Psychiatrist reacts to: "I have too much self-awareness"

Summary

视频剧本探讨了人类大脑中的默认模式网络（DMN）及其与自我意识的联系。讲者指出，与动物不同，人类可以通过DMN进行自我反思，这种能力使人们能够从元认知层面思考自己的行为和存在。然而，这种过度活跃的自我反思可能导致抑郁，因为人们会将个人失败归咎于自己，从而感到自责和无望。视频中还提到了像氯胺酮这样的解离性药物，它们通过关闭DMN来治疗抑郁症，提供了一种减轻过度自我意识并快速改善情绪的方法。

Takeaways

• 🧠 自我意识是人类特有的能力，由大脑的默认模式网络（Default Mode Network, DMN）提供。
• 🔄 默认模式网络使我们能够进行自我反思，但过度活跃可能导致抑郁。
• 🚫 抑郁时，DMN的高度活跃可能导致个体对微小事件也有过度的自我指责。
• 🤔 抑郁个体可能会有自我贬低的想法，如认为自己是家庭的负担。
• 💊 某些药物，如氯胺酮（Ketamine），可以通过关闭DMN来迅速缓解抑郁症状。
• ⚠️ 氯胺酮是受控药物，不推荐非法或非医疗指导下使用。
• 🌌 氯胺酮等药物通过产生解离效果，帮助个体从自我反思中抽离出来。
• 🧪 目前还有对其他物质如裸盖菇素（Psilocybin）和MDMA的研究，它们也可能影响DMN。
• 📉 这些药物通过打破自我感知，减少过度的自我意识，可能对抑郁症有帮助。
• 🏥 药物使用应在医生指导下进行，以避免潜在的副作用和风险。
• 📚 有关DMN的科学研究支持了上述观点，如Marcus E. Raichle的研究。
• 🤷‍♂️ 高度的自我意识可能是问题的一部分，因为它可能导致个体在社交场合过度关注自己。

