Toward a new understanding of mental illness - Thomas Insel
[Music]
[Music]
so<00:00:16.400> let's<00:00:16.640> start<00:00:16.920> with<00:00:17.119> some<00:00:17.600> good<00:00:17.800> news<00:00:18.359> and
so let's start with some good news and
so let's start with some good news and
the<00:00:18.560> good<00:00:18.720> news<00:00:18.960> has<00:00:19.119> to<00:00:19.240> do<00:00:19.400> with<00:00:19.600> what<00:00:19.800> do<00:00:19.960> we
the good news has to do with what do we
the good news has to do with what do we
know<00:00:20.600> based<00:00:20.960> on<00:00:21.760> biomedical<00:00:22.439> research<00:00:23.279> that
know based on biomedical research that
know based on biomedical research that
actually<00:00:23.840> has<00:00:24.480> changed<00:00:25.480> the<00:00:26.119> outcomes<00:00:26.679> for
actually has changed the outcomes for
actually has changed the outcomes for
many<00:00:27.560> very<00:00:27.880> serious
many very serious
many very serious
diseases<00:00:30.039> start<00:00:30.240> with<00:00:30.480> leukemia<00:00:31.439> acute
diseases start with leukemia acute
diseases start with leukemia acute
lymphoblastic<00:00:32.719> leukemia<00:00:33.399> all<00:00:34.360> most<00:00:34.800> common
lymphoblastic leukemia all most common
lymphoblastic leukemia all most common
cancer<00:00:35.520> of<00:00:36.000> children<00:00:37.000> when<00:00:37.160> I<00:00:37.280> was<00:00:37.440> a<00:00:37.600> student
cancer of children when I was a student
cancer of children when I was a student
the<00:00:39.079> mortality<00:00:39.760> rate<00:00:39.960> was<00:00:40.160> about
the mortality rate was about
the mortality rate was about
95%<00:00:42.520> today<00:00:43.320> some<00:00:43.600> 25<00:00:44.120> 30<00:00:44.399> years<00:00:44.640> later<00:00:45.039> we're
95% today some 25 30 years later we're
95% today some 25 30 years later we're
talking<00:00:45.520> about<00:00:45.680> a<00:00:45.800> mortality<00:00:46.320> rate<00:00:46.559> that's
talking about a mortality rate that's
talking about a mortality rate that's
reduced<00:00:47.800> by
reduced by
reduced by
85%<00:00:49.719> 6,000<00:00:50.520> children<00:00:51.079> each<00:00:51.320> year<00:00:51.640> who<00:00:51.920> would
85% 6,000 children each year who would
85% 6,000 children each year who would
have<00:00:52.520> previously<00:00:53.079> died<00:00:53.359> of<00:00:53.520> this<00:00:53.680> disease<00:00:54.559> are
have previously died of this disease are
have previously died of this disease are
cured<00:00:56.039> if<00:00:56.120> you<00:00:56.239> want<00:00:56.399> the<00:00:56.559> really<00:00:56.719> big<00:00:56.960> numbers
cured if you want the really big numbers
cured if you want the really big numbers
look<00:00:57.960> at<00:00:58.160> these<00:00:58.559> numbers<00:00:58.879> for<00:00:59.079> heart<00:00:59.359> disease
look at these numbers for heart disease
look at these numbers for heart disease
heart<00:01:00.840> disease<00:01:01.160> used<00:01:01.359> to<00:01:01.480> be<00:01:01.600> the<00:01:01.719> biggest
heart disease used to be the biggest
heart disease used to be the biggest
killer<00:01:02.359> particularly<00:01:02.760> for<00:01:02.920> men<00:01:03.079> in<00:01:03.239> their<00:01:03.359> 40s
killer particularly for men in their 40s
killer particularly for men in their 40s
today<00:01:04.400> we've<00:01:04.559> seen<00:01:05.000> a<00:01:05.680> 63%<00:01:06.680> reduction<00:01:07.080> in
today we've seen a 63% reduction in
today we've seen a 63% reduction in
mortality<00:01:07.799> from<00:01:08.080> heart<00:01:08.520> disease<00:01:09.520> remarkably
mortality from heart disease remarkably
mortality from heart disease remarkably
1.1<00:01:11.439> million<00:01:11.960> deaths<00:01:12.400> averted<00:01:13.119> every<00:01:13.720> year
1.1 million deaths averted every year
1.1 million deaths averted every year
AIDS<00:01:15.240> incredibly<00:01:16.240> has<00:01:16.439> just<00:01:16.600> been<00:01:16.799> named<00:01:17.119> in
AIDS incredibly has just been named in
AIDS incredibly has just been named in
the<00:01:17.439> past<00:01:17.640> month<00:01:17.960> a<00:01:18.200> chronic<00:01:18.759> disease<00:01:19.759> meaning
the past month a chronic disease meaning
the past month a chronic disease meaning
that<00:01:20.280> a<00:01:20.439> 20-year-old<00:01:21.079> who<00:01:21.200> becomes<00:01:21.520> infected
that a 20-year-old who becomes infected
that a 20-year-old who becomes infected
with<00:01:22.040> HIV<00:01:22.840> is<00:01:23.040> expected<00:01:23.479> not<00:01:23.600> to<00:01:23.759> live<00:01:24.119> weeks
with HIV is expected not to live weeks
with HIV is expected not to live weeks
months<00:01:24.960> or<00:01:25.799> a<00:01:25.960> couple<00:01:26.200> of<00:01:26.360> years<00:01:26.640> as<00:01:26.799> we<00:01:27.119> said
months or a couple of years as we said
months or a couple of years as we said
only<00:01:27.759> a<00:01:27.920> decade<00:01:28.280> ago<00:01:28.960> but<00:01:29.079> is<00:01:29.240> thought<00:01:29.439> to<00:01:29.560> live
only a decade ago but is thought to live
only a decade ago but is thought to live
decades<00:01:31.040> probably<00:01:31.479> to<00:01:31.720> die<00:01:32.159> in<00:01:32.360> his<00:01:32.560> 60s<00:01:32.960> or
decades probably to die in his 60s or
decades probably to die in his 60s or
70s<00:01:33.600> from<00:01:33.880> other<00:01:34.159> causes<00:01:34.520> altogether<00:01:35.479> these
70s from other causes altogether these
70s from other causes altogether these
are<00:01:35.840> just<00:01:36.479> remarkable<00:01:37.479> remarkable<00:01:38.159> changes
are just remarkable remarkable changes
are just remarkable remarkable changes
in<00:01:39.119> the<00:01:39.240> outlook<00:01:39.600> for<00:01:39.799> some<00:01:39.960> of<00:01:40.079> the<00:01:40.200> biggest
in the outlook for some of the biggest
in the outlook for some of the biggest
killers<00:01:41.960> and<00:01:42.119> one<00:01:42.439> in<00:01:42.640> particular<00:01:43.200> that<00:01:43.320> you
killers and one in particular that you
killers and one in particular that you
probably<00:01:43.920> wouldn't<00:01:44.240> know<00:01:44.479> about<00:01:44.799> stroke
probably wouldn't know about stroke
probably wouldn't know about stroke
which<00:01:45.520> has<00:01:45.640> been<00:01:45.960> along<00:01:46.159> with<00:01:46.320> heart<00:01:46.520> disease
which has been along with heart disease
which has been along with heart disease
one<00:01:46.960> of<00:01:47.079> the<00:01:47.159> biggest<00:01:47.439> killers<00:01:47.799> in<00:01:47.960> this
one of the biggest killers in this
one of the biggest killers in this
country<00:01:49.000> is<00:01:49.119> a<00:01:49.320> disease<00:01:49.680> in<00:01:49.840> which<00:01:50.079> now<00:01:50.360> we
country is a disease in which now we
country is a disease in which now we
know<00:01:50.880> that<00:01:51.040> if<00:01:51.200> you<00:01:51.399> can<00:01:51.880> get<00:01:52.159> people<00:01:52.640> into<00:01:53.040> the
know that if you can get people into the
know that if you can get people into the
emergency<00:01:53.600> room<00:01:53.920> within<00:01:54.159> 3<00:01:54.399> hours<00:01:54.640> of<00:01:54.799> the
emergency room within 3 hours of the
emergency room within 3 hours of the
onset<00:01:55.920> some<00:01:56.240> 30%<00:01:56.840> of<00:01:57.000> them<00:01:57.240> will<00:01:57.399> be<00:01:57.520> able<00:01:57.719> to
onset some 30% of them will be able to
onset some 30% of them will be able to
