ADHD & How Anyone Can Improve Their Focus | Huberman Lab Essentials
发布时间 2025-07-31 12:00:38 来源
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In this Huberman Lab Essentials episode, I explore the biology and psychology of attention-deficit/hyperactivity disorder (ADHD), ...
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Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health, and performance. I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today we are going to talk all about attention deficit hyperactivity disorder or ADHD. Now just a quick reminder that anytime we discuss a psychiatric disorder, it's important that we remember that all of us have the temptation to self-diagnose or to diagnose others. The clear and real diagnosis of ADHD really should be carried out by a psychiatrist, a physician, or a very well-trained clinical psychologist.
欢迎来到Huberman实验室精华栏目。在这里，我们回顾过去的节目，提炼出对心理健康、身体健康和表现最有效且可操作的科学工具。我是Andrew Huberman，斯坦福大学医学院神经生物学和眼科学的教授。今天我们要谈论的是注意力缺陷多动障碍，简称ADHD。这里我想快速提醒一下，每当我们讨论一种精神障碍时，重要的是要记住，我们所有人都有自我诊断或为他人诊断的倾向。ADHD明确且真实的诊断应该由精神科医生、医生或经过良好培训的临床心理学家来进行。
Right now the current estimates are that about one in ten children and probably more have ADHD. Now fortunately about half of those will resolve with proper treatment, but the other half typically don't. The other thing that we are seeing a lot nowadays is increased levels of ADHD in adults. For sake of today's discussion, attention, focus, and concentration are essentially the same thing. So people with ADHD have trouble holding their attention. What is attention? Well attention is perception. It's how we are perceiving the sensory world.
目前的估计是，大约十分之一的儿童可能患有多动症（ADHD），甚至可能更多。幸运的是，其中大约一半在接受适当治疗后可以得到缓解，但另一半通常不会好转。我们现在还观察到成人中多动症的发病率也在增加。在今天的讨论中，注意力、专注力和集中力可以看作同一个概念。因此，多动症患者难以保持注意力。那么，什么是注意力呢？注意力就是感知力，是我们感知周围感官世界的方式。
For instance right now you are hearing sound waves, you are seeing things, you are sensing things against your skin, but you are only paying attention to some of those. And the ones that you are paying attention to are your perceptions. So if you hear my voice, you are perceiving my voice. You are not paying attention to your other senses at the moment. You might even be outside in a breeze and until I said that, you might not be perceiving that breeze, but your body was sensing it all along. So attention and focus are more or less the same thing, but impulse control is something separate. Because impulse control requires pushing out or putting the blinders on to sensory events in our environment.
例如，现在你正在听声音，你看到东西，你感受到皮肤上的触觉，但你只注意到其中的一部分。而你注意到的部分就是你的感知。所以，如果你听到我的声音，你就是在感知声音。此刻你没有关注其他感觉。你可能正在室外感受微风，但直到我提到时，你才意识到微风的存在，但你的身体一直在感受它。因此，注意力和专注力大致相同，而冲动控制则是另一回事。因为冲动控制需要我们屏蔽或忽略周围环境中的感官刺激。
It means lack of perception. Impulse control is about limiting our perception. People with ADHD have poor attention and they have high levels of impulsivity. Yes, they are distractable. Yes, they are impulsive. Yes, they are easily annoyed by things happening in the room. They sometimes have a high level of emotionality as well. However, people with ADHD can have a hyper focus and incredible ability to focus on things that they really enjoy or are intrigued by. Now this is a very important point because people with ADHD have the capacity to attend, but they can't engage that attention for things that they don't really, really want to do.
这句话的意思是缺乏感知。冲动控制是关于限制我们的感知。注意力缺陷多动障碍（ADHD）患者注意力差，而且冲动性强。是的，他们容易分心，是的，他们很冲动，是的，他们容易被房间内发生的事情激怒。他们有时也会表现出高度的情绪化。然而，ADHD患者也可能对他们真正喜欢或感兴趣的事情表现出超强的专注力。这是一个非常重要的点，因为ADHD患者有能力集中注意力，但他们无法将这种注意力用于他们不太想做的事情。
There are a couple of other things that people with ADHD display quite often. One is challenges with time perception. People with ADHD often run late. They often procrastinate. But what's interesting and surprising is that if they are given a deadline, they actually can perceive time very well. And they often can focus very well if the consequences of not completing a task or not attending are severe enough. If they are not really concerned about a deadline or consequence, well then they tend to lose track of time and they tend to underestimate how long things will take.
