ABOUT THE SPEAKER
Rebecca Brachman - Neuroscientist, writer, entrepreneur
Rebecca Brachman is a pioneer in the field of preventative psychopharmacology, developing drugs to enhance stress resilience and prevent mental illness.

Why you should listen

Current treatments for mood disorders only suppress symptoms without addressing the underlying disease, and there are no known cures. The drugs Rebecca Brachman is developing would be the first to prevent psychiatric disorders such as post-traumatic stress disorder (PTSD) and depression.

Brachman completed her PhD at Columbia University, prior to which she was a fellow at the National Institutes of Health, where she discovered that immune cells carry a memory of psychological stress and that white blood cells can act as antidepressants and resilience-enhancers. Brachman's research has been featured in The Atlantic, WIRED and Business Insider, and her work was recently described by Dr. George Slavich on NPR as a "moonshot project that is very much needed in the mental health arena."

In addition to conducting ongoing research at Columbia, Brachman is an NYCEDC Entrepreneurship Lab Fellow and cofounder of Paravax -- a biotech startup developing vaccine-like prophylactic drugs ("paravaccines") -- along with her scientific collaborator, Christine Ann Denny. She is also working on a non-profit venture to repurpose existing generic drugs for use as prophylactics, and previously served as the Interim Program Director for Outreach at the Zuckerman Institute at Columbia University.

Brachman is also a playwright and screenwriter. She holds Bachelor's degrees in both neuroscience and creative wWriting, and she is currently working on a tech-focused writing project with her long-time writing partner, Sean Calder ("Grimm," "Damages," "ER"). She served as the director of NeuWrite, a national network of science-writing groups that fosters ongoing collaboration between scientists, writers and artists, and she has been featured as a storyteller at The Story Collider.

(Photo: Kenneth Willardt)

More profile about the speaker
Rebecca Brachman | Speaker | TED.com
TEDxNewYork

Rebecca Brachman: Could a drug prevent depression and PTSD?

Rebecca Brachman: 药物有可能防止抑郁症和创后应激障碍吗?

Filmed:
1,563,420 views

发现新药物的路不仅有偶然,也有改革性的发现。在这个科学是如何发生的故事里,神经学家Rebecca Brachman 与我们分享了一项令人兴奋的发现-预防精神疾病,比如抑郁症和创后应激障碍症。听听这个非同一般,具有争议的演讲吧。
- Neuroscientist, writer, entrepreneur
Rebecca Brachman is a pioneer in the field of preventative psychopharmacology, developing drugs to enhance stress resilience and prevent mental illness. Full bio

Double-click the English transcript below to play the video.