Q & A

什么是默认模式网络（Default Mode Network，DMN）？

默认模式网络是大脑的一部分，它赋予我们自我意识的能力。它是负责自我反思的脑区，使人类能够对自己的行为和思想进行内省。

为什么人类与动物相比拥有更高度的自我意识？

人类与动物相比，最大的区别之一就是人类拥有更为发达的默认模式网络，这使得人类能够进行自我反思，而动物则不会对自己的行为进行深入的思考。

当一个人被拒绝时，他们的默认模式网络会怎样活动？

当一个人被拒绝，尤其是多次被拒绝时，他们的默认模式网络会变得更加活跃，开始产生关于自我的负面思考，可能导致自我评价降低。

抑郁症患者与默认模式网络有什么关系？

研究发现，抑郁症患者的默认模式网络往往过度活跃，这可能导致他们持续地进行自我反思，从而加剧了抑郁的症状。

什么是自我反思的元认知问题？

自我反思的元认知问题是指个体在面对挑战或失败时，大脑的默认模式网络高度活跃，导致个体不断地在更高层次上审视自己，可能会错误地将小问题个人化，从而产生无端的自责。

为什么一些精神活性药物如氯胺酮（Ketamine）可以用于治疗抑郁症？

氯胺酮作为一种解离性药物，能够暂时关闭默认模式网络，减少个体的自我意识，从而快速缓解抑郁症状。但这种使用应在专业医疗监督下进行，以避免滥用和副作用。

除了氯胺酮，还有哪些物质可能影响默认模式网络？

除了氯胺酮，其他一些精神活性物质，如裸盖菇素（Psilocybin）和 MDMA，也在研究中被认为可以影响默认模式网络，通过改变个体的自我感知来治疗抑郁症。

为什么在治疗抑郁症时使用这些精神活性物质需要谨慎？

这些物质虽然在治疗上可能有快速效果，但它们也是已知的滥用物质，可能带来危险的副作用。因此，它们应在专业医生的指导下使用，并且需要有适当的剂量控制和监督。

自我意识过度活跃与抑郁症之间的关系是什么？

自我意识过度活跃，即默认模式网络的高活跃状态，会导致个体持续地进行自我反思，这可能会使个体在面对失败或挑战时产生更多的负面情绪，从而加剧抑郁症状。

如何理解在社交场合中默认模式网络的活跃对个体的影响？

在社交场合中，如果默认模式网络过于活跃，个体可能会过度关注自己的表现和他人对自己的看法，从而忽略了与他人的互动，这可能会导致社交焦虑和不适。

为什么说自我意识可能是抑郁症患者的问题之一？

因为高度的自我意识可能导致个体在面对日常生活中的挫折时，更容易陷入自我批评和负面思考，这种过度的自我反思可能会加剧抑郁症状，使个体难以摆脱抑郁情绪。

Outlines

00:00

🧠 自我意识与默认模式网络

第一段主要讨论了自我意识与默认模式网络（Default Mode Network, DMN）之间的关系。默认模式网络是大脑中负责自我意识和自我反思的部分，它是人类与其他动物的主要区别之一。人类的自我反思能力可能导致自我批评和抑郁情绪。当人们抑郁时，他们的默认模式网络异常活跃，导致过度的自我关注和负面思维。此外，还提到了某些药物如氯胺酮（ketamine）能够通过抑制默认模式网络来快速缓解抑郁症状，但同时强调了不应滥用这些药物，而应在医生指导下使用。

05:02

💊 抗抑郁药物的作用机制

第二段深入探讨了抗抑郁药物的作用机制，特别是氯胺酮如何通过关闭默认模式网络来迅速减轻抑郁症状。与SSRIs等传统的抗抑郁药物相比，氯胺酮的效果可以在短时间内显现，但同时也强调了其潜在的滥用风险和副作用。此外，还提到了其他一些正在试验阶段的物质，如psilocybin和MDMA，它们也能够通过改变个体的自我感知来影响默认模式网络，从而可能对抑郁症有所帮助。然而，这些物质也可能带来创伤和危险，因此不建议未经医疗指导自行使用。

Keywords

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Highlights

自我意识是人类与动物之间最大的区别之一，由大脑的默认模式网络（Default Mode Network, DMN）提供。

人类的自我反思能力是由DMN实现的，它允许我们对自己的行为和自我感觉进行反思。

当DMN过度活跃时，可能会导致抑郁，因为个体会开始对自己产生负面思考。

抑郁患者的DMN通常比正常人活跃，这会导致自我批评和自我责备的思维模式。

Ketamine作为一种治疗手段，能够迅速减轻抑郁症状，因为它能够关闭DMN。

Ketamine通过造成个体与自身的分离，从而减少自我意识的过度集中。

Ketamine治疗应在医生指导下进行，不推荐私自使用。

除了Ketamine，其他一些致幻物质如psilocybin和MDMA也在试验中，它们同样能够影响DMN。

这些致幻物质通过改变个体的自我感知，减少对自身的过度关注，从而可能对抑郁有治疗效果。

自我意识过高是抑郁的一个关键问题，通过减少这种过度的自我关注可以改善症状。

过度的自我意识会导致个体在社交场合过度关注自己，而不是他人。

当个体的自我意识降低，他们不再过度关注自己时，抑郁的症状可以得到缓解。

自我意识的降低可以减少个体在社交场合的焦虑感。

某些物质通过破坏个体的自我感知，可以减少抑郁和焦虑的症状。

虽然某些物质可以治疗抑郁，但它们也可能带来创伤和危险，如可能导致PTSD。

对于抑郁的治疗，重要的是找到平衡自我意识和减少其过度活动的方法。

神经科学研究表明，通过特定的物质干预DMN可以治疗抑郁。

Marcus E. Raichle的研究提供了关于DMN和自我意识的科学依据。

Transcripts

you gotta save them for oh dude okay so

this is actually i'm glad because i

almost

i almost posted in response to this

okay so this person is actually

brilliant because it is actually there's

good scientific evidence that this is

part of the problem so every mental

health professional i've ever talked to

has been like

you have a lot of self-awareness men and

i'm like yes i actually think that is

part of the problem

absolutely true so this is can i can i

just

harvard andy for here for a second yeah

that's the point

yeah okay so we have this part of our

brain called the default mode network

okay and the default mode network is the

part of our brain that gives us the

capacity

for self-awareness so if we look at like

animals and humans the biggest

difference between

animals and humans most and animals and

humans anyway is the

is the default mode network so like

animals you know like let's say like you

take a deer or something like a deer

will go about its day and then it won't

think about itself going about its day

but human beings have this capacity of

self-reflection

and so um that capacity for

self-reflection

is this thing called the default mode

network so what i can do

is you know look at my like look at the

actions that i take

and kind of reflect on

my sense of self within these actions um

let me just think about how to explain

that better so

you know if i ask like if a deer looks

around for food in 10 places

and doesn't find food the deer doesn't

start to feel

like an idiot because it hasn't been

able to find food and it's like over 10.

