Summary of Huberman Lab Podcast Episode: Mind Healing: Insights from Dr. Karl Deisseroth | Huberman Lab
Podcast: Huberman Lab
7 min. read
— Description —
Discover the potential of optogenetics in revolutionizing psychiatric treatments Gain insights into the causal understanding of mental health conditions and explore targeted therapies Join Dr
Andrew Huberman on a journey towards a brighter future in psychiatry.
Mind Healing: Insights from Dr. Karl Deisseroth | Huberman Lab
Table of contents
Key Takeaways
Introduction
The Art And Science Of Psychiatry
Successes In Psychiatric Treatments
What Will Move The Needle In Psychiatric Treatment?
Defining Channelrhodopsins & Optogenetics
Future Of Channelrhodopsins And Optogenetics
Using And Understanding Cues From The Body
Brain-Machine Interface
ADHD
Psychedelic Medicine
Tips For Stress Mitigation And Improved Focus
Key Takeaways
- Psychiatry is built around diseases diagnosed with words that don’t appear on scans or neuroimaging – unlike cardiology. We still have a long way to go in our understanding of the brain
- Treatments in psychiatry can come with frustrations because the drugs and therapies with the best results are non-specific and often have the greatest side effects
- The hope of optogenetics is to arm physicians with a true causal understanding of circuit underlying certain conditions of mental health disease and inform targeted treatments from there
- The specificity of optogenetics is only useful if you have an understanding of how to use that information
- There is a risk with all treatment, but it doesn’t appear that the risks in psychedelics exceed risks tolerated in other branches of medicine
- “There’s a central cord of optimism that where we’re headed is not only possible but likely.” – Dr. Andrew Huberman
Introduction
- Dr. Karl Deisseroth, M.D., Ph.D. (@KarlDeisseroth), is a Clinical Psychiatrist and scientist who directs a bioengineering research laboratory at Stanford University School of Medicine. His work aims to understand and develop treatments for disorders of the mind such as depression, attention deficit disorders (ADHD & ADD), autism, schizophrenia, anxiety, eating disorders, borderline personality, and obsessive-compulsive disorder.
- In this episode of Huberman Lab, Dr. Huberman and Dr. Deisseroth discuss research progress in developing cures for mental health disease and break down how the brain works in a healthy state and with emotional distress.
- Host: Andrew Huberman (@hubermanlab)
- Book: Projections: A Story of Human Emotions by Karl Deisseroth
The Art And Science Of Psychiatry
- Neurologists use imaging to diagnose stroke, Alzheimer’s, brain damage, etc.
- Psychiatry is built around diseases diagnosed with words that don’t appear on scans or neuroimaging
- Future of mental health diagnoses: efforts are being made to look at brain waves and imaging but still has ways to go
- What happens in the brain and psychiatric diseases is physical and measurables will likely be developed
- Barriers to psychiatry: the stigma of mental health disorders prevents people from seeking treatment
- Nuances in psychiatry: there is a difference between colloquial use of words and medical use of terminology
- “You never really know what’s going on in the mind of another person.” – Dr. Karl Deisseroth
- Sometimes other people observing someone is the best gauge of what’s happening in a person – e.g., husband may see that wife is sleeping more, eating less, and could be heading into depression
- We actually know very little about the microcircuitry of the human brain
Successes In Psychiatric Treatments
- Cognitive-behavioral therapy is extremely beneficial in treating panic disorder
- Successful medications: anti-psychotic medications for schizophrenia – and many medications used for the treatment of various mental health conditions
- Electroconvulsive therapy is extremely effective in severe depression as long as administered safely and in a controlled environment
- The most frustrating thing about electroconvulsive therapy is the lack of specificity – you’re causing a brain-wide seizure – but it works
- Frustration in treatment: some of the most anti-psychotic drugs, therapies, and medications are the least specific and have the greatest side effects but have the best results
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Vagus nerve stimulation: a way to get into the brain without going directly into the brain
- FDA approved for depression but is dose-limited because it stimulates everything nearby in the neck
- Physicians can turn up the intensity in real-time remotely or in-person
- Some psychiatrists sample small doses of drugs to understand what patients feel and side effects
What Will Move The Needle In Psychiatric Treatment?