00:13
This is a tuberculosis结核 ward病房,
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这是一个肺结核病房,
00:16
and at the time this picture图片 was taken采取
in the late晚了 1800s,
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在十九世纪末
00:19
one in seven of all people
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每七个人中就有一个
00:22
died死亡 from tuberculosis结核.
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死于肺结核。
00:24
We had no idea理念
what was causing造成 this disease疾病.
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我们不清楚这个病的起因。
00:28
The hypothesis假设 was actually其实
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我们猜想
00:30
it was your constitution宪法
that made制作 you susceptible易感.
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可能是我们的体质决定了我们的易感染性。
00:33
And it was a highly高度 romanticized浪漫 disease疾病.
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而且这种病被披上了浪漫滴外衣。
00:36
It was also called consumption消费,
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被称为痨病。
00:39
and it was the disorder紊乱 of poets诗人
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它是诗人,
00:42
and artists艺术家 and intellectuals知识分子.
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艺术家,智者得的病。
00:45
And some people actually其实 thought
it gave you heightened提高 sensitivity灵敏度
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有些人甚至认为这种病让你变得更敏感,
00:48
and conferred授予 creative创作的 genius天才.
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并且赋予你天才的特质。
00:52
By the 1950s,
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到二十世纪五十年代,
00:54
we instead代替 knew知道
that tuberculosis结核 was caused造成
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我们发现肺结核是由
00:57
by a highly高度 contagious传染性的
bacterial细菌 infection感染,
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一种传染性很强的细菌感染引起的,
01:00
which哪一个 is slightly less romantic浪漫,
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并没有那么浪漫,
01:03
but that had the upside上边
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然而这
01:05
of us being存在 able能够 to maybe
develop发展 drugs毒品 to treat对待 it.
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让我们想到研发药物来治疗这种疾病的可能性。
01:08
So doctors医生 had discovered发现
a new drug药物, iproniazid异丙烟肼,
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于是医生们发现了一种新药-异丙嗪,
01:11
that they were optimistic乐观
might威力 cure治愈 tuberculosis结核,
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他们乐观地认为可以治愈肺结核,
01:15
and they gave it to patients耐心,
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他们把这种药给病人服用,
01:16
and patients耐心 were elated高昂.
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病人们很兴奋。
01:18
They were more social社会, more energetic有活力.
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他们变得更活跃,充满生机。
01:22
One medical report报告 actually其实 says
they were "dancing跳舞 in the halls大厅."
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一项医学报告提到,他们“ 在走廊手舞足蹈。“
01:27
And unfortunately不幸,
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可惜的是
01:29
this was not necessarily一定
because they were getting得到 better.
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这并不意味着他们在康复。
01:32
A lot of them were still dying垂死.
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很多病人依然频临死亡。
01:35
Another另一个 medical report报告 describes介绍 them
as being存在 "inappropriately不适当 happy快乐."
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另外有一份医学报告称他们“不正常得开心”
01:43
And that is how the first
antidepressant抗抑郁剂 was discovered发现.
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第一种抗抑郁药物就这样发明了。
01:47
So accidental偶然 discovery发现
is not uncommon罕见 in science科学,
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这种巧合在科学领域并不多见,
01:52
but it requires要求 more
than just a happy快乐 accident事故.
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但是它需要的不仅仅是开心的巧合。
01:55
You have to be able能够 to recognize认识 it
for discovery发现 to occur发生.
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你需要有能力在这种巧合发生的时候抓住它。
01:59
As a neuroscientist神经学家,
I'm going to talk to you a little bit
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作为一个神经学家,让我与你分享一些
02:02
about my firsthand第一手 experience经验
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我的第一手经验
02:03
with whatever随你 you want to call
the opposite对面 of dumb luck运气 --
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你可能会称之为狗屎运,
02:06
let's call it smart聪明 luck运气.
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我更倾向于称之为聪明的运气。
02:08
But first, a bit more background背景.
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首先,说说背景知识。
02:12
Thankfully感激地, since以来 the 1950s,
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自二十世纪五十年代,
02:15
we've我们已经 developed发达 some other drugs毒品
and we can actually其实 now cure治愈 tuberculosis结核.
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我们研发了其他药物,我们现在事实上已经可以治愈肺结核。
02:19
And at least最小 in the United联合的 States状态,
though虽然 not necessarily一定 in other countries国家,
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至少在美国是这样。
02:22
we have closed关闭 our sanitoriumssanitoriums
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我们关闭了疗养院
02:24
and probably大概 most of you
are not too worried担心 about TBTB.
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而且可能你们大部分人已经不是那么担心肺结核。
02:28
But a lot of what was true真正
in the early 1900s
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可是在二十世纪初我们对于
02:31
about infectious传染病 disease疾病,
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传染病的担心,
02:33
we can say now
about psychiatric精神病 disorders障碍.
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和当今的精神病类似。
02:36
We are in the middle中间
of an epidemic疫情 of mood心情 disorders障碍
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我们正陷于情绪困扰之中
02:39
like depression萧条 and post-traumatic创伤后
stress强调 disorder紊乱, or PTSDPTSD.
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比如抑郁症和创后应激障碍,PTSD。
02:44
One in four of all adults成年人
in the United联合的 States状态
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在美国,每四个人中就有一个
02:48
suffers患有 from mental心理 illness疾病,
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受精神疾病的困扰,
02:50
which哪一个 means手段 that if you haven't没有
experienced有经验的 it personally亲自
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也就是说即使你可能本身没有,
02:53
or someone有人 in your family家庭 hasn't有没有,
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或者你的家人没有,
02:55
it's still very likely容易
that someone有人 you know has,
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可是很有可能你认识的人有,
02:58
though虽然 they may可能 not talk about it.
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只是他们不说而已。
03:02
Depression萧条 has actually其实 now surpassed超越
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抑郁症实际上已经超越了
03:05
HIVHIV/AIDS艾滋病, malaria疟疾, diabetes糖尿病 and war战争
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艾滋病,疟疾,糖尿病和战争
03:10
as the leading领导 cause原因
of disability失能 worldwide全世界.
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成为全球范围健康的头号杀手。
03:13
And also, like tuberculosis结核 in the 1950s,
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就像二十世纪五十年代时的肺结核一样,
03:17
we don't know what causes原因 it.
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我们不清楚它的起因。
03:19
Once一旦 it's developed发达, it's chronic慢性,
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一旦发病,就是慢性
03:21
lasts持续 a lifetime一生,
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会伴随你一生,
03:22
and there are no known已知 cures治愈.
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而且目前无法治愈。
03:26
The second第二 antidepressant抗抑郁剂 we discovered发现,
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第二种抗抑郁药同样
03:28
also by accident事故, in the 1950s,