患有注意力缺陷多动障碍（ADHD）的人往往会表现出一些其他特征。其中一个是对时间感知的挑战。他们常常迟到，也常常拖延。但有趣且令人惊讶的是，如果给他们一个最后期限，他们其实能很好地感知时间。如果任务不完成或不出席的后果足够严重，他们通常能很好地集中注意力。但如果他们对最后期限或后果不是很在意，他们往往会失去时间感，低估事情所需的时间。
The other thing that people with ADHD have real trouble with is so called working memory. Now you might think that people with ADHD would have really poor memories, but in fact that's not the case. People with ADHD often can have a terrific memory for past events that can remember upcoming events quite well. Their memory is clearly working. However, one aspect of memory in particular that we call working memory is often disrupted. Working memory is the ability to keep specific information online to recycle it in your brain over and over again so that you can use it in the immediate or short term.
患有注意力缺陷多动障碍（ADHD）的人在所谓的工作记忆方面常常遇到困难。你可能会认为有ADHD的人记忆力很差，但实际上并非如此。ADHD患者往往对于过去的事件有出色的记忆，而且能很好地记住即将发生的事情。他们的记忆显然可以正常运作。然而，记忆的一个特定方面，即我们所说的工作记忆，常常会受到干扰。工作记忆是指能够在短期内不断在大脑中重复和使用特定信息的能力。
A good example of this would be you meet somebody, they tell you their name, they give you their phone number verbally, and you have to walk back to your phone and enter it into your phone. People without ADHD might have to put some effort into it. It might feel like a bit of a struggle, but typically they would be able to recite that phone number in their mind over and over and then put it into their phone. People with ADHD tend to lose the ability or lack the ability to remember things that they just need to keep online for anywhere from 10 seconds to a minute or two.
一个很好的例子是，当你遇到一个人，他们告诉你他们的名字，并口头给了你他们的电话号码，你需要走回到你的手机旁，把电话号码输入进去。没有注意力缺陷多动症（ADHD）的人可能需要花一些精力去做这件事，虽然可能会觉得有点困难，但通常他们能够在心里反复默念电话号码，然后把它输入手机。而有注意力缺陷多动症的人通常会失去或缺乏记住这些只能在线保持10秒到一两分钟的信息的能力。
Okay, so we've more or less established the kind of menu of items that people with ADHD tend to have some have all of them, some have just a subset of them. Their severity can range from very intense to mild, but in general it's challenges with attention and focus, challenges with impulse control, they get annoyed easily, they have kind of an impulsivity, they can't stay on task. Time perception can be off and they have a hard time with anything that's mundane that they're not really interested in. But again, I just want to highlight that people with ADHD are able to obtain heightened levels of focus, even hyper focus for things that are exciting to them and that they really want to engage in.
好的，我们已经大致确定了多动症（ADHD）患者常见的一些特征。有些人全部都有，有些人则只有其中的一部分。这些特征的严重程度可能从非常强烈到轻微不等。一般来说，他们在注意力和专注力方面会面临挑战，难以控制冲动，容易感到烦躁，无法持续专注于任务。他们的时间感知可能不准，对于不太有兴趣的事情很难投入。不过，我想再次强调的是，ADHD患者在面对他们感兴趣或令人兴奋的事物时，仍然能够表现出超常的专注，甚至是高度专注。
So let's drill into this issue of why people with ADHD actually can focus very intensely on things that they enjoy and are curious about. Now, enjoyment and curiosity, they're just the way that we describe our human experience of liking things, wanting to know more about them. But from a neurobiological perspective, they have a very clear identity and signature and that's dopamine. Dopamine is released from neurons, it's what we call a neuromodulator and in particular dopamine creates a heightened state of focus. It tends to contract our visual world and it tends to make us pay attention to things that are outside and beyond the confines of our skin.
让我们深入探讨一下为什么有注意力缺陷多动障碍（ADHD）的人能够非常专注于他们感兴趣和喜欢的事物。享受和好奇心是我们用来描述我们喜欢某些事物并想了解更多的方式。然而，从神经生物学的角度来看，这些感受与多巴胺密切相关。多巴胺是神经元释放的一种神经调节物质，特别是它能够创造一个高度集中的状态。多巴胺会让我们更加关注超出自身皮肤范围的事物，并收缩我们的视觉世界，使我们更加专注于外界。
That's what we call exteroception. So as I mentioned earlier, you have all these senses coming in and you can only perceive some of them because you're only paying attention to some of them. Dopamine, when it's released in our brain, tends to turn on areas of our brain that narrow our visual focus and our auditory focus. So it creates a cone of auditory attention that's very narrow creates a tunnel of visual attention that's very narrow. Whereas when we have less dopamine, we tend to view the entire world. We tend to see the whole scene that we are in. We tend to hear everything all at once.
