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Russian
00:00:11
Hello everyone.00:00:14
You know, this was beautiful music.00:00:16
I think of inviting
those guys to my lectures,00:00:20
100 percent attendance will be guaranteed.00:00:24
(Laughter)00:00:25
The organizers have put wires all over me00:00:28
and said that now I am
a part of a collective mind,00:00:34
that we are one brain.00:00:37
One part of this brain,
which is me, wanted to ask you:00:00:41
"Do you know whose self-portrait it is?"00:00:45
Van Gogh, Vincent Van Gogh.00:00:47
Very well.00:00:50
And this one?00:00:54
Pablo Picasso.00:00:56
You sure know this guy.00:00:59
Harrison Ford, a Hollywood actor.00:01:02
Do you know what these people
have in common?00:01:06
They all suffered from depression.00:01:13
A very approximate estimation suggests00:01:18
that about 350 million people in the world00:01:21
are currently diagnosed with depression.00:01:25
And the costs of treatment,
of taking care of those people,00:01:29
is about 210 billion dollars per year.00:01:36
According to the World
Health Organization,00:01:40
by 2020,00:01:45
depression will become the second
most common cause for disability.00:01:51
In other words, this disease
is the disease of the century.00:01:54
The disease of our society.00:01:57
Interestingly enough,
the World Health Organization00:02:05
has conducted research is some countries00:02:08
to see how widespread the depression
is among the population.00:02:15
Which country do you think ended up first00:02:19
in terms of depressed people?00:02:23
Surprisingly, it was sunny France.00:02:28
In France, every fifth adult00:02:33
is diagnosed with depression.00:02:37
You know, there is one country00:02:39
that had no depressed patients till 2020.00:02:45
Who can name that country?00:02:48
China.00:02:51
And it is not because it is
a communist country and everyone is happy.00:02:55
(Laughter)00:02:58
In the framework of the Chinese culture00:03:02
depression is not a disease00:03:05
but a personality trait.00:03:08
And since 2000, when Chinese adopted00:03:11
the criteria of depression
for the patients,00:03:15
the depression appeared immediately.00:03:17
But even by now,
it is around nine percent.00:03:22
These are interesting facts.00:03:24
The number of depressed people
grows constantly,00:03:29
and we are facing
some very serious problems.00:03:33
Look at this slide and these numbers.00:03:37
Fifty percent of depressed people
do not get diagnosed.00:03:43
Why?00:03:45
A depressed person
will never come with a complaint00:03:48
about feeling unhappy00:03:52
or having a bad mood00:03:56
or having lost the meaning of life.00:04:01
To a depressed person, this doesn't look
like disease symptoms,00:04:05
and so doctors cannot
establish such diagnosis.00:04:07
Moreover, there are
no lab tests available.00:04:12
We can take blood and analyse it,00:04:14
but it will not help us
recognizing depression.00:04:18
The depression diagnosis gets established00:04:22
as a result of a dialogue
between a doctor and a patient.00:04:29
What is a necessary condition for that?00:04:33
At least one of them has to be healthy.00:04:36
(Laughter)00:04:37
Which is not always the case.00:04:42
Moving on.00:04:46
For treating patients with depression
we use a certain type of medicine00:04:49
called antidepressants.00:04:55
Sadly, the effects of antidepressants
develop very slowly.00:05:02
Only during second month
of constant use of the medicine,00:05:07
a patient starts feeling some improvement.00:05:13
But during that period,00:05:16
patients experience nothing
but the side effects of this medicine,00:05:20
before the healing effects
stat taking place.00:05:23
And 50% of people drop using the medicine00:05:28
within first weeks of taking it.00:05:34
Furthermore,00:05:35
let's have a look at the last sentence.00:05:40
In the case of 30–40 percent
of the patients00:05:44
the medicine has no effect whatsoever.00:05:48
And it is a huge, huge problem.00:05:54
For many years, the scientists
were looking for a molecule of happiness,00:06:00
thinking that the lack
of a particular molecule in the brain00:06:06
was the cause of depression.00:06:11
The search was unsuccessful00:06:14
because the way our brain works00:06:17
is based on neural networks00:06:21
