Essentials: The Science & Treatment of Obsessive Compulsive Disorder (OCD)
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 talking about obsessive-compulsive disorder or OCD.
今天，我们谈论的是强迫症或强迫症。
First of all, as the name suggests, OCD includes thoughts or obsessions and compulsions, which are actions.
首先，顾名思义，强迫症包括思想或强迫观念，即行为。
The obsessions and the compulsions are often linked.
强迫观念和强迫行为常常是联系在一起的。
In fact, most of the time, the obsessions and the compulsions are linked such that the compulsion, the behavior, is designed to relieve the obsession.
事实上，大多数时候，强迫观念和强迫行为是相互联系的，因此强迫行为、行为都是为了缓解强迫观念而设计的。
However, one of the hallmark themes of obsessive-compulsive disorder is that the obsessions are intrusive.
然而，强迫症的标志主题之一是强迫观念具有侵入性。
People don't want to have them.
人们不想拥有它们。
They don't enjoy having them.
他们不喜欢拥有它们。
They just seem to pop into people's minds, and they seem to pop into their mind recurrently.
它们似乎只是突然出现在人们的脑海中，而且似乎反复出现在人们的脑海中。
And the compulsions, unlike other sorts of behaviors, provide brief relief to the obsession, but then very quickly reinforce or strengthen the obsession.
与其他类型的行为不同，强迫行为可以短暂缓解强迫症，但随后很快就会强化或加强强迫症。
OCD is extremely common.
强迫症非常常见。
In fact, current estimates are that anywhere from 2.5% to as high as 3% or even 4% of people suffer from true OCD.
事实上，目前估计有 2.5% 到 3% 甚至 4% 的人患有真正的强迫症。
That is an astonishingly high number.
这是一个惊人的高数字。
Another thing to point out is that OCD is currently listed as number seven in terms of the most debilitating illnesses, not just mental illnesses or disorders, but all types of illnesses, including things like asthma and cancer, et cetera.
另一件需要指出的是，强迫症目前在最使人衰弱的疾病中排名第七，不仅仅是精神疾病或紊乱，而是所有类型的疾病，包括哮喘和癌症等。
So you can imagine with that standing at number seven, that it is both extremely common and extremely debilitating, and as a consequence, it's now realized that many hours, days, weeks, months, or even years of work performance or showing up at work, of relational interactions really suffer as a consequence of people having OCD.
因此，你可以想象，排在第七位的情况是，它既极其常见，又极其令人衰弱，因此，现在人们意识到，许多小时、几天、几周、几个月甚至几年的工作表现或在工作中出现的关系互动确实会因为患有强迫症的人而受到影响。
With recurrent intrusive thoughts happening at very high frequency or even at moderate frequency, people are spending a lot of time thinking about this stuff, and they're thinking about the behaviors they need to engage in and then engaging in the behaviors which, as I mentioned before, just serve to strengthen the compulsions.
由于侵入性想法以非常高的频率甚至中等的频率发生，人们会花很多时间思考这些东西，他们会思考他们需要从事的行为，然后从事这些行为，正如我之前提到的，这些行为只会增强强迫行为。
And so they're not actually doing the other things that make us functional human beings, like commuting to work or doing homework or doing work or listening when people are talking or interacting or sports or working out.
因此，他们实际上并没有做其他使我们成为功能性人类的事情，比如上下班、做作业、工作或在人们交谈、互动、运动或锻炼时倾听。
All the things that make for a rich quality life are taken over by OCD in many cases.
在很多情况下，强迫症取代了所有创造丰富品质生活的东西。
Another thing you'll soon learn is that sadly, a lot of the obsessions and compulsions in OCD often relate to taboo topics, and that's because the general categories of OCD fall into three different bins.
您很快就会了解到的另一件事是，可悲的是，强迫症中的许多痴迷和强迫行为通常与禁忌话题有关，这是因为强迫症的一般类别分为三个不同的类别。
Checking obsessions and compulsions, repetition obsessions and compulsions, and order obsessions and compulsions.
检查强迫观念和强迫行为、重复强迫观念和强迫行为以及顺序强迫观念和强迫行为。
The checking ones are somewhat obvious, checking the stove or checking the locks.
检查的内容有些明显，检查炉子或检查锁。
Repetition obsessions and compulsions obviously can dovetail with the checking ones, but those tend to be things like counting off of a certain number of numbers, like one, two, three, four, five, six, seven, seven, six, five, four, three, two, one.
重复的痴迷和强迫显然可以与检查的习惯相吻合，但这些往往是像数一定数量的数字一样，比如一、二、三、四、五、六、七、七、六、五、四、三、二、一。
People will perform that repeatedly or feel that they have to.
人们会重复这样做或者觉得他们必须这样做。
So we have checking, we have repetition, and then there's order.
所以我们有检查，有重复，然后是秩序。
Order oftentimes is thought of as putting cleanliness or making sure everything is aligned and perfect and orderly.
秩序通常被认为是保持清洁或确保一切都对齐、完美和有序。
And oftentimes that is the case, but there are other forms of order that people with OCD can focus on in an obsessive and compulsive way.
通常情况就是如此，但强迫症患者还可以以强迫性的方式关注其他形式的秩序。
Things like incompleteness, the idea that one can't walk away from something or stop doing something because something's not right or complete in that picture.
诸如不完整之类的事情，即人们无法离开某件事或停止做某事，因为图片中的某件事不正确或不完整。
It could be the way the table is set.
这可能是餐桌布置的方式。
It could be the way that something's written on a page.
这可能是在页面上书写内容的方式。
It could be an email.
它可能是一封电子邮件。
It can also be in terms of symmetry, that everything be aligned and symmetric in some way.
也可以是对称性，即一切都以某种方式对齐和对称。
This could be seen perhaps in young kids.
这也许可以在年幼的孩子身上看到。
This is one example that I read in the literature of children that need to arrange their stuffed animals in the exact same order every day and in a particular order, to the point where if you were to move the little stuffed frog over next to the stuffed rabbit, that the child would have an anxiety reaction to that and feel literally compelled, driven to fix that, maybe even multiple times over and over again.
这是我在文献中读到的一个例子，孩子们每天都需要以完全相同的顺序和特定的顺序排列他们的毛绒动物，以至于如果你把小毛绒青蛙移到毛绒兔子旁边，孩子就会对此产生焦虑反应，并感到真正被迫、被迫去解决这个问题，甚至可能一遍又一遍地解决这个问题。
And then the other aspect of order, which is a little bit less than intuitive, is this notion of disgust.
然后秩序的另一个方面，有点不太直观，就是厌恶的概念。
This idea that something is contaminated.
这种认为某物被污染的想法。
So we often think about OCD and handwashing behavior in response to people feeling that something is contaminated, a space, a towel, et cetera, or even simply somebody else's hand, and so they're unwilling to shake somebody's hand.
因此，我们经常想到强迫症和洗手行为，因为人们感觉某些东西被污染了，比如一个空间、一条毛巾等等，甚至只是别人的手，所以他们不愿意与别人握手。
You can imagine how these different bins of obsessions and compulsions, checking, repetition, and order, could be extremely debilitating depending on how severe they are and how many different domains of life they show up in.