这就是我们所说的外感知。如我之前提到的，你有很多感官输入，但你只能感知到其中的一部分，因为你只专注于其中一些。当多巴胺在我们的脑中释放时，它会激活大脑的一些区域，使我们的视觉和听觉焦点变得更窄。这样，它就会形成一个很窄的听觉注意范围和一个很窄的视觉注意隧道。而当我们体内的多巴胺较少时，我们则倾向于看到整个世界，能看到整个场景，并倾向于一次性听到所有声音。
So as I describe this, hopefully you're already starting to see and understand how having dopamine release can allow a person, whether or not they have ADHD or not, to direct their attention to particular things in their environment. So now what we're doing is we're moving away from attention as this vague ambiguous term and we're giving it a neurochemical identity, dopamine. And we are giving it a neural circuit identity and just to put a little bit of flavor and detail on which neural circuits those are, I wanted to discuss two general types of neural circuits that dopamine tends to enhance.
所以当我描述这一点时，希望你能开始看到并理解，释放多巴胺如何帮助一个人，无论他们是否有注意力缺陷多动障碍（ADHD），将注意力集中在环境中的特定事物上。因此，我们现在不再将注意力视为一个模糊的概念，而是为其赋予了一种神经化学身份——多巴胺。与此同时，我们也在为其赋予一个神经回路的身份。为了更具体地说明哪些神经回路受到多巴胺的增强，我想讨论两种大致类型的神经回路。
The first one is called the default mode network. The default mode network is the network of brain areas in your brain and my brain and in everybody's brain. That is active when we're not doing anything when we're just sitting there idle at rest. The other set of circuits that we're going to think about and talk about with respect to ADHD are the task networks, the networks of the brain that make you goal oriented. And those are a completely different set of brain areas. However, the default mode network and these task networks are communicating with one another and they're doing that in very interesting ways.
第一个被称为默认模式网络。默认模式网络是存在于你我和所有人脑中的一组大脑区域。在我们什么都不做、只是静坐休息时，它是活跃的。我们将要讨论的与多动症（ADHD）有关的另一组电路是任务网络，这是促进我们以目标为导向的大脑网络。这些是完全不同的一组大脑区域。然而，默认模式网络和这些任务网络会彼此通信，而且它们以非常有趣的方式进行交流。
Frontal cortex, no surprises in the front and you have a dorsal top and side lateral part, dorsal lateral prefrontal cortex. And then you have a brain area called the posterior singulate cortex. And then you have an area called the lateral pride alope. Again, you don't need to remember these names. These are three brain areas that normally are synchronized in their activity. So when one of these areas is active in a typical person, the other areas would be active as well.
额，没有什么意外——在大脑的正面有额叶皮层（frontal cortex），然后在顶部有背侧部分和侧面有侧面部分，即背侧前额叶皮层（dorsal lateral prefrontal cortex）。接着，还有一个叫做后扣带皮层（posterior cingulate cortex）的脑区。再有一个区域叫做侧向顶叶（lateral parietal lobe）。不过，你不需要记住这些名字。正常情况下，这三个脑区的活动是同步的。也就是说，当其中一个区域在一个典型的人身上活跃时，其他区域也会活跃。
And in a person with ADHD or even a person who has subclinical ADHD or in any human being who hasn't slept well, what you find is the default mode network is not synchronized. These brain areas are just not playing well together. Now the task networks include a different set of structures. It still involves the prefrontal cortex, but it's a different part of the prefrontal cortex. Okay, tends to be the medial prefrontal cortex. And there are some other brain areas that the medial prefrontal cortex is communicating to all the time mainly to suppress impulses.
在患有多动症（ADHD）或即使是具有亚临床多动症特征的人，或者任何一个没有休息好的人身上，你会发现大脑的默认模式网络是不同步的。这些大脑区域之间的配合不是很理想。相对于默认模式网络，任务网络则包括了一组不同的结构。虽然它仍然涉及到前额叶皮层，但却是前额叶皮层的另一个部分，通常是指内侧前额叶皮层。内侧前额叶皮层一直在与其他一些大脑区域进行沟通，主要作用是抑制冲动行为。
Anytime you're restricting your behavior, these task directed networks are very active. Okay. Now normally in a person without ADHD, the task networks and the default mode networks are going in kind of seesaw fashion. They are actually what we call anti correlated in a person with ADHD. They actually tend to be more correlated. The default mode networks and the task networks are actually more coordinated. And we can now confidently say based on brain imaging studies that when somebody gets better when they're treated for ADHD or when they age out of ADHD as sometimes is the case that the default mode networks and the task networks tend to become anti correlated again.
