克里斯·帕尔默博士：你的饮食可能正在引发焦虑、抑郁和脑雾（今天可做的6个简单改变）

情绪波动、脑子发懵、精力不足，这些他们都遇到了。

So fluctuation in mood, they're experiencing brain fog, they're experiencing low energy.

那他们该从哪里开始呢？

Where should they start?

我觉得普通人其实可以自己先从一些基本的做法入手。

The basics that I think people can really do on their own.

我就先从这儿说起。

And I'll start there.

我得先说明一下，我是个精神科医生，主要治疗精神分裂症和双相情感障碍这类疾病。

I just wanna say as a caveat, because I'm a psychiatrist who treats like schizophrenia and bipolar.

所以那些孩子的家长听了可能会说：别跟我讲这些空话。

And so those those parents are listening to me like, don't give me this

对。

Yeah.

这些都没用。

Fluff.

别跟我来这套虚的，咱们直接说重点

Don't like, me the real Let's go

这种话题我们经常聊。

to that often.

对。

Yeah.

这个我们后面会谈到。

We can get to that.

但对于绝大多数成年人，甚至孩子来说，我觉得可以归结为生活方式医学的六大支柱。

But for the overwhelming majority of adults and even children, I would say it breaks into the six pillars of what we call lifestyle medicine.

我们会分别来看饮食与营养、运动、睡眠、减少或避免有害物质的使用，以及冥想或正念等减压方法。

And so we're gonna look at diet and nutrition, movement or exercise, sleep, minimizing or reducing harmful substances if you happen to use any of them, stress reduction practices like meditation or mindfulness.

通常第六点人们会提到人际关系，而且是有意为之。

And then usually that sixth bucket, people will talk about relationships on purpose.

但我更愿意把它扩展为人生目标。

I like to broaden it to purpose.

我认为这是其中一项主要作用。

And I think that's one of the primary roles.

它当然不是唯一的，但确实是关系所发挥的主要作用之一。

It's certainly not the only, but one of the primary roles that relationships serve.

所以我通常会说，关系或者说是人生目标。

So I I kinda say relationships slash purpose.

你们的听众早就对人生目标、人际关系、冥想和正念很熟悉了。

So all of your listeners are already all over purpose and relationships and meditation and mindfulness.

减少有害物质的使用。

Reducing harmful substances.

这一点很明显。

It's pretty obvious.

我说的是酒精、大麻、吸烟、电子烟这类东西。

I'm talking about alcohol, marijuana, smoking, vaping, those kind of things.

这些对身体都没什么好处。

So those are not good for you.

不管你听谁说的，都说 vaping 对你有好处，其实根本不是这么回事

No no matter what you've heard, no matter who said this vape is really good for you, it's really

没错

not

一点都不好

good

那为什么不好呢？

Why is for it no good?

它到底对身体有什么影响？

What's it doing?

这要看 vape 里头含什么成分，但我们的身体根本不是设计来把化学物质吸进肺里的

So it depends on what's in the vape, but we are actually not designed to inhale chemicals into our lungs.

有意思

Interesting.

肺部本来就不该接触这些 vape 里的化学物质

Our lungs are not supposed to have this vape chemical in them.

而且你知道，确实出现过一些极端案例，有人因为使用了可能被污染的电子烟，引发了危及生命的肺炎样症状。

And, you know, there have been extreme examples where people actually develop life threatening kinda pneumonia type situations from possibly contaminated vapes.

但长期研究显示，使用电子烟的人更容易出现与这一领域相关的健康问题。

But we know from long term studies that people who are vaping are more likely to still have health conditions on that specific topic.

如果有人一直在吸传统香烟，又戒不掉，那么用电子烟代替会不会好一点？

If somebody is smoking tobacco, and they can't stop smoking tobacco, is vaping better for them?

是的，对这些人来说，电子烟确实更安全一些。

Yes, it is better for them.

如果你正吸香烟，实在戒不掉，但愿意改用电子烟代替，那不妨试试看，先换成电子烟。

So if you're moving from smoking cigarettes, you cannot quit, but maybe you could just vape instead of smoking cigarettes, then go ahead, start vaping.

但你终究得戒掉电子烟，因为电子烟本身也不健康。

But then at some point, I want you to stop vaping because vaping's not healthy for you.

对。

Right.

而且具体还要看里面含的是什么物质，因为有些人是在用电子烟吸大麻成分。

And then it really depends on the substance that it's in it because people are vaping THC.

他们在用电子烟吸尼古丁。

They're vaping nicotine.

他们吸的东西五花八门。

They're vaping all sorts of things.

最糟糕的是，即使人们从吸烟转为吸尼古丁电子烟，尼古丁的含量也往往高得离谱，远超以前吸烟时的水平。

And the the tragic news is even when people switch from smoking cigarettes to vaping nicotine, more often than not, the nicotine concentrations are stratospheric compared to what they were smoking.

结果反而让他们对尼古丁的依赖比以前更严重了。

And so they end up getting even more addicted to nicotine than they ever had been.

现在他们根本戒不掉了。

And now they really can't stop.

医生。

Doctor.

大麻对大脑有什么影响？

What's marijuana doing to the brain?

大麻的成分其实非常复杂。

Marijuana actually has a lot of constituents.

如果你说的是整个植物，那里面含有多种化学物质。

If you're talking about the whole plant, it's got a lot of different chemicals in it.

有些可能是中性的。

Some that might be neutral.

有些人认为其中一些可能有益。

Some will argue might be beneficial.

CBD是最常被提及、可能对人有好处的成分。

CBD is the most commonly touted one that might have some benefits for people.

我们可以明确地说，THC对人脑有害。

I think what we can unequivocally say is that THC is bad for the human brain.

THC会引发多种作用。

So THC does a lot of different things.

它在我们大脑和身体的各个部位与受体发生作用。

It's interacting with these receptors throughout our brain and body.

它会让心率加快。

It makes your heart rate go up.

我的一些科学研究核心在于，它会损害线粒体的功能。

You know, central to some of my science work is it can impair mitochondrial function.

这些存在于细胞里的微小结构叫线粒体，它会影响它们正常运作的能力。

So these tiny things in our cells called mitochondria, it can impair their ability to function.

归根结底，我们清楚地知道，大量吸食大麻的人会出现认知功能下降。

And at the end of the day, the end result is that we know that people who smoke a lot of marijuana will have cognitive impairment.

他们的动力也会明显减弱。

They will have impairment in motivation.

不过，对大多数人来说，这应该并不意外。

Now this is probably not a shock to most people.

想象一下，一个少年整天待在父母家的地下室里打游戏、吸大麻。

So imagine the teenage boy in his parents basement playing video games all day smoking weed.

他没什么干劲，还一副无所谓的样子。

He's less than motivated, and he's chillaxed about it.

他根本不介意自己什么都没做。

He's not bothered that he's not doing a lot.