leave<00:01:58.200> the<00:01:58.439> hospital<00:01:59.240> without<00:01:59.560> any
leave the hospital without any
leave the hospital without any
disability
disability
disability
whatsoever<00:02:02.280> remarkable
whatsoever remarkable
whatsoever remarkable
stories<00:02:04.640> good<00:02:04.880> news<00:02:05.200> stories<00:02:06.119> all<00:02:06.280> of<00:02:06.479> which
stories good news stories all of which
stories good news stories all of which
boil<00:02:07.159> down<00:02:07.920> to<00:02:08.920> understanding<00:02:09.399> something
boil down to understanding something
boil down to understanding something
about<00:02:10.000> the<00:02:10.160> diseases<00:02:10.720> that<00:02:10.920> has<00:02:11.120> allowed<00:02:11.599> us
about the diseases that has allowed us
about the diseases that has allowed us
to<00:02:12.680> detect<00:02:13.239> early<00:02:14.239> and<00:02:14.440> intervene<00:02:15.040> early
to detect early and intervene early
to detect early and intervene early
early<00:02:16.400> detection<00:02:16.920> early<00:02:17.239> intervention
early detection early intervention
early detection early intervention
that's<00:02:18.480> the<00:02:18.680> story<00:02:19.640> for<00:02:19.920> these<00:02:20.239> successes
that's the story for these successes
that's the story for these successes
unfortunately<00:02:22.080> the<00:02:22.239> news<00:02:22.560> is<00:02:22.720> not<00:02:23.000> all<00:02:23.319> good
unfortunately the news is not all good
unfortunately the news is not all good
let's<00:02:24.360> talk<00:02:24.560> about<00:02:24.840> one<00:02:25.040> other<00:02:25.440> story<00:02:26.040> which
let's talk about one other story which
let's talk about one other story which
has<00:02:26.360> to<00:02:26.480> do<00:02:26.640> with<00:02:26.879> suicide<00:02:27.800> now<00:02:28.040> this<00:02:28.160> is<00:02:28.400> of
has to do with suicide now this is of
has to do with suicide now this is of
course<00:02:28.879> not<00:02:29.080> a<00:02:29.280> disease<00:02:29.920> per<00:02:30.120> say<00:02:30.959> it's<00:02:31.160> a
course not a disease per say it's a
course not a disease per say it's a
condition<00:02:32.160> or<00:02:32.360> it's<00:02:32.519> a<00:02:33.000> situation<00:02:33.640> that<00:02:33.760> leads
condition or it's a situation that leads
condition or it's a situation that leads
to
to
to
mortality<00:02:35.840> what<00:02:35.959> you<00:02:36.080> may<00:02:36.239> not<00:02:36.480> realize<00:02:36.840> is
mortality what you may not realize is
mortality what you may not realize is
just<00:02:37.280> how<00:02:37.560> prevalent<00:02:38.040> it<00:02:38.160> is<00:02:38.400> there<00:02:38.519> are
just how prevalent it is there are
just how prevalent it is there are
38,000<00:02:40.280> suicides<00:02:41.280> each<00:02:41.480> year<00:02:41.680> in<00:02:41.800> the<00:02:41.879> United
38,000 suicides each year in the United
38,000 suicides each year in the United
States<00:02:42.640> that<00:02:42.760> means<00:02:43.080> one<00:02:43.360> about<00:02:43.599> every<00:02:43.840> 15
States that means one about every 15
States that means one about every 15
minutes<00:02:45.400> third<00:02:45.680> most<00:02:46.080> common<00:02:46.440> cause<00:02:46.680> of<00:02:46.920> death
minutes third most common cause of death
minutes third most common cause of death
amongst<00:02:47.680> people<00:02:48.080> between<00:02:48.360> the<00:02:48.440> ages<00:02:48.720> of<00:02:48.840> 15
amongst people between the ages of 15
amongst people between the ages of 15
and<00:02:49.599> and<00:02:49.959> 25<00:02:50.959> it's<00:02:51.159> kind<00:02:51.239> of<00:02:51.400> an<00:02:51.560> extraordinary
and and 25 it's kind of an extraordinary
and and 25 it's kind of an extraordinary
story<00:02:52.560> when<00:02:52.680> you<00:02:52.840> realize<00:02:53.319> that<00:02:53.480> this<00:02:53.599> is
story when you realize that this is
story when you realize that this is
twice<00:02:54.239> as<00:02:54.440> common<00:02:54.720> as<00:02:55.120> homicide<00:02:56.120> and<00:02:56.319> actually
twice as common as homicide and actually
twice as common as homicide and actually
more<00:02:57.040> common<00:02:57.400> as<00:02:57.519> a<00:02:57.640> source<00:02:57.879> of<00:02:58.080> death<00:02:58.440> than
more common as a source of death than
more common as a source of death than
traffic<00:02:59.440> fatality<00:02:59.959> ities<00:03:00.200> in<00:03:00.360> this
traffic fatality ities in this
traffic fatality ities in this
country<00:03:02.280> now<00:03:02.680> when<00:03:02.840> we<00:03:03.040> talk<00:03:03.280> about<00:03:03.599> suicide
country now when we talk about suicide
country now when we talk about suicide
there<00:03:04.680> is<00:03:04.920> also<00:03:05.440> a<00:03:06.080> medical<00:03:06.560> contribution
there is also a medical contribution
there is also a medical contribution
here<00:03:07.400> because<00:03:07.799> 90%<00:03:08.599> of<00:03:08.799> suicides<00:03:09.760> are<00:03:09.959> related
here because 90% of suicides are related
here because 90% of suicides are related
to<00:03:10.440> a<00:03:10.560> mental<00:03:10.840> illness<00:03:11.519> depression<00:03:12.280> bipolar
to a mental illness depression bipolar
to a mental illness depression bipolar
disorder<00:03:13.760> schizophrenia<00:03:14.760> anorexia
disorder schizophrenia anorexia
disorder schizophrenia anorexia
borderline<00:03:16.120> personality<00:03:16.680> there's<00:03:16.799> a<00:03:16.959> long
borderline personality there's a long
borderline personality there's a long
list<00:03:18.040> of<00:03:18.239> disorders<00:03:18.720> that
list of disorders that
list of disorders that
contribute<00:03:20.480> and<00:03:20.640> as<00:03:20.879> I<00:03:21.000> mentioned<00:03:21.400> before
contribute and as I mentioned before
contribute and as I mentioned before
often<00:03:22.560> early<00:03:22.879> in<00:03:23.120> life<00:03:23.920> but<00:03:24.080> it's<00:03:24.280> not<00:03:24.480> just
often early in life but it's not just
often early in life but it's not just
the<00:03:24.799> mortality<00:03:25.440> from<00:03:25.680> these<00:03:26.239> disorders<00:03:27.239> it's
the mortality from these disorders it's
the mortality from these disorders it's
also<00:03:28.000> morbidity<00:03:28.640> if<00:03:28.720> you<00:03:28.879> look<00:03:29.159> at<00:03:29.480> DIS<00:03:29.799> dis
also morbidity if you look at DIS dis
also morbidity if you look at DIS dis
ability<00:03:30.799> is<00:03:31.000> measured<00:03:31.560> by<00:03:31.720> the<00:03:31.799> World<00:03:32.120> Health
ability is measured by the World Health
ability is measured by the World Health
Organization<00:03:33.120> with<00:03:33.560> something<00:03:33.920> they<00:03:34.040> call
Organization with something they call
Organization with something they call
the<00:03:34.480> disability<00:03:35.120> adjusted<00:03:35.640> life<00:03:35.920> years<00:03:36.640> it's
the disability adjusted life years it's
the disability adjusted life years it's
kind<00:03:37.000> of<00:03:37.120> a<00:03:37.360> metric<00:03:37.760> that<00:03:37.879> nobody<00:03:38.159> would<00:03:38.360> think
kind of a metric that nobody would think
kind of a metric that nobody would think
of<00:03:38.760> except<00:03:39.000> an<00:03:39.200> economist<00:03:40.080> except<00:03:40.360> it's<00:03:40.560> one
of except an economist except it's one
of except an economist except it's one
way<00:03:40.879> of<00:03:41.000> trying<00:03:41.200> to<00:03:41.519> capture<00:03:42.519> what<00:03:42.720> is<00:03:43.000> lost<00:03:43.560> in