你可以想象，这些不同的强迫观念、检查、重复和秩序，可能会让人极度虚弱，具体取决于它们的严重程度以及它们出现在生活的多少个不同领域。
And I know I've said it multiple times now, but I'm going to say it many times throughout this episode in a somewhat obsessive but I believe justified way, that every time that one engages in the compulsion related to the obsession, the obsession simply becomes stronger.
我知道我已经说过很多次了，但我会在这一集中以一种有点强迫性但我相信合理的方式多次说过，每当一个人陷入与强迫症相关的强迫时，强迫症就会变得更强烈。
So you can imagine what a powerful and debilitating loop that really is.
所以你可以想象这是一个多么强大而又令人衰弱的循环。
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。
I discovered AG1 way 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。
The reason I started taking AG1, and the reason I still take it every day, is because AG1 is, to my knowledge, the highest quality and most comprehensive of the foundational nutritional supplements on the market.
我开始服用 AG1 的原因，以及我仍然每天服用的原因，是因为据我所知，AG1 是市场上质量最高、最全面的基础营养补充剂。
AG1 is 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.
AG1 旨在支持肠道健康、免疫健康和整体能量等方面，它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。
I get asked pretty much all the time, "If I could only take one supplement, what should that supplement be?" And my answer is always AG1.
我经常被问到，“如果我只能服用一种补充剂，那么该补充剂应该是什么？”我的答案始终是AG1。
It has just been so helpful for supporting all aspects of physical health, mental health, and performance.
它对于支持身体健康、心理健康和表现的各个方面都非常有帮助。
If you would 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 free bottle of their new omega-3 coenzyme Q10 product.
AG1 限时免费赠送一瓶新的 omega-3 辅酶 Q10 产品。
Omega-3 and coenzyme Q10 are known to support cardiovascular health, cellular health and energy generally, brain health, and much more.
众所周知，Omega-3 和辅酶 Q10 可支持心血管健康、细胞健康和能量、大脑健康等。
I personally take them both every day.
我个人每天都会服用它们。
Again, go to drinkag1.com/huberman to get a free bottle of the new omega-3 coenzyme Q10 with your first AG1 subscription.
同样，请访问 Drinkag1.com/huberman，首次订阅 AG1 即可免费获得一瓶新型 omega-3 辅酶 Q10。
So let's drill a little bit deeper into how the obsessions and compulsions relate to one another.
因此，让我们更深入地探讨一下强迫观念和强迫行为之间的关系。
If we were to draw a line between the obsessions and the compulsions, that line could be described as anxiety.
如果我们要在强迫观念和强迫行为之间划清界限，那么这条界限可以被描述为焦虑。
Now, we need to define what anxiety is, and to be quite honest, most of psychology and science can't agree on exactly what anxiety is.
现在，我们需要定义什么是焦虑，老实说，大多数心理学和科学界无法就焦虑到底是什么达成一致。
Typically, the way we think about fear is that it's a heightened state of autonomic arousal, so increased heart rate, increased breathing, sweating, et cetera, in response to an immediate and present threat or perceived threat.
通常，我们对恐惧的看法是，它是一种自主神经兴奋的高度状态，因此心率加快、呼吸增加、出汗等等，以应对即时和当前的威胁或感知到的威胁。
Whereas anxiety, generally speaking in the scientific literature, relates to the same sorts of thought patterns and somatic bodily responses, heart rate, breathing, et cetera, but without a clear and present danger being in the environment or right there.
然而，一般来说，在科学文献中，焦虑与相同类型的思维模式和躯体反应、心率、呼吸等有关，但在环境中或那里没有明显且现实的危险。
So that's the way that we're going to talk about anxiety now.
这就是我们现在谈论焦虑的方式。
And anxiety is really what binds the obsessions and compulsions, such that someone will have an intrusive thought.
焦虑确实会束缚强迫观念和强迫行为，从而使某人产生侵入性想法。
Some people are probably wondering if there's a genetic component to OCD, and indeed there is, although the nature of it isn't exactly clear.
有些人可能想知道强迫症是否存在遗传因素，事实上确实存在，尽管其本质尚不清楚。
Based on twin studies where researchers have examined identical twins, fraternal twins, even identical twins that share the same sac in utero, what we call monochorionic, so sitting in the same little bag during pregnancy, or in different little bags, you can see different levels of what's called genetic concordance.
根据双胞胎研究，研究人员检查了同卵双胞胎、异卵双胞胎，甚至是在子宫内共享同一个囊的同卵双胞胎，即我们所说的单绒毛膜，因此在怀孕期间坐在同一个小袋子中，或放在不同的小袋子中，你可以看到不同水平的所谓遗传一致性。
But if we were to just sort of cut a broad swath through all of the genetic data, it's fair to say that about 40% to 50% of OCD cases have some genetic component, some mutation or some inherited aspect that's genetic and that one could point to if they got their genome mapped.
但如果我们对所有遗传数据进行大范围的剖析，可以公平地说，大约 40% 到 50% 的强迫症病例具有某些遗传成分、某些突变或某些遗传方面，如果他们绘制了基因组图谱，人们就可以指出这些遗传因素。
Now, while that's interesting, I don't think it's terribly useful for most people.
现在，虽然这很有趣，但我认为它对大多数人来说并不是很有用。
First of all, you can't really control your genes.
首先，你无法真正控制你的基因。
You can't pick who your parents were, as they say.
正如人们所说，你无法选择你的父母是谁。
So just know that there is a genetic component in about half of people with OCD, but not always.
因此，只要知道大约一半的强迫症患者存在遗传因素，但并非总是如此。
Now, as is typical for this podcast, I want to focus on some of the neural mechanisms and chemical systems in the brain and body that generate obsessive-compulsive disorder.
现在，正如本播客的典型做法，我想重点关注大脑和身体中产生强迫症的一些神经机制和化学系统。
So let's take a step back and look at the neural circuitry.
让我们退后一步看看神经回路。
What's going on in the brain and body of people with OCD?
强迫症患者的大脑和身体发生了什么？
Why the intrusive recurrent thoughts?
为什么会反复出现侵入性的想法？
Many studies, we can fairly say dozens if not hundreds of studies, have now identified a particular circuit or loop of brain areas that are interconnected and very active in obsessive-compulsive disorder.
许多研究，我们可以公平地说，数十甚至数百项研究，现在已经确定了大脑区域的特定回路或环路，这些区域是相互关联的并且在强迫症中非常活跃。
That loop includes the cortex, which is kind of the outer shell of the human brain, the lumpy stuff as it sometimes appears if the skull is removed, and it involves an area called the striatum, which is involved in action selection and holding back action.
这个循环包括皮质，它是人类大脑的外壳，如果头骨被移除，它有时会出现块状的东西，并且它涉及一个称为纹状体的区域，该区域涉及动作选择和抑制动作。
The cortex and the striatum are in this intricate back-and-forth talk.
皮质和纹状体处于这种复杂的来回对话中。
It's really loops of connections.