他根本不介意自己的大脑状态不好，因为他觉得挺放松的。

He's not bothered that his brain doesn't work all that great because he's relaxed.

这样过日子可不怎么样，更谈不上在生活中找到目标、维系关系，或者做其他任何有意义的事。

Not a great way to go through life, and certainly not a great way to have purpose in your life and relationships and everything else.

但更重要的是，长期下来它会损害大脑功能。

But more importantly, it can impair brain function over time.

我们最明显的证据是，THC会增加患精神病的风险。

And the most striking evidence that we have is that THC can increase risk for psychosis.

这一点在动物实验中已经得到了证实。

And we know that from animal models.

你可以让动物别无选择，只能接受某种物质。

So you can take an animal that has no choice in whether they're getting something or not.

我们给它们注射THC，它们就会出现严重的脑部问题，比如精神障碍。

We can give them THC, and they can develop severe brain conditions, like conditions.

我们还有很多人类数据，尤其是流行病学研究，毕竟我们不可能拿一千个孩子做随机对照试验，让一半每天吸大麻，另一半完全不吸。

We have a lot of human data, more epidemiological data, because we can't do a randomized controlled trial of a thousand kids and have half of them smoke marijuana every day and half of them not.

伦理委员会绝不会批准这样的实验。

Would never be approved by an ethics board.

所以我们只能观察那些吸烟和不吸烟的人，看看前者是否更容易出现精神病性障碍。

So instead we have to look at people who are smoking versus not smoking and seeing are they more likely to develop psychotic disorders.

事实上，他们患上类似精神分裂症或双相情感障碍的风险，大概是不吸烟者的四倍。

And in fact, it seems that they're probably about four times more likely to develop something like schizophrenia or bipolar disorder than people who don't.

所以，大麻并不好。

So marijuana, not good.

酒精也是类似的情况，对大脑不好，对代谢健康也没好处。

Alcohol, similar kind of story, not good for your brain, not good for metabolic health.

我想大多数人应该都知道运动的建议。

You know, I think most people probably know the exercise recommendation.

多动动。

Move.

尽量增加肌肉量。

Try to build muscle.

就算你现在是个沙发土豆，特别超重，随便做点什么也好。

Like, even if you're a couch potato right now and really overweight, just anything.

在客厅里走走。

Walk around your living room.

做几个深蹲。

Do some squats.

跳一两下开合跳。

Do one or two jumping jacks.

随便做什么都行。

Like, anything.

先从哪儿开始都行。

Just start somewhere.

我还会建议大家尽量到户外去活动。

And then I would probably encourage people to try to get outside.

如果刚开始运动，就试着到户外，因为那时候你其实是在同时获得好几种好处。

If they're really new to movement, try to go outside because you're getting, like, multiple interventions at that point.

你离开屏幕了，所以别出门还把手机举在脸前面。

You're getting away from a screen, so don't walk outside with your cell phone in front of your face.

出去走走，好好感受大自然。

Walk outside and just enjoy nature.

试着留心一下你周围的环境。

Like, try to be mindful of your environment.

就算在城市里，你也能抬头看看天空、云彩，或者留意周围的树木，哪怕是街角的小公园也好。

Even if you're in the city, you can still look at the sky and see the clouds or look at what trees might be around, or any little corner park or something.

对。

Yeah.

这样你就同时获得了阳光、接触自然，还练了正念。

So that can become an intervention where now you're getting some sunlight, now you're out in nature, now you're practicing some mindfulness.

走路的时候，你暂时远离了屏幕，给大脑一点喘息的空间。

As you're moving your legs and walking around, you're getting away from screens for at least a little bit of time, and that can give your brain a break.

从简单的活动到练CrossFit，运动的方式多得很。

So lots of ways to do movement all the way up to do CrossFit.

去跑个马拉松吧。

Go run a marathon.

想做什么就做什么吧。

Do like like what whatever you wanna do.

是的。

Yeah.

对。

Yeah.

至于饮食，说实话，这是最复杂的话题。

And then nutrition honestly, nutrition is the most complicated story.

我想先对大家说的一点是，没有一种饮食方案适合所有人。

And I think the first thing that I wanna just say for everyone is that there's not a one size fits all nutrition strategy for all humans.

为什么会这样呢？

And why is that?

因为不同的人有不同的敏感性、过敏反应、偏好，肠道菌群也不同，还继承了父母不同的基因和表观遗传特征。

Because different humans have different sensitivities, allergies, preferences, they have different gut microbiota, they have different genetics and epigenetics that they inherited from their parents.

每个人都不一样。

They have all sorts of differences.

所以有些人吃某种饮食会特别好。

And so some people are going to do really well on one type of diet.

有些人吃全谷物特别棒，但另一些人则对麸质极度敏感，比如患有乳糜泻。

Some people might do really great with whole grain foods, and others might have gluten insensitivity in the extreme form of celiac disease.

对这样的人来说，吃全谷物反而会很糟糕。

And that person is going to do horribly with whole grain foods.

所以根本不存在一刀切的方案。

And so there's no one size fits all.

有些人吃坚果状态特别好。

Other people might do great with nuts.

但也有人对坚果有致命过敏。

Other people might have fatal allergies to nuts.

我们得承认，人与人真的不一样。

We just have to acknowledge people are different.

这正是我在听播客或接受采访时经常遇到的难题——人们总希望我给出三条适合每个人的建议。

And that's one of the things that I I'm always challenged by in even, like, podcasts or interviews is people are like, well, give me the three recommendations for everyone.

但实际上，这做不到。

And it's like, well, it's not

确实不可能。

It's not possible.

对。

Yeah.

可惜的是。

Unfortunately.

所以我想说，事情没那么简单，但又不想让人听到这句话就误解。

So I wanna say it's not that simple, but I don't want people to hear that phrase.

别把‘没那么简单’听成‘根本不可能’。

It's not that simple and hear it as it's impossible.

所以就以为这事根本行不通。

Therefore, it's impossible.

这并不是做不到的。

It's not impossible.

这也不是什么高深的技术。

It's not rocket science.

你只需要懂一点，再愿意稍微尝试一下就行。

You just have to know a little bit, and you just have to be willing to experiment a little bit.

我通常推荐的一个普适原则，结合我们之前讨论过的超加工食品，就是吃真正天然的完整食物——那种你祖父母辈可能在餐桌上见过的食物。

I think the universal principle that I usually recommend, very appropriate based on all of the stuff that we've already discussed about ultra processed foods is eat real whole foods that your great grandparents may have seen on their table, on a plate, somewhere, somehow.

你可以自己动手加工它们。

And you can process them yourselves.

可以做成炖菜、菜肴，随便你怎么弄。

You can make them into stews or dishes or whatever.

如果你喜欢土豆泥，把土豆压碎也没问题。

I mean, you can mash the potatoes if you're into mashed potatoes.