way of trying to capture what is lost in
way of trying to capture what is lost in
terms<00:03:44.080> of<00:03:44.799> disability<00:03:45.799> from<00:03:46.000> medical<00:03:46.319> causes
terms of disability from medical causes
terms of disability from medical causes
and<00:03:46.879> as<00:03:47.000> you<00:03:47.080> can<00:03:47.200> see<00:03:47.519> virtually<00:03:48.360> 30%<00:03:49.360> of<00:03:49.519> all
and as you can see virtually 30% of all
and as you can see virtually 30% of all
disability<00:03:50.319> from<00:03:50.519> all<00:03:50.680> medical<00:03:51.080> causes<00:03:51.959> can
disability from all medical causes can
disability from all medical causes can
be<00:03:52.280> attributed<00:03:53.239> to<00:03:53.560> mental<00:03:53.920> disorders<00:03:54.360> neuros
be attributed to mental disorders neuros
be attributed to mental disorders neuros
psychiatric<00:03:55.959> syndromes<00:03:56.959> you're<00:03:57.200> probably
psychiatric syndromes you're probably
psychiatric syndromes you're probably
thinking<00:03:57.760> that<00:03:57.879> doesn't<00:03:58.079> make<00:03:58.280> any<00:03:58.480> sense<00:03:58.799> I
thinking that doesn't make any sense I
thinking that doesn't make any sense I
mean<00:03:59.840> cancer<00:04:00.159> seems<00:04:00.519> far<00:04:00.720> more<00:04:01.319> serious<00:04:02.319> heart
mean cancer seems far more serious heart
mean cancer seems far more serious heart
disease<00:04:02.920> seems<00:04:03.280> far<00:04:03.480> more
disease seems far more
disease seems far more
serious<00:04:05.400> but<00:04:05.560> you<00:04:05.640> can<00:04:05.799> see<00:04:06.040> actually<00:04:06.319> they're
serious but you can see actually they're
serious but you can see actually they're
further<00:04:06.920> down<00:04:07.159> this<00:04:07.280> list<00:04:07.519> and<00:04:07.640> that's
further down this list and that's
further down this list and that's
because<00:04:08.040> we're<00:04:08.239> talking<00:04:08.519> here<00:04:08.720> about
because we're talking here about
because we're talking here about
disability<00:04:10.280> what<00:04:10.560> drives<00:04:11.120> the<00:04:11.319> disability
disability what drives the disability
disability what drives the disability
for<00:04:12.159> these<00:04:12.400> disorders<00:04:13.040> like<00:04:13.720> schizophrenia
for these disorders like schizophrenia
for these disorders like schizophrenia
and<00:04:14.599> bipolar<00:04:15.239> and<00:04:15.880> depression<00:04:16.880> why<00:04:17.040> are<00:04:17.239> they
and bipolar and depression why are they
and bipolar and depression why are they
number<00:04:18.199> one<00:04:18.639> here<00:04:19.639> well<00:04:19.840> there<00:04:19.919> are<00:04:20.359> probably
number one here well there are probably
number one here well there are probably
three<00:04:20.880> reasons<00:04:21.280> one<00:04:21.400> is<00:04:21.519> that<00:04:21.680> they're<00:04:22.079> highly
three reasons one is that they're highly
three reasons one is that they're highly
prevalent<00:04:22.840> about<00:04:23.080> one<00:04:23.280> in<00:04:23.520> five<00:04:23.880> people<00:04:24.160> will
prevalent about one in five people will
prevalent about one in five people will
suffer<00:04:24.759> from<00:04:24.919> one<00:04:25.080> of<00:04:25.280> these<00:04:25.880> disorders<00:04:26.520> in
suffer from one of these disorders in
suffer from one of these disorders in
the<00:04:26.840> course<00:04:27.040> of<00:04:27.240> their<00:04:28.120> lifetime<00:04:29.120> the<00:04:29.240> second
the course of their lifetime the second
the course of their lifetime the second
of<00:04:29.680> of<00:04:29.759> course<00:04:29.960> is<00:04:30.160> that<00:04:30.600> for<00:04:30.840> some<00:04:31.000> people
of of course is that for some people
of of course is that for some people
these<00:04:31.520> become<00:04:31.880> truly<00:04:32.240> disabling<00:04:32.800> and<00:04:32.960> it's
these become truly disabling and it's
these become truly disabling and it's
about<00:04:33.360> four<00:04:33.639> to<00:04:33.800> 5%<00:04:34.560> perhaps<00:04:34.919> one<00:04:35.080> in<00:04:35.240> 20<00:04:35.919> but
about four to 5% perhaps one in 20 but
about four to 5% perhaps one in 20 but
what<00:04:36.360> really<00:04:36.800> drives<00:04:37.800> these<00:04:38.000> numbers<00:04:38.800> this
what really drives these numbers this
what really drives these numbers this
High<00:04:39.400> morbidity<00:04:40.400> and<00:04:40.520> to<00:04:40.680> some<00:04:40.840> extent<00:04:41.120> the
High morbidity and to some extent the
High morbidity and to some extent the
high
high
high
mortality<00:04:43.000> is<00:04:43.199> the<00:04:43.400> fact<00:04:43.600> that<00:04:43.800> these<00:04:44.240> start
mortality is the fact that these start
mortality is the fact that these start
very<00:04:45.000> early<00:04:45.320> in<00:04:45.600> life<00:04:46.759> 50%<00:04:47.759> will<00:04:47.960> have<00:04:48.120> onset
very early in life 50% will have onset
very early in life 50% will have onset
by<00:04:48.680> age<00:04:48.880> 14<00:04:50.160> 75%<00:04:51.160> by<00:04:51.360> age<00:04:52.039> 24<00:04:53.039> a<00:04:53.240> picture<00:04:53.560> that
by age 14 75% by age 24 a picture that
by age 14 75% by age 24 a picture that
is<00:04:54.039> very<00:04:54.280> different<00:04:54.639> than<00:04:54.800> what<00:04:54.919> one<00:04:55.080> would
is very different than what one would
is very different than what one would
see<00:04:56.199> if<00:04:56.320> you're<00:04:56.479> talking<00:04:56.800> about<00:04:57.080> cancer<00:04:57.440> or
see if you're talking about cancer or
see if you're talking about cancer or
heart<00:04:57.880> disease<00:04:58.520> diabetes<00:04:59.120> hypertension<00:04:59.919> most
heart disease diabetes hypertension most
heart disease diabetes hypertension most
of<00:05:00.280> the<00:05:00.759> major<00:05:01.120> illnesses<00:05:02.039> that<00:05:02.160> we<00:05:02.320> think
of the major illnesses that we think
of the major illnesses that we think
about<00:05:03.160> as<00:05:03.320> being<00:05:03.520> sources<00:05:03.880> of<00:05:04.039> morbidity<00:05:04.440> and
about as being sources of morbidity and
about as being sources of morbidity and
mortality<00:05:06.160> these<00:05:06.320> are<00:05:06.560> indeed<00:05:07.240> The<00:05:07.440> Chronic
mortality these are indeed The Chronic
mortality these are indeed The Chronic
disorders<00:05:09.120> of<00:05:09.360> young
disorders of young
disorders of young
people<00:05:12.400> now<00:05:12.720> I<00:05:12.880> started<00:05:13.280> by<00:05:13.440> telling<00:05:13.680> you<00:05:13.880> that
people now I started by telling you that
people now I started by telling you that
there<00:05:14.160> were<00:05:14.320> some<00:05:14.479> good<00:05:14.639> news<00:05:14.880> stories<00:05:15.280> this
there were some good news stories this
there were some good news stories this
is<00:05:15.520> obviously<00:05:15.960> not<00:05:16.160> one<00:05:16.320> of<00:05:16.440> them<00:05:16.720> this<00:05:16.800> is<00:05:17.000> the
is obviously not one of them this is the
is obviously not one of them this is the
part<00:05:17.360> of<00:05:17.479> it<00:05:17.680> that<00:05:17.840> is<00:05:18.360> perhaps<00:05:18.759> most
part of it that is perhaps most
part of it that is perhaps most
difficult<00:05:19.479> and<00:05:19.639> in<00:05:19.960> in<00:05:20.039> a<00:05:20.199> sense<00:05:20.400> this<00:05:20.520> is<00:05:20.639> a
difficult and in in a sense this is a
difficult and in in a sense this is a