这确实是连接的循环。
There's a third element in this cortico-striatal loop, as it's called, and that's the thalamus.
这个皮质纹状体环中有第三个元素，正如它所说的那样，那就是丘脑。
Now, the thalamus is not a structure I've talked a lot about before on this podcast, but it's one of my favorite structures to think about and teach about in neuroanatomy, which I teach back at Stanford and have taught for many years elsewhere.
现在，丘脑不是我之前在这个播客上谈论过很多的结构，但它是我在神经解剖学中最喜欢思考和教授的结构之一，我在斯坦福大学教授神经解剖学，并在其他地方教授了很多年。
Because the thalamus is this incredible egg-like structure in the center of your brain that has different channels through it, channels for relaying visual information or auditory information or touch information from your environment up into your cortex, and as a consequence, making certain things that are happening to you and around you apparent to you, making you aware of them, making you perceive them, and suppressing others.
因为丘脑是大脑中心这个令人难以置信的鸡蛋状结构，它有不同的通道，这些通道将来自环境的视觉信息或听觉信息或触觉信息传递到你的皮质，因此，使发生在你和你周围的某些事情对你来说显而易见，让你意识到它们，让你感知它们，并抑制其他事物。
At the same time, your thalamus is surrounded by a kind of a shell, something called the thalamic reticular nucleus.
与此同时，你的丘脑被一种外壳包围，称为丘脑网状核。
Again, you don't have to remember the names, but the thalamic reticular nucleus, as I'm going to call it, serves as a sort of gate as to which information is allowed to pass through up to your conscious experience and which is not.
再说一次，你不必记住名字，但丘脑网状核，正如我所说的，充当一种大门，决定哪些信息可以通过你的意识体验，哪些不能。
So let's zoom out and take a look at the circuit that we've got and that we now know, based on neuroimaging studies, is intimately involved in generating obsessions and compulsions in OCD.
因此，让我们缩小范围，看看我们所拥有的电路，根据神经影像学研究，我们现在知道，该电路与强迫症中的强迫观念和强迫行为密切相关。
We have a cortex or neocortex, which is involved in perception and understanding of what's happening.
我们有一个皮质或新皮质，它涉及对正在发生的事情的感知和理解。
We have the striatum and basal ganglia, which are involved in generating behaviors, go, and suppressing behaviors, no go.
我们有纹状体和基底神经节，它们参与产生行为，“走”，以及抑制行为，“不走”。
And we have the thalamus, which collects all of our sensory experience in parallel, hearing, touch, smell, et cetera.
我们有丘脑，它同时收集我们所有的感官体验，听觉、触觉、嗅觉等等。
Not so much smell through the thalamus, I should mention, but the other senses that is.
我应该提一下，与其说是通过丘脑的气味，不如说是通过其他感官。
And then that thalamus is encased by the thalamic reticular nucleus, which serves as a kind of a guard saying, "You can pass through and you can pass through, but you, you, you can't pass through up to conscious understanding and perception."
然后丘脑被丘脑网状核包围，丘脑网状核充当一种守卫，说：“你可以穿过，你可以穿过，但是你，你，你不能穿过有意识的理解和感知。”
So that loop, this cortico-striatal thalamic loop, is the circuit thought to underlie OCD, and dysfunction in that circuit is what's thought to underlie OCD.
因此，这个环路，即皮质纹状体丘脑环路，被认为是强迫症的基础回路，而该回路的功能障碍被认为是强迫症的基础。
How do we know that this circuit is involved in OCD?
我们怎么知道这个回路与强迫症有关？
Well, there we can look to some really interesting studies that involve bringing human subjects into the laboratory and generating their obsessions and compulsions, and then imaging their brain using any variety of techniques that we talked about before.
好吧，我们可以看看一些非常有趣的研究，这些研究涉及将人类受试者带入实验室并产生他们的痴迷和强迫行为，然后使用我们之前讨论过的各种技术对他们的大脑进行成像。
So what they do typically is bring subjects into the laboratory who have an obsession about germs and contamination and a compulsion to hand wash.
因此，他们通常所做的就是将那些对细菌和污染有痴迷并有洗手强迫症的受试者带入实验室。
And they give these people, believe it or not, a sweaty towel that contains the sweat and the odor and the liquid, basically, from somebody else's hands.
不管你信不信，他们给了这些人一条汗湿的毛巾，里面含有汗水、气味和液体，基本上都是从别人的手上滴下来的。
In fact, they'll sometimes have someone wipe their own sweat off the back of their neck and put it on the towel, and then they'll put it in front of the person, which as you can imagine, for someone with OCD, is incredibly anxiety-provoking, and almost always evokes these obsessions about, oh, this is really bad.
事实上，他们有时会让人把自己脖子后面的汗擦掉，然后把它放在毛巾上，然后他们会把它放在这个人面前，你可以想象，对于患有强迫症的人来说，这会令人难以置信地引起焦虑，并且几乎总是会引起这些困扰，哦，这真的很糟糕。
This is really bad.
这实在是太糟糕了。
I need to clean.
我需要清洁。
I need to clean.
我需要清洁。
I need to clean.
我需要清洁。
Now, they're doing all this while someone is in a brain scanner or while they're being imaged for positron emission tomography, and then they can also look at the patterns of activation in the brain while the person is doing hand washing.
现在，他们在某人接受脑部扫描或进行正电子发射断层扫描成像时完成所有这些工作，然后他们还可以观察该人洗手时大脑的激活模式。
Although sometimes the apparati associated with these imaging studies make it hard to do a lot of movement, they can do these sorts of studies.
尽管有时与这些成像研究相关的设备很难进行大量运动，但他们可以进行此类研究。
They have done these sorts of studies in many subjects using different variations of what I just described, and lo and behold, what lights up, and when I say lights up, what sorts of brain regions are more metabolically active, more blood flow, more neural activity?
他们在许多受试者中进行了此类研究，使用了我刚才描述的不同变体，你瞧，什么亮起来了，当我说亮起来时，什么样的大脑区域代谢更活跃，血流量更多，神经活动更多？
Well, it's this particular cortico-striatal-thalamic loop.
嗯，这就是这个特殊的皮质-纹状体-丘脑环。
In addition to that, some of the drug treatments that are effective in some, and I want to emphasize some individuals at suppressing obsessions and/or compulsions, such as the selective serotonin reuptake inhibitors or SSRIs, which we'll talk about in a little bit.
除此之外，一些药物治疗对某些人有效，我想强调一些人可以抑制强迫症和/或强迫行为，例如选择性血清素再摄取抑制剂或 SSRI，我们稍后会讨论。
When people take those drugs, they see not just a suppression of the obsession and compulsion, but also a suppression of these particular neural circuits.
当人们服用这些药物时，他们不仅会看到对强迫症和强迫症的抑制，而且还会看到对这些特定神经回路的抑制。
They become less active.
他们变得不那么活跃。
Now, I want to emphasize and telegraph a little bit of what's coming later.
现在，我想强调并传达一些稍后将要发生的事情。
These drugs, like SSRIs, do not work for everybody with OCD.