只要你在约束自己的行为，这些任务导向型的网络就会非常活跃。在没有多动症（ADHD）的人中，任务网络和默认模式网络通常呈现某种“跷跷板”模式的互动。它们实际上是反相关的。而在有多动症的人身上，这两种网络往往更加相关和协调。根据脑成像研究，我们现在可以自信地说，当人们通过治疗多动症而好转或者随着年龄增长多动症的症状减轻时，默认模式网络和任务网络往往会再次变得反相关。
What dopamine is doing in this context is dopamine is acting like a conductor dopamine is saying this circuit should be active than that circuit should be active. It should be default mode network. And then when the default mode network is not active, then it should be the task network. And in ADHD, there's something about the dopamine system that is not allowing it to conduct these networks and make sure that they stay what you know the engineers are physicists or mathematicians would say out of phase to be anti correlated.
在这个背景下，多巴胺扮演着指挥的角色，多巴胺负责指挥：现在应该激活这个神经回路，然后激活那个神经回路。默认模式网络应该启动，然后当默认模式网络不活跃时，就该启动任务网络了。而在注意力缺陷多动障碍（ADHD）中，多巴胺系统却出现了一些问题，无法有效指挥这些网络，无法确保它们保持工程师、物理学家或数学家所说的“相位差”，即“反相关”状态。
So what exactly is going on with the dopamine system in people with ADHD and what's going on with the dopamine system in people that have terrific levels of attention for any task. Well, in the year 2015, an important paper came out and it formalized this so called low dopamine hypothesis of ADHD. It turns out that if dopamine levels are too low in particular circuits in the brain, that it leads to unnecessary firing of neurons in the brain that are unrelated to the task that one is trying to do and that is unrelated to the information that one is trying to focus on.
那么，究竟多动症患者的多巴胺系统发生了什么，而那些在任何任务中都能保持极佳注意力的人又是怎样的呢？2015年有一篇重要的论文正式提出了多动症的低多巴胺假说。研究发现，如果大脑中特定回路的多巴胺水平过低，会导致大脑中某些与当前任务无关的神经元不必要地发出信号，这妨碍人们专注于他们试图完成的任务和信息。
So if you think back before you've got this default mode network and a task related network and they need to be in this kind of concert of anti correlation and in ADHD, they're firing together. Well, the problem seems to be that when dopamine is low, neurons fire more than they should in these networks that govern attention. This is the so called low dopamine hypothesis. And if you start looking anecdotally at what people with ADHD have done for decades, what you find is that they tend to use recreational drugs or they tend to indulge in non drug stimulants.
所以，如果你回想一下，当你有默认模式网络和任务相关网络时，它们需要以相反的方式协同工作。而在多动症（ADHD）中，它们同时活动。问题似乎在于，当多巴胺水平较低时，这些控制注意力的网络中的神经元活动比应有的频繁。这就是所谓的低多巴胺假说。如果你非正式地观察几十年来患有多动症的人，你会发现他们往往会使用娱乐性药物或者沉迷于非药物的刺激物。
So things like smoking a half a pack of cigarettes and drinking four cups of coffee a day or if the person had access to it using cocaine as a recreational drug or an amphetamine as a recreational drug. All of those substances that I just described in particular cocaine and amphetamine, but also coffee and cigarettes, increased levels of multiple neurotransmitters, but all have the quality of increasing levels of dopamine in the brain and in particular in the region of the brain.
像每天抽半包香烟、喝四杯咖啡，或者如果有条件的话，将可卡因或安非他明用作娱乐性毒品。所有我刚提到的这些物质，尤其是可卡因和安非他明，还有咖啡和香烟，都会增加多种神经递质的水平，但它们都有一个共同点，就是提高大脑中多巴胺的水平，特别是大脑的某个区域。
In the regions of the brain that regulate attention and these task related and default mode networks now young children, fortunately don't have access to those kinds of stimulants most of the time, but if you look at children, even very young children with ADHD, they show things like preference for sugary foods, which also act as dopamine inducing stimulants. For a long time, it was thought that children with ADHD consume too many sugary foods or drank too much soda or adults with ADHD would take recreational drugs like methamphetamine or cocaine or would drink coffee to access or smoke cigarettes to access because they had poor levels of attention and because they couldn't make good decisions, they were too impulsive and so forth.