你完全可以对食物做各种各样的处理。

You can you can do all sorts of things with your food.

我完全不反对用香料和其他天然食材让食物更美味。

And I'm not at all opposed to making your food delicious with adding spices and other things to it.

但这些都属于真正的天然食材，不像你在超市塑料袋里买来的那些东西，成分复杂得连名字都念不出来。

But those are all real whole foods as opposed to the things that you buy in a plastic bag from the grocery store that have several ingredients that you have no idea how to pronounce.

每个人的食物选择和饮食结构都会不一样，因为我们每个人都不一样。

The foods and the actual makeup of our diet will look different for everyone because we're so different.

那我们该怎么看待炎症这样的指标呢？

But what do we need to know then about markers like inflammation?

我觉得这些才是更普遍、更关键的问题，对吧？

I think those are the things that are more common, right?

你还提到了线粒体。

You mentioned there mitochondria as well.

这些其实都是我们身体里很重要的部分，值得我们更深入地去了解。

It's like, these are the things that are parts of us that we need to understand more deeply.

只有真正理解了这些，我们才能弄清楚哪些食物适合我们，哪些不适合。

And then that will help us figure out, well, what foods are right for us and those that are not.

这么说对吗？

Is that accurate?

我觉得没错。

I think it is accurate.

我对饮食和营养的看法其实非常复杂。

And I think about diet and nutrition in actually really complex ways.

大多数人只想着吃够有营养的东西来保持健康。

Most people think about it as making sure you get enough nutritious stuff to promote health.

所以最常听到的说法就是‘营养密集型食物’。

So the most commonly used term is nutrient dense foods.

多吃营养密集型食物，就没问题了。

Eat nutrient dense foods and you'll be good.

那超加工食品有什么问题呢？

And what's wrong with ultra processed foods?

其实也不是说它们有什么坏处，只是营养太单薄了。

Well, nothing really is wrong with them, but they are nutrient deficient.

你只是在摄入热量，却缺少身体所需的那些营养成分。

You're just eating calories without the good nutrients that you need.

而且

And

有些营养师甚至会这么说。

so some dietitians will even say that.

你尽管吃你爱的超加工食品，但别忘了时不时加点西兰花。

Go ahead and eat all the all the ultra processed foods you want, but then throw in some broccoli here and there.

可惜，这种方法行不通。

Unfortunately, that's not gonna work.

所以，营养确实是必需的。

So there is a need for nutrition.

人体需要营养，需要各种维生素、足够的蛋白质，以及其他各种必需成分。

There is a need for nutrients, for all the different vitamins and adequate amount of protein and other things that we need.

对。

Yes.

确实如此。

That's true.

但饮食和饮食干预的意义远不止于此。

But diet and dietary interventions can be so much more than that.

有些人需要减重，这时候我们就得制定策略，帮助他们实现目标。

Some people may benefit from losing weight in which we want to come up with strategies to help them accomplish that.

还有些人其实代谢出了问题，因为他们营养不良或者体重过轻。

Other people can actually be metabolically compromised because they are malnourished or underweight.

想想神经性厌食症患者，或者癌症患者，他们长期严重抑郁，吃不下东西，总是恶心，食欲全无，实际上已经快饿死了。

So think of somebody with anorexia nervosa, or a cancer patient with severe unrelenting depression who can't eat or just has completely lost his appetite and is nauseous all the time and is now starving to death really for all intents and purposes.

我觉得他们同样面临代谢问题，但根源是营养不良。

I would actually argue that they too have a metabolic problem, but it's malnutrition.

就是缺乏身体必需的营养素。

It's a lack of essential nutrients.

所以对这些人来说，干预方法很简单：多吃点。

And so the intervention for those people is eat more.

我们需要帮你补充储备。

We need to replenish your stores.

如果可能的话，我们需要让你摄入的热量超过消耗。

We need to get you to have a calorie surplus if possible.

你看，我刚刚提到的这两种方法完全是相反的。

So right there I just mentioned two polar opposite interventions.

一组人需要减重，另一组人则需要增重。

One group needs to lose weight, another group needs to gain weight.

还有一类人对某些食物敏感，他们可能会做排除饮食，或者试着找出哪些食物会引起不适，哪些对自己有益，哪些反而有害。

And then there are people who have food sensitivities, so they might do elimination diets, or just try to figure out what am I sensitive to, what do I thrive on, what don't I thrive on.

最后一种我常提到的饮食干预，本身就可以成为一种治疗方法。

And then the final category that I usually talk about is kind of a dietary intervention that can actually become a treatment unto itself.

通常是通过禁食或者模拟禁食的饮食方式来实现。

It's usually in the form of fasting or a fasting mimicking diet.

模拟禁食的饮食方法有很多种。

And there are many types of fasting mimicking diets.

最广为人知的可能是生酮饮食，但还有其他几种。

Probably the most commonly known one is a ketogenic diet, but there are others.

还有一种植物性、低热量的模拟禁食饮食，研究者沃尔特·隆戈在这方面挺有名的。

There are plant sourced, low calorie fasting mimicking diets that researcher Walter Longo is kind of known for.

但归根结底，这些方法的核心都是让你暂时不吃东西，或者让身体误以为你在禁食——其实你并没有真饿着，生酮饮食的巧妙之处就在于此，它让身体以为自己在禁食，实际上你还在吃东西。

But ultimately, they are all centered on this process of going without or tricking your body that maybe it is going without even when it's not, which is kind of the sneaky thing about the ketogenic diet is it tricks your body into thinking that it's fasting when it's really not fasting.

不过要提醒一点，人不能一直禁食，那叫挨饿，坚持一周左右就会有生命危险。

But the reason that is important to just note is that, you know, people should not fast forever for good health because that's called starvation, and you'll die within a week or so.

对健康一点好处都没有。

Not good for your health.

所以这并不是一种每个人都该长期坚持的健康饮食方式。

And so this isn't technically a lifelong healthy diet that everybody should be on.

但在合适的时间、合适的条件下，它确实能发挥强大的修复作用。

And yet it can have powerful healing properties when done for the right amount of time in the right circumstances.

有些人可能会对这个持怀疑态度。

I mean, some people might be skeptical of this.

所以，如果有人还不清楚，我想指出的是，地球上每一个文化几千年来都把禁食当作一种疗愈方式或宗教实践。

So in case anyone is, I just wanna point out every culture on earth has used fasting as either a healing practice or a religious practice for millennia.

对。

Mhmm.

我觉得这绝非偶然。

I don't think that's a coincidence.

我认为，世界各地的人们都发现，一旦禁食，有时候真的会发生奇迹。

I think that humans in every culture on earth have noticed, gosh, when we fast, miracles can sometimes happen.

是的。

Yeah.

不同的文化或宗教会把禁食的作用归因于神明的慈悲与治愈，诸如此类。

And different cultures or religions have attributed the mechanism of action to God, you know, showing mercy and healing or whatever.

