Thomas Insel: Toward a new understanding of mental illness

Thomas Insel: Toward a new understanding of mental illness

Translator: Joseph Geni
Reviewer: Thu-Huong Ha So let’s start with some good news, and the good news has to do with what do we know based on biomedical research that actually has changed the outcomes for many very serious diseases? Let’s start with leukemia, acute lymphoblastic leukemia, ALL, the most common cancer of children. When I was a student, the mortality rate was about 95 percent. Today, some 25, 30 years later, we’re talking about a mortality rate that’s reduced by 85 percent. Six thousand children each year who would have previously died of this disease are cured. If you want the really big numbers, look at these numbers for heart disease. Heart disease used to be the biggest killer, particularly for men in their 40s. Today, we’ve seen a 63-percent reduction in mortality from heart disease — remarkably, 1.1 million deaths averted every year. AIDS, incredibly, has just been named, in the past month, a chronic disease, meaning that a 20-year-old who becomes infected with HIV is expected not to live weeks, months, or a couple of years, as we said only a decade ago, but is thought to live decades, probably to die in his ’60s or ’70s from other causes altogether. These are just remarkable, remarkable changes in the outlook for some of the biggest killers. And one in particular that you probably wouldn’t know about, stroke, which has been, along with heart disease, one of the biggest killers in this country, is a disease in which now we know that if you can get people into the emergency room within three hours of the onset, some 30 percent of them will be able to leave the hospital without any disability whatsoever. Remarkable stories, good-news stories, all of which boil down to understanding something about the diseases that has allowed us to detect early and intervene early. Early detection, early intervention, that’s the story for these successes. Unfortunately, the news is not all good. Let’s talk about one other story which has to do with suicide. Now this is, of course, not a disease, per se. It’s a condition, or it’s a situation that leads to mortality. What you may not realize is just how prevalent it is. There are 38,000 suicides each year in the United States. That means one about every 15 minutes. Third most common cause of death amongst people between the ages of 15 and 25. It’s kind of an extraordinary story when you realize that this is twice as common as homicide and actually more common as a source of death than traffic fatalities in this country. Now, when we talk about suicide, there is also a medical contribution here, because 90 percent of suicides are related to a mental illness: depression, bipolar disorder, schizophrenia, anorexia, borderline personality. There’s a long list of disorders that contribute, and as I mentioned before, often early in life. But it’s not just the mortality from these disorders. It’s also morbidity. If you look at disability, as measured by the World Health Organization with something they call the Disability Adjusted Life Years, it’s kind of a metric that nobody would think of except an economist, except it’s one way of trying to capture what is lost in terms of disability from medical causes, and as you can see, virtually 30 percent of all disability from all medical causes can be attributed to mental disorders, neuropsychiatric syndromes. You’re probably thinking that doesn’t make any sense. I mean, cancer seems far more serious. Heart disease seems far more serious. But you can see actually they are further down this list, and that’s because we’re talking here about disability. What drives the disability for these disorders like schizophrenia and bipolar and depression? Why are they number one here? Well, there are probably three reasons. One is that they’re highly prevalent. About one in five people will suffer from one of these disorders in the course of their lifetime. A second, of course, is that, for some people, these become truly disabling, and it’s about four to five percent, perhaps one in 20. But what really drives these numbers, this high morbidity, and to some extent the high mortality, is the fact that these start very early in life. Fifty percent will have onset by age 14, 75 percent by age 24, a picture that is very different than what one would see if you’re talking about cancer or heart disease, diabetes, hypertension — most of the major illnesses that we think about as being sources of morbidity and mortality. These are, indeed, the chronic disorders of young people. Now, I started by telling you that there were some good-news stories. This is obviously not one of them. This is the part of it that is perhaps most difficult, and in a sense this is a kind of confession for me. My job is to actually make sure that we make progress on all of these disorders. I work for the federal government. Actually, I work for you. You pay my salary. And maybe at this point, when you know what I do, or maybe what I’ve failed to do, you’ll think that I probably ought to be fired, and I could certainly understand that. But what I want to suggest, and the reason I’m here is to tell you that I think we’re about to be in a very different world as we think about these illnesses. What I’ve been talking to you about so far is mental disorders, diseases of the mind. That’s actually becoming a rather unpopular term these days, and people feel that, for whatever reason, it’s politically better to use the term behavioral disorders and to talk about these as disorders of behavior. Fair enough. They are disorders of behavior, and they are disorders of the mind. But what I want to suggest to you is that both of those terms, which have been in play for a century or more, are actually now impediments to progress, that what we need conceptually to make progress here is to rethink these disorders as brain disorders. Now, for some of you, you’re going to say, “Oh my goodness, here we go again. We’re going to hear about a biochemical imbalance or we’re