但今年夏天，Mint Mobile 有更好的待遇。
Every plan, including unlimited, is $15 a month.
每个计划（包括无限计划）每月 15 美元。
And unlike ice cream, it won't drip down your wrist or look nothing like the picture.
与冰淇淋不同的是，它不会从你的手腕上滴下来，也不会看起来像图片一样。
Does anyone have any cash?
有人有现金吗？
Give it a try at mintmobile.com/switch.
请访问 mintmobile.com/switch 尝试一下。
Speaker 4:
演讲者4：
Upfront payment of $45 for 3 months, $90 for 6 months, or $180 for 12-month plan required.
3 个月预付款 45 美元，6 个月预付款 90 美元，12 个月计划预付款 180 美元。
$15 per month equivalent.
每月 15 美元等值。
Taxes and fees extra.
税费另计。
New customer offer.
新客户优惠。
For initial plan term only.
仅适用于初始计划期限。
Greater than 50 gigabytes may slow when network is busy.
当网络繁忙时，超过 50 GB 的速度可能会变慢。
See terms.
查看条款。