kind<00:05:20.880> of<00:05:21.080> confession<00:05:21.520> for<00:05:21.720> me<00:05:22.440> my<00:05:22.919> job<00:05:23.919> is<00:05:24.120> to
kind of confession for me my job is to
kind of confession for me my job is to
actually<00:05:25.479> make<00:05:25.680> sure<00:05:26.080> that<00:05:26.240> we<00:05:26.400> make<00:05:27.000> progress
actually make sure that we make progress
actually make sure that we make progress
on<00:05:28.479> all<00:05:28.680> of<00:05:28.840> these<00:05:29.080> disorders<00:05:29.840> I<00:05:30.000> work<00:05:30.560> for<00:05:30.800> the
on all of these disorders I work for the
on all of these disorders I work for the
federal<00:05:31.280> government<00:05:31.639> actually<00:05:31.800> I<00:05:31.880> work<00:05:32.039> for
federal government actually I work for
federal government actually I work for
you<00:05:32.360> you<00:05:32.520> pay<00:05:32.720> my<00:05:32.919> salary<00:05:33.400> and<00:05:33.960> and<00:05:34.120> maybe<00:05:34.479> at
you you pay my salary and and maybe at
you you pay my salary and and maybe at
this<00:05:34.800> point<00:05:35.000> when<00:05:35.120> you<00:05:35.240> know<00:05:35.560> what<00:05:35.720> I<00:05:35.840> do<00:05:36.120> or
this point when you know what I do or
this point when you know what I do or
maybe<00:05:36.680> what<00:05:36.800> I<00:05:37.000> fail<00:05:37.280> to<00:05:37.440> do<00:05:37.960> you'll<00:05:38.199> think
maybe what I fail to do you'll think
maybe what I fail to do you'll think
that<00:05:38.600> I<00:05:39.039> probably<00:05:39.240> ought<00:05:39.360> to<00:05:39.479> be<00:05:39.639> fired<00:05:40.479> and<00:05:40.600> I
that I probably ought to be fired and I
that I probably ought to be fired and I
could<00:05:40.880> certainly<00:05:41.520> understand<00:05:41.800> that<00:05:42.680> but<00:05:43.080> what
could certainly understand that but what
could certainly understand that but what
I<00:05:43.319> want<00:05:43.440> to<00:05:43.639> suggest<00:05:44.039> and<00:05:44.160> the<00:05:44.280> reason<00:05:44.560> I'm
I want to suggest and the reason I'm
I want to suggest and the reason I'm
here<00:05:45.039> is<00:05:45.160> to<00:05:45.319> tell<00:05:45.479> you<00:05:45.720> that<00:05:45.960> I<00:05:46.080> think<00:05:46.280> we're
here is to tell you that I think we're
here is to tell you that I think we're
about<00:05:47.039> to<00:05:48.039> be<00:05:48.199> in<00:05:48.319> a<00:05:48.479> very<00:05:48.680> different<00:05:49.039> world<00:05:49.880> as
about to be in a very different world as
about to be in a very different world as
we<00:05:50.160> think<00:05:50.319> about<00:05:50.600> these<00:05:50.960> these
we think about these these
we think about these these
illnesses<00:05:52.639> what<00:05:52.800> I've<00:05:52.960> been<00:05:53.120> talking<00:05:53.360> to<00:05:53.479> you
illnesses what I've been talking to you
illnesses what I've been talking to you
about<00:05:53.919> so<00:05:54.160> far<00:05:54.479> is<00:05:54.720> mental<00:05:55.120> disorders
about so far is mental disorders
about so far is mental disorders
diseases<00:05:56.479> of<00:05:56.639> the<00:05:56.800> mind<00:05:57.479> that's<00:05:57.720> actually
diseases of the mind that's actually
diseases of the mind that's actually
becoming<00:05:58.600> a<00:05:58.840> rather<00:05:59.120> unpopular<00:05:59.639> popular<00:06:00.000> term
becoming a rather unpopular popular term
becoming a rather unpopular popular term
these<00:06:00.639> days<00:06:00.880> and<00:06:01.080> people<00:06:01.360> feel<00:06:01.680> that<00:06:02.160> for
these days and people feel that for
these days and people feel that for
whatever<00:06:02.720> reason<00:06:03.080> it's<00:06:03.360> politically<00:06:03.880> better
whatever reason it's politically better
whatever reason it's politically better
to<00:06:04.400> use<00:06:04.639> the<00:06:04.800> term<00:06:05.199> behavioral<00:06:05.800> disorders<00:06:06.759> and
to use the term behavioral disorders and
to use the term behavioral disorders and
to<00:06:07.039> talk<00:06:07.280> about<00:06:08.120> these<00:06:08.360> as<00:06:08.840> disorders<00:06:09.280> of
to talk about these as disorders of
to talk about these as disorders of
behavior<00:06:10.560> fair<00:06:10.800> enough<00:06:11.160> they<00:06:11.280> are<00:06:11.560> disorders
behavior fair enough they are disorders
behavior fair enough they are disorders
of<00:06:12.199> behavior<00:06:12.680> and<00:06:12.840> they<00:06:12.960> are<00:06:13.199> disorders<00:06:13.680> of
of behavior and they are disorders of
of behavior and they are disorders of
the<00:06:13.960> mind<00:06:14.720> but<00:06:14.840> what<00:06:14.960> I<00:06:15.080> want<00:06:15.199> to<00:06:15.360> suggest<00:06:15.800> to
the mind but what I want to suggest to
the mind but what I want to suggest to
you<00:06:17.000> is<00:06:17.199> that<00:06:17.479> both<00:06:17.680> of<00:06:17.919> those<00:06:18.160> terms<00:06:18.759> which
you is that both of those terms which
you is that both of those terms which
have<00:06:19.160> been<00:06:19.520> in<00:06:19.800> play<00:06:20.080> for<00:06:20.319> a<00:06:20.520> century<00:06:20.919> or<00:06:21.080> more
have been in play for a century or more
have been in play for a century or more
are<00:06:22.120> actually<00:06:22.560> now<00:06:22.960> impediments<00:06:23.599> to<00:06:23.800> progress
are actually now impediments to progress
are actually now impediments to progress
that<00:06:25.039> what<00:06:25.280> we<00:06:25.759> need<00:06:26.919> conceptually<00:06:27.919> to<00:06:28.160> make
that what we need conceptually to make
that what we need conceptually to make
progress<00:06:28.919> here<00:06:29.360> is<00:06:29.680> to<00:06:29.919> rethink<00:06:30.520> these
progress here is to rethink these
progress here is to rethink these
disorders<00:06:32.120> as<00:06:32.319> brain
disorders as brain
disorders as brain
disorders<00:06:34.240> now<00:06:34.720> for<00:06:34.919> some<00:06:35.080> of<00:06:35.240> you<00:06:35.400> you're
disorders now for some of you you're
disorders now for some of you you're
going<00:06:35.639> to<00:06:35.759> say<00:06:36.039> oh<00:06:36.240> my<00:06:36.400> goodness<00:06:37.240> here<00:06:37.400> we<00:06:37.599> go
going to say oh my goodness here we go
going to say oh my goodness here we go
again<00:06:38.360> we're<00:06:38.520> going<00:06:38.639> to<00:06:38.800> hear<00:06:39.000> about<00:06:39.440> a
again we're going to hear about a
again we're going to hear about a
biochemical<00:06:40.520> imbalance<00:06:41.080> or<00:06:41.240> we're<00:06:41.360> going<00:06:41.440> to
biochemical imbalance or we're going to
biochemical imbalance or we're going to
hear<00:06:41.800> about<00:06:42.080> drugs<00:06:42.479> or<00:06:42.639> we're<00:06:42.759> going<00:06:42.840> to<00:06:43.000> hear
hear about drugs or we're going to hear
hear about drugs or we're going to hear
about<00:06:44.360> some<00:06:44.720> very<00:06:45.039> simplistic
about some very simplistic
about some very simplistic
notion<00:06:47.639> that<00:06:47.759> will<00:06:48.039> take<00:06:48.280> our<00:06:49.280> subjective
notion that will take our subjective
notion that will take our subjective
experience<00:06:50.440> and<00:06:50.599> turn<00:06:50.759> it<00:06:50.919> into<00:06:51.400> molecules<00:06:52.400> or
experience and turn it into molecules or
experience and turn it into molecules or
maybe<00:06:53.400> into<00:06:54.400> some<00:06:54.680> sort<00:06:54.919> of<00:06:55.919> uh<00:06:56.639> very<00:06:56.960> flat