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偶然发现于二十世纪五十年代,
03:31
from an antihistamine抗组胺药
that was making制造 people manic躁狂,
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是从让人躁狂的抗组胺药中发现的,
03:35
imipramine丙咪嗪.
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丙咪嗪。
03:38
And in both the case案件 of the tuberculosis结核
ward病房 and the antihistamine抗组胺药,
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无论是在结核病还是抗组胺药的个案中,
03:41
someone有人 had to be able能够 to recognize认识
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都需要有人发现
03:43
that a drug药物 that was designed设计
to do one thing --
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一种本来用于治疗一种病的药物
03:46
treat对待 tuberculosis结核
or suppress压制 allergies过敏 --
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治疗结核或者抗过敏
03:48
could be used to do
something very different不同 --
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都可以用于完全不同的治疗-
03:51
treat对待 depression萧条.
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治疗抑郁症。
03:53
And this sort分类 of repurposing再利用
is actually其实 quite相当 challenging具有挑战性的.
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这种改变事实上非常具有挑战性。
03:56
When doctors医生 first saw
this mood-enhancing改善情绪 effect影响 of iproniazid异丙烟肼,
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当医生们最早看到异丙嗪情绪提升的作用时,
04:00
they didn't really recognize认识
what they saw.
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他们并没有意识到他们看到的是什么。
04:02
They were so used to thinking思维 about it
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他们总是习惯性地从
04:04
from the framework骨架
of being存在 a tuberculosis结核 drug药物
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治疗肺结核的药物
04:07
that they actually其实 just listed上市 it
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的副作用
04:09
as a side effect影响, an adverse不利的 side effect影响.
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不良的副作用来考虑。
04:12
As you can see here,
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基于这个原因,
04:13
a lot of these patients耐心 in 1954
are experiencing经历 severe严重 euphoria欣快症.
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在1954 年许多病人表现出异常的快乐。
04:18
And they were worried担心
that this might威力 somehow不知何故 interfere干扰
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于是医生们担心这种状态会影响病人
04:22
with their recovering恢复 from tuberculosis结核.
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肺结核的治疗。
04:25
So they recommended推荐的 that iproniazid异丙烟肼
only be used in cases of extreme极端 TBTB
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于是他们建议异丙嗪只可以用于严重的结核病患者
04:31
and in patients耐心 that were
highly高度 emotionally感情上 stable稳定,
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以及心理状态非常稳定的病人,
04:36
which哪一个 is of course课程 the exact精确 opposite对面
of how we use it as an antidepressant抗抑郁剂.
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这显然和我们治疗抑郁病患者截然相反。
04:40
They were so used to looking at it
from the perspective透视 of this one disease疾病,
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他们太过习惯于只关注一个病的状况,
04:44
they could not see the larger implications启示
for another另一个 disease疾病.
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而未能从另一个疾病的角度看到药物更广的适用。
04:49
And to be fair公平,
it's not entirely完全 their fault故障.
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公正地说,这不全是他们的错。
04:52
Functional实用 fixedness固定性
is a bias偏压 that affects影响 all of us.
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我们可能都受着教条主义的影响,
04:54
It's a tendency趋势 to only
be able能够 to think of an object目的
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我们倾向于只考虑一个事物
04:58
in terms条款 of its traditional传统
use or function功能.
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传统意义上的使用和功能。
05:01
And mental心理 set is another另一个 thing. Right?
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而且思维方式是另一回事。 对吗?
05:03
That's sort分类 of this preconceived先入为主 framework骨架
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这种
05:05
with which哪一个 we approach途径 problems问题.
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我们用于思考的思维定式
05:07
And that actually其实 makes品牌 repurposing再利用
pretty漂亮 hard for all of us,
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使得发散思考变得相当困难,
05:10
which哪一个 is, I guess猜测, why they gave
a TV电视 show显示 to the guy who was,
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也就是,我想,为什么电视节目亲赖于那些
05:14
like, really great at repurposing再利用.
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善于发散性思维的人们。
05:16
(Laughter笑声)
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(笑声)
05:19
So the effects效果 in both the case案件
of iproniazid异丙烟肼 and imipramine丙咪嗪,
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所以,在这两个例子中,异丙嗪和丙咪嗪
05:23
they were so strong强大 --
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药效都很强-
05:24
there was mania狂躁,
or people dancing跳舞 in the halls大厅.
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狂躁或是人们在走廊跳舞。
05:27
It's actually其实 not that surprising奇怪
they were caught抓住.
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他们被注意到并不奇怪。
05:30
But it does make you wonder奇迹
what else其他 we've我们已经 missed错过.
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那么你会否想到我们是否还忽视了其他东西。
05:35
So iproniazid异丙烟肼 and imipramine丙咪嗪,
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所以异丙嗪和丙咪嗪
05:37
they're more than just
a case案件 study研究 in repurposing再利用.
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他们不仅仅是发散思维的一个案例,
05:39
They have two other things in common共同
that are really important重要.
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他们有其他两样重要的共性,
05:42
One, they have terrible可怕 side effects效果.
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其一, 他们有很强的副作用
05:45
That includes包括 liver toxicity毒性,
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包括肝中毒,
05:47
weight重量 gain获得 of over 50 pounds英镑,
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体重增加超过50 磅,
05:50
suicidality自杀.
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自杀倾向。
05:52
And two, they both
increase增加 levels水平 of serotonin血清素,
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第二, 他们都增加了血清素的指标
05:56
which哪一个 is a chemical化学 signal信号 in the brain,
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大脑中的一个化学信号,
05:59
or a neurotransmitter神经递质.
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或者神经传递组织。
06:01
And those two things together一起,
right, one or the two,
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这两个副作用一起,对,第一个或者第二个
06:03
may可能 not have been that important重要,
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可能不是那么重要,
06:05
but the two together一起 meant意味着
that we had to develop发展 safer更安全 drugs毒品,
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但是两者合并意味着我们必须开发更安全的药物
06:09
and that serotonin血清素 seemed似乎
like a pretty漂亮 good place地点 to start开始.
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而且血清素似乎是个好的突破口。
06:13
So we developed发达 drugs毒品
to more specifically特别 focus焦点 on serotonin血清素,
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于是我们研制了专注于血清素的药物,
06:17
the selective可选择的 serotonin血清素
reuptake再摄取 inhibitors抑制剂, so the SSRIsSSRIs类药物,
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选择性5-羟色胺再摄取抑制剂, SSRIs,
06:21
the most famous著名 of which哪一个 is Prozac百忧解.
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最有名的就是Prozac。
06:24
And that was 30 years年份 ago,
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那是30 年前,
06:26
and since以来 then we have mostly大多
just worked工作 on optimizing优化 those drugs毒品.
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从那时起我们致力于优化这些药物。
06:29
And the SSRIsSSRIs类药物, they are better
than the drugs毒品 that came来了 before them,