going to hear about drugs or we’re going to hear about some very simplistic notion that will take our subjective experience and turn it into molecules, or maybe into some sort of very flat, unidimensional understanding of what it is to have depression or schizophrenia. When we talk about the brain, it is anything but unidimensional or simplistic or reductionistic. It depends, of course, on what scale or what scope you want to think about, but this is an organ of surreal complexity, and we are just beginning to understand how to even study it, whether you’re thinking about the 100 billion neurons that are in the cortex or the 100 trillion synapses that make up all the connections. We have just begun to try to figure out how do we take this very complex machine that does extraordinary kinds of information processing and use our own minds to understand this very complex brain that supports our own minds. It’s actually a kind of cruel trick of evolution that we simply don’t have a brain that seems to be wired well enough to understand itself. In a sense, it actually makes you feel that when you’re in the safe zone of studying behavior or cognition, something you can observe, that in a way feels more simplistic and reductionistic than trying to engage this very complex, mysterious organ that we’re beginning to try to understand. Now, already in the case of the brain disorders that I’ve been talking to you about, depression, obsessive compulsive disorder, post-traumatic stress disorder, while we don’t have an in-depth understanding of how they are abnormally processed or what the brain is doing in these illnesses, we have been able to already identify some of the connectional differences, or some of the ways in which the circuitry is different for people who have these disorders. We call this the human connectome, and you can think about the connectome sort of as the wiring diagram of the brain. You’ll hear more about this in a few minutes. The important piece here is that as you begin to look at people who have these disorders, the one in five of us who struggle in some way, you find that there’s a lot of variation in the way that the brain is wired, but there are some predictable patterns, and those patterns are risk factors for developing one of these disorders. It’s a little different than the way we think about brain disorders like Huntington’s or Parkinson’s or Alzheimer’s disease where you have a bombed-out part of your cortex. Here we’re talking about traffic jams, or sometimes detours, or sometimes problems with just the way that things are connected and the way that the brain functions. You could, if you want, compare this to, on the one hand, a myocardial infarction, a heart attack, where you have dead tissue in the heart, versus an arrhythmia, where the organ simply isn’t functioning because of the communication problems within it. Either one would kill you; in only one of them will you find a major lesion. As we think about this, probably it’s better to actually go a little deeper into one particular disorder, and that would be schizophrenia, because I think that’s a good case for helping to understand why thinking of this as a brain disorder matters. These are scans from Judy Rapoport and her colleagues at the National Institute of Mental Health in which they studied children with very early onset schizophrenia, and you can see already in the top there’s areas that are red or orange, yellow, are places where there’s less gray matter, and as they followed them over five years, comparing them to age match controls, you can see that, particularly in areas like the dorsolateral prefrontal cortex or the superior temporal gyrus, there’s a profound loss of gray matter. And it’s important, if you try to model this, you can think about normal development as a loss of cortical mass, loss of cortical gray matter, and what’s happening in schizophrenia is that you overshoot that mark, and at some point, when you overshoot, you cross a threshold, and it’s that threshold where we say, this is a person who has this disease, because they have the behavioral symptoms of hallucinations and delusions. That’s something we can observe. But look at this closely and you can see that actually they’ve crossed a different threshold. They’ve crossed a brain threshold much earlier, that perhaps not at age 22 or 20, but even by age 15 or 16 you can begin to see the trajectory for development is quite different at the level of the brain, not at the level of behavior. Why does this matter? Well first because, for brain disorders, behavior is the last thing to change. We know that for Alzheimer’s, for Parkinson’s, for Huntington’s. There are changes in the brain a decade or more before you see the first signs of a behavioral change. The tools that we have now allow us to detect these brain changes much earlier, long before the symptoms emerge. But most important, go back to where we started. The good-news stories in medicine are early detection, early intervention. If we waited until the heart attack, we would be sacrificing 1.1 million lives every year in this country to heart disease. That is precisely what we do today when we decide that everybody with one of these brain disorders, brain circuit disorders, has a behavioral disorder. We wait until the behavior becomes manifest. That’s not early detection. That’s not early intervention. Now to be clear, we’re not quite ready to do this. We don’t have all the facts. We don’t actually even know what the tools will be, nor what to precisely look for in every case to be able to get there before the behavior emerges as different. But this tells us how we need to think about it, and where we need to go. Are we going to be there soon? I think that this is something that will happen over the course of the next few years, but I’d like to finish with a quote about trying to predict how this will happen by somebody who’s thought a lot about changes in concepts and changes in technology. “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next 10.” — Bill Gates. Thanks very much. (Applause)