这些药物，如 SSRIs，并不适合所有强迫症患者。
And as many of you know, they carry other certain problems and side effects for many, but not all individuals.
正如你们许多人所知，它们对许多人（但不是所有人）带来其他某些问题和副作用。
That collection of studies of data, fMRI, PET scanning in humans, the treatment with SSRIs, really point squarely to the fact that the cortico-striatal-thalamic loop is likely to be the basis of OCD.
这些数据研究、功能磁共振成像、人体 PET 扫描、SSRI 治疗，确实直接指出了这样一个事实：皮质-纹状体-丘脑环很可能是强迫症的基础。
Now, of course, other circuits could also be involved, but the cortico-striatal-thalamic circuit seems to be the main circuit generating OCD-like behavior.
当然，现在还可能涉及其他回路，但皮质-纹状体-丘脑回路似乎是产生类似强迫症行为的主要回路。
But as you'll next learn, when thinking about the various behavioral treatments and drug treatments and holistic treatments for OCD, what you'll notice is that each one taps into a different component of this cortico-striatal-thalamic loop.
但正如您接下来将了解到的，当考虑强迫症的各种行为治疗、药物治疗和整体治疗时，您会注意到每种治疗都利用了皮质-纹状体-丘脑环路的不同组成部分。
By understanding the underlying mechanism, why certain drugs and behavioral treatments work and don't work will become immediately apparent.
通过了解潜在的机制，某些药物和行为治疗有效和无效的原因将立即变得显而易见。
And in thinking about that, in knowing that, you'll be able to make excellent choices, I believe, in terms of what sorts of treatments you pursue, what sorts of treatments you abandon, and most importantly, the order, the sequence that you pursue and apply those treatments.
我相信，在思考这一点、了解这一点后，您将能够做出出色的选择，包括您追求哪种治疗、放弃哪种治疗，以及最重要的是，您追求和应用这些治疗的顺序和顺序。
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 you get a great night's sleep is to make sure that the temperature of your sleeping environment is correct.
确保您睡个好觉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 asleep 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 nearly five 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近五年了，它彻底改变并改善了我的睡眠质量。
The latest Eight Sleep model is the Pod 5.
最新的八睡眠型号是 Pod 5。
This is what I'm now sleeping on, and I absolutely love it.
这就是我现在睡觉的地方，我非常喜欢它。
It has so many incredible features.
它有很多令人难以置信的功能。
For instance, the Pod 5 has a feature called Autopilot, which is an AI engine that learns your sleep patterns and then adjusts the temperature of your sleeping environment across different sleep stages.
例如，Pod 5有一个名为Autopilot的功能，这是一个人工智能引擎，可以学习你的睡眠模式，然后在不同的睡眠阶段调整你的睡眠环境温度。
It'll even elevate your head if you're snoring, and it makes other shifts to optimize your sleep.
如果您打鼾，它甚至会抬高您的头部，并进行其他转换以优化您的睡眠。
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。
Before we go any further, I'd like to give people a little bit of a window into what a diagnosis for OCD would look like, give you a sense of the sorts of questions that a clinician would ask to determine whether or not somebody has OCD or not.
在我们进一步讨论之前，我想为人们提供一个了解强迫症诊断的窗口，让您了解临床医生在确定某人是否患有强迫症时会提出的各种问题。
The most commonly used test of OCD, or for OCD, I should say, is called the Yale-Brown Obsessive Compulsive Scale.
最常用的强迫症测试，或者我应该说的强迫症测试，被称为耶鲁-布朗强迫量表。
And this is, scientists love acronyms, as do the military, and it's the Y-BOCS, the Y-BOCS, the Y-BOCS.
这就是，科学家喜欢缩写词，军队也喜欢缩写词，就是 Y-BOCS、Y-BOCS、Y-BOCS。
Before the clinician would proceed with any kind of direct questions, they would very clearly define what obsessions and compulsions are.
在临床医生提出任何类型的直接问题之前，他们会非常清楚地定义什么是强迫观念和强迫行为。
And here I'm actually reading from the Y-BOCS.
我实际上正在阅读 Y-BOCS 的内容。
So quote, "Obsessions are unwelcome and distressing ideas, thoughts, images, or impulses that repeatedly enter your mind.
因此，引用这样的话：“痴迷是指反复出现在你脑海中的不受欢迎且令人痛苦的想法、想法、图像或冲动。
They may seem to occur against your will.
它们的发生似乎违背了您的意愿。
They may be repugnant to you.
他们可能令你反感。
You may recognize them as senseless, and they may not fit your personality." Then there are compulsions.
你可能会认为它们毫无意义，而且它们可能不适合你的个性。”然后就是强迫症。
Quote, "Compulsions, on the other hand, are behaviors or acts that you feel driven to perform, although you may recognize them as senseless or excessive.
引用：“另一方面，强迫行为是你感到被迫执行的行为或行为，尽管你可能认为它们是毫无意义或过度的。
At times you may try to resist doing them, but this may prove difficult.
有时您可能会尝试抵制这样做，但这可能会很困难。
You may experience anxiety that does not diminish until the behavior is completed." Now, there are a tremendous number of questions on the Y-BOCS, so I'm just going to highlight a few of the general categories.
在该行为完成之前，你可能会感到焦虑，这种焦虑不会减轻。”现在，关于 Y-BOCS 存在大量问题，因此我将重点介绍一些一般类别。
Typically, the person will fill out a checklist, so they will designate whether or not currently or in the past they have, for instance, aggressive obsessions, fear that one might harm themselves, fear that one might harm others, fear that they'll steal things, fear that they will act on unwanted impulses, currently or in the past or both.
通常，这个人会填写一份清单，这样他们就会指出他们现在或过去是否有，例如，攻击性的痴迷，担心一个人可能会伤害自己，担心一个人可能会伤害别人，担心他们会偷东西，担心他们会在当前或过去或两者兼而有之时做出不必要的冲动。
That's one category.
这是一类。
The other one are contamination obsessions, so concerned with dirt or germs, bothered by sticky substances or residues, et cetera.
另一种是对污染的痴迷，即对污垢或细菌的关注，对粘性物质或残留物等的困扰。
So there are a bunch of different categories that include, for instance, sexual obsessions, what are called saving obsessions, even moral obsessions, right?
所以有很多不同的类别，例如，包括性痴迷，所谓的拯救痴迷，甚至道德痴迷，对吗？
Excess concern with right or wrong or morality, concerned with sacrilege and blasphemy Obsession with need for symmetry and exactness.
过度关注对错或道德，关注亵渎和亵渎，痴迷于对称性和精确性。
Again, all of these questions being answered as either present in the past or not present in the past, present currently or not present currently.
同样，所有这些问题都被回答为过去存在或过去不存在、当前存在或当前不存在。
And then the test generally transitions over to questions about target symptoms.
然后测试通常会转向有关目标症状的问题。
They really try and get people to identify if they have obsessions, what are their exact obsessions?
他们确实试图让人们确定他们是否有强迫症，他们到底有什么强迫症？
Now, this turns out to be really important because as we talk about some of the therapies that really work, I'll just give away a little bit of why they work best in certain cases and why they don't work as well in other cases.