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SSRI类药物比以前的药物都好,
06:32
but they still have a lot of side effects效果,
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但是他们也还有副作用,
06:35
including包含 weight重量 gain获得, insomnia失眠,
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包括体重增加,失眠,
06:38
suicidality自杀 --
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自杀倾向-
06:40
and they take a really long time to work,
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而且药效产生慢,
06:42
something like four to six weeks
in a lot of patients耐心.
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有些患者需要4到6个星期才见效。
06:45
And that's in the patients耐心
where they do work.
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这是在那些药物产生疗效的患者中。
06:47
There are a lot of patients耐心
where these drugs毒品 don't work.
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也有许多患者对药物没有反应。
06:50
And that means手段 now, in 2016,
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也就是说,现在,在2016年,
06:53
we still have no cures治愈
for any mood心情 disorders障碍,
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我们依然没有治愈情绪障碍的药物,
06:57
just drugs毒品 that suppress压制 symptoms症状,
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只有抑制症状的药物,
06:59
which哪一个 is kind of the difference区别 between之间
taking服用 a painkiller止痛药 for an infection感染
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就好像治疗感染的时候,止痛药和
07:03
versus an antibiotic抗生素.
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抗菌素的区别。
07:04
A painkiller止痛药 will make you feel better,
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止痛药让你感觉好些,
07:06
but is not going to do anything
to treat对待 that underlying底层 disease疾病.
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但不能治愈引起痛症的病。
07:10
And it was this flexibility灵活性
in our thinking思维
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是我们思维的灵活性
07:13
that let us recognize认识
that iproniazid异丙烟肼 and imipramine丙咪嗪
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让我们发现 了异丙嗪和丙咪嗪
07:16
could be repurposed改变用途 in this way,
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可以用作其他用途,
07:18
which哪一个 led us to the serotonin血清素 hypothesis假设,
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引领我们走向血清素,
07:20
which哪一个 we then, ironically讽刺地, fixated迷恋 on.
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然后我们专注于
07:23
This is brain signaling发信号, serotonin血清素,
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大脑的信号,血清素
07:26
from an SSRISSRI commercial广告.
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一种SSRI药物
07:27
In case案件 you're not clear明确,
this is a dramatization戏剧化.
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如果你不清楚的话,这是图示。
07:30
And in science科学, we try
and remove去掉 our bias偏压, right,
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在科学领域,我们尽可能排除偏见,是吧?
07:34
by running赛跑 double-blinded双盲 experiments实验
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通过双盲试验
07:37
or being存在 statistically统计学 agnostic不可知
as to what our results结果 will be.
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或者对我们的试验数据持中立的态度。
07:40
But bias偏压 creeps蠕动 in more insidiously阴险
in what we choose选择 to study研究
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但是偏见却悄悄地渗入到我们研究的课题
07:45
and how we choose选择 to study研究 it.
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以及我们选择的研究方法。
07:48
So we've我们已经 focused重点 on serotonin血清素 now
for the past过去 30 years年份,
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所以在过去30年我们潜心于血清素的同时,
07:51
often经常 to the exclusion排除 of other things.
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也排除了其他的事物。
07:54
We still have no cures治愈,
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我们依然没有根治的方法。
07:57
and what if serotonin血清素
isn't all there is to depression萧条?
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假如血清素不是抑郁的全部?
08:00
What if it's not even the key part部分 of it?
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或者如果它根本不是抑郁的核心?
08:02
That means手段 no matter how much time
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那就意味着无论我们花多少时间
08:04
or money or effort功夫 we put into it,
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或是金钱,或是努力,
08:07
it will never lead to a cure治愈.
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我们永远找不到治愈的办法。
08:10
In the past过去 few少数 years年份,
doctors医生 have discovered发现
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在过去的几年,医生们发现了
08:13
probably大概 what is the first truly new
antidepressant抗抑郁剂 since以来 the SSRIsSSRIs类药物,
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自从SSRI以来的第一种新抗抑郁药
08:18
CalypsolCalypsol,
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Calypsol
08:19
and this drug药物 works作品 very quickly很快,
within a few少数 hours小时 or a day,
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而且这种药见效快,只需几个小时或者一天。
08:23
and it doesn't work on serotonin血清素.
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而且它不影响血清素。
08:25
It works作品 on glutamate谷氨酸,
which哪一个 is another另一个 neurotransmitter神经递质.
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它作用于谷氨酸,另一种神经传感器。
08:28
And it's also repurposed改变用途.
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这也是一个重新定位的例子。
08:29
It was traditionally传统 used
as anesthesia麻醉 in surgery手术.
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这种药传统上是用于手术中的麻醉剂。
08:33
But unlike不像 those other drugs毒品,
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不像其他的药物,
08:35
which哪一个 were recognized认可 pretty漂亮 quickly很快,
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很快就得到认同,
08:37
it took us 20 years年份
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人们用了20 年
08:38
to realize实现 that CalypsolCalypsol
was an antidepressant抗抑郁剂,
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才意识到 Calypsol 是一种抗抑郁药物。
08:41
despite尽管 the fact事实 that it's actually其实
a better antidepressant抗抑郁剂,
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尽管事实上
08:44
probably大概, than those other drugs毒品.
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它可能比其他的药物都更有效。
08:45
It's actually其实 probably大概 because of the fact事实
that it's a better antidepressant抗抑郁剂
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事实上有可能正因为它是一种更有效的抗抑郁药
08:50
that it was harder更难 for us to recognize认识.
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所以才更难以被大家认识。
08:52
There was no mania狂躁 to signal信号 its effects效果.
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没有狂躁来凸显它的副作用。
08:54
So in 2013, up at Columbia哥伦比亚 University大学,
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所以在2013年, 在哥伦比亚大学,
08:57
I was working加工 with my colleague同事,
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我在和我的同事
08:59
Dr博士. Christine克里斯汀 Ann Denny丹尼,
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Christine Ann Denny 博士工作
09:01
and we were studying研究 CalypsolCalypsol
as an antidepressant抗抑郁剂 in mice老鼠.
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我们在研究Calypsol作为抗抑郁药物在老鼠身上的反应。
09:05
And CalypsolCalypsol has, like,
a really short half-life半衰期,
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Calypsol的半衰期很短,
09:08
which哪一个 means手段 it's out of your body身体
within a few少数 hours小时.
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就是说它在几小时内就会被排出体外。
09:11
And we were just piloting试点.
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我们只是在试验,
09:13
So we would give an injection注射 to mice老鼠,
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所以我们会给老鼠注射
09:15
and then we'd星期三 wait a week,
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我们然后等一个星期,
09:16
and then we'd星期三 run
another另一个 experiment实验 to save保存 money.