100 Replies to “Thomas Insel: Toward a new understanding of mental illness”

  1. He is right. He should be fired. What he says gives me the creeps. If you wonder why, then watch the movie "Minority Report"

  2. If the World is not deterministic, why physics and maths always work?
    Top thinkers don't believe in free-will. They say that past experiences and genetics determine how you act. 🙂

  3. Is it me or Ted Talks is giving too much attention to neuroscience? I mean, it is a fascinating subject, but this guy clearly doesn't have anything new to tell us.

  4. "Early intervention/behavioral disease/intervening before behavior becomes different:" such talk might provoke fear of the emergence of a "thought police" if we had not already handed over to "Western" psychiatrists the power to judge if people who have broken no law are behaving "differently," in a "disordered way" or inappropriately enough to lock them up and drug them indefinitely against their will…or if we did not welcome such talk as heralding the end of coercive psychiatry in The West."

  5. I use the word in its most literal and general sense here, but I'm referring to the claim that the brain is not sufficient cause for the mind and, more specifically, the seemingly arbitrary separation of the objective and subjective self.

  6. How can he claim that its starts early in life when the natural path of growing up is full of pain and suffering that leads to enlightenment and adulthood. His position is the same as the rest of the quack psychiatric world that normal human behavior and the emotional roller coaster of adolescence emotions is a disease to be treated chemically.

  7. Evolution is using our consciousness and creativity to evolve evolution. In other words our next great leap in evolutionary advancement is based in our technology as defined by our curiosity and intelligence. The purpose of our intelligence is to make the next step.

  8. This sounds really amazing to me, and the direction things need to go. It's too bad it feels like the opposite of where we're heading.

  9. Determinism in the context of human evolution and our reality in general is a facade and an illusion, because we do not have the capacity (at least currently) to measure every event that may have contributed to the resulting reality. You cannot prove general determinism in any scientific test as the events that add up to make any event are complex beyond our comprehension. Determinism in simple experiments is repeatable only if you measure the result in simple terms.

  10. There has been a lot of research in Oslo, Norway, by Dr Kalle Reichelt, and at the University of Sunderland, UK, into the effects of gluten and casein in problems of the mind. Gluten appears to cause autoimmune reactions where T-cells may attack the myelin sheath on nerve endings, creating a breakdown in nervous system communication. Studies Reveal that hospitalized schizophrenics have been able to return to normal life when following a gluten free and casein free diet. [email protected]

  11. No. There is an evolutionary advantage of having the illusion of being conscious. However, everything in this World is ruled by the laws of physics. 🙂

  12. I'll bet the brain is Turing complete and has a small enough Kolmogorov complexity in its own language to understand itself, contrary to what he says at around 8:00. We just need to do more science.