还有其他各种说法，比如我们是在驱赶那些明显存在的邪灵。

A variety of other, you know, we're we're exercising the demons that were clearly present.

对。

Mhmm.

几千年来，人们提出了各种各样的解释。

And so all sorts of explanations have been evoked over millennia.

作为医生和科学家，我想说的是，科学现在终于跟上了，简直让人惊叹。

And what I'm here to say as a physician and scientist is that the science is now catching up to say, woah.

禁食确实对身体和大脑产生了许多惊人的效果，它能促进康复。

This actually is really doing a lot of amazing things in the body and brain, and it is promoting healing.

如果有人信仰特别虔诚，对我这样讲觉得不太舒服，那也没关系——上帝很可能也是通过生物学和生理学在起作用。如果你愿意说这是上帝的旨意，是上帝希望我们做的，是祂在我们禁食时展现慈悲，那祂依然可能是通过科学机制来改变身体、让这一切生效的。

Now if anybody's super religious and they're a little annoyed with me for saying it like that, God was probably involved in biology and physiology So if you wanna stick with this is God's thing, this is what God wants us to do, and he shows mercy, when we do it, well, he would still probably work through scientific methods to change biology and make it work that way.

我不确定。

I don't know.

但关键在于，我们可以更精细地运用这些方法，针对合适的人、在合适的时机，来促进康复。

But that's the thing where we can start to get really sophisticated with using these interventions with the right people in the right circumstances to promote healing and recovery.

你之前提到过，你的某些患者有精神分裂症或双相情感障碍，你说他们不会满足于这些表面的解决方式。

Earlier you mentioned clients of yours or people who are struggling with schizophrenia or bipolar, and you're saying that they wouldn't appreciate these more surface level solutions.

我们先说双相情感障碍吧，我觉得这个话题我们听得更多一些。

We'll start with bipolar, which we hear about a lot more often I feel.

那到底是什么？

What is it?

有多少人正在受这个问题困扰？

How many people are struggling with it?

那通常有哪些推荐的做法？

And what are some of the recommended steps there?

双相情感障碍就是那种发病率急剧上升的疾病之一。

So bipolar disorder is one of those disorders that is skyrocketing in prevalence.

为什么会这样？

Why is that?

我觉得，不管是哪种诊断标签，大家对背后的原因都争议很大。

I think that with all of them, with all of the different diagnostic labels, there's so much disagreement about why is that.

这确实是个关键又重要的问题。

It's such a critical question and an important question.

我想明确说一下，我完全理解不同的解释都存在。

And I just wanna say for the record, I fully understand that there are different explanations.

我觉得这些解释大致可以分成三类。

And the explanations fall into kind of three categories, I would say.

第一类，是我们现在更能识别和诊断出来了。

Category one, we're just better at recognizing it and diagnosing it.

这当然是好事。

And that's a good thing.

这真的非常好。

It's a really good thing.

现在人人都在谈论心理健康。

Everybody's talking about mental health today.

连《有目的》播客都在聊心理健康。

We've got On Purpose Podcast talking about mental health.

所以自然大家都去检查、去接受治疗了。

And so of course everybody is just getting diagnosed and getting the treatment they need.

但要说发病率真的在飙升，尤其是双相情感障碍这种病，很多人觉得它跟基因有关，这不太可能。

But the rates can't possibly really be increasing, especially with something like bipolar because many in the field believe it's genetic.

这种病的发病率不可能在这么短的时间内就发生改变。

And that wouldn't change in prevalence over such a short period of time.

第二类是怀疑态度。

The second category is disbelief.

这怎么可能是真的呢。

This can't possibly be true.

美国人就是爱抱怨、又懒。

Americans are just whiny, lazy people.

现在人人都喜欢给自己贴个标签。

Everybody loves to have a label.

大家都想显得与众不同。

They all wanna be special.

现在人人都想与众不同，都想有个标签，最好还多几个。

Everybody wants to be special these days, and they all want a label or more.

所以大家都想说自己有注意力缺陷多动症。

And so that everybody wants to have ADD.

每个人都有这么或那样的诊断。

Everybody's got one that has has this, that, the other.

这么多人不可能真有这么多精神健康问题，这根本是假的。

And there's no way this many people can really have this many mental health conditions, and so it's all fake.

或者跟这有关，有些人就是喜欢吃药，比如多动症患者。

And or kind of related to that, people are just seeking pills because they like the pills, so with ADHD.

人人都想吃兴奋剂。

Oh, everybody just wants to be on stimulants.

他们都在钻系统的空子。

They're all gaming the system.

一个个跑去精神科，说自己有注意力缺陷的症状，其实根本不是那么回事。

They're all going into the psychiatrist complaining about how they have symptoms of ADHD when they really don't.

他们真正想要的，就是那些药。

And really what they just want is their they want their drugs.

他们想要阿得拉和利他林，而且已经上瘾了。

They want Adderall and Ritalin, and they're hooked on them.

这就是问题的核心。

And that's what that's about.

第三类人呢，是真正有状况的。

And then the third category is no folks.

这一类人的比例其实正在上升，而我就属于这一类。

They're they're really actually going up in prevalence, and I'm in that category.

我不是说另外两类完全不存在。

Not to say that the other You're

一种潮流罢了。

a fad category.

我也没说另外两类完全不会发生。

Not to say that the other two can sometimes occur.

是的，我确实认识一些人，他们喜欢贴标签，甚至过于依赖这些标签来获得关注。

Yes, I do know some people who like labels and probably like them too much and want attention from them.

是的，我也认为现在大家更愿意谈论心理健康了，也确实比三十年前更早发现了一些原本会被忽略的病例。

And yes, I do think that we are talking about mental health more, and we are diagnosing people who maybe would have been missed thirty years ago.

我觉得这确实是真实的。

I do think that's real.

我不是说这些情况不真实，但我觉得大部分数据背后的原因很惊人，因为统计数据实在太吓人了。

So I'm not saying that those aren't true, but I think the bulk of the statistics because the stats are staggering.

仅在美国，双相情感障碍的成人发病率已经翻了一倍，儿童和青少年中的发病率更是呈指数级上升。

With bipolar disorder in The United States alone, the rates have doubled in adults, and they're up exponentially in children and adolescents.

说到儿童和青少年，有一项研究甚至发现诊断率飙升了4000%。

And like with children and adolescents just to I mean one study found a 4000% increase in the diagnosis.

这主要是因为上世纪六七十年代，根本没人会给儿童诊断双相情感障碍。

That was largely because in the 1960s and 70s nobody diagnosed children with bipolar disorder.

现在呢，只要孩子有点坐不住、情绪不稳定、爱发脾气，我们就可能直接贴上双相的标签，可这根本不符合双相的医学定义。

And now we're kind of you know, if they're a little fidgety and moody and throw tantrums, We might label that bipolar even though it's not really the definition of bipolar at all.