but if we think about human beings if i

you know ask ten girls out

and then they say no like as a human

being i start to think

about myself in that way and then i say

oh my god i'm such an idiot

so human beings have this this and if

you really think about it it's actually

like quite

profound and it's an amazing capability

that our brain has

where we can do like meta-level thinking

about ourselves as we move about in the

world

that is done by the default mode network

so it's essentially our capacity for

self-awareness

now the interesting thing is that once

we have the default mode network

we also evolutionarily speaking by

ourselves

the possibility of depression and what

we

find is that people who are depressed

have overly active default mode networks

okay so let's think about this for a

second okay so like

i asked 10 girls well as two girls out

default mode network is not active

it's just they said no okay both of them

said they had boyfriends no big deal i'm

not

thinking about myself in that way i

asked 10 girls out they all say no

now this default mode network activates

and it's like hey man like maybe

you're ugly or something like that right

it starts like thinking negative

thoughts about you

and it's sort of this meta-level

problem-solving thing where it's like

looking at you as a person and saying

can we change something about ourselves

to increase our overall chances of

success

okay so that's what the

default mode network does now when

someone gets depressed

their default mode network is highly

active

okay and then what happens is when i ask

two girls out but my

default note mode network is highly

active from depression

then i start thinking those meta

thoughts about how i'm the problem

in this big situation except now the

situation is tiny

and when the default mode network is

hyperactive even tiny little things that

really shouldn't be my fault

become like my fault because this

circuit in my brain

that's like being self-reflective is

always on so then you get to these weird

thoughts that depressed people have

like oh my family would be better off

without me and it's just like such a

weird thought but what you really see is

that

this is a situation where you know their

mind

is viewing like a meta problem with

themselves in things that are completely

unrelated

oh like these people are gonna fire me

because i'm a waste of space and like

all the time you're thinking about

yourself thinking about yourself

thinking about yourself

which is literally your capacity for

self-reflection exactly like this guy is

saying

okay so it's like what he's saying he's

like yes your self-awareness is part of

the problem

your mind's being stuck at always

looking at yourself

instead of taking a step back is

actually correlated neuroscientifically

with depression

this person is a hundred percent correct

so

other evidence kind of weird right so

now we have these things like

novel treatments for depression like

ketamine so ketamine is an example

of don't recommend you use ketamine is a

substance of abuse

that can also be used in a licensed and

prescribed way to treat depression

and what ketamine is is it deep it's

like a dissociative agent right so what

it does is it causes you to like

separate from yourself

and so what ketamine does so ketamine is

one of the quickest acting

treatments for depression so if someone

is in a depressive episode and they get

administered ketamine

they can improve within like hours

whereas most things like ssris or

antidepressant medication

will take weeks right so i really do not

recommend that people use ketamine

recreationally because when you use it

as a treatment there's a purity

guarantee there's also an administration

issue because it is a drug of abuse

it's administered with like a nurse

nearby because there can be dangerous

side effects so don't recreationally use

ketamine

or don't even like you know get it

prescribed like use it under the

guidance of a physician

but the key thing here is the

neuroscience of it okay so what does

ketamine do in the brain

so what it does is shut off the default

mode network

so in that dissociation where i stop

getting stuck in myself it actually

shuts off the default mode network

and so some of these other substances

which are you know they're trials now

for things like psilocybin and

mdma and stuff all of those like

hallucinogen substances that cause

people to have this like cosmic

sense of connection it separates you

from this kind of thinking

which is like instead of your high

self-awareness being focused on you

all the time now suddenly like with

these substances your mind is able to

like

pull back from that and you actually

shut off the default mode network

okay so this is actually brilliant it's

a wonderful observation

yes okay so the brain's default mode

network people sometimes want references

right so here's a good

i guess this is written by marcus e

rachley

okay two hours later

does that make sense chad i don't know

if i

you're failing this class for sure

i'm lost okay so

basically this is what the paper says we

normally have an intact sense of self

okay this intact sense of self and our

high awareness of ourselves we're always

looking at ourselves like

like an active default mode network

means that when i'm at a party

instead of paying attention to other

people my mind is constantly occupied by

thinking about myself oh i look stupid

i sound stupid people aren't talking to

me

people are talking to other the focus

of your mind is on i you are the object

of your attention

okay like anxiety yes

then what happens so so when this person

says

like this person on on loretta's says

you know i actually think that

self-awareness is the problem they're

absolutely right because their

self-awareness is a high

level i mean is is their default mode

network being highly active

then we can look at neuroscience papers

and what we discover

is that substances like psilocybin

fracture our sense of self and that can

be traumatic and dangerous by the way

and leave people with ptsd which is why

i don't recommend you do it

fracture the sense of self but when when

you stop when that sense of self gets

fractured you're no longer

stuck thinking about yourself and when

you're no longer stuck

thinking about yourself this problem of

over self-awareness goes away and people

get better

in terms of depression does that make

sense