在大脑中负责注意力调节的区域，以及与任务相关的网络和默认模式网络中，年轻儿童大多数时间没有接触那些类型的刺激物。然而，如果你观察患有注意力缺陷多动障碍（ADHD）的儿童，甚至是非常年轻的儿童，他们会表现出对甜食的偏好，因为甜食也能诱发多巴胺的产生。长期以来，人们认为患有ADHD的儿童摄入过多的甜食或碳酸饮料，或者患有ADHD的成年人会使用像甲基苯丙胺或可卡因这样的娱乐性药物，或者喝咖啡、吸烟来刺激注意力。这是因为他们的注意力水平较低，不能做出良好的决策，容易冲动等等。
Knowing what we now know about dopamine and the fact that having enough dopamine is required in order to coordinate these neural circuits that allow for focus and quality decision making, an equally valid idea is that these children and these adults are actually trying to self-medicate by pursuing these compounds. Things like cocaine lead to huge increases in dopamine. Well, what happens when somebody with ADHD takes that drug? It turns out they actually obtain heightened levels of focus. Their ability to focus on things other than things they absolutely care intensely about goes up. Likewise, children who consume anything that increases their levels of dopamine.
根据我们现在对多巴胺的了解，以及拥有足够的多巴胺能够协调神经回路从而促进专注和优质决策的事实，一种同样合理的观点是，这些儿童和成人实际上是在通过追求这些化合物来自我疗愈。像可卡因这样的物质可以导致多巴胺大幅增加。那么，如果一个有注意力缺陷多动症（ADHD）的人服用了这些药物，会发生什么呢？结果表明，他们的专注力实际上得到了提高。他们除了对极为关心的事情以外，还能够更好地集中注意力。 同样，那些可以增加多巴胺水平的物质也对儿童有类似的影响。
If those children have ADHD, they tend to be calmer. They tend to be able to focus more. So dopamine and low levels of dopamine apparently are what's wrong in people with ADHD. That dopamine hypothesis is what led to the idea that treating people, children and adults included with dopamine-nergic compounds would somehow increase their ability to focus. And if you look at the major drugs that were developed and now marketed by pharmaceutical companies for the treatment of ADHD, those drugs have names like Ritalin.
如果那些孩子患有多动症（ADHD），他们往往会显得更平静，也更容易集中注意力。研究表明，这可能是由于多动症患者的多巴胺水平较低。多动症的这种多巴胺假说导致人们产生了一个想法，即通过使用影响多巴胺的化合物来治疗包括孩子和成年人在内的患者，可以提高他们的注意力。如果你看一下制药公司研发并销售用于治疗多动症的主要药物，这些药物的名字包括利他林等。
Nowadays, it's typically things like Adderall, Modaphanil and some of the other derivatives. They all serve to increase levels of dopamine in particular dopamine in the networks that control task directed behavior and that coordinate the default mode network. And these task-related networks. Let's take a step back for a second and just ask, what are these drugs? We know they increased dopamine, but what are they really? Well, Ritalin, also called methylphenidate, is very similar to amphetamine, speed, or what's typically called speed in the street drug nomenclature.
如今，一般会提到像是「阿得拉」「莫达非尼」以及其他一些衍生药物。这些药物主要用于增加大脑中多巴胺的水平，特别是那些控制任务导向行为和协调默认模式网络的多巴胺网络。我们先退一步，问问看这些药物到底是什么？我们知道它们能增加多巴胺，但是它们究竟是什么呢？比如说，「利他林」，也叫「哌甲酯」，与安非他命（在街头毒品中通常称为“速度”）非常相似。
Adderall is basically a combination of amphetamine and dextro amphetamine. Now, some of you probably realize this that Adderall is amphetamine, but I'm guessing that there are a good number of you out there, perhaps even parents and kids that don't realize that these drugs like cocaine and amphetamine, methamphetamine, which are incredibly dangerous and incredibly habit-forming and have high potential for abuse. Well, the pharmaceutical versions of those are exactly what are used to treat ADHD. Now, they're not exactly like cocaine and amphetamine, but they are structurally and chemically very similar.
Adderall 基本上是一种由安非他命和右旋安非他命组成的药物。可能有些人已经知道这一点，就是 Adderall 其实就是安非他命，但我猜还有很多人，可能包括一些家长和孩子，并不清楚这一点。像可卡因、安非他命和甲基安非他命这些药物极其危险且容易上瘾，具有很高的滥用风险。而治疗多动症（ADHD）所使用的药物正是这些药物的药品版本。虽然它们并不完全等同于可卡因和安非他命，但在结构和化学成分上非常相似。
And their net effect in the brain and body is essentially the same, which is to increase dopamine, primarily, but also to increase levels of a neuromodulator called epinephrine or nor epinephrine, also called noradrenaline and adrenaline, those names are the same. So what I'm essentially saying is that the drugs that are used to treat ADHD are stimulants, and they look very much like, in fact, nearly identical to some of the so-called street drug stimulants that we all hear are so terrible. However, I do want to emphasize that at the appropriate dosages and working with a quality psychiatrist or neurologist or family physician does have to be a board certified MD that prescribes these things.