有些人一看到这些表现，就会诊断为双相，然后就开始治疗。

Some people will diagnose that as bipolar and start treating it.

双相情感障碍的常规治疗主要是情绪稳定剂，还有大量其他精神类药物。

The usual treatments for bipolar disorder are mood stabilizers and pretty much mood stabilizers and lots of other psychiatric meds.

但不幸的是，太多人对这些药根本没反应。

And the unfortunate reality is far too many people don't respond to those.

确实有人效果特别好，我完全支持这种情况。

There are some who respond beautifully to them, and I'm all for that.

但没效果的人实在太多了。

Far too many don't.

既然效果不佳，为什么还在大量开药？

Why are they still being given out if they don't work?

我觉得是因为一个半真半假的说法——它们偶尔对某些人确实有用。

I think it's it's because of that half truth that they do sometimes work for some people.

于是就有人在街头巷尾，至少在舆论上大声疾呼：这药救了我的命。

And so you'll have people marching in the streets kind of figuratively at least saying this saved my life.

别把这药拿走。

Don't take this away.

但任何了解双相障碍患者的人都知道，绝大多数人根本无法通过治疗达到缓解和康复。

But for anybody who knows anyone with bipolar disorder, the overwhelming majority of people do not achieve remission and recovery from the treatment.

我们这个行业告诉他们，你只是得了慢性病。

And we as a field tell them you just have a chronic disorder.

这种病会伴随你一生。

You'll have this for life.

我们真的非常抱歉。

We're really sorry.

精神科里没有治愈一说。

We don't have cures in psychiatry.

根本就不存在什么根治。

There's no such thing as a cure.

你只能尽力而为，学会与它共处。

And you're just going to have to do your best and manage.

我们会尽全力帮助你。

We'll our best to help you.

但说实话，你可能还是会时不时住院，而这根本不是你的错。

But, yeah, you'll probably be in and out of hospitals sometimes through no fault of your own.

你按时吃药，一丝不苟，可一到换季，症状还是会出现。

You'll be taking your pills religiously, and then the season will change, and you'll have an episode.

我们真的就是

And we just we just don't

不知道该怎么应对这种情况。

know what to do about that.

我觉得

I think

你真正想问我的，大概是饮食对这些人能起到什么作用吧。

what the real question you were probably asking me was how could diet play a role for them?

对。

Mhmm.

当人们听我说饮食可能对严重精神疾病有帮助时，大多数人还是持怀疑态度。

You know, when people hear me talk about diet can play a role for severe mental illness, most are still skeptical.

但我们现在已经有成百上千，甚至可能上万的双相障碍患者，通过生酮饮食或模拟禁食的饮食方式，显著改善了症状，甚至达到了缓解。

But we now have absolutely hundreds, but probably I've heard from thousands of people who've been diagnosed with bipolar disorder, who have experienced significant improvement and or remission of their symptoms using ketogenic diets or fasting mimicking diets.

我想先说明一下，因为对有些人来说，‘生酮’这个词本身可能会让人不舒服。

And I wanna just say upfront, because some people ketogenic can even be kind of a triggering word for some people.

我特别想强调，你可以选择纯素生酮饮食。

And I just wanna say upfront, you can do a vegan ketogenic diet.

你也可以选择素食生酮饮食。

You can do a vegetarian ketogenic diet.

当然，也可以选择杂食生酮饮食。

You can do an omnivore ketogenic diet.

甚至全肉生酮饮食也是可行的。

You can do a carnivore ketogenic diet.

所以，生酮饮食涵盖的食物范围其实很广。

So there's a broad range of foods that people can eat and be on a ketogenic diet.

关键不在于食物是植物性还是动物性来源。

So it's not about plant sourced versus animal sourced foods.

也不是说非得天天吃培根。

It's not about eating bacon all the time.

有些人确实这么吃，对他们来说也算生酮，但如果你不想顿顿吃培根，也没必要非得这样。

Some people make it that, and that it can be ketogenic for them, but it doesn't have to be all bacon if you don't want it to be all bacon.

说实话，光吃培根肯定不是什么健康饮食。

And all bacon probably is not a healthy diet, I'll just say for the record.

你肯定需要比这更全面的营养。

You probably need a little more nutrition than that.

面对那些持怀疑态度的人，我第一句通常会说：这怎么可能呢？

Usually the first thing that I say for the skeptics who are like that, there's no way that can be true.

听起来太离谱了，简直疯了，好像他在胡说八道。

This sounds unbelievable or crazy or it sounds like he's a quacker.

他肯定在卖东西。

He's selling something.

很多人都这么想。

A lot of people think that.

你就是在推销什么吧。

You're selling something.

其实，我从没因为有人采用生酮饮食而拿过任何版税。

I'm like, well, actually, I don't get paid any royalties for people who do ketogenic diets.

要是能拿就好了。

I wish I did.

真希望有个生酮协会，每有一个人尝试，就给我发一毛钱版税，可惜没这回事。

I wish there was a ketogenic society that would give me a 10¢ royalty or something for everybody who tries it, but no such luck.

我想跟所有怀疑的人说清楚一点：很多人觉得生酮饮食只是个流行的减肥法，但其实它早在一百年前就由一位医生发明了，目的只有一个——控制癫痫发作。

I think one of the really important things to just point out for any skeptics right off the bat is that although a lot of people know that keto diet is this fad weight loss diet, in fact it was developed a hundred years ago by a physician for one and only one purpose, and that is to stop seizures.

生酮饮食本质上是一种治疗癫痫的方法。

That the ketogenic diet is an epilepsy treatment.

真的吗。

Wow.

而且现在它已经被证实是经过科学验证的癫痫疗法。

And it is actually now an evidence based epilepsy treatment.

我们有大量对照试验的支持。

We have many controlled trials.

我们有两项被医学界视为金标准的系统评价——考科蓝综述，证实生酮饮食对癫痫，尤其是儿童癫痫，具有非常显著的疗效，即使药物无法控制发作时也有效。

We have two kind of gold standard medical reviews called the Cochrane Reviews that support that the ketogenic diet is a very effective treatment for epilepsy, especially childhood epilepsy, even when medications fail to stop the seizures.

这一点特别重要，因为事实上，我们经常把治疗癫痫的药物用于多种精神健康问题，尤其是双相情感障碍。

And the reason that's so important to point out is that it turns out that we use epilepsy treatments for a wide range of mental health conditions, but in particular bipolar disorder.

很多抗癫痫药，比如德巴金、卡马西平、拉莫三嗪、加巴喷丁等等，最初都是为治疗癫痫而研发的。

So a lot of anticonvulsants like dabicote, Tegretol, Lamictal, Gabapentin, others are used for they were actually developed initially for epilepsy.