maybe into some sort of uh very flat
maybe into some sort of uh very flat
unid<00:06:58.280> dimensional<00:06:59.280> understanding<00:06:59.960> of<00:07:00.160> what
unid dimensional understanding of what
unid dimensional understanding of what
it<00:07:00.520> is<00:07:01.280> to<00:07:01.520> have<00:07:01.759> depression<00:07:02.199> or
it is to have depression or
it is to have depression or
schizophrenia<00:07:04.400> when<00:07:04.560> we<00:07:04.759> talk<00:07:05.039> about<00:07:05.360> the
schizophrenia when we talk about the
schizophrenia when we talk about the
brain<00:07:06.919> it<00:07:07.039> is<00:07:07.360> anything<00:07:08.199> but<00:07:08.400> unidimensional
brain it is anything but unidimensional
brain it is anything but unidimensional
or<00:07:09.520> simplistic<00:07:10.080> or<00:07:10.680> reductionistic<00:07:11.680> it
or simplistic or reductionistic it
or simplistic or reductionistic it
depends<00:07:12.240> of<00:07:12.400> course<00:07:13.400> on<00:07:13.680> what<00:07:13.960> scale<00:07:14.440> or<00:07:14.759> what
depends of course on what scale or what
depends of course on what scale or what
scope<00:07:15.199> you<00:07:15.280> want<00:07:15.400> to<00:07:15.599> think<00:07:16.039> about<00:07:17.039> but<00:07:17.520> this
scope you want to think about but this
scope you want to think about but this
is<00:07:19.919> an<00:07:20.120> organ<00:07:20.680> of<00:07:21.160> surreal<00:07:22.000> complexity<00:07:23.000> and<00:07:23.120> we
is an organ of surreal complexity and we
is an organ of surreal complexity and we
are<00:07:23.560> just<00:07:23.840> beginning<00:07:24.280> to
are just beginning to
are just beginning to
understand<00:07:26.720> how<00:07:26.840> to<00:07:27.080> even<00:07:27.319> study<00:07:27.599> it<00:07:28.000> whether
understand how to even study it whether
understand how to even study it whether
you're<00:07:28.360> thinking<00:07:28.639> about<00:07:28.800> the<00:07:29.000> 100<00:07:29.199> billion
you're thinking about the 100 billion
you're thinking about the 100 billion
neurons<00:07:30.080> that<00:07:30.199> are<00:07:30.280> in<00:07:30.400> the<00:07:30.560> cortex<00:07:31.280> or<00:07:31.479> the
neurons that are in the cortex or the
neurons that are in the cortex or the
100<00:07:31.919> trillion<00:07:32.400> synapses<00:07:33.360> that<00:07:33.520> make<00:07:33.680> up<00:07:33.879> all
100 trillion synapses that make up all
100 trillion synapses that make up all
the
the
the
connections<00:07:36.319> we<00:07:36.520> have<00:07:36.840> just<00:07:37.120> begun<00:07:38.039> to<00:07:38.240> try<00:07:38.400> to
connections we have just begun to try to
connections we have just begun to try to
figure<00:07:38.919> out<00:07:39.639> how<00:07:39.759> do<00:07:39.919> we<00:07:40.199> take<00:07:40.560> this<00:07:40.879> very
figure out how do we take this very
figure out how do we take this very
complex<00:07:41.919> machine<00:07:42.919> that<00:07:43.080> does<00:07:43.440> extraordinary
complex machine that does extraordinary
complex machine that does extraordinary
kinds<00:07:44.360> of<00:07:44.520> information<00:07:45.080> processing<00:07:45.720> and<00:07:46.440> and
kinds of information processing and and
kinds of information processing and and
use<00:07:46.840> our<00:07:47.039> own<00:07:47.360> minds<00:07:47.840> to<00:07:48.280> understand<00:07:48.479> this
use our own minds to understand this
use our own minds to understand this
very<00:07:49.000> complex<00:07:49.479> brain<00:07:49.800> that<00:07:49.960> supports<00:07:50.400> it
very complex brain that supports it
very complex brain that supports it
supports<00:07:51.240> our<00:07:51.360> own<00:07:51.560> minds<00:07:51.840> it's<00:07:52.000> a<00:07:52.240> it's
supports our own minds it's a it's
supports our own minds it's a it's
actually<00:07:52.639> a<00:07:52.759> kind<00:07:52.840> of<00:07:52.960> cruel<00:07:53.280> trick<00:07:53.520> of
actually a kind of cruel trick of
actually a kind of cruel trick of
evolution<00:07:55.240> that<00:07:56.240> we<00:07:56.520> simply<00:07:56.879> don't<00:07:57.280> have<00:07:57.599> a
evolution that we simply don't have a
evolution that we simply don't have a
brain<00:07:58.120> that<00:07:58.240> seems<00:07:58.479> to<00:07:58.599> be<00:07:58.800> wired<00:07:59.080> well<00:07:59.240> enough
brain that seems to be wired well enough
brain that seems to be wired well enough
enough<00:07:59.960> to<00:08:00.400> understand<00:08:00.639> itself<00:08:01.360> in<00:08:01.479> a<00:08:01.639> sense
enough to understand itself in a sense
enough to understand itself in a sense
it<00:08:02.080> actually<00:08:02.360> makes<00:08:02.560> you<00:08:02.720> feel<00:08:03.000> that<00:08:03.400> when
it actually makes you feel that when
it actually makes you feel that when
you're<00:08:03.680> in<00:08:03.840> the<00:08:04.039> safe<00:08:04.319> zone<00:08:04.520> of<00:08:04.680> studying
you're in the safe zone of studying
you're in the safe zone of studying
Behavior<00:08:05.520> or<00:08:05.800> cognition<00:08:06.319> something<00:08:06.560> you<00:08:06.680> can
Behavior or cognition something you can
Behavior or cognition something you can
observe<00:08:07.720> that<00:08:07.879> in<00:08:08.000> a<00:08:08.120> way<00:08:08.319> feels<00:08:08.599> more
observe that in a way feels more
observe that in a way feels more
simplistic<00:08:09.319> and<00:08:09.720> reductionistic<00:08:10.720> than
simplistic and reductionistic than
simplistic and reductionistic than
trying<00:08:11.280> to<00:08:11.960> engage<00:08:12.639> this<00:08:13.400> very<00:08:13.800> complex
trying to engage this very complex
trying to engage this very complex
mysterious<00:08:14.919> organ<00:08:15.639> that<00:08:15.759> we're<00:08:15.919> beginning<00:08:16.440> to
mysterious organ that we're beginning to
mysterious organ that we're beginning to
try<00:08:16.800> to<00:08:17.319> understand<00:08:18.199> now<00:08:19.000> already<00:08:19.599> in<00:08:19.759> the
try to understand now already in the
try to understand now already in the
case<00:08:20.280> of<00:08:20.520> the<00:08:20.879> brain<00:08:21.280> disorders<00:08:21.960> that<00:08:22.080> I've
case of the brain disorders that I've
case of the brain disorders that I've
been<00:08:22.400> talking<00:08:22.639> to<00:08:22.759> you<00:08:22.919> about<00:08:23.280> depression
been talking to you about depression
been talking to you about depression
obsessive<00:08:24.319> compulsive<00:08:24.840> disorder
obsessive compulsive disorder
obsessive compulsive disorder
post-traumatic<00:08:26.400> stress<00:08:26.759> disorder<00:08:27.759> while<00:08:27.960> we
post-traumatic stress disorder while we
post-traumatic stress disorder while we
don't<00:08:28.440> have<00:08:28.759> a<00:08:29.120> an<00:08:29.520> indepth<00:08:30.280> understanding<00:08:31.280> of
don't have a an indepth understanding of
don't have a an indepth understanding of
how<00:08:31.879> they<00:08:32.080> are<00:08:33.080> abnormally<00:08:34.080> processed<00:08:34.599> or
how they are abnormally processed or
how they are abnormally processed or
what<00:08:34.919> the<00:08:35.039> brain<00:08:35.279> is<00:08:35.440> doing<00:08:35.719> in<00:08:35.880> these
what the brain is doing in these
what the brain is doing in these
illnesses<00:08:36.760> we<00:08:36.919> have<00:08:37.080> been<00:08:37.240> able<00:08:37.560> to<00:08:37.919> already
illnesses we have been able to already
illnesses we have been able to already