现在，事实证明这非常重要，因为当我们谈论一些真正有效的疗法时，我将透露一些为什么它们在某些情况下效果最好以及为什么它们在其他情况下效果不佳。
It turns out that it becomes very important for the clinician and the patient to not just identify the obsessions and the compulsions generally in a kind of a generic or top contour way, but to really encourage or even force the patient to define very precisely what the biggest, most catastrophic fear is, what the obsession really relates to.
事实证明，对于临床医生和患者来说，不仅要以一种通用或顶级轮廓的方式识别强迫观念和强迫行为，而且要真正鼓励甚至强迫患者非常精确地定义最大的、最具灾难性的恐惧是什么，以及强迫观念真正与什么相关，这变得非常重要。
That turns out to be very important in disrupting this cortico-striatal-thalamic loop and getting relief from symptoms one way or the other.
事实证明，这对于破坏皮质-纹状体-丘脑循环并以某种方式缓解症状非常重要。
So the Yale-Brown Obsessive Compulsive Scale, this Y-BOCS, again, is very extensive.
因此，耶鲁-布朗强迫量表（Y-BOCS）的范围非常广泛。
It goes on for dozens of pages, actually, and has all these different categories, not so much designed to just pinpoint what people obsess about or what they feel compelled to do, but to also try and identify what is the fear that's driving all this, right?
事实上，它有几十页，并且有所有这些不同的类别，其设计目的不仅仅是为了查明人们痴迷的东西或他们觉得有必要做的事情，而是为了尝试找出驱动这一切的恐惧是什么，对吗？
In the way that we've set this up thus far, we've been talking about obsessions and compulsions as kind of existing in a vacuum.
到目前为止，我们一直在谈论存在于真空中的强迫观念和强迫行为。
You're obsessed about germs, and you're compelled to wash your hands.
你对细菌很着迷，所以你不得不洗手。
Obsessed about germs, compelled to wash your hands.
痴迷于细菌，被迫洗手。
Or obsessed about symmetry, compelled to put right angles on everything, or obsessed about counting and therefore counting, et cetera.
或者痴迷于对称，强迫所有东西都成直角，或者痴迷于计数并因此计数，等等。
The deeper layer to all that is, what is the fear exactly if one were to not perform the compulsion?
更深层次的是，如果一个人不执行强制措施，到底害怕什么？
Meaning, what is the fear that's driving the obsession?
意思是，是什么恐惧导致了这种痴迷？
So that brings us to a very powerful category of treatments that I should say does not work in everybody with OCD, but works in many people with OCD and really speaks to the underlying neural circuitry that generates OCD and how to interrupt it.
因此，这给我们带来了一种非常强大的治疗方法，我应该说，这种治疗方法并不对每个强迫症患者都有效，但对许多强迫症患者有效，并且真正涉及产生强迫症的潜在神经回路以及如何中断它。
And that is the treatment of cognitive behavioral therapy and, in particular, exposure-based cognitive behavioral therapy.
这就是认知行为疗法，特别是基于暴露的认知行为疗法。
Cognitive behavioral therapy and exposure therapy in the context of OCD most often involves trying to get people to tolerate, not relieve their anxiety.
强迫症背景下的认知行为疗法和暴露疗法通常涉及试图让人们容忍而不是缓解他们的焦虑。
This is extremely important, and I realize there's variation to this depending on the style of cognitive behavioral therapy, the style of exposure therapy.
这非常重要，而且我意识到，根据认知行为疗法、暴露疗法的风格，这一点会有所不同。
But almost across the board, the goal, again, is to get people to feel the anxiety that normally they are able to at least partially relieve, however briefly, by engaging in the compulsion.
但几乎所有的目标都是让人们感受到通常情况下他们能够通过参与强迫行为至少部分缓解的焦虑，无论时间多么短暂。
So if we think back to that circuit of cortico-striatal-thalamic, what's going on here?
那么，如果我们回想一下皮质-纹状体-丘脑的回路，这里发生了什么？
Where is CBT intervening?
CBT 干预在哪里？
Well, as you recall, the cortex is involved in conscious perception.
嗯，正如你所记得的，皮质参与有意识的感知。
The thalamus and that thalamic reticular nucleus are involved in the passage of certain types of experience up to our conscious perception and not others.
丘脑和丘脑网状核参与某些类型的经验传递到我们的意识感知，而不是其他经验。
And the striatum is involved in this go, no-go type behavior.
纹状体参与了这种走、不走类型的行为。
When OCD is really expressing itself in its fullness, people feel an anxiety around a particular thought, and they either have a go, for instance, wash hands, or a no-go, do not turn left type reaction.
当强迫症真正充分地表达自己时，人们会对某个特定的想法感到焦虑，他们要么会去，例如洗手，要么会做出不去、不向左转的反应。
By having people progressively, in a kind of hierarchical way, reveal their precise source of anxiety, their utmost fear in this context, what happens is they feel enormous amounts of autonomic arousal.
通过让人们以一种分层的方式逐步揭示他们的焦虑的确切来源，他们在这种情况下最大的恐惧，发生的事情是他们感到大量的自主唤醒。
Now, in the context of anxiety treatment or other types of treatments, the goal would be to teach people to dampen, to lessen their anxiety through breathing techniques or through visualization techniques, or through self-talk, or through social support.
现在，在焦虑治疗或其他类型的治疗中，目标是教人们通过呼吸技巧、可视化技巧、自言自语或社会支持来抑制、减轻焦虑。
Any of the number of things that are well-known to help people self-regulate their own anxiety.
任何众所周知的可以帮助人们自我调节焦虑的事情。
Here, it's the opposite.
在这里，情况恰恰相反。
What they're trying to get the patient to do is to really feel the anxiety at its maximum but then do the exact opposite of whatever the normal compulsion is.
他们试图让患者真正感受到最大程度的焦虑，然后做与正常强迫行为完全相反的事情。
So if normally the compulsion is to wash one's hands, then the idea is to suppress hand washing while being in the experience of the utmost anxiety.
因此，如果通常的强迫行为是洗手，那么我们的想法就是在极度焦虑的情况下抑制洗手。
Now, I want to be very clear.
现在，我想说得非常清楚。
This is not the sort of thing you want to do on your own.
这不是你想要自己做的事情。
This is not the sort of thing you want to do for a friend.
这不是你想为朋友做的事情。
This is done by trained, licensed psychologists and psychiatrists because the goal, again, is to bring the person right up close to the thing that they fear the most and then to interrupt the circuit.
这是由训练有素、有执照的心理学家和精神病学家完成的，因为目标再次是让人们接近他们最害怕的东西，然后中断电路。
What's happening is the person is feeling compelled to act, act, act to relieve the anxiety, and through a progressive type of exposure, right, you don't throw people in the deep end in this kind of therapy right off the bat.
所发生的情况是，人们感到有必要采取行动、采取行动、采取行动来缓解焦虑，通过渐进式的暴露，对吧，你不会立即让人们陷入这种治疗的深渊。
You gradually ratchet them toward or move them toward the discussion of exactly what they fear the most, and then eventually move them toward the interruption of the compulsion as they're feeling this extremely elevated anxiety.