这些药本质上是抗癫痫药，但大多数听众如果听过这些名字，多半是因为它们常被当作精神科药物开给患者。

They're really epilepsy pills, but most of your listeners, if they recognize any of those names, they recognize them as psychiatric pills or psychiatric medications because they're most commonly prescribed for that.

所以，既然我们早就把治疗癫痫的药物广泛用于精神健康领域，那就不该惊讶，一种能控制癫痫发作的饮食，也可能对某些人有帮助。

And so in a way, given that we use epilepsy treatments all the time for mental health conditions, it shouldn't be shocking that a diet that can stop seizures might also play a role for some people.

是的。

Yeah.

真没想到。

Wow.

我以前完全不知道。

I had no idea.

这太令人着迷了。

That's fascinating.

我是说，我们是怎么发现，一百年前用过的疗法，现在居然又能派上用场的？

Like, how did we even discover that something that was used a hundred years ago for that was possible now to use again?

第一项关于精神健康的研究发表于1965年。

The first published study for mental health was in 1965.

一些研究人员对患有精神分裂症的女性进行了研究，让她们只坚持了两周的生酮饮食，结果发现她们的症状至少有所改善。

Some researchers did a study of women with schizophrenia, put them on a ketogenic diet for just two weeks, and they noticed at least some improvement in their symptoms.

大多数人甚至根本没认真考虑过，也没去想过这一点。

Largely, people haven't even really seriously considered it, or thought about it.

通常人们都默认，精神疾病患者没法坚持饮食控制。

And the usually, the assumption is that people with mental illness can't do a diet.

没错。

Right.

这话说得对。

That's I mean yeah.

人们觉得精神疾病患者太虚弱了。

People with mental illness are too impaired.

他们病得太重了。

They're really sick.

根本不可能让他们节食。

There's no way they could do a diet.

但是呢？

But?

我想说的是，请别低估他们想要康复的决心。

What I'm here to say is that please don't shortchange them and underestimate their determination to get better.

我现在正在帮助患有精神分裂症、双相情感障碍和严重抑郁症的人改变饮食，并坚持下去。

Because I'm getting people with schizophrenia and bipolar disorder and crippling depression to be able to change their diet and stick with it.

当人们为生命而战时，即使身体状况很差，他们也能展现出惊人的能力。

When people are fighting for their life, it's really amazing what they're capable of doing even when they're so impaired.

即使他们的状况已经很差了。

Even when they're so impaired.

我不是来说他们没有障碍的。

I'm not here to say they're not impaired.

我也不是来说这很容易的。

I'm also not here to say it's easy.

我不是想说，随便告诉他们一个生酮饮食，两天后就能痊愈了。

I'm not here to say like, oh, just tell them ketogenic diet and then two days later they're gonna be cured.

事情不是这么做的。

That's not the way this works.

他们需要支持，需要教育，需要大量的帮助。

People need support, they need education, they need a lot of help.

他们真的需要大量的帮助。

They absolutely need a lot of help.

但这完全是可能的。

But it is possible.

这是可以做到的。

It is doable.

当我们支持这些人时，他们是能做到的。

And when we support these people, they can do it.

好消息是，虽然有些人可能觉得这听起来像是个案，或者以为Chris Palmer在编故事，但目前全球已经有20项关于生酮饮食治疗多种精神健康问题的对照试验正在进行。

And the, you know, the great news is that although to some people this may sound anecdotal or Chris Palmer's making stuff up or what, We now have 20 controlled trials underway around the world of the ketogenic diet for a wide range of mental health conditions.

其中八项是随机对照试验。

Eight of them are randomized controlled trials.

我们还有几个初步试验，以及大量已发表的病例报告。

And we have several pilot trials, many case reports already published.

我刚刚发表了一篇综述文章，梳理了生酮饮食在精神健康领域被应用的频率。

I actually just published a review article on this topic of how often has the ketogenic diet been used for mental health conditions.

目前文献中已发表的相关研究超过50篇，参与这些试验的人数超过1900人。

We have over 50 publications already published in the literature, and over 1,900 people, 1,900 people who participated in these trials.

其中绝大多数人都报告了某种程度的改善。

And the overwhelming majority of them found some benefit.

但我并不是想说所有人都完全康复了，因为精神健康问题远比单纯饮食要复杂得多。

Now I'm not trying to say all of them were cured of their mental health condition because mental health is a lot more complicated than just diet.

我并不是说某一种治疗方法能神奇地治好所有人，因为事情没那么简单。

And I'm not here to say any one treatment is gonna magically fix everyone, because that's not the way it works.

我收到来自世界各地许多饱受慢性、严重且致残性精神疾病困扰的人的反馈，其中很多人实现了完全缓解，有时甚至停用了精神类药物。

And I hear from people around the world who have suffered from chronic severe crippling mental illnesses, and a lot of them are getting full remission, sometimes off of their psychiatric medication.

他们有时能够完全逐渐停药。

Sometimes they're able to completely taper off.

而且即便是这样，当他们获得缓解时，这个过程也并非像想象中那么简单，这确实让人感到惊讶。

And even that, like when they get remission, it's not like this simple process, shocking, surprisingly.

因为大家可能会觉得，哎，如果病情缓解了，他们应该高兴得又蹦又跳，一直笑才对。

Because you would think that like, oh, if I put them into remission, they should be so happy jumping up and down for joy, smiling all the time.

确实有一部分人是这样。

And there's some of that.

但几乎每个人都会经历一个阶段，就是为自己失去的人生感到深深的悲痛。

There's also this phase that almost everybody goes through of profound grief for the life that they've lost.

他们会意识到，自己刚刚把三十年的生命都耗费在了这场疾病上。

They recognize I just lost thirty years of my life to that illness.

天啊。

Wow.

为什么三十年前没人告诉我这些呢？

Why didn't somebody give this to me thirty years ago?

因为那时候我还在上大学。

Because I was in college.

我有个女朋友。

I had a girlfriend.

我们本来打算结婚的。

We were gonna get married.

可当我患上精神分裂症后，我失去了一切。

And when I became schizophrenic, I lost everything.

我不得不退学。

I had to drop out of college.

从那以后，我再也没谈过恋爱。

I've never had a girlfriend since.

我失去了所有朋友。

I lost all my friends.

我再也无法独立生活了。

I couldn't live independently anymore.

我胖了很多。

I gained all this weight.

这三十年来，我一直被社会排斥。

I've been a pariah in society for thirty years.

现在我好起来了？

And now I'm better?

那我接下来该做什么？

What am I supposed to do?

克里斯，听你这么说，我觉得我们已经谈了宏观，也谈了微观，但当你这样描述时，我忍不住想，是什么让你把一生都献给了这份工作？

Chris, when I'm listening to you, I'm thinking we've talked about the macro, we've talked about the micro, but when I'm hearing you talk about it that way, I'm like, what made you dedicate your life to this work?

这不只是你做的事，这就是你本身。

Because this isn't just something that you do, it's who you are.