在大脑和身体中，它们的净效果基本相同，主要是增加多巴胺的水平，同时也会提高一种叫做肾上腺素或去甲肾上腺素（这两个名字是同一个东西）的神经调节物的水平。也就是说，用来治疗多动症的药物实际上是兴奋剂，它们在结构上与一些被称为“街头毒品”的兴奋剂非常相似，几乎是一样的。然而，我想强调的是，这些药物在合适的剂量下，并在经过认证的精神科医生、神经科医生或家庭医生的指导下使用，才能确保安全和效果。
Many people with ADHD achieve excellent relief with these drugs, not all of them, but many of them do, especially if these treatments are started early in life. So now knowing what these drugs are, I want to raise the question of why prescribe these drugs. Children have a brain that's very plastic, meaning it can remodel itself and change in response to experience very, very quickly compared to adults. Taking stimulants as a child, if you are a child diagnosed with ADHD, allows that forebrain task-related network to come online, to be active at the appropriate times.
许多患有多动症（ADHD）的人通过这些药物获得了显著的改善，并不是所有人都有效，但很多人确实受益，尤其是在生命早期就开始这些治疗的人。因此，在了解这些药物是什么之后，我想提出一个问题：为什么要开这些药物？儿童的大脑具有很强的可塑性，也就是说，与成年人相比，儿童的大脑能够快速地根据经验自我重塑和变化。如果你是一个被诊断为多动症的儿童，服用兴奋剂可以使前脑与任务相关的网络在适当的时候激活和运作。
And because those children are young, it allows those children to learn what focus is and to sort of follow or enter that tunnel of focus. Now, by taking a drug, it's creating focus artificially. It's not creating focus because they're super interested in something. It's chemically inducing a state of focus. And let's face it, a lot of childhood and school and becoming a functional adult is about learning how to focus even though you don't want to do something. So what are we to make of this whole picture that we need more dopamine, but these kids with ADHD, they're getting their dopamine by way of a drug which is for all the world and fetamines. What are the long term consequences? Where are the short term consequences?
因为这些孩子还小，这让他们有机会学习什么是专注，并能够进入那种专注的状态。通过服用药物，他们是通过化学手段人为地制造专注，并不是因为他们对某件事特别感兴趣而专注。说实话，童年、上学以及成长为一个能正常运作的成人，很大程度上就是学习如何在不想做某事时，依然能够专注。那么，在这样一个需要更多多巴胺的大背景下，患有多动症的孩子通过服用类似安非他命的药物来获取多巴胺，我们应该怎么看待这个现象呢？长期的影响是什么？短期的影响又是什么？
Well, in order to get to some of those answers, I went to one of my colleagues, a pediatric neurologist that specializes in the treatment of epilepsy and ADHD in kids of all ages from age three to 21. I asked the following questions. First of all, I asked, what do you think about giving young kids and fetamine provided that the lowest possible doses used and that that dosage is modulated as they grow older and develop those powers of attention. Their observation was that they've seen more kids benefit than not benefit from that.
为了得到一些答案，我去找了一位同事，他是一位专门治疗儿童癫痫和注意力缺陷多动障碍（ADHD）的儿科神经科医生，治疗对象是从三岁到二十一岁不等的各年龄段孩子。我向他提出了几个问题。首先，我问他对给予幼儿安非他命的看法，前提是使用最低剂量，并随着孩子的成长和专注能力的发展来调整剂量。他的观察是，比起没有受益的孩子，受益的孩子更多。
Now, the fact that this person, this now friend of mine and colleague of mine, has so much expertise in the way that the brain works and is considering putting their child on such medication, I said, you know, why wouldn't you wait until your kid reaches puberty? I mean, we know that in boys and in girls, there are increases in testosterone and estrogen during puberty that dramatically change the way that the body appears, but also that dramatically changed the way that the brain functions in particular.