  13. Urine therapy is the best cure for mental illness or most other illnesses. It has been time tested. It provides a PERFECT BIOFEEDBACK loop to the brain and arms it with the information it needs to self-heal.

  14. This is interesting, but it seems to be based on the idea that our brain shapes our behavior, which I think is only half true. Behavior shapes the brain, the brain shapes behavior, its a two way street.

  15. Erm, like Delusions and Hallucinations? You can maybe argue against parts of it, but to throw the whole DSM out is just silly.

  16. You can have Machines in a non-deterministic space. Also indeterminisim does not save free will, it just destroys it even more.

  17. The Autism Action Network has called for Thomas Insel's resignation, due to alleged conflict of interest (his brother works in the vaccine industry) and outrage at his expressed refusal to unequivocally acknowledge the growing number of autism spectrum diagnoses – from Wikipedia.

  18. The laws of physics define the relationship cause/effect of everything. "free will" and (apparently) random events can be explained/predicted by the laws of physics. It's possible to predict dice rolls based on physical equations if we have all the information about the system: gravitational field, air friction, initial velocity and angular velocity, etc. Of course, it is almost impossible for a human to have all this information in advance so we prefer to say dice rolls are random events.

  19. *physics equations
    Since the cells, molecules and respective reactions in our brain must respect the determinism imposed by the laws of physics, so our actions or "free will", which are just a product of these reactions.
    The advantage of the illusion of "free will", ie., deciding what is best based on our past experiences and intelligence, compared to a dedicated architecture that only serves one purpose is the fact it can learn and adapt to different scenarios.

  20. No, quite the opposite. It just states that the brain is not just a "magical box" that can't ever be understood by scientists.

  21. Hmm. Made a little mistake back there. Free-will is an illusion, not consciousness. Consciousness is related with cognition. It is what helps us get information/awareness from the outside world and from ourselves, which is then used to take the right decisions. It is like a very sophisticated sensor and one of the most important tools for our survival.

  22. If you want to particularize awareness to just awareness of ourselves or our "mind", thinks don't change that much in your favor. Machines aren't only aware about the outside World but also about their own status.
    It seems quite silly to compare the awareness of machines to the awareness of human beings because one is really basic (maybe things will change in a near future) while the other is very sophisticated.

  23. That's just not true. People wouldn't act the same way because they were born with different characteristics, intelligence and have different past experiences. What I am saying is there is a cause/effect relationship in our actions. You can't deny that the intelligence you were born with for example doesn't affect the way you act. Consciousness is not generated or risen by matter? Ok. There is no point in discussing this further if we have completely different beliefs :/

  24. Bullshit. The world is a deterministic system all right, and so are humans. Yes there is no free will. The thing is we do not (and will never) due to the principial limitations of our knowledge be able to predict future events with enough precision to meaningfully be able to make good predictions about everything.

  25. Not taking them is worse? Unless you develop suicidal thoughts and behaviors. And while they are most dangerous going on AND coming off, the danger is always present. No physician would prescribe a drug that might cause strokes to a person at risk for strokes. To give sad people a drug with a possible side effect of suicidality is the very definition of "malpractice."

  26. Yeah, no, look into it. More soldiers killing themselves than being killed by enemies. You "doubt it" because the media won't talk about it. Look into for yourself.

  27. There is no free will – or rather, individuals have about as much free will as computers do on their own programming. Except humans are not standardized, therefore our decision making processes are not identical, giving the rise to the "feeling" we have free will – that we make decisions based on internal categories unaffected by our genetic, cellular pre-determined construction of our chemical based computing device we call "the brain".

  28. It is all a matter of percentages. The percentage of people who commit suicide because of meds is smaller than the percentage of people who would commit suicide if no one went on meds. It is the same with all medication and even surgery. You play the odds and hope that you don't lose.