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然后我们为了省钱会再进行另一个试验。
09:20
And one of the experiments实验 I was running赛跑,
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在我的一个试验中,
09:22
we would stress强调 the mice老鼠,
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我们会给老鼠们施加压力,
09:23
and we used that as a model模型 of depression萧条.
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我们把这当作一个抑郁样本。
09:26
And at first it kind of just looked看着
like it didn't really work at all.
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起初看起来好像根本没什么作用
09:29
So we could have stopped停止 there.
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所以我们本应该停止。
09:31
But I have run this model模型
of depression萧条 for years年份,
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但是我做这个抑郁试验多年,
09:34
and the data数据 just looked看着 kind of weird奇怪的.
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收集到的数据有些怪。
09:36
It didn't really look right to me.
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反正就是看起来不对。
09:38
So I went back,
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于是我回去,
09:39
and we reanalyzed再分析 it
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重新分析
09:41
based基于 on whether是否 or not they had gotten得到
that one injection注射 of CalypsolCalypsol
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根据它们是否被注射 Calypsol
09:44
a week beforehand预先.
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一星期前
09:46
And it looked看着 kind of like this.
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数据是这样的
09:48
So if you look at the far left,
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如果你看最左边,
09:51
if you put a mouse老鼠 in a new space空间,
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如果你把一只老鼠放在一个新环境
09:53
this is the box, it's very exciting扣人心弦,
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这是那个盒子,它很兴奋,
09:55
a mouse老鼠 will walk步行 around and explore探索,
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老鼠会到处走来走去。
09:58
and you can see that pink line线
is actually其实 the measure测量 of them walking步行.
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你看到的粉色线时它们走动的记录
10:02
And we also give it
another另一个 mouse老鼠 in a pencil铅笔 cup杯子
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我们还给它提供了另外一只装在笔盒里的老鼠
10:05
that it can decide决定 to interact相互作用 with.
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如果它愿意,可以和它交流。
10:07
This is also a dramatization戏剧化,
in case案件 that's not clear明确.
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这也是一个图示,让大家看得更清楚。
10:10
And a normal正常 mouse老鼠 will explore探索.
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一个正常的老鼠会探索。
10:14
It will be social社会.
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会社交。
10:16
Check检查 out what's going on.
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查看周围在发生什么。
10:18
If you stress强调 a mouse老鼠
in this depression萧条 model模型,
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如果你给老鼠压力,让它抑郁,
10:20
which哪一个 is the middle中间 box,
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像中间的这个盒子,
10:23
they aren't social社会, they don't explore探索.
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它们不会社交,不会探索,
10:25
They mostly大多 just kind of hide隐藏
in that back corner, behind背后 a cup杯子.
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多数时间它们会躲在杯子后面角落。
10:29
Yet然而 the mice老鼠 that had gotten得到
that one injection注射 of CalypsolCalypsol,
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然而那些注射了一针Calypsol的老鼠
10:32
here on your right,
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在右边
10:34
they were exploring探索, they were social社会.
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它们在探索,在交流。
10:36
They looked看着 like they
had never been stressed强调 at all,
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它们看上去似乎从未被抑郁
10:40
which哪一个 is impossible不可能.
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不可思议。
10:42
So we could have just stopped停止 there,
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我们本可以就此打住,
10:44
but Christine克里斯汀 had also used
CalypsolCalypsol before as anesthesia麻醉,
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但是Christine曾经使用过Calypsol 做为麻醉药物,
10:49
and a few少数 years年份 ago she had seen看到
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几年前她曾经看到
10:50
that it seemed似乎 to have
some weird奇怪的 effects效果 on cells细胞
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它似乎对细胞有些奇怪的作用
10:53
and some other behavior行为
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而且一些其他行为
10:54
that also seemed似乎 to last
long after the drug药物,
224
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似乎在用药之后持续很久,
10:57
maybe a few少数 weeks.
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可能有几个星期。
10:58
So we were like, OK,
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于是我们觉得,好的,
10:59
maybe this is not completely全然 impossible不可能,
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也许这不是完全不可能。
11:02
but we were really skeptical怀疑的.
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但是我们也充满疑惑。
11:03
So we did what you do in science科学
when you're not sure,
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于是我们做了在科学上当你疑惑的时候该做的事,
11:06
and we ran it again.
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再次试验。
11:08
And I remember记得 being存在 in the animal动物 room房间,
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我记得在动物房
11:11
moving移动 mice老鼠 from box to box
to test测试 them,
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把老鼠从一个盒子放到另一个盒子来试验它们,
11:15
and Christine克里斯汀 was actually其实 sitting坐在
on the floor地板 with the computer电脑 in her lap膝部
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Christine 就坐在地上, 腿上放着她的手提电脑,
11:18
so the mice老鼠 couldn't不能 see her,
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这样老鼠就看不到她。
11:20
and she was analyzing分析
the data数据 in real真实 time.
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她在做实地数据分析。
11:22
And I remember记得 us yelling大呼小叫,
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我记得我们大叫,
11:23
which哪一个 you're not supposed应该 to do
in an animal动物 room房间 where you're testing测试,
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(当然不应该在做测试的动物房这样做)
11:27
because it had worked工作.
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因为我们成功了。
11:28
It seemed似乎 like these mice老鼠
were protected保护 against反对 stress强调,
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似乎这些老鼠受到了能够对抗压力的保护,
11:33
or they were inappropriately不适当 happy快乐,
however然而 you want to call it.
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或者说他们不适当地快乐,你怎么形容都好。
11:36
And we were really excited兴奋.
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我们非常激动。
11:39
And then we were really skeptical怀疑的,
because it was too good to be true真正.
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然后我们变得很疑惑因为这个结果好得令人难以置信。
11:43
So we ran it again.
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1200
于是我们又做了一次试验。
11:45
And then we ran it again in a PTSDPTSD model模型,
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我们又做了一次,不过是用 PTSD 模式
11:48
and we ran it again
in a physiological生理 model模型,
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然后我们又做了一次心理试验模式
11:50
where all we did was give stress强调 hormones激素.
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我们给他们压力荷尔蒙
11:53
And we had our undergrads本科生 run it.
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我们让本科生做的实验
11:54
And then we had our collaborators合作者
halfway across横过 the world世界 in France法国 run it.
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然后我们让在法国的合作者实验
11:59
And every一切 time someone有人 ran it,
they confirmed确认 the same相同 thing.