Identify<00:08:40.159> some<00:08:40.320> of<00:08:40.479> the<00:08:40.719> connectional
Identify some of the connectional
Identify some of the connectional
differences<00:08:41.719> or<00:08:41.880> some<00:08:42.000> of<00:08:42.120> the<00:08:42.240> ways<00:08:42.440> in<00:08:42.640> which
differences or some of the ways in which
differences or some of the ways in which
the<00:08:43.479> circuitry<00:08:44.120> is<00:08:44.320> different<00:08:44.720> for<00:08:44.959> people
the circuitry is different for people
the circuitry is different for people
who<00:08:45.399> have<00:08:45.600> these<00:08:45.800> disorders<00:08:46.480> we<00:08:46.640> call<00:08:46.839> this
who have these disorders we call this
who have these disorders we call this
the<00:08:47.120> human<00:08:47.440> connectome<00:08:48.320> and<00:08:48.440> you<00:08:48.560> can<00:08:48.720> think
the human connectome and you can think
the human connectome and you can think
about<00:08:49.080> the
about the
about the
connectome<00:08:50.880> sort<00:08:51.040> of<00:08:51.160> as<00:08:51.240> the<00:08:51.399> wiring<00:08:51.800> diagram
connectome sort of as the wiring diagram
connectome sort of as the wiring diagram
of<00:08:52.320> the<00:08:52.399> brain<00:08:52.600> you'll<00:08:52.800> hear<00:08:52.959> more<00:08:53.120> about<00:08:53.320> this
of the brain you'll hear more about this
of the brain you'll hear more about this
in<00:08:53.640> a<00:08:53.720> few<00:08:53.920> minutes<00:08:54.560> the<00:08:54.720> important<00:08:55.120> piece
in a few minutes the important piece
in a few minutes the important piece
here<00:08:55.880> is<00:08:56.040> that<00:08:56.200> as<00:08:56.320> you<00:08:56.519> begin<00:08:56.800> to<00:08:57.240> look<00:08:58.240> at
here is that as you begin to look at
here is that as you begin to look at
people<00:08:58.760> who<00:08:59.040> have<00:08:59.800> these<00:09:00.040> disorders<00:09:00.519> the<00:09:00.640> one
people who have these disorders the one
people who have these disorders the one
in<00:09:01.000> five<00:09:01.279> of<00:09:01.440> us<00:09:01.640> who<00:09:01.800> struggle<00:09:02.560> in<00:09:02.760> some<00:09:03.000> way
in five of us who struggle in some way
in five of us who struggle in some way
you<00:09:03.839> find<00:09:04.120> that<00:09:04.240> there's<00:09:04.440> a<00:09:04.560> lot<00:09:04.680> of<00:09:04.839> variation
you find that there's a lot of variation
you find that there's a lot of variation
in<00:09:05.839> the<00:09:05.959> way<00:09:06.120> that<00:09:06.240> the<00:09:06.399> brain<00:09:07.040> is
in the way that the brain is
in the way that the brain is
wired<00:09:08.760> but<00:09:08.920> there<00:09:09.040> are<00:09:09.240> some<00:09:09.440> predictable
wired but there are some predictable
wired but there are some predictable
patterns<00:09:11.000> and<00:09:11.160> those<00:09:11.399> patterns<00:09:12.320> are<00:09:12.640> risk
patterns and those patterns are risk
patterns and those patterns are risk
factors<00:09:13.399> for<00:09:13.640> developing<00:09:14.079> one<00:09:14.200> of<00:09:14.360> these
factors for developing one of these
factors for developing one of these
disorders<00:09:16.279> it's<00:09:16.440> a<00:09:16.560> little<00:09:16.760> different<00:09:17.040> than
disorders it's a little different than
disorders it's a little different than
the<00:09:17.279> way<00:09:17.399> we<00:09:17.480> think<00:09:17.640> about<00:09:17.839> brain<00:09:18.079> disorders
the way we think about brain disorders
the way we think about brain disorders
like<00:09:18.680> Huntington's<00:09:19.360> or<00:09:19.600> Parkinson's<00:09:20.200> or
like Huntington's or Parkinson's or
like Huntington's or Parkinson's or
Alzheimer's<00:09:20.920> disease<00:09:21.240> where<00:09:21.360> you<00:09:21.440> have<00:09:21.560> a
Alzheimer's disease where you have a
Alzheimer's disease where you have a
bombed<00:09:22.079> out<00:09:22.320> part<00:09:22.480> of<00:09:22.600> your<00:09:22.760> cortex<00:09:23.760> here
bombed out part of your cortex here
bombed out part of your cortex here
we're<00:09:24.120> talking<00:09:24.399> about<00:09:24.680> traffic<00:09:25.000> jams<00:09:25.440> or
we're talking about traffic jams or
we're talking about traffic jams or
sometimes<00:09:26.040> detours<00:09:26.880> or<00:09:27.240> sometimes<00:09:27.600> problems
sometimes detours or sometimes problems
sometimes detours or sometimes problems
with<00:09:28.120> just<00:09:28.279> the<00:09:28.360> way<00:09:28.519> that<00:09:28.640> things<00:09:28.800> are
with just the way that things are
with just the way that things are
connected<00:09:29.640> and<00:09:29.800> the<00:09:29.880> way<00:09:30.040> that<00:09:30.160> the<00:09:30.240> brain
connected and the way that the brain
connected and the way that the brain
functions<00:09:30.880> you<00:09:31.000> could<00:09:31.200> if<00:09:31.320> you<00:09:31.440> want<00:09:32.079> compare
functions you could if you want compare
functions you could if you want compare
this<00:09:33.120> to<00:09:34.120> on<00:09:34.240> the<00:09:34.360> one<00:09:34.560> hand<00:09:34.760> a<00:09:34.920> myocardial
this to on the one hand a myocardial
this to on the one hand a myocardial
infarction<00:09:36.040> a<00:09:36.200> heart<00:09:36.440> attack<00:09:37.120> where<00:09:37.279> you<00:09:37.480> have
infarction a heart attack where you have
infarction a heart attack where you have
dead<00:09:37.880> tissue<00:09:38.160> in<00:09:38.279> the<00:09:38.399> heart<00:09:38.800> versus<00:09:39.079> an
dead tissue in the heart versus an
dead tissue in the heart versus an
arhythmia<00:09:40.240> where<00:09:40.480> the<00:09:41.160> organ<00:09:41.560> simply<00:09:41.800> isn't
arhythmia where the organ simply isn't
arhythmia where the organ simply isn't
functioning<00:09:42.560> because<00:09:42.760> of<00:09:42.880> the<00:09:43.000> communication
functioning because of the communication
functioning because of the communication
problems<00:09:44.000> within<00:09:44.200> it<00:09:44.640> either<00:09:44.880> one<00:09:45.040> would<00:09:45.360> kill
problems within it either one would kill
problems within it either one would kill
you<00:09:45.920> then<00:09:46.120> only<00:09:46.320> one<00:09:46.480> of<00:09:46.600> them<00:09:46.839> will<00:09:47.000> you<00:09:47.160> find
you then only one of them will you find
you then only one of them will you find
a<00:09:47.880> major<00:09:48.360> lesion<00:09:49.360> as<00:09:49.440> we<00:09:49.600> think<00:09:49.760> about<00:09:50.000> this
a major lesion as we think about this
a major lesion as we think about this
probably<00:09:50.560> it's<00:09:50.839> better<00:09:51.120> to<00:09:51.360> actually<00:09:51.680> go<00:09:51.880> a
probably it's better to actually go a
probably it's better to actually go a
little<00:09:52.200> deeper<00:09:52.480> into<00:09:52.720> one<00:09:52.920> particular
little deeper into one particular
little deeper into one particular
disorder<00:09:53.800> and<00:09:53.920> that<00:09:54.120> would<00:09:54.240> be<00:09:54.480> schizophrenia
disorder and that would be schizophrenia
disorder and that would be schizophrenia
because<00:09:55.720> I<00:09:55.839> think<00:09:56.000> that's<00:09:56.120> a<00:09:56.360> good<00:09:56.640> case<00:09:57.240> for
because I think that's a good case for
because I think that's a good case for
helping<00:09:57.760> to<00:09:58.200> understand<00:09:58.440> why<00:09:58.640> thinking<00:09:58.920> of
helping to understand why thinking of
helping to understand why thinking of