  29. Look, we (deterministic people in general) have strong arguments against the existence of free-will and why it is an illusion. You might not agree with all of them, but that's ok. However, calling us ignorant would be the same thing or worst than (because determinism is not an actual belief) calling an atheist ignorant. Ignorance means that you're clueless about a topic, not that you're wrong.
    Also, intelligence is a personal trait just like personality.

  30. There is a limitation on human knowledge in almost every field. In Maths, there are several equations that are unsolvable. About the "brains can't understand brains", I also don't agree. A brain might be too complex for a human to understand it on his own, but that's why in science we tend to separate problems into different parts or subproblems. Each part is then solved by a different researcher.

  31. Mostly in agreement with your statement there.
    However to 1) No, because WE cannot predict it – giving US the illusion this is important and worthwhile. Our actions will NOT be the same after this conversation is over, because it changes us slightly, even if by using energy/becoming more agitated/awake.

  32. So we are arriving a consensus here. Our actions are the product of the structure and chemical reactions that happen in our brain, which in turn, can be fully predicted by the laws of physics. A system where every chain of events can be fully predicted by some laws or rules is a deterministic system.
    Ok, but that's another thing. I am talking about human intelligence, which means the ability of a person to solve a problem in a certain period of time. That's a personal trait.

  33. Well this conversation won't lead us to anywhere. You believe in mind and conscious awareness as something ethereal that can't be explained through the basic reactions that happen in your brain. I don't. However, recent studies are starting to show that the brain is just like any other machine, but a bit more sophisticated. For me, believing that the brain is a magical box that can't be explained through physics is almost like believing in the God of the gaps.

  34. you cant separate light from dark same is the body and disease..treatment to it is universality of vision.. by being original and versatile..

  35. Many of todays diseases in our young has to do with what society asks of them. You have to be skinny, you have to have this education, you have to have sex, you have to succedd, you have to… This amount of presure creates most of the problem or inflate the ones who happear late in life. We have to start saying that it's ok, if you're a little big, it's ok, not to be #1 in class, it's ok, to be #2 in sports, it's ok if you don't have sex. Life is already the big challenge we all have to face.

  36. I was diagnosed at age 9… and I am still not 100% stable and functional. Even early detection does not solve everything. Until we can create specialize medications and therapies for each individual, the problem in all mental disorders goes on. No two people suffer in the same way. So even with the mass amount of drugs available, and variety of therapies out there, people continue to suffer, and play guinea pig until the perfect combination is found. It's hard.

  37. great this video…. nowhere to post..thatswhy here… just want to ask ..ain't these corrupt people suffering from very serious mental disorder… make a classification…put all of them in asylum… why people who sit in there room… very down and out have mental disorders

  38. I tried to, but I can't. Psychology is a joke, and conflating hard biological science with the previously mentioned pseudoscience makes him a joke too.

  39. Repent of your sins for the Kingdom of heaven is at hand. Ask Jesus to forgive you and for him to be Lord of your life. ask for the Holy Ghost.

    God so loved the world and he sent his Son Jesus Christ to die for your sins so that all who believes in him shall have eternal life. Faith in Jesus Christ not only makes you right with God, but makes you a Child of God and a co-heir with Jesus. Repent and be baptised in the Name of Jesus Christ.

  40. Wow… And there was I thinking people kill themselves because this planet is a spiritually violating world of shit.

    But no… Our wiring is all wrong.

    All we need to do is catch kids earlier and earlier and turn them into ignorant zombie worker bees who are happy to be exploited from cradle to grave.

    Our brains are perfect at birth… Don't change our brains – change the world.

  41. Yes but as we grow older the environment and social aspects shape our brain and it's wiring. That's why babies are born normal, then as they grow older all sorts of dangers are doomed to affect a human being, that's unescapable

  42. Well, I'm a student, so it's not a scientific statement, but generally speaking brain has an ability to compensate the loss of function in whatever damaged structure, because healthy neurons in different areas can do the job of those malfunctioning while needed. It's all about the connections between them. And I guess, that during this 10 years brain can adjust the way I described it, but afterwards the steadily increasing use of compensation mechanisms exceeds it's range and the symptoms occur.