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每一次的试验都验证了同样的结果。
12:03
It seemed似乎 like
this one injection注射 of CalypsolCalypsol
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似乎一剂 Calypsol 的注射
12:05
was somehow不知何故 protecting保护
against反对 stress强调 for weeks.
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可以防止压力过量几个星期。
12:09
And we only published发表 this a year ago,
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一年前我们发表了这个,
12:11
but since以来 then other labs实验室
have independently独立地 confirmed确认 this effect影响.
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从那时起其他的实验室独立验证了这项效果
12:15
So we don't know what causes原因 depression萧条,
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1920
所以我们不知道抑郁的本源,
12:18
but we do know that stress强调
is the initial初始 trigger触发
255
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但是我们知道压力是诱因
12:22
in 80 percent百分 of cases,
256
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2336
百分之八十的个案中,
12:24
and depression萧条 and PTSDPTSD
are different不同 diseases疾病,
257
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2216
抑郁和创伤后应激障碍是不同的疾病,
12:26
but this is something
they share分享 in common共同.
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2016
但是他们有共性
12:28
Right? It is traumatic创伤 stress强调
259
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对吧?那就是强大的压力
12:30
like active活性 combat战斗 or natural自然 disasters灾害
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就像剧烈的战斗或者自然灾害
12:33
or community社区 violence暴力 or sexual有性 assault突击
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或者社区暴力,性侵
12:36
that causes原因 post-traumatic创伤后
stress强调 disorder紊乱,
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都会引起创伤后应激障碍,
12:38
and not everyone大家 that is exposed裸露 to stress强调
develops发展 a mood心情 disorder紊乱.
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但是不是每个经历过刺激的人都会产生情绪障碍。
12:44
And this ability能力 to experience经验
stress强调 and be resilient弹性
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这种经历创伤但能恢复
12:47
and bounce弹跳 back and not develop发展
depression萧条 or PTSDPTSD
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而且不形成抑郁或创伤后应激障碍
12:52
is known已知 as stress强调 resilience弹性,
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就是我们说的抗压恢复能力。
12:54
and it varies变化 between之间 people.
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这种能力每个人都不一样。
12:56
And we have always thought of it
as just sort分类 of this passive被动 property属性.
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我们一直以为它是一种负面因素
13:00
It's the absence缺席 of susceptibility感受性 factors因素
269
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是缺乏敏感因素
13:02
and risk风险 factors因素 for these disorders障碍.
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以及这些心理障碍的风险因素
13:05
But what if it were active活性?
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但是如果它是活性的,
13:08
Maybe we could enhance提高 it,
272
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也许我们可以加强它
13:09
sort分类 of akin类似的 to putting on armor盔甲.
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好像给它戴上盔甲。
13:13
We had accidentally偶然 discovered发现
the first resilience-enhancing弹性增强 drug药物.
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我们碰巧发现了第一种提高抗压力的药物。
13:18
And like I said, we only gave
a tiny amount of the drug药物,
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像我说的那样,我们只给了很小剂量的药物,
13:21
and it lasted历时 for weeks,
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1576
药效持续了几个星期,
13:23
and that's not like anything
you see with antidepressants抗抑郁药.
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这不是你所了解的抗抑郁药物。
13:26
But it is actually其实 kind of similar类似
to what you see in immune免疫的 vaccines疫苗.
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但是它却像是接种疫苗
13:31
So in immune免疫的 vaccines疫苗,
you'll你会 get your shots镜头,
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2936
如果你接种了疫苗,
13:34
and then weeks, months个月, years年份 later后来,
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那么几周,几个月,几年后,
13:37
when you're actually其实 exposed裸露 to bacteria,
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当你接触细菌的时候
13:39
it's not the vaccine疫苗 in your body身体
that protects保护 you.
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不是你身体里的疫苗在保护你,
13:42
It's your own拥有 immune免疫的 system系统
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是你自身的免疫系统
13:43
that's developed发达 resistance抵抗性 and resilience弹性
to this bacteria that fights打架 it off,
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已经产生了对这种细菌的抗体在对抗细菌
13:47
and you actually其实 never get the infection感染,
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而你从未真正被感染过。
13:50
which哪一个 is very different不同
from, say, our treatments治疗. Right?
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这和我们的治疗不同,是吧?
13:53
In that case案件, you get the infection感染,
you're exposed裸露 to the bacteria,
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在那种情况下,你接种,接触细菌,
13:57
you're sick生病, and then you take,
say, an antibiotic抗生素 which哪一个 cures治愈 it,
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你生病,然后你吃抗生素来治疗
14:00
and those drugs毒品 are actually其实 working加工
to kill the bacteria.
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而那些药物实际上杀死了细菌
14:04
Or similar类似 to as I said before,
with this palliative治标不治本,
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或者像我以前所说的,使用这种姑息治疗,
14:07
you'll你会 take something
that will suppress压制 the symptoms症状,
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你服用药物掩盖病症,
14:10
but it won't惯于 treat对待
the underlying底层 infection感染,
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而不能治愈引起病痛的源头
14:12
and you'll你会 only feel better
during the time in which哪一个 you're taking服用 it,
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在你用药的时候你觉得好些,
14:16
which哪一个 is why you have to keep taking服用 it.
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于是你不得不持续用药。
14:18
And in depression萧条 and PTSDPTSD --
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对于抑郁和创伤后应激障碍
14:20
here we have your stress强调 exposure曝光 --
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我们看到你的焦虑
14:22
we only have palliative治标不治本 care关心.
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我们只能保守治疗,
14:25
Antidepressants抗抑郁药 only suppress压制 symptoms症状,
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抗抑郁药只能缓解症状,
14:28
and that is why you basically基本上
have to keep taking服用 them
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所以你得不停地使用药物
14:30
for the life of the disease疾病,
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在你整个患病阶段
14:32
which哪一个 is often经常
the length长度 of your own拥有 life.
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通常会是你的一生。
14:35
So we're calling调用 our resilience-enhancing弹性增强
drugs毒品 "paravaccinesparavaccines,"
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所以我们把提升恢复能力的药叫做类疫苗
14:40
which哪一个 means手段 vaccine-like疫苗样,
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意思是和疫苗相似
14:41
because it seems似乎
like they might威力 have the potential潜在
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因为它似乎有
14:44
to protect保护 against反对 stress强调
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抗焦虑的潜质
14:46
and prevent避免 mice老鼠 from developing发展
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防止老鼠患上
14:49
depression萧条 and post-traumatic创伤后
stress强调 disorder紊乱.
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抑郁症和创伤后应激障碍症。
14:52
Also, not all antidepressants抗抑郁药
are also paravaccinesparavaccines.
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而且,不是所有的抗抑郁药物都是疫苗类的。
14:57
We tried试着 Prozac百忧解 as well,
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我们尝试过Prozac,
14:58