this<00:09:59.160> as<00:09:59.440> a<00:09:59.519> brain<00:09:59.760> disorder<00:10:00.320> matters<00:10:01.320> these
this as a brain disorder matters these
this as a brain disorder matters these
are<00:10:02.079> scans<00:10:02.800> from<00:10:03.360> Judy<00:10:03.720> Rapaport<00:10:04.320> and<00:10:04.440> her
are scans from Judy Rapaport and her
are scans from Judy Rapaport and her
colleagues<00:10:05.120> at<00:10:05.279> the<00:10:05.480> National<00:10:05.800> Institute<00:10:06.160> of
colleagues at the National Institute of
colleagues at the National Institute of
Mental<00:10:06.560> Health<00:10:07.040> in<00:10:07.160> which<00:10:07.440> they<00:10:07.560> studied
Mental Health in which they studied
Mental Health in which they studied
children<00:10:08.640> with<00:10:08.839> very<00:10:09.000> early<00:10:09.279> onset
children with very early onset
children with very early onset
schizophrenia<00:10:10.640> and<00:10:10.760> you<00:10:10.839> can<00:10:10.959> see<00:10:11.200> already<00:10:11.519> in
schizophrenia and you can see already in
schizophrenia and you can see already in
the<00:10:11.800> top<00:10:12.000> there<00:10:12.320> areas<00:10:12.600> that<00:10:12.720> are<00:10:12.920> red<00:10:13.200> or
the top there areas that are red or
the top there areas that are red or
orange<00:10:14.240> yellow<00:10:14.760> are<00:10:14.959> places<00:10:15.240> where<00:10:15.440> there's
orange yellow are places where there's
orange yellow are places where there's
less<00:10:15.880> gray<00:10:16.160> matter<00:10:16.800> and<00:10:16.959> as<00:10:17.079> they<00:10:17.200> follow<00:10:17.519> them
less gray matter and as they follow them
less gray matter and as they follow them
over<00:10:17.959> 5<00:10:18.160> years<00:10:18.399> comparing<00:10:18.800> them<00:10:18.920> to<00:10:19.079> age<00:10:19.360> match
over 5 years comparing them to age match
over 5 years comparing them to age match
controls<00:10:20.440> you<00:10:20.560> can<00:10:20.760> see<00:10:21.120> that<00:10:21.480> particularly
controls you can see that particularly
controls you can see that particularly
in<00:10:22.079> areas<00:10:22.399> like<00:10:22.519> the<00:10:22.640> dorsal<00:10:23.040> lateral
in areas like the dorsal lateral
in areas like the dorsal lateral
prefrontal<00:10:23.920> cortex<00:10:24.920> or<00:10:25.440> the<00:10:25.640> superior
prefrontal cortex or the superior
prefrontal cortex or the superior
temporal<00:10:26.480> gyrus<00:10:26.880> there's<00:10:27.040> a<00:10:27.200> profound<00:10:27.680> loss
temporal gyrus there's a profound loss
temporal gyrus there's a profound loss
of<00:10:28.200> gray<00:10:28.440> matter<00:10:28.959> and<00:10:29.040> it's<00:10:29.360> important<00:10:29.680> if<00:10:29.760> you
of gray matter and it's important if you
of gray matter and it's important if you
try<00:10:30.040> to<00:10:30.279> model<00:10:30.680> this<00:10:30.839> you<00:10:30.920> can<00:10:31.079> think<00:10:31.320> about
try to model this you can think about
try to model this you can think about
normal<00:10:32.279> development<00:10:32.800> as<00:10:32.920> a<00:10:33.160> loss<00:10:33.440> of<00:10:33.640> cortical
normal development as a loss of cortical
normal development as a loss of cortical
Mass<00:10:34.480> loss<00:10:34.680> of<00:10:34.800> cortical<00:10:35.160> gray<00:10:35.560> matter<00:10:36.560> and
Mass loss of cortical gray matter and
Mass loss of cortical gray matter and
what's<00:10:36.920> happening<00:10:37.279> in<00:10:37.440> schizophrenia<00:10:38.120> is
what's happening in schizophrenia is
what's happening in schizophrenia is
that<00:10:38.360> you<00:10:38.519> overshoot<00:10:39.040> that<00:10:39.160> Mark<00:10:39.440> and<00:10:39.600> at<00:10:39.720> some
that you overshoot that Mark and at some
that you overshoot that Mark and at some
point<00:10:40.160> when<00:10:40.320> you<00:10:40.440> overshoot<00:10:40.959> you<00:10:41.120> cross<00:10:41.360> a
point when you overshoot you cross a
point when you overshoot you cross a
threshold<00:10:42.440> and<00:10:42.560> it's<00:10:42.760> that<00:10:43.040> threshold<00:10:44.040> where
threshold and it's that threshold where
threshold and it's that threshold where
we<00:10:44.399> talk<00:10:44.680> we<00:10:44.800> say<00:10:45.120> this<00:10:45.279> is<00:10:45.399> a<00:10:45.600> person<00:10:46.200> who<00:10:46.440> has
we talk we say this is a person who has
we talk we say this is a person who has
this<00:10:46.880> disease<00:10:47.720> because<00:10:47.959> they<00:10:48.079> have<00:10:48.200> the
this disease because they have the
this disease because they have the
behavioral<00:10:49.279> symptoms<00:10:50.279> of<00:10:50.440> hallucinations
behavioral symptoms of hallucinations
behavioral symptoms of hallucinations
and<00:10:51.320> delusions<00:10:52.040> that's<00:10:52.200> something<00:10:52.440> we<00:10:52.560> can
and delusions that's something we can
and delusions that's something we can
observe<00:10:53.560> but<00:10:53.720> look<00:10:53.839> at<00:10:54.040> this<00:10:54.240> closely<00:10:54.639> and<00:10:54.760> you
observe but look at this closely and you
observe but look at this closely and you
can<00:10:55.079> see<00:10:55.360> that<00:10:55.880> actually<00:10:56.880> they've<00:10:57.240> crossed<00:10:58.079> a
can see that actually they've crossed a
can see that actually they've crossed a
different<00:10:58.560> threshold<00:10:59.000> they'<00:10:59.320> crossed<00:10:59.560> a
different threshold they' crossed a
different threshold they' crossed a
brain<00:11:00.120> threshold<00:11:01.040> much<00:11:01.680> earlier<00:11:02.680> that
brain threshold much earlier that
brain threshold much earlier that
perhaps<00:11:03.240> not<00:11:03.440> at<00:11:03.600> age<00:11:03.839> 22<00:11:04.480> or<00:11:04.680> 20<00:11:05.360> but<00:11:05.480> even<00:11:05.720> by
perhaps not at age 22 or 20 but even by
perhaps not at age 22 or 20 but even by
age<00:11:06.120> 15<00:11:06.480> or<00:11:06.720> 16<00:11:07.120> you<00:11:07.279> can<00:11:07.440> begin<00:11:07.639> to<00:11:07.760> see<00:11:08.279> the
age 15 or 16 you can begin to see the
age 15 or 16 you can begin to see the
trajectory<00:11:09.079> for<00:11:09.279> development<00:11:09.720> is<00:11:09.920> quite
trajectory for development is quite
trajectory for development is quite
different<00:11:10.440> at<00:11:10.560> the<00:11:10.720> level<00:11:10.920> of<00:11:11.040> the<00:11:11.200> brain<00:11:11.920> not
different at the level of the brain not
different at the level of the brain not
at<00:11:12.200> the<00:11:12.320> level<00:11:12.560> of
at the level of
at the level of
behavior<00:11:14.279> why<00:11:14.440> does<00:11:14.639> this<00:11:14.839> matter<00:11:15.120> well<00:11:15.360> first
behavior why does this matter well first
behavior why does this matter well first
because<00:11:15.920> for<00:11:16.120> brain<00:11:16.360> disorders<00:11:16.959> behavior<00:11:17.440> is
because for brain disorders behavior is
because for brain disorders behavior is
the<00:11:17.839> last<00:11:18.480> thing<00:11:18.800> to<00:11:18.959> change<00:11:19.320> we<00:11:19.440> know<00:11:19.600> that
the last thing to change we know that
the last thing to change we know that
for<00:11:19.880> Alzheimer's<00:11:20.480> for<00:11:20.680> Parkinson's<00:11:21.360> for
for Alzheimer's for Parkinson's for
for Alzheimer's for Parkinson's for
huntingtons<00:11:22.399> there<00:11:22.519> are<00:11:22.680> changes<00:11:23.000> in<00:11:23.120> the
huntingtons there are changes in the