你逐渐引导他们讨论他们最害怕的事情，然后最终在他们感到极度焦虑时中断强迫行为。
Of course, within the context of a supportive clinical setting.
当然，这是在支持性临床环境的背景下进行的。
But in doing that, what you are teaching people is that the anxiety can exist without the need to engage in the compulsion.
但在这样做的过程中，你教导人们的是，焦虑可以存在，而不需要参与强迫。
So I'd like to just briefly summarize the key elements of cognitive behavioral therapy and exposure therapy and how they can be combined with drug treatments that are very effective.
因此，我想简单总结一下认知行为疗法和暴露疗法的关键要素，以及它们如何与非常有效的药物治疗相结合。
Much of what I'm going to talk about next relates to the data and indeed the practice of an incredible research scientist and clinician.
接下来我要讨论的大部分内容都与数据以及一位令人难以置信的研究科学家和临床医生的实践有关。
So this is Helen Blair Simpson, or I should say Dr. Helen Blair Simpson, because she is indeed an MD, medical doctor, and a PhD research scientist at Columbia University School of Medicine, and one of the world's foremost experts, if not the expert.
这是海伦·布莱尔·辛普森，或者我应该说海伦·布莱尔·辛普森博士，因为她确实是哥伦比亚大学医学院的医学博士、医学博士和博士研究科学家，如果不是专家，也是世界上最重要的专家之一。
I would put her in a category of maybe just one to three people who is most knowledgeable about the mechanisms of OCD, is actively researching OCD in humans, trying to find new treatments, trying to unveil new mechanisms, and expand on our current understanding, and who also treats OCD quite actively in her own clinic.
我会把她归入一到三个人的类别，他们对强迫症的机制最了解，正在积极研究人类强迫症，试图寻找新的治疗方法，试图揭示新的机制，并扩展我们目前的理解，并且她也在自己的诊所中非常积极地治疗强迫症。
She describes that the key procedures are exposures Of course, done in person and with the actual thing that evokes the obsessions and compulsions.
她描述说，关键的程序是暴露，当然，是亲自完成的，并且是用引起痴迷和强迫的实际事物进行的。
And the goal, of course, then is to gradually and progressively increase the level of anxiety, but then to intervene in so-called ritual prevention to prevent the person from engaging in the compulsion.
当然，目标是逐渐增加焦虑程度，然后干预所谓的仪式预防，以防止人陷入强迫行为。
Typically, this is done through two planning sessions with the patient, so describing to the patient what will happen and when it will happen, and how long it will happen, so that they're not just thrown into this out of the blue.
通常，这是通过与患者进行两次计划会议来完成的，因此向患者描述将发生什么、何时发生以及将发生多长时间，这样他们就不会突然陷入困境。
And then 15 exposure sessions done twice a week or more.
然后每周进行两次或以上 15 次暴露训练。
So the one thing to really understand about cognitive behavioral therapy is that it can take some period of time, several or more weeks, as many as 10 or 12 weeks.
因此，要真正了解认知行为疗法的一件事是，它可能需要一段时间，几周或更长的时间，最多 10 或 12 周。
In addition, Dr. Blair Simpson and others have explored what are the best treatments for patients with OCD by comparing cognitive behavioral therapy alone, placebo, so essentially no intervention or something that takes an equivalent amount of time but is not thought to be effective in treatment, as well as selective serotonin reuptake inhibitors.
此外，布莱尔·辛普森博士和其他人通过比较单独的认知行为疗法、安慰剂（因此基本上不进行干预）或需要相当时间但被认为对治疗无效的疗法，以及选择性血清素再摄取抑制剂，探索了强迫症患者的最佳治疗方法。
Placebo did not reduce the obsessions or compulsions to any significant degree.
安慰剂并没有在任何程度上减少强迫观念或强迫行为。
However, cognitive behavioral therapy had a dramatic effect in reducing the obsessions and compulsions, such that by four weeks, that score, that in this case ranged from eight to 20, dropped all the way from 25 down to about 11.
然而，认知行为疗法在减少强迫观念和强迫行为方面具有显着效果，到了四个星期，这个分数（在本例中为 8 到 20）从 25 一路下降到 11 左右。
So it's a huge drop in the severity of the symptoms.
所以症状的严重程度大幅下降。
Perhaps one of the most underestimated but powerful tools to improve your mental health, your physical performance, and your cognitive performance is ensuring you get enough hydration every day.
确保您每天摄入足够的水分，也许是改善您的心理健康、身体表现和认知表现的最被低估但最强大的工具之一。
The unfortunate reality, however, is that tap water often contains contaminants that negatively impact our health.
然而不幸的现实是，自来水通常含有对我们的健康产生负面影响的污染物。
So while we're trying to get great hydration, that can cause serious problems.
因此，当我们努力补充水分时，这可能会导致严重的问题。
In fact, a 2020 study by the Environmental Working Group estimated that more than 200 million Americans are exposed to PFAS chemicals, also known as forever chemicals, through drinking tap water.
事实上，环境工作组 2020 年的一项研究估计，超过 2 亿美国人通过饮用自来水接触到 PFAS 化学物质（也称为永久化学物质）。
These forever chemicals are linked to serious health issues, such as hormone disruption, gut microbiome disruption, fertility issues, and many other health problems, some of which are just now coming to light.
这些永久性化学物质与严重的健康问题有关，例如激素紊乱、肠道微生物组紊乱、生育问题和许多其他健康问题，其中一些问题刚刚被发现。
For all these reasons, I was thrilled when I came across Rorra Water Filters, and now they're a sponsor of this podcast.
出于所有这些原因，当我遇到 Rorra 滤水器时，我感到很兴奋，现在他们是这个播客的赞助商。
Rorra makes what I believe are the best water filters on the market.
我认为 Rorra 制造的是市场上最好的滤水器。
I've been using the Rorra countertop system for almost a year now.
我使用 Rorra 台面系统已经快一年了。
Rorra's filtration technology removes harmful substances, including endocrine disruptors and disinfection byproducts, while preserving beneficial minerals like magnesium and calcium.
Rorra 的过滤技术可去除有害物质，包括内分泌干扰物和消毒副产物，同时保留镁和钙等有益矿物质。
It requires no installation or plumbing, so it's extremely convenient.
它不需要安装或管道，因此非常方便。
It's built from medical-grade stainless steel, and it fits beautifully on your countertop.
它由医用级不锈钢制成，非常适合放在您的台面上。
It's something that you would want to have in your kitchen.
这是您希望在厨房里拥有的东西。
If you'd like to try Rorra, you can go to rorra.com/huberman and get an exclusive discount.
如果您想尝试 Rorra，可以访问 rorra.com/huberman 并获得独家折扣。
Again, that's Rorra, R-O-R-R-A.com/huberman.
再说一次，那是 Rorra，R-O-R-R-A.com/huberman。
Now, what's really interesting is that when you look at the effects of SSRIs in the treatment of OCD symptoms, they had a significant effect in reducing the symptoms of OCD, but the severity of their symptoms was still much greater than those receiving cognitive behavioral therapy alone.