and that had no effect影响.
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没有效果。
15:01
So if this were to translate翻译 into humans人类,
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所以如果用于人类的话,
15:04
we might威力 be able能够 to protect保护 people
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我们可能可以保护那些
15:06
who are predictably可以预见 at risk风险
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高危人群
15:08
against反对 stress-induced应力诱导 disorders障碍
like depression萧条 and PTSDPTSD.
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免受焦虑引起的心理疾病的困扰,
比如抑郁症和创伤后应激障碍症。
15:12
So that's first responders反应
and firefighters消防员,
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也就是第一反应者,消防员,
15:16
refugees难民, prisoners囚犯 and prison监狱 guards卫士,
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难民,罪犯,监管人员
15:20
soldiers士兵, you name名称 it.
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士兵,等等。
15:23
And to give you a sense
of the scale规模 of these diseases疾病,
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让我们了解一下这些疾病的数据
15:27
in 2010, the global全球 burden负担 of disease疾病
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在2010年,全球疾病负担
15:30
was estimated预计 at 2.5 trillion dollars美元,
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大约2.5万亿
15:35
and since以来 they are chronic慢性,
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由于它们是慢性病
15:36
that cost成本 is compounding复利
and is therefore因此 expected预期 to rise上升
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这个花销还要复加,所以预期会
15:39
up to six trillion dollars美元
in just the next下一个 15 years年份.
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在未来15 年内上升到6万亿元。
15:44
As I mentioned提到 before,
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我前面提到过
15:46
repurposing再利用 can be challenging具有挑战性的
because of our prior biases偏见.
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基于我们的偏见,发散思维具有挑战性
15:50
CalypsolCalypsol has another另一个 name名称,
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Calypsol 有另一个名字
15:53
ketamine氯胺酮,
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氯胺酮
15:55
which哪一个 also goes by another另一个 name名称,
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也称作
15:57
Special特别 K,
329
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K 仔
15:58
which哪一个 is a club俱乐部 drug药物 and drug药物 of abuse滥用.
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是一种在夜总会可以见到的被滥用的药物。
16:02
It's still used across横过 the world世界
as an anesthetic麻药.
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它还在全世界被用作麻醉剂。
16:05
It's used in children孩子.
We use it on the battlefield战场.
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它被用于儿童。我们在战场使用。
16:08
It's actually其实 the drug药物 of choice选择
in a lot of developing发展 nations国家,
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在很多国家属于非处方药物
16:11
because it doesn't affect影响 breathing呼吸.
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因为它不会影响呼吸。
16:13
It is on the World世界 Health健康 Organization组织
list名单 of most essential必要 medicines药品.
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在世界卫生组织被列为必要药物。
16:18
If we had discovered发现 ketamine氯胺酮
as a paravaccineparavaccine first,
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如果我们早些发现氯胺酮可以用作疫苗
16:22
it'd它会 be pretty漂亮 easy简单 for us to develop发展 it,
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那我们就可以把他研发成疫苗
16:25
but as is, we have to compete竞争
with our functional实用 fixedness固定性
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可是,我们不得不对抗我们的功能固定性
16:29
and mental心理 set that kind of interfere干扰.
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以及教条思维
16:33
Fortunately幸好, it's not
the only compound复合 we have discovered发现
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幸运的是,这不是我们发现的唯一
16:37
that has these prophylactic预防性,
paravaccineparavaccine qualities气质,
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具有疫苗潜质的药物。
16:41
but all of the other drugs毒品
we've我们已经 discovered发现,
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但是所有其他我们发现的药物
16:44
or compounds化合物 if you will,
they're totally完全 new,
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都很新
16:46
they have to go through通过
the entire整个 FDAFDA approval赞同 process处理 --
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它们不得不通过整个药物与食品审批过程
16:50
if they make it before
they can ever be used in humans人类.
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在他们可以在人身上使用之前
16:54
And that will be years年份.
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我们得等许多年。
16:55
So if we wanted something sooner,
347
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所以如果我们早些
16:58
ketamine氯胺酮 is already已经 FDA-approvedFDA批准.
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氯胺酮已经通过了审批
17:00
It's generic通用, it's available可得到.
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它是通用的,可用的。
17:03
We could develop发展 it for a fraction分数
of the price价钱 and a fraction分数 of the time.
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4160
我们可以在很短的时间用很便宜的价格开发研制
17:08
But actually其实, beyond
functional实用 fixedness固定性 and mental心理 set,
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可是实际上,除了固定思维和教条,
17:12
there's a real真实 other challenge挑战
to repurposing再利用 drugs毒品,
352
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还有另一个挑战
17:16
which哪一个 is policy政策.
353
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就是制度。
17:18
There are no incentives奖励 in place地点
354
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没有奖励制度
17:20
once一旦 a drug药物 is generic通用 and off patent专利
and no longer exclusive独家
355
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只要一种药物是通用药物而且没有专利,不再为一家所有
17:24
to encourage鼓励 pharma制药 companies公司
to develop发展 them,
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2337
来鼓励药厂研发产品,
17:26
because they don't make money.
357
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因为没钱可赚。
17:28
And that's not true真正 for just ketamine氯胺酮.
That is true真正 for all drugs毒品.
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这不仅仅针对氯胺酮,所有的药都一样。
17:32
Regardless而不管, the idea理念 itself本身
is completely全然 novel小说 in psychiatry精神病学,
359
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无论怎样,在精神病领域这个
17:38
to use drugs毒品 to prevent避免 mental心理 illness疾病
360
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使用药物防止精神病
17:42
as opposed反对 to just treat对待 it.
361
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而不是相反地去治疗是一个新奇的想法。
17:44
It is possible可能 that 20, 50,
100 years年份 from now,
362
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也许20, 50, 100 年后,
17:49
we will look back now
at depression萧条 and PTSDPTSD
363
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我们会回头看抑郁症和创伤后应激障碍症,
17:53
the way we look back
at tuberculosis结核 sanitoriumssanitoriums
364
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就像我们现在回头看肺结核和疗养院
17:57
as a thing of the past过去.
365
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一样
17:59
This could be the beginning开始 of the end结束
of the mental心理 health健康 epidemic疫情.
366
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5240
这有可能是结束精神病泛滥的开始。
18:05
But as a great scientist科学家 once一旦 said,
367
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有位伟大的科学家曾说过
18:09
"Only a fool傻子 is sure of anything.
368
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只要傻子才确知一切。
18:12
A wise明智的 man keeps保持 on guessing揣测."
369
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聪明人总是不断猜想。
18:16
Thank you, guys.
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谢谢你们!
18:17
(Applause掌声)
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(掌声)
Translated by Hong Zhang
Reviewed by Jiawei Ni