  43. Ok, good point. Not every function can be managed by every part of the brain. What I had in mind were the functions of neocortex' (which we commonly call just cortex) neurons, hippocampus is made of archicortex (different type). For example people that suffered a stroke can lose some of their limb function and regain it by rehabilitation. And they do by "forcing" other neurons to create new connections, because the old neurons died.

  44. Besides brain needs some time to answer a lesion. Compensation (creating new synapses) is a slow process and scooping a part of the brain is a sudden event, which brings sudden effects. When we talk about mental illnesses like schizophrenia – they progress gradually, so the brain can deal with it for some time, but still the degeneration is faster and that's why one day we observe pathological behavior changes.

  45. Some cretins will never get off the taboo around mental illness. I love the idea of music and dance therapy. But not the way it is practised today…

  46. Going back to the scientific law that from nothing comes nothing, applying that to moods emotions and memory it's easier to see that much of who we are and what we feel has a biological foundation within our organic brain as an organ. I know a gentleman that, other than being an alcoholic was a loving functional "normal" human male. Drs gave him vivitrol and he slipped fast into DPD and depression w anxiety. How does a chemical cause a change in mood and emotion if they're just psych disorders?

  47. Music and dance therapy has done amazing things in my life, truly amazing. I was 13 when I first experienced depression and I'm 27 now and still do it because it keeps me very happy and connected with reality. But what do you mean "not the way it is practiced today?"

  48. Thomas Insel, if you are reading this…I'd like to give information I've discovered about brain disorders. I started to experience depression at age 13, had a panic attack at age 23, severe anxiety at age 26. Throughout my life of very high ups and very low downs, and lots of personal research, I've "cured" myself so to speak. I really want to be part of the movement that changes what we know about brain disorders and how we can help others.

  49. I believe the current practices are quite simplistic, if I am not mistaken… More molecular ingredients within great music and expressive movement ought to be used for the betterment of mental health.

  50. Actually, there can be medical issues with the brain in depressed people. It can be a combination of factors. Low serotonin levels, low levels of neurotransmitters, over active sympathetic nervous system. The problem is that there are too many factors. You can't directly measure brain chemistry easily, and people's lives will affect how they feel, so you can't easily say this will be the quick fix. There are depressed people who are well off.

  51. Not al parts of the brain function for the same thing. Te parts that keep the personality and behavior intact can be unchanged, and at that same moment the motor o sensory areas can be affected. You can find some changes early in the brain that not necessarily affect the persons "mind" but they can help to predict future psychiatric manifestations.

  52. Still biological determinism….fail. A vast majority of these 'conditions' are the result of environmental influences, particularly during early developmental years. Heres how we reduce people suffering: Be kind to one another!  

  53. Great talk, but not sure I support the premise.   The loss of grey matter/cortical function is not evident in many schizophrenics with continuing intellectual reserve/capacity.   Either that, or we need to differentiate the brain condition of schizophrenia into those with intellectual decay and those without.

  54. Dysthymia,  " bad state of mind ",  sometimes also called neurotic depression, dysthymic disorder or chronic depression, is a mood disorder, consisting of the same cognitive & physical problems as in depression, with less severe, but  longer – lasting  symptoms. Replacement for the term  " depressive personality "  in the late 1970's. IRA  P.S. So, he didn't catch that, what's the worst than depression itself. I was there & know for sure. I was on electroshocks for a month  ( 3 times a week ),  didn't help a thing, was on Zoloft  ( antidepressant )  didn't help at all, on the contrary weight gain  ( 20 – 25  kilos )  which was more depressive. Then, I put my medicine in the garbage, bought a bike, sat on & went to the Center for Rehab every day. My psychiatrist  ( good one, run this Center ),  but didn't realized that's dysthymia, but hey, who I'm to tell her  ( I told her just about medicine in garbage, after 2 months ).  Then, she said, it's OK. But, when I saw something like this video, it's on my mind, maybe soon.  P.P.S. My condition was unchanged for 3 years. 2 years I wasn't working at all. Now, I work for more than 6 months & if want some pause I just go to the Center for  2 – 3  days & go on with my life. Also, have a dog & a cat, go to walk, pet them …  It's in short, just like that.  😉