现在，真正有趣的是，当你观察 SSRIs 在治疗强迫症症状方面的效果时，你会发现它们在减轻强迫症症状方面有显着效果，但其症状的严重程度仍然比单独接受认知行为治疗的人要严重得多。
So what happens when you combine them?
那么当你将它们结合起来时会发生什么呢？
Well, they explored that as well, and the combination of cognitive behavioral therapy and the SSRIs together did not lead to any further decrease in OCD symptoms.
好吧，他们也对此进行了探索，认知行为疗法和 SSRI 的结合并没有导致强迫症症状的进一步减轻。
This points to the idea that cognitive behavioral therapy is the most effective treatment.
这表明认知行为疗法是最有效的治疗方法。
And again, when I say cognitive behavioral therapy now, I'm still referring to cognitive behavioral/exposure therapy done in the way that I detailed before, twice a week for 12 weeks or more.
再说一次，当我现在说认知行为疗法时，我仍然指的是按照我之前详述的方式进行的认知行为/暴露疗法，每周两次，持续 12 周或更长时间。
So for those of you that have sought treatment and you're taking a SSRI, or if you're thinking about treatment and you're prescribed an SSRI, the ideal scenario really would be to combine the drug treatment with cognitive behavioral therapy, or in some cases, maybe cognitive behavioral therapy alone.
因此，对于那些已经寻求治疗并且正在服用 SSRI 的人，或者如果您正在考虑治疗并且开了 SSRI 处方，理想的情况确实是将药物治疗与认知行为疗法相结合，或者在某些情况下，可能单独使用认知行为疗法。
Although that's a decision that you really have to make with the close advice and oversight of a licensed physician because, of course, these are prescription drugs.
尽管您确实必须在有执照的医生的密切建议和监督下做出决定，因为当然，这些是处方药。
And any time you're going to add or remove a prescription drug or change dosage, you really want to do that in close discussion with and on the advice of your physician.
每当您要添加或删除处方药或改变剂量时，您都需要与医生密切讨论并根据医生的建议进行操作。
I don't just say that to protect me.
我这么说不仅仅是为了保护我。
I say that to protect you and because it's just the right thing to do.
我这么说是为了保护你，因为这是正确的做法。
So what I'm about to tell you next is most certainly going to come as a big surprise, which is that despite the fact that the selective serotonin reuptake inhibitors can be effective in reducing the symptoms of OCD, at least somewhat, and certainly more than placebo, there is very little, if any, evidence that the serotonin system is disrupted in OCD.
因此，我接下来要告诉你的内容肯定会让人大吃一惊，那就是，尽管选择性血清素再摄取抑制剂可以有效地减轻强迫症的症状，至少在一定程度上，而且肯定比安慰剂更有效，但几乎没有证据表明强迫症中的血清素系统受到破坏。
And I have to point out that this is a somewhat consistent theme in the field of psychiatry.
我必须指出，这是精神病学领域的一个有些一致的主题。
That is, a given drug can be very effective or even partially effective in reducing symptoms or in changing the overall landscape of a psychiatric disorder or illness, and yet there is very little, if any, evidence that that particular system is what's causal for OCD or anxiety or depression, et cetera.
也就是说，某种药物在减轻症状或改变精神障碍或疾病的整体状况方面可能非常有效，甚至部分有效，但几乎没有证据表明该特定系统是导致强迫症、焦虑或抑郁等的原因。
Now, earlier, we were talking about not reducing anxiety but learning anxiety tolerance in order to deal with and treat OCD in the context of cognitive behavioral therapies.
现在，早些时候，我们谈论的不是减少焦虑，而是学习焦虑耐受力，以便在认知行为疗法的背景下处理和治疗强迫症。
That doesn't necessarily rule out cannabis as a candidate for the treatment of OCD, and in fact, this has been explored.
这并不一定排除大麻作为治疗强迫症的候选药物，事实上，这已经被探索过。
A study from Dr. Blair Simpson herself looked at this.
布莱尔·辛普森博士本人的一项研究对此进行了研究。
This was a fairly small-scale study.
这是一项相当小规模的研究。
So first of all, I'll give you the title, and again, we'll provide a link.
首先，我会给您标题，然后我们将再次提供一个链接。
This is entitled, "Acute Effects of Cannabinoids on Symptoms of Obsessive-Compulsive Disorder: A Human Laboratory Study." I'm just reading from their conclusions here.
该文章的标题是“大麻素对强迫症症状的急性影响：一项人类实验室研究”。我只是在这里阅读他们的结论。
The data suggests that smoked cannabis, whether containing primarily THC or CBD, has little acute impact, meaning immediate impact on OCD symptoms, and yields smaller reductions in anxiety compared to placebo.
数据表明，吸食大麻，无论主要含有 THC 还是 CBD，都没有什么急性影响，这意味着对强迫症症状有立竿见影的影响，并且与安慰剂相比，对焦虑的缓解程度较小。
So they did not see a, when I say a positive effect, I mean a ameliorative effect, an effect in reducing symptoms of OCD from cannabis or CBD.
所以他们没有看到，当我说积极效果时，我指的是改善效果，即减少大麻或 CBD 强迫症症状的效果。
Another treatment that's becoming somewhat common, or at least people are commonly excited about is transcranial magnetic stimulation.
另一种越来越常见的治疗方法，或者至少人们普遍感到兴奋的方法是经颅磁刺激。
So this is the use of a magnetic coil, this is completely non-invasive, placed on one portion of the skull, and one can direct magnetic energy toward particular areas of the brain to either suppress or nowadays you can also activate particular brain regions.
这就是磁线圈的使用，这是完全非侵入性的，放置在头骨的一部分上，可以将磁能引导到大脑的特定区域以抑制或现在您也可以激活特定的大脑区域。
There are some interesting data showing that if TMS is applied to areas of the brain involved in the generation of motor action, so the so-called motor areas or supplementary motor areas as they're called, while people think about or have intrusive thoughts, we know that the TMS coil can interrupt the motor behaviors, the compulsive behaviors, and at least in a small cohort of studies, in a small number of patients within those studies, this has been shown to be effective, not just while the coil is on the head, of course, but after the study has been performed or the treatment's been performed, in reducing OCD symptoms by disrupting the tendency for the compulsive behavior to be so automatic.
有一些有趣的数据表明，如果 TMS 应用于参与产生运动动作的大脑区域，即所谓的运动区域或辅助运动区域，当人们思考或有侵入性想法时，我们知道 TMS 线圈可以中断运动行为、强迫行为，并且至少在一小群研究中，在这些研究中的少数患者中，这已被证明是有效的，而不仅仅是当线圈位于头部时，当然，但是在进行研究或进行治疗之后，通过破坏强迫行为如此自动的倾向来减少强迫症症状。
Right now, I don't think it's fair to say that TMS is a magic bullet either.
现在，我认为说 TMS 是灵丹妙药也不公平。
I think there's a lot of excitement about TMS and in particular, I really want to nail this point home, in particular, there's excitement about the combination of TMS with drug treatments, or the combination of TMS with cognitive behavioral therapy.