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ABOUT THE SPEAKER
Rebecca Brachman - Neuroscientist, writer, entrepreneur
Rebecca Brachman is a pioneer in the field of preventative psychopharmacology, developing drugs to enhance stress resilience and prevent mental illness.

Why you should listen

Current treatments for mood disorders only suppress symptoms without addressing the underlying disease, and there are no known cures. The drugs Rebecca Brachman is developing would be the first to prevent psychiatric disorders such as post-traumatic stress disorder (PTSD) and depression.

Brachman completed her PhD at Columbia University, prior to which she was a fellow at the National Institutes of Health, where she discovered that immune cells carry a memory of psychological stress and that white blood cells can act as antidepressants and resilience-enhancers. Brachman's research has been featured in The Atlantic, WIRED and Business Insider, and her work was recently described by Dr. George Slavich on NPR as a "moonshot project that is very much needed in the mental health arena."

In addition to conducting ongoing research at Columbia, Brachman is an NYCEDC Entrepreneurship Lab Fellow and cofounder of Paravax -- a biotech startup developing vaccine-like prophylactic drugs ("paravaccines") -- along with her scientific collaborator, Christine Ann Denny. She is also working on a non-profit venture to repurpose existing generic drugs for use as prophylactics, and previously served as the Interim Program Director for Outreach at the Zuckerman Institute at Columbia University.

Brachman is also a playwright and screenwriter. She holds Bachelor's degrees in both neuroscience and creative wWriting, and she is currently working on a tech-focused writing project with her long-time writing partner, Sean Calder ("Grimm," "Damages," "ER"). She served as the director of NeuWrite, a national network of science-writing groups that fosters ongoing collaboration between scientists, writers and artists, and she has been featured as a storyteller at The Story Collider.

(Photo: Kenneth Willardt)

More profile about the speaker
Rebecca Brachman | Speaker | TED.com