- Frustrations: (1) psychiatrists don’t have the level of understanding that other fields of medicine have – it isn’t like cardiology with a clear understanding of biology and physiology; (2) symptoms vary across people
-
Need clearer understanding: most psychiatric treatments have been discovered serendipitously
- Anti-depression drugs were first created to cure tuberculosis
- Need to identify circuits and patterns of activity driving activity in “healthy” state versus “non-healthy” state – to allow treatment along the path in a targeted manner
Defining Channelrhodopsins & Optogenetics
- In plants channelrhodopsins function as light-gated ion channels – when a light particle hits them, ions rush in the pore
- The movement of ions across the membrane is how the human brain and neural code for on and off
- Mechanism of channelrhodopsins spurred the new field of optogenetics
- Optogenetics: control neurons with algae protons (channelrhodopsins) using light – used to understand and manipulate sensation, cognition, action
- Protocol of gene injection: channel rhodopsinsare are put into a vector (adeno-associated virus (AAV)) packaged with DNA and injected into a specific part of the body depending on the desired outcome
- Protocol of light delivery: inject ½ mm light-emitting photon under the skin
Future Of Channelrhodopsins And Optogenetics
- Early barriers to overcome: channelrhodopsins don’t move many ions because they have a small current so have to pack a lot in without damaging cells
- 2007 put channelrhodopsins in mice to control actions in mice
- 2021 put channelrhodopsins in the eyes of human beings and made a blind person see
- The broader significance of optogenetics is understanding because once you know how circuitry works and what matters, treatment options become more grounded
- In principle, channelrhodopsins will enable treatments to turn on or off specific regions of the brain which lead to depression, anxiety, etc.
- Optogenetics would allow for more precise stimulation methods without affecting other parts of the body
- The specificity of optogenetics is only useful if you have an understanding of how to use that information
Using And Understanding Cues From The Body
- The eyes are rich in information – eye contact can be intense, mistimed, avoided, absent
- The pairing of what’s going on in eyes with body language, verbal cues provides additional information
- Psychiatrists learn to hone in on whatever data stream is given and can detect changes in tone of voice, eyes, etc. to inform diagnoses
Brain-Machine Interface
- Brain-machine interface: devices that will stimulate patterns of activity of neurons
- Using electrodes to gather information from neurons will allow us to understand what’s going on in the brain but still has risks
- Could allow information collection and stimulation only when needed and with greater specificity
- Identify patterns to target psychiatric interventions and timepoints
ADHD
- ADHD: symptoms of hyperactive or inattentive states; the key thing is that it’s present across different domains of life and isn’t specific to one setting
- There is debate about what percentage of the population with symptoms should be treated with medicine
- Working on quantitative EEG diagnosis
- It’s debatable whether behaviors and interactions with the sensory world could induce or activate ADD or ADHD – it must be disrupting social or occupational functioning in non-adaptive ways
Psychedelic Medicine
- Psychedelics create both an opportunity for therapeutic benefit and a risk
- This is not the first time there has been a movement of psychedelics for medicinal purpose
- Psychedelics alter the experience of reality in precise ways and there is an opportunity
- There is a risk with all treatment, but it doesn’t appear the risks in psychedelics exceed the risks tolerated in other branches of medicine
- Patients with depression are often stuck and can’t look to the future so they discount the value of their own action – psychedelics may improve this symptom by opening new paths or representations of seeing future or altered state
- MDMA increases brain levels of dopamine and serotonin modulator which can be useful for the treatment of trauma
- The brain learns from the experiences of psychedelics: psychedelics elicit experience at the moment and lasting impact after
Tips For Stress Mitigation And Improved Focus
- Carve out protected time to just think – can even be while driving – any time to sit still
- Make time for yourself without a phone, checking email, notifications, etc.
- Learn to be physically still
- Embrace that different stages of life come with unique needs