从你对这份工作的热情，还有你每天对待支持和服务对象时投入的能量，就能看出来。

You can tell by the passion you have for it, the energy you have for the people that you support and serve and work with every day.

就像你自己说的，从商业角度看，你其实并没有直接的利害关系。

Like you said, you don't have any skin in the game when you look at it from a business point of view.

那这份动力到底从何而来？

So where's that coming from?

我从小就很早就开始经历精神健康方面的困扰，

I have had my own struggles with mental illness from a very young age in terms

了

of

比如强迫症，后来发展成严重的抑郁，甚至有过自杀的念头，各种问题都经历过。

OCD, later crippling depression, suicidality, all sorts of things.

如果你愿意，我很乐意以后详细聊聊这些经历。

And I'm happy to go into that at some point if you want to.

但我最终选择成为精神科医生，真正的原因是因为我妈妈。

But the real reason I ended up becoming a psychiatrist is because of my mother.

我家里一共有八个孩子。

I'm from a family of eight kids.

我妈妈四十岁出头的时候，之前一直还算正常。

And when my mom was in her early 40s, she had been relatively, quote, unquote, normal up until then.

就是专心带孩子，帮爸爸打理生意，过着中西部典型的中产生活。

Just raising a family, helping my father run his business, just living a normal middle class life in the Midwest.

她家里接连发生了一连串让人难以承受的变故，压得她喘不过气。

A series of events happened in her family that were ridiculously stressful and put a tremendous burden on her.

她先是出现了一种她说的‘精神崩溃’，很快演变成重度抑郁和自杀念头，紧接着又出现了幻觉等精神病性症状。

And she had what started as what she called a nervous breakdown that quickly turned into depression and suicidality, and then pretty quickly turned into psychotic symptoms.

她被送进了医院。

And she was hospitalized.

开始服药治疗。

She was medicated.

也在接受心理治疗。

She was getting psychotherapy.

她接受了精神健康领域能提供的一切治疗。

She was getting all of the treatment that the mental health field had to offer.

但全都无效。

None of it worked.

她余生都饱受慢性精神病的折磨，人生彻底被毁了。

And she ended up living the rest of her life with a chronic psychotic disorder, and it ruined her life.

这绝不是轻描淡写。

It's not an understatement.

她失去了对所有

She lost custody of all of

八个孩子的监护权。

her eight kids.

我曾经去和她一起住过一段时间。

I went to live with her for a while.

后来我们一度无家可归。

We end up homeless together for a while.

我的意思是，那简直是一场噩梦。

I mean, was a nightmare.

但她失去了对孩子们的监护权。

But she loses custody of her kids.

她失去了自己的生意。

She loses her business.

她失去了所有的钱。

She loses all of her money.

她因为这种精神病性障碍，失去了朋友、家人，还有许多其他东西。

She loses friends, family, all sorts of things due to this psychotic disorder.

我亲眼目睹了这一切发生。

And I saw all of that happen.

我对整个精神卫生系统感到无比愤怒。

And I was furious with the mental health field.

极度愤怒。

Furious.

他们怎么这么无能？

Why are they so incompetent?

他们为什么不帮帮她？

Why aren't they helping her?

我当时

Like, I

我知道她有问题。

knew there was something wrong with her.

很明显。

It was clear.

她有妄想。

She was delusional.

她觉得自己是抹大拉的马利亚转世。

She thought she was Mary Magdalene reincarnated.

她觉得世界末日就要来了。

She thought the world was ending.

她会对周围的人产生妄想和猜疑。

She would get paranoid about people.

我的意思是，各种症状都出现了。

I mean, all sorts of symptoms.

所以我早就觉得她不对劲，

So I knew there was something wrong with her,

但我实在无法相信，精神健康领域竟然能这么无能。

but I was just in disbelief that the mental health field could be so incompetent.

他们为什么不去帮她？

Why aren't they helping her?

他们为什么不能让她好起来？

Why aren't they making her better?

他们有医院啊。

They have a hospital.

他们到底在干什么？

What are they doing?

当

And when

我看到他们对她做的事，简直吓坏了——给她吃那些药，整个人像行尸走肉，可精神状态还是乱七八糟。

I saw what they were doing, I was horrified because they were putting her on medicines that made her seem like a zombie, but she was still crazy.

我当时就想，他们到底在干什么？是故意在害她吗？

And I was like, what what are they do are they poisoning her on purpose?

这到底算什么？

Like, what what is that?

他们到底在搞什么名堂？

Like, what what are they doing?

最后，正是她的经历让我决定成为一名精神科医生，因为我亲眼目睹了精神疾病有多摧残人。

And ultimately, she's the reason I became a psychiatrist because I saw how devastating mental illness can be.

不过幸运的是，并不是每个人都会这么惨。

It's not that devastating for everybody, thankfully.

有些人症状比较轻或者中等，那就好了。

Some people have mild, moderate things, and that's great.

但我看到，精神疾病真的能毁掉一个人的一生。

But I saw that it can literally ruin a person's life.

它能摧毁整个家庭，而她完全是无辜的。

It can ruin an entire family and that she was innocent.

她什么都没做错，不该承受这些。

She didn't do anything to deserve any of that.

她没有吸毒。

She wasn't using drugs.

她根本没做错任何事，一点责任都没有。

She wasn't there was no blame.

她完全不该为这一切负责。

No way to blame her for any of it.

于是我选择了这个行业，希望至少能做点不一样的事，带来一些改变。

And I went into the field hoping that maybe somehow I might be able to make a difference and do something different.

谢谢你分享这些。

Thank you for sharing that.

你能把痛苦转化为动力，真的让人佩服。虽然我没法想象这些年你看着这一切却无能为力，心里有多难受，肯定也感到绝望过。

It's incredible that you were able to, you know, turn a pain into a purpose for you, even though I can't imagine how painful it was over those years just watching that and feeling helpless I'm sure at times and hopeless.

你觉得如果现在知道了这些，是不是会有不同的方法来帮助和支持她？

Do you believe that if you knew what you know now then that there were different ways of helping and supporting her?

绝对是。

A 100%.

你知道，当我……

You know, when when I

后来我进了精神科，结果成了那种只会开一堆没多大用处的药的‘坏医生’。

went into psychiatry, I became one of those evil psychiatrists who just doled out pills that didn't really work.

那时候我觉得特别无力，也对这个行业感到特别绝望。

And I felt so helpless and so hopeless for our field.

是因为你不得不这么做吗？

Because you had to?

还是说

Or

因为那是我唯一能用的手段，人们往往会陷入危及生命的状况。

Because those were the only tools that I had available, and people would end up in life threatening situations.

他们会出现躁狂和精神病症状，对自己或他人构成威胁，我们总得做点什么。

They would be manic and psychotic and a danger to themselves or others, and we had to do something.