  55. Thomas Insel is very optimistic.  I really do hope science comes up with solutions to brain disorders—be it depression or ADHD.  On a completely separate note, early detection and early intervention of inequality and a strong social safety net would give the United States of America the best outcome as well.

  56. Early prevention and detection is incredibly crucial in reducing mortality rates. Mental illness is an early onset disease, with most people having it in their early years of their life. We are on the new frontier for innovations with mental illnesses, but there are still basic things that we are doing that are holding us back. Chemical imbalances in the brain are a big cause for many of these illnesses, so it is time to start treating this like diseases of the brain. That does not mean that it is not multifactorial, and we still have so much to learn about the brain. In order to understand mental disorders we must understand the complexity of the brain. With new medical technology on the rise and being developed rapidly, we are learning new things every day. There are predictable patterns in the brain that contribute to these disorders so the more we understand them, the better we can help the patient. I think that continuing research on the brain is crucial to helping patients with mental illnesses to give them the best care they can get. I agree with Doctor Insel when he says that we should treat these as brain disorders. If we treat these as behavioral disorders, we can still get the big picture but still miss the small details that matter the most. We are on the brink to having the tools to predict these brain changes before the symptoms start. Therefore if we can see those brain changes, we can predict the symptoms and take care of them before they even start or at the very least be proactive with a treatment plan. We study the effects of various drugs on the parts of the brain where these diseases affect the most, therefore it should be classified as a brain disorder. Even before that we can research the brain to find the sources of these diseases so we can follow the patterns. When we can successfully predict these chemical/functional patterns in the brain, we can detect a disease as early as possible. When we can do early detection we can prevent a disease from spiraling out of control or taking over and we can treat that disease and come up with a plan as soon as possible. That is not only incredibly beneficial for the patient but the physician as well because you can avoid a whole bunch of future issues.

  57. Bravo Thomas,

    Very few people have the courage to talk about how much we still have to learn about Mental Illness in the context of childhood.

    For example their is still so much that we don't know, about disorders of mood or personality and how those disorders manifest themselves among our kiddos that are spending time every day battling low self-esteem and negative cycles of thinking.


  58. I always thought that behaviour is mostly dépendent on peer pressures, surroundings expectations, routines and customs, forced patterns, etc. In plain words: OUTSIDE causes. Brain disorders, mental handicaps, intellect underdevelopment were very rarely related to INTENTIONAL behaviour.

  59. The sad thing is that this talk is still deeply ignorant of the fact that all labelled mental disorders are not mental disorders , because they only exist as ideas without knowledge of the human soul which commented lately annuals all these labels as ignorant notions of the nature of the ego and the source of consciousness. Until these so called expects are humble to their own higher selves the stigma and ignorance will continue . For example schizophrenia is a concept with no scientific validity that limits the mind to the brain. It's time to catch up with those who are advanced in metaphysical wisdom and spiritual knowledge.

  60. Before we get too wild with science, why don't we just think of art therapy? Music? Dance? Visual Arts?
    Like that has had profound changes on so many people.

  61. the only thing to understand ts theres no such thing as mental illness, it's a design to pervert the course of justice invented by criminals

  62. "The polarization of brain medicine into two specialties may in part reflect an intuitive Cartesian dualism in human psychology. Children intuitively accept that certain mental functions, such as perception, planning, or mental calculation, require the brain; however, other functions, such as emotion, desire, belief, or pretense, are independent of the physical organ.