现在，这个人是我的朋友和同事，他们在大脑运作方面有很深的专业知识，并且考虑给他们的孩子服用这样药物。我就问，为什么不等到孩子进入青春期呢？因为我们知道，男孩和女孩在青春期时，体内的睾酮和雌激素都会增加，这不仅显著改变身体外观，也会显著改变大脑的运作方式。
We know this, that puberty triggers the activation of so-called frontotemporal, task-related executive functioning. That's just fancy science speak for being able to focus, being able to direct your attention, being able to control your impulses. And their answer was very specific and I think very important. What they said was, look, neuroplasticity is greatest in childhood and tapers off after about age 25, but neuroplasticity from age three until age 12 or 13 is exceedingly high.
我们知道，青春期会触发所谓的额颞叶任务相关执行功能的激活。简单来说，这就是指能够集中注意力、能够引导注意力、能够控制冲动。他们的回答非常具体，我认为也非常重要。他们说，大脑的可塑性在儿童期是最大的，之后在大约25岁时开始减弱，但从3岁到12或13岁期间，大脑的可塑性极高。
If you have the opportunity to work with a quality physician and treat these things early, these drugs can allow these frontal circuits, these task-related circuits to achieve their appropriate levels of functioning and for kids to learn how to focus in a variety of different contexts. So we've talked about the neural circuits of focus and the chemistry of focus, but we haven't talked yet about what would make us better at focusing and what focusing better really is.
如果你有机会与优秀的医生合作并及早治疗这些问题，这些药物可以帮助大脑的额叶回路和与任务相关的回路达到适当的功能水平，让孩子们在各种环境下学会如何专注。我们已经讨论过专注的神经回路和专注的化学作用，但还没谈到是什么能让我们更擅长集中注意力，以及真正提高专注力意味着什么。
So let's take a step back and think about how we focus and how to get better at focus. And I'm going to share with you a tool for which there are terrific research data that will allow you in a single session to enhance your ability to focus in theory forever. What we're about to talk about is when attention works and when attention falters and what we are specifically going to talk about are what are called attentional blinks, not actual eye blinks. Attentional blinks are really easy to understand if you think about a where's Waldo task. You know this task where's Waldo where there are a bunch of people and objects and things in a picture and somewhere in there is Waldo with the striped hat and the glasses and skinny dude and you have to find Waldo.
让我们退一步思考一下我们的专注力，以及如何提升专注力。我将与您分享一项工具，基于出色的研究数据，它能够让您在一次练习中，理论上永远提升您的专注能力。我们将讨论的是注意力何时有效、何时失效，特别是所谓的“注意力间隙”，而不是眼睛的眨动。当您想到“找沃尔多”这个任务时，注意力间隙就很容易理解。您知道这个任务吧，在一幅图画里，有很多人和物体，而沃尔多就隐藏在其中，他戴着条纹帽子、眼镜，是个瘦个子，您需要在众多元素中找到沃尔多。
And so it's a visual search and it's visual search for an object that has distinct features but is embedded in this ocean of other things that could easily be confused as Waldo. So you tend to look look look look look look look look look look when you find Waldo or when you search for a target in some other visual search task at that moment your nervous system celebrates a little bit and it celebrates through the release of neurochemicals that make you feel good. You found it and you pause. Now the pause is interesting because when you pause what we know from many experiments is that in that moment of pause and mild celebration however mild you are not able to see another Waldo sitting right next to it.
这是一个视觉搜索的过程，我们要在大量容易与之混淆的物体中寻找一个具有独特特征的目标，比如寻找"沃尔多"。于是，你会不断地寻找，直到找到沃尔多或在其他视觉搜索任务中找到目标时，你的神经系统会稍微庆祝一下。这种庆祝通过释放让你感觉良好的神经化学物质来实现。此时你找到了目标，停下来欣赏。不过，这个停顿很有趣，因为许多实验表明，在这样轻微庆祝和停顿的时刻，你可能看不到就在旁边的另一个沃尔多。
So what this means is in attending to something in searching and in identifying a visual target your attention blinked it shut off for a second if you see something that you're looking for or you're very interested in something you are definitely missing other information. In part because you're over focusing on something and this leads to a very interesting hypothesis about what might go wrong and ADHD where we've always thought that they cannot focus and yet we know they can focus on things they care very much about well maybe just maybe they are experiencing more attentional blinks then people who do not have ADHD.