huntingtons there are changes in the
brain<00:11:23.519> a<00:11:23.720> decade<00:11:24.040> or<00:11:24.200> more<00:11:24.760> before<00:11:25.000> you<00:11:25.160> see
brain a decade or more before you see
brain a decade or more before you see
the<00:11:26.040> first<00:11:26.360> signs<00:11:27.160> of<00:11:27.279> a<00:11:27.440> behavioral<00:11:28.040> change
the first signs of a behavioral change
the first signs of a behavioral change
the<00:11:30.000> tools<00:11:30.320> that<00:11:30.480> we<00:11:30.639> have<00:11:31.000> now<00:11:31.320> allow<00:11:31.720> us<00:11:31.920> to
the tools that we have now allow us to
the tools that we have now allow us to
detect<00:11:32.639> these<00:11:32.839> brain<00:11:33.160> changes<00:11:33.639> much<00:11:33.920> earlier
detect these brain changes much earlier
detect these brain changes much earlier
long<00:11:35.240> before<00:11:35.519> the<00:11:35.680> symptoms<00:11:36.120> emerge<00:11:37.079> but<00:11:37.399> most
long before the symptoms emerge but most
long before the symptoms emerge but most
important<00:11:38.279> go<00:11:38.560> back<00:11:38.760> to<00:11:39.000> where<00:11:39.240> we<00:11:39.560> started
important go back to where we started
important go back to where we started
the<00:11:40.800> good<00:11:41.040> news<00:11:41.399> stories<00:11:42.200> in<00:11:42.399> medicine<00:11:43.279> are
the good news stories in medicine are
the good news stories in medicine are
early<00:11:44.120> detection<00:11:44.720> early
early detection early
early detection early
intervention<00:11:47.040> if<00:11:47.279> we<00:11:47.560> waited<00:11:48.440> until<00:11:48.760> the
intervention if we waited until the
intervention if we waited until the
heart<00:11:49.639> attack<00:11:50.639> we<00:11:50.760> would<00:11:50.959> be<00:11:51.240> sacrificing<00:11:52.079> 1.1
heart attack we would be sacrificing 1.1
heart attack we would be sacrificing 1.1
million<00:11:53.519> lives<00:11:54.040> every<00:11:54.240> year<00:11:54.440> in<00:11:54.600> this<00:11:54.800> country
million lives every year in this country
million lives every year in this country
to<00:11:55.519> heart<00:11:55.760> disease<00:11:56.600> that<00:11:56.720> is<00:11:57.000> precisely<00:11:57.519> what
to heart disease that is precisely what
to heart disease that is precisely what
we<00:11:57.800> do<00:11:58.240> today<00:11:59.320> when<00:11:59.519> we<00:11:59.720> decide<00:12:00.200> that
we do today when we decide that
we do today when we decide that
everybody<00:12:01.079> with<00:12:01.279> one<00:12:01.440> of<00:12:01.639> these<00:12:02.320> brain
everybody with one of these brain
everybody with one of these brain
disorders<00:12:03.440> brain<00:12:03.800> circuit<00:12:04.240> disorders<00:12:05.120> has<00:12:05.279> a
disorders brain circuit disorders has a
disorders brain circuit disorders has a
behavioral<00:12:06.120> disorder<00:12:06.560> we<00:12:06.760> wait<00:12:07.040> until<00:12:07.920> the
behavioral disorder we wait until the
behavioral disorder we wait until the
behavior<00:12:08.519> becomes
behavior becomes
behavior becomes
manifest<00:12:10.600> that's<00:12:10.760> not<00:12:10.959> early<00:12:11.320> detection
manifest that's not early detection
manifest that's not early detection
that's<00:12:12.560> not<00:12:12.800> early<00:12:13.360> intervention<00:12:14.360> now<00:12:14.519> to<00:12:14.639> be
that's not early intervention now to be
that's not early intervention now to be
clear<00:12:15.000> we're<00:12:15.199> not<00:12:15.360> quite<00:12:15.560> ready<00:12:15.760> to<00:12:15.880> do<00:12:16.079> this
clear we're not quite ready to do this
clear we're not quite ready to do this
we<00:12:16.399> don't<00:12:16.680> have<00:12:16.839> all<00:12:17.000> the<00:12:17.160> facts<00:12:17.480> we<00:12:17.600> don't
we don't have all the facts we don't
we don't have all the facts we don't
actually<00:12:18.639> even<00:12:19.040> know<00:12:20.040> what<00:12:20.240> the<00:12:20.399> tools<00:12:20.720> will
actually even know what the tools will
actually even know what the tools will
be<00:12:22.440> nor<00:12:22.720> what<00:12:22.880> to<00:12:23.240> precisely<00:12:23.760> look<00:12:24.000> for<00:12:24.320> in
be nor what to precisely look for in
be nor what to precisely look for in
every<00:12:24.839> case<00:12:25.480> to<00:12:25.639> be<00:12:25.800> able<00:12:26.000> to<00:12:26.240> get<00:12:26.480> there
every case to be able to get there
every case to be able to get there
before<00:12:27.079> the<00:12:27.639> behavior<00:12:28.639> emerges<00:12:29.399> as<00:12:29.639> different
before the behavior emerges as different
before the behavior emerges as different
but<00:12:30.800> this<00:12:31.040> tells<00:12:31.360> us<00:12:31.600> how<00:12:31.760> we<00:12:31.880> need<00:12:32.000> to<00:12:32.199> think
but this tells us how we need to think
but this tells us how we need to think
about<00:12:32.600> it<00:12:33.040> and<00:12:33.199> where<00:12:33.320> we<00:12:33.440> need<00:12:33.600> to<00:12:33.800> go<00:12:34.600> are<00:12:34.720> we
about it and where we need to go are we
about it and where we need to go are we
going<00:12:34.959> to<00:12:35.079> be<00:12:35.240> there<00:12:35.440> soon<00:12:35.920> I<00:12:36.120> think<00:12:36.680> that<00:12:36.880> this
going to be there soon I think that this
going to be there soon I think that this
is<00:12:37.240> something<00:12:37.519> that<00:12:37.639> will<00:12:37.839> happen<00:12:38.519> over<00:12:38.720> the
is something that will happen over the
is something that will happen over the
course<00:12:39.079> of<00:12:39.199> the<00:12:39.320> next<00:12:39.519> few<00:12:39.760> years<00:12:40.040> but<00:12:40.160> I'd
course of the next few years but I'd
course of the next few years but I'd
like<00:12:40.440> to<00:12:40.600> finish<00:12:41.519> with<00:12:41.680> a<00:12:41.839> quote<00:12:42.160> about<00:12:42.560> trying
like to finish with a quote about trying
like to finish with a quote about trying
to<00:12:42.959> predict<00:12:43.320> how<00:12:43.519> this<00:12:43.639> will<00:12:43.880> happen<00:12:44.480> by
to predict how this will happen by
to predict how this will happen by
somebody<00:12:44.959> who's<00:12:45.199> thought<00:12:45.399> a<00:12:45.519> lot<00:12:45.800> about
somebody who's thought a lot about
somebody who's thought a lot about
changes<00:12:46.480> in<00:12:46.720> Concepts<00:12:47.120> and<00:12:47.279> changes<00:12:47.560> in
changes in Concepts and changes in
changes in Concepts and changes in
technology<00:12:48.680> we<00:12:48.839> always<00:12:49.199> overestimate<00:12:49.880> the
technology we always overestimate the
technology we always overestimate the
change<00:12:50.360> that<00:12:50.480> will<00:12:50.680> occur<00:12:50.920> in<00:12:51.040> the<00:12:51.160> next<00:12:51.360> two
change that will occur in the next two
change that will occur in the next two
years<00:12:52.240> and<00:12:52.800> underestimate<00:12:53.800> the<00:12:53.920> change<00:12:54.240> that
years and underestimate the change that
years and underestimate the change that
will<00:12:54.560> occur<00:12:55.120> in<00:12:55.240> the<00:12:55.399> next<00:12:55.639> 10<00:12:56.240> Bill<00:12:56.519> Gates
will occur in the next 10 Bill Gates
will occur in the next 10 Bill Gates
thanks<00:12:57.360> very<00:12:57.519> much
Thomas Insel, research, mental, illness, suicide, brain, disorder, early, detection, national, institute, of, mental, health, TED, TEDx, TEDxCaltech, TED-Ed, TED, Ed, TEDEducation