我认为 TMS 有很多令人兴奋的地方，特别是，我真的很想强调这一点，尤其是 TMS 与药物治疗的结合，或者 TMS 与认知行为疗法的结合，令人兴奋。
I realize that a number of listeners of this podcast are probably interested in the non-typical or holistic treatments for OCD.
我意识到这个播客的许多听众可能对强迫症的非典型或整体治疗感兴趣。
Dr. Blair Simpson's lab has at least one study exploring the role of mindfulness meditation for the treatment of OCD.
布莱尔·辛普森博士的实验室至少有一项研究探索正念冥想在治疗强迫症中的作用。
There, the data are a little bit complicated, and I should mention that good things are happening, at least in the United States, probably elsewhere as well, but good things are happening in terms of the exploration of things like meditation and other, let's call them non-traditional or holistic forms of treatment for psychiatric disorders because of the division of complementary health that's now been launched by the National Institutes of Health.
在那里，数据有点复杂，我应该提到，至少在美国，可能在其他地方也正在发生好事，但在探索冥想等方面正在发生好事，让我们称它们为精神疾病的非传统或整体治疗形式，因为美国国立卫生研究院现在推出了补充健康部门。
So whereas before people would think about meditation or yoga nidra or even CBD supplementation for that matter, as kind of fringe maybe, or kind of woo or non-traditional at the very least, the National Institutes of Health in the United States has now devoted an entire division, an entire institute, purely for the exploration of things like breathing practices, meditation, et cetera.
因此，在人们考虑冥想或瑜伽休息术，甚至 CBD 补充剂之前，可能是一种边缘，或者至少是一种追求或非传统，美国国立卫生研究院现在专门投入了整个部门、整个研究所，纯粹用于探索呼吸练习、冥想等事物。
So there's a cancer institute, there's a hearing and deafness institute, there's a vision institute, and now there's this complementary health institute, which I think is a wonderful addition to the more traditional aspects of medicine.
所以有一个癌症研究所，有一个听力和耳聋研究所，有一个视觉研究所，现在有一个补充健康研究所，我认为这是对医学更传统方面的一个很好的补充。
I think no possible useful treatment should be overlooked or unresearched, in my opinion, provided that can be done safely.
我认为，只要可以安全地进行，任何可能有用的治疗方法都不应该被忽视或不加以研究。
Turns out that mindfulness meditation can be useful in the treatment of OCD, but mainly by way of how it impacts the focus on and the ability to engage in cognitive behavioral therapies.
事实证明，正念冥想对于治疗强迫症很有用，但主要是通过它如何影响认知行为疗法的注意力和能力。
So it's very unlikely, at least by my read of the data, to be a direct effect of meditation on relieving the symptoms.
因此，至少从我读到的数据来看，冥想不太可能对缓解症状产生直接影响。
Rather, it seems that meditation is increasing focus on things like cognitive behavioral therapy homework and to not focus on other things, and therefore indirectly improving the symptoms of OCD.
相反，冥想似乎正在增加对认知行为治疗作业等事情的关注，而不是关注其他事情，从而间接改善强迫症的症状。
Now, somewhat surprisingly, at least to me, there have also been a fairly large number of studies exploring how nutraceuticals, as they're sometimes called, supplements that are available over the counter can impact the treatment of obsessive-compulsive disorder.
现在，有些令人惊讶的是，至少对我来说，还有相当多的研究探索非处方药保健品（有时被称为补充剂）如何影响强迫症的治疗。
One compound that I'd like to focus on is inositol, and here I'm referring specifically to myo-inositol because it comes in several forms.
我想重点关注的一种化合物是肌醇，在这里我特指肌醇，因为它有多种形式。
And it does appear that 900 milligrams of inositol can improve sleep and can reduce anxiety, perhaps when taken at that dosage or higher dosages.
看来 900 毫克肌醇确实可以改善睡眠并减少焦虑，也许以该剂量或更高剂量服用即可。
So I think there's a great future for these nutraceuticals, meaning I think more systematic exploration, in particular of lower dosages in the context of OCD treatment.
因此，我认为这些营养保健品有一个美好的未来，这意味着我认为需要进行更系统的探索，特别是在强迫症治疗中降低剂量。
And as we saw before for the SSRIs and other prescription drug treatments, I think there really needs to be an exploration of these nutraceuticals in combination with behavioral therapies, and who knows, maybe with brain machine interface like transcranial magnetic stimulation as well.
正如我们之前在 SSRI 和其他处方药治疗中看到的那样，我认为确实需要对这些营养保健品与行为疗法相结合进行探索，谁知道呢，也许还可以与经颅磁刺激等脑机接口相结合。
What I've tried to provide is an opportunity to really drill deep into the neural circuitry and an understanding of where OCD comes from, and also to give you a sense of how the individual behavioral and drug treatments work and perhaps don't work, so that you can really make the best-informed choices.
我试图提供的是一个真正深入研究神经回路并了解强迫症从何而来的机会，同时让您了解个人行为和药物治疗如何发挥作用，也许不起作用，以便您能够真正做出最明智的选择。
Again, highlighting the fact that OCD is an extremely common, extremely common and yet extremely debilitating condition, and one that I hope that if any of you have or that you know people that have it, that you'll both gain sympathy and understanding for what they're dealing with, perhaps as a consequence of some of the information presented today, and maybe help them direct their treatment, find better treatment, and of course, apply those treatments for some relief.
再次强调这样一个事实，强迫症是一种极其常见、极其常见但又极其令人衰弱的疾病，我希望，如果你们中有人患有强迫症，或者您认识患有强迫症的人，你们都会对他们正在处理的事情获得同情和理解，也许是今天提供的一些信息的结果，也许可以帮助他们指导治疗，找到更好的治疗，当然，应用这些治疗来缓解症状。
In closing, I'd like to thank you for this in-depth discussion about the mechanisms and various treatments for obsessive compulsive disorder and some of the related disorders.
最后，我要感谢您对强迫症和一些相关疾病的机制和各种治疗方法的深入讨论。
And as always, thank you for your interest in science.
一如既往，感谢您对科学的兴趣。
NFL football season is here, which means when you switch to Verizon, it feels like touchdown because you get NFL Sunday Ticket from YouTube on us when you buy an eligible 5G phone on select unlimited plans, which means you can watch every out-of-market game every Sunday afternoon.
NFL 橄榄球赛季即将到来，这意味着当您切换到 Verizon 时，感觉就像触地得分，因为当您购买符合条件的 5G 手机并选择无限制套餐时，您就可以从 YouTube 获得 NFL 周日门票，这意味着您可以在每周日下午观看每场非市场比赛。
And it's all on us.
这一切都在我们身上。
Now, that's the Verizon way to kick off the NFL football season right.
现在，这就是 Verizon 开启 NFL 橄榄球赛季的方式。
Switch and get NFL Sunday Ticket from YouTube on us.
切换并从 YouTube 获取 NFL 周日门票。
Only with Verizon.
仅与威瑞森合作。