where millions of nerve cells
form a network,00:06:26
and hundreds, thousands of molecules
make the network function.00:06:32
And a failure in one or many molecules00:06:36
can lead to such effect.00:06:39
So I can say that00:06:43
even today we know neither the cause00:06:51
nor the mechanics of this disease.00:06:55
But there are many interesting theories.00:07:00
And one of the theories -00:07:03
that's the theory
I am going to tell you about.00:07:07
There was this guy in 1965,00:07:12
a scientist Martin Seligman.00:07:15
He was performing tests on dogs.00:07:18
He would put a dog into a cage -00:07:21
such tests are prohibited now00:07:23
as ethical norms do not allow00:07:26
using dogs in such experiments -00:07:29
and passed a current
through half of the cage,00:07:35
a weak current which was
nonetheless rather unpleasant for a dog.00:07:40
He would be doing so for five to six days.00:07:45
On day seven he would put
an animal into this cage,00:07:52
immediately subjecting it to pain,00:07:57
but leaving the door of the cage open.00:08:03
It gave the dog an opportunity
to escape the unpleasant sensation.00:08:11
What happened?00:08:13
80% of dogs were indeed
running out of the cage,00:08:18
but 20% stayed inside,00:08:23
sort of consenting to the pain.00:08:27
He called it "learned helplessness",00:08:31
which in Estonian sounds as00:08:39
'õppitud abitus',00:08:41
or "выученная беспомощность" in Russian.00:08:45
In his article, he wrote:
"I taught the animals to be unhappy".00:08:52
Some years later, a theory appeared,00:08:58
stating that the cause of depression was —00:09:01
I quote —00:09:05
"formation of stable negative patterns00:09:11
that are fixed in the brain
due to its insufficient plasticity."00:09:19
It means a person learns to be unhappy00:09:23
but at the same time00:09:25
brain plasticity keeps them
from retraining and becoming happy.00:09:33
It is an interesting theory.00:09:37
You see, our brain is very stable
and it has to be stable.00:09:45
It has to remember the information,00:09:49
it has to remember our skills,00:09:51
this is the basis of its stability.00:09:55
At the same time, the brain is bombed
by a vast flow of information,00:10:04
visual, verbal,00:10:06
it hears, it sees,00:10:09
it undergoes constant stress.00:10:13
This stability can be reached
only if the brain has plasticity.00:10:20
Without plasticity this information flow,00:10:23
this bombardment can destroy our brain.00:10:28
Brain plasticity.00:10:30
It is indispensable for learning00:10:35
but it is also necessary for retraining.00:10:40
Brain plasticity is quite
impressive in children.00:10:45
A one-year-old child can learn
a thousand times more stuff than an adult.00:10:51
They have remarkable plasticity.00:10:55
This plasticity, this ability to learn00:10:59
resides in a small brain structure
called hippocampus.00:11:06
"Hippocampus" means a sea horse.00:11:10
Really, it is highlighted over here,00:11:12
it is shown in yellow in a brain,00:11:15
and the way this structure looks00:11:17
indeed reminds a sea horse.00:11:23
What is the purpose of this structure?00:11:26
It turns out that00:11:27
this structure is responsible
for memory formation.00:11:34
And the information
that serves as a basis for memory00:11:38
is kept in this structure for two weeks,00:11:42
then it is sent to other
parts of the brain.00:11:46
The hippocampus
is cleared of old information00:11:50
and is ready to take new information in.00:11:54
And it was discovered that this structure00:11:59
is the only or one of the few
locations in the brain00:12:05
where a constant formation
of new nerve cells is happening.00:12:12
This process is called neurogenesis.00:12:17
This neurogenesis was observed
not only in children,00:12:22
it was discovered in an adult brain, too.00:12:27
It takes approximately a day00:12:31
for around 600 to 800
nerve cells to generate;00:12:35
they get organized into neural networks00:12:42
and are able to perceive
the new information, to retrain.00:12:48
The neurogenesis is shown on this diagram00:12:51
The new cells are shown in blue here ...00:12:57
What was discovered?00:13:00
The patients who attempted suicide00:13:06
had a lower number of these new cells.00:13:10
The patients who have gone