我们必须让他们活下来，或者我总觉得有责任让他们活下来，而这是我唯一学到的办法。

We had to keep them alive, or I felt compelled to try to keep them alive, and that was the only tool that I had learned about.

我一直对这些方法持怀疑态度。

I always was skeptical of all of it.

我在精神健康领域做的一切，我都保持着合理的怀疑，因为我明白，当年他们对我妈妈用的也是这套，根本没用。

I always kept a healthy dose of skepticism about everything I was doing in the mental health field because I recognized this is the same thing that they did for my mom and it didn't work.

那为什么我们就该相信这套能管用呢？

So why should we think this is gonna be any better?

但我感到无能为力。

But I felt helpless.

我不知道还能做什么。

I didn't know what else to do.

我现在充满希望，因为当我们把所有这些科学成果整合起来，真正理解一些现在就能实施的干预方法——比如生酮饮食，虽然它对精神分裂症患者大脑的作用机制非常复杂，

I am now filled with tremendous hope that when we put it all together, when we put all of this science together, and we understand some actual interventions that can really be done right now in 2024, like a ketogenic diet, the science of how that would help the brain of someone with schizophrenia gets really complicated fast.

但我能理解这些科学原理。

I can understand that science.

我不行，是的。

I can't, yeah.

其他人不需要懂。

Other people don't need to.

他们只需要知道，我们会让你开始这种饮食，帮您落实，提供指导和支持，弄清楚哪些你能做，哪些你不想做。

They just need to understand that you're going to do this diet, and we're going to help you do it, and we're going to coach you and provide support and, you know, and figure out what what you can do and what you don't wanna do.

这是一种切实可行的治疗方法。

And it's an achievable treatment.

它在2024年的今天就是一种现实、可及的疗法，能够挽救生命。

It's a realistic, accessible treatment today in 2024, and it can save lives.

我最充满希望的是，这种更广泛的理论能帮助我们开发出更多工具、疗法和策略。

What I am most hopeful about is the way that this broader theory can help us develop even more tools and treatments and strategies.

我非常期待，这能迫使我们重新思考领域内许多现行的做法。

And I'm really hopeful it will force us to rethink a lot of what we're doing in our field.

它会促使我们寻找根本原因，并采用更有效的疗法。

It will force us to look for root causes, to use treatments.

有些疗法我认为应该谨慎使用。

Some of them need to be used sparingly, I would argue.

也许只在危及生命的情况下使用，但之后我们必须转向促进健康的治疗方式。

Maybe in life threatening situations, but then we need to move on to health promoting treatments.

我已经五十多岁了。

I'm in my fifties.

我不知道自己还能活多久，但我相信，以我余生的时间，我们完全有可能见证精神健康领域的彻底变革。

I don't know how much more time I have, but I think I have enough time that in my lifetime, I believe it is possible that we will see a transformation of the mental health field.

到那时，我们会回望2024年对精神疾病的治疗方式，觉得它近乎野蛮。

And we will look back on the way we treated mental illness in 2024 as almost barbaric.

对。

Yes.

他们当时是怎么想的呢？

And how could they have done that?

为什么就不采用那些更有效的办法呢？

Like, why why didn't they use these other strategies that are so much more effective?

我非常期待，未来十年到二十年内我们能看到这样的转变。

I am really hopeful that we may see that day in the next ten to twenty years.

如果有家长，或者将来要当父母的人正在听，而且家族中有心理健康问题的历史，他们不想把这些传给孩子，那该注意些什么？

And if there are parents and future parents listening who have in their family had a history of mental health and they don't wanna pass it on to their children, what are the things they should be looking at?

真的有可能不传给下一代吗？

Is it possible to not pass it on?

如果你身上有增加风险的基因，那确实已经传给孩子了。

If you do have genes that increase risk, you have passed them on.

这并不是作为父母的错。

It's not your fault as a parent.

你的父母传给了你，他们的父母也传给了他们。

Your parents did it to you and their parents did it to them.

所以别再为此自责了，别花时间去纠结这个。

And so don't don't spend any time or thought beating yourself up over that.

基因确实会遗传，但短期内我们没法改变这些。

So genetics do get passed on, and we're not changing those anytime soon.

表观遗传也会遗传，可惜的是，这事儿更复杂了。

Epigenetics also get passed on unfortunately, and that gets more complicated.

如果你当父母前经历过创伤，比如童年时被父母家暴，令人意外的是，你已经把那段经历的某些影响传递给了孩子。

It means that if you've been traumatized as a parent, if you had a horrible childhood, your parents physically beat you, surprisingly you have passed at least a glimpse of that experience onto your children.

当人经历创伤，尤其是长期创伤时，会引发一些变化，我们可以简单称之为表观遗传改变。

When people have trauma, especially prolonged trauma, it causes changes in what I think we can safely just call epigenetics.

这可能意味着你的DNA发生了修饰。

And that might mean modifications to your DNA.

也可能涉及微小RNA分子之类的物质，它们能通过卵子和精子传给下一代，影响孩子未来的心理健康和代谢健康。

It might mean like microRNA molecules and other kind of things that actually can get transferred in eggs and sperm cells to new children and can impact their future mental health and metabolic health.

有些部分是无法改变的。

Some parts are unchangeable.

但好消息是，基因甚至表观遗传都不是这些疾病的主要决定因素。

But the good news, the great news, is that genes and even epigenetics are not the primary determinants of these illnesses.

我相信，真正起决定作用的是环境，是我们生活方式。

I believe environment, the way we live our lives is.

最有力的证据就是这些疾病的发病率呈指数级上升。

And the strongest testament to that is actually the exponential rise in rates.

我们的基因并没有改变。

Our genes have not changed.

我们的表观遗传可能发生了变化，但表观遗传本身是可以正向或负向改变的。

Our epigenetics may have changed, but epigenetics can change one way or another.

如果你是孩子的父母，我们会做所有那些常规且显而易见的事。

If you are a parent to a child, we're gonna do all of the usual obvious things.

你会爱自己的孩子。

You're gonna love your child.

你会给孩子提供安全感。

You're gonna provide safety.

你也不会事事替他们包办。

You're not gonna coddle completely.

你要让他们独立，去承担一些风险。

You're gonna let them be independent, take some risks.

要允许他们偶尔失败。

You're gonna let them fail every now and then.

这些你都可以做到。

You're can do all of those things.

你要大力支持并鼓励他们交朋友、融入社群。

You're gonna really support and encourage them to have friends and community.

要让他们多活动，多到户外去，诸如此类的事情。

You're gonna have them move, you're gonna have them get outside, all of that stuff.

大多数父母最大的盲点，就是日复一日允许孩子吃进嘴里的东西。

Probably the single biggest blind spot for most parents is what you're allowing your child to put into his or her mouth day after day after day.

如果他们生活在美國，很大可能吃了很多超加工食品。

If they live in America, there is a very very good chance they are eating a lot of ultra processed foods.