    Related studies have demonstrated that even adults struggle to acquire scientific knowledge that clashes with the innate intuitions of childhood, and tend to revert to intuition for unfamiliar scenarios. Thus, one intriguing possibility is that early failures to identify structural lesions for certain brain disorders, coupled with an innate human reluctance to ascribe certain mental functions to the organ itself, allowed two separate disciplines of brain medicine to emerge.

    This resulted in the current situation: a Cartesian divide between neurology, for disorders of the ‘wires’, and psychiatry, for disorders of the ‘psyche’."

    – Trends in Cognitive Sciences, February 2016

  63. Субтитры какой-то безграмотный долбаёб писал. Жесть просто.

  64. If your reading this…'s a last ditch effort to get some help. I have something wrong with my brain and am getting no help from my doctors. My wife Lou has ovarian cancer stage 3 and is very ill….things are not looking very good and we have two Children together Jude and Isla. I'm afraid i will not be well enough to look after them once she is no longer with us… there anyone that can help me? I need this special brain scan to make a diagnosis and the proper treatment….many thanks and GOD bless Lee…☺

  65. This is the complete opposite approach we need for dealing with mental health. We need a better psychological understanding because most problems are due to childhood trauma. This idea of "brain disorders" is exactly what he says it isn`t, a reductionist approach. He gives very few scientific facts supporting his point.

  66. I know this was posted a long time ago… but I've been saying for years that the way to overcome brain disorders is to start testing and diagnosing children as early as humanly possible. I've been told that it's unethical to diagnose children, and I staunchly disagree. If you diagnose them with something they actually have, like bipolar disorder or schizophrenia or other disorders, it will give them the chance at a normal life. But we don't, we diagnose them with disorders that are allowed to give kids, like Autism and ADHD, giving these kids medication that might actually make their conditions more severe and more catastrophic. We need to learn how to accurately diagnose children, so they don't have to wait until they are 18 or older to start getting a better range of diagnosis options. Limiting a child's diagnosis is limited the possibilities of healthy outcomes.

  67. Did Judy Rappaport really discover the changes occured in the human brains due to schizophrenia or actually rather the damage caused by the drugs used to treat schizophrenia in the brains of these unfortunate people? That's the most important question that awaits a satisfactory answer. If it's the latter rather than the former then needless to say that this creates of an issue of liabilities.

  68. Gotta stop looking at them as diseases but as personality adaptations to external tensors in order to heal them. It's like defining any disease as chronic and then trying to "cure" the patients.

    Let's stop being fools staring at shadows on the wall and start looking at the fire, shall we?

  69. Does anyone know where he is getting these statistics from? I want to use this for a paper I'm writing but I need to cite him.

  70. The image he shows of schizophrenic's brains at 10:29 were from people who had been taking antipsychotic drugs. This is much more likely the culprit of the brain volume loss. That's a major miss by Insel in this presentation.

  71. The issue i have with this is what about cptsd ptsd dissociative disorders etc. If you focus soley on biology and genetics what do you do about those?

  72. Thomas Insel
    Needs to take Major Tranquilisers
    This is the only way he will ever learn that these drugs shouldn't be used on Humans or Animals
    I have said for over 20 years that I would never want my worst enemy to take Major Tranquilisers
    Because even VERY SHORT TERM USE of these poisons can screw your
    Brain, Body and Nervous System up for life
    If people like Thomas Insel were to screw up their own Bodies, Brains and Nervous Systems
    They would then at least learn what sort of HELP we Patients and Ex Patients really need
    To still have a good life.
    He mentions Suicide
    Withdrawal Symptoms Kill
    Withdrawal Syndromes Kill
    Medication Spellbinding Kills
    Tardive Psychosis Kills
    If Thomas Insel was to try his own 'Medicine' He would know this
    If Thomas Insel was to try his own 'Medicine' He would know what he was talking about.

  73. Unfortunately his talk is based on the premise that brain malfunction simply occurs on its own without any influence from the environment; it's a massive false assumption.

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