through a serious psychological trauma00:13:17
have a lower number of these cells,00:13:20
fewer neurons are created
in this structure.00:13:26
And the scientists suggested00:13:28
that this may be the cause of depression.00:13:34
A question arose:00:13:36
How can we influence00:13:39
the plasticity of the hippocampus
and this neurogenesis?'00:13:45
It is also written in here:00:13:48
a decrease in neurogenesis
may be a cause of depression.00:13:54
I want to show you one slide.00:13:56
Please pay attention.00:13:59
We can color these new cells
created in hippocampus00:14:05
in black like here and next to it, in red;00:14:11
those red dots represent
the newborn nerve cells.00:14:16
Then the neurogenesis processes
of a control person were compared00:14:22
with that of a runner.00:14:24
A runner.00:14:27
Who does running mean?00:14:28
It is a physical activity.00:14:30
What do we see?00:14:31
Look how the number
of these new cells has changed.00:14:36
It turned out that physical activities
stimulate the neurogenesis greatly.00:14:43
The same effect was found00:14:47
in antidepressant fluoxetine — Prozac.00:14:51
It too reinforces, or increases,
the number of new cells.00:14:58
What else does contribute
to healing these cells?00:15:02
An enhanced environment.00:15:07
Children's toys have this function:00:15:13
they stimulate neurogenesis in a child.00:15:17
What can stimulate it in an adult?00:15:19
What can count as an enhanced
environment for an adult?00:15:24
Travelling.00:15:27
This too enhances person's environment.00:15:30
An interesting research
was conducted on taxi drivers00:15:35
who constantly need
to remember how to navigate.00:15:39
It turned out the volume
of hippocampus was a lot bigger00:15:46
in London taxi drivers
than in the population on average.00:15:51
It was an interesting publication.00:15:57
Next.00:16:00
I want to show you this slide,00:16:02
maybe the conference organizers
will put a video for me.00:16:09
Here is a child.00:16:14
Young mothers, who has
children of this age?00:16:18
Have you observed how they walk?00:16:25
They don't walk, as some tell us.00:16:28
They hop.00:16:29
I have three grandchildren,
and they all hop.00:16:32
None of them walks normally.00:16:35
And I often hear from mothers:
"Why are you hopping? Walk normally!"00:16:39
Never say that to your children.00:16:43
It turns out that this hopping00:16:47
contributes to neurogenesis
in the hippocampus.00:16:53
This is an interesting fact
that was discovered recently.00:16:56
That is, children, when hopping...00:16:58
the brain sends them a signal to hop00:17:01
and by hopping they improve
the plasticity of the brain.00:17:06
It is great.00:17:08
I like children.00:17:10
There she goes!00:17:12
Do you see how?!00:17:14
(Laughter) (Applause)00:17:16
Awesome!00:17:18
I can no longer hop like that.00:17:22
Let's move on.00:17:25
Have a look, here I show several things00:17:30
that improve our brain plasticity00:17:35
and its capacity for retraining.00:17:40
Here is physical activity,
here is travelling,00:17:44
here are antidepressants when necessary.00:17:49
Immediately a question pops up:00:17:51
why doesn't all this work
for all the patients?00:17:58
You see,00:18:02
with all these things we give the brain
an opportunity to retrain00:18:09
but it's up to the person to retrain.00:18:11
Because really, everything we know,
we have learned by ourselves.00:18:16
Neither professors nor school teachers —00:18:18
teachers generally ruin everything —00:18:20
(Laughter)00:18:23
(Applause)00:18:25
cannot make us learn.00:18:27
The learning part is up to us.00:18:29
And those things,
they will just give us an opportunity.00:18:32
They will open the doors
to this retraining.00:18:38
These are the things
I wanted to tell you today.00:18:43
Thank you for listening.00:18:44
(Applause)Description:
Уже давно известно, что депрессия - это болезнь, и её надо лечить. Однако до сих пор существуют мифы по поводу антидепрессантов и того, что больной должен делать сам для своего излечения. Professor of pharmacology and drug toxicology at the University of Tartu, member of many pharmacology related societies This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/about/programs-initiatives/tedx-program
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