这段话的意思是，当你正在寻找和识别一个视觉目标时，你的注意力会短暂“关闭”一瞬间（即注意力闪烁）。如果你对某个正在寻找的东西非常感兴趣，实际上你可能会遗漏其他信息。这部分是因为你过度专注于某件事。这引出了一个非常有趣的假设：关于多动症（ADHD）患者的问题。我们一直以为他们无法集中注意力，但我们知道他们能够专注于自己非常感兴趣的事情。或许，他们体验的注意力闪烁比没有多动症的人更多。
And indeed there are data now to support the possibility that that's actually what's happening so what they really need is this property that we call open monitoring first of all your visual system has two modes of processing it can be highly focused a so to straw views however there's also a property of your visual system that allows you to dilate your gaze to be in so called panoramic vision panoramic vision is actually mediated by a separate stream. Or set of neural circuits going from the eye into the brain and it's a stream or set of circuits that isn't just wide angle view it also is better at processing things in time it's frame rate is higher you can use panoramic vision to access the state that we call open monitoring when people do that they are able to attend to and recognize multiple targets so this is something that can be trained up and people can practice whether not they have ADHD.
确实，现在有数据支持这种可能性：这就是实际发生的情况。所以，他们真正需要的是我们称之为“开放监控”的这个特性。首先，你的视觉系统有两种处理模式：一种是高度集中的视野，我们可以称之为“专注模式”。然而，你的视觉系统还有另一种特性，可以让你扩展视野，进入所谓的“全景视野”。全景视野实际上是通过一条不同的神经通路从眼睛传导到大脑的。这条通路不仅为我们提供宽广的视野，还能更好地处理时间上的信息，因为它的“帧率”更高。你可以通过全景视野进入我们所说的“开放监控”状态。当人们这样做时，他们能够关注和识别多个目标。这是一种可以通过训练和练习来提高的技能，无论他们是否患有多动症（ADHD）。
Or not what involves is learning how to dilate your gaze consciously that's actually quite easy for most people you can consciously go into open gaze and then you can contract your field of view as well. That might not seem like a significant or unusual practice or that it would have any impact at all but remarkably just doing that once for 17 minutes significantly reduce the number of attentional blinks that people would carry out in other words their focus got better in a near permanent way without any additional training.
这段话可以翻译成：
或许你并不认为学习如何有意识地扩展视野有多重要，但实际上这对大多数人来说相当简单。你可以有意识地进入宽广的视野模式，然后也能收缩你的视野范围。虽然这看起来好像不是什么特别的练习，或者不起眼，但令人惊讶的是，只要这样做一次持续17分钟，人们注意力中的“盲点”数量就会显著减少。换句话说，他们的注意力变得更持久了，并且不需要额外的训练。
Now let's talk about actual blinks the sort that you do with your eyelids believe it or not your perception of time is also changed on a rapid basis moment to moment basis by how often you blink I want to just emphasize one study in particular which is quite appropriately titled time dilates after spontaneous blinking the exam in the relationship between fluctuations in the same way. In timing and blinking and to make a long story short what they found is that right after blinks we reset our perception of time now what's interesting and will immediately make sense to you as to why this is important is that the rate of blinking is controlled by dopamine.
现在让我们谈谈真正的眨眼，也就是用眼睑的眨眼。信不信由你，你对时间的感知也会因为眨眼的频率在时刻变化。我特别想强调一项研究，题目非常贴切，叫做“自发性眨眼后时间膨胀”，研究了时间感和眨眼频率的波动之间的关系。总之，他们发现，在每次眨眼后的那一刻，我们对时间的感知会重新调整。令人感到有趣且很容易理解这为何重要的是，眨眼的频率是由多巴胺控制的。
So what this means is that dopamine is controlling attention blinks relate to attention and focus and therefore the dopamine and blinking system is one way that you constantly modulate and update your perception of time and fortunately it's also one that you can control. So the basic takeaway of this study was that blinking controls time perception but also that levels of dopamine can alter your sense of time and stay with me here and that blinking and dopamine are inextricably linked they are working together to control your attention.
这段文字的意思是，多巴胺在控制注意力的过程中起着重要作用，而眨眼也与注意力和专注有关。因此，多巴胺和眨眼系统是你不断调整和更新时间感知的一种方式，而且幸运的是，这是你可以控制的方式。这个研究的基本结论是，眨眼可以影响时间感知，同时多巴胺的水平也会改变你的时间感知。眨眼和多巴胺是密不可分的，它们一起合作来控制你的注意力。
Let's remember back to the very beginning of the episode what's going on in people with ADHD they are not good at managing their time they tend to run late or they are disorganized their dopamine is low we know that as well and so they are underestimating time intervals and so it makes perfect sense that they would be late it makes perfect sense that they would lose track of time or the ability to focus.
回想一下这一集刚开始时所讨论的内容，在患有多动症（ADHD）的人身上，会出现一些情况。他们不擅长管理时间，经常迟到或者显得很没有条理。我们知道，他们的多巴胺水平较低，因此他们通常会低估时间间隔。这就很容易理解为什么他们会迟到，或者为什么他们会失去对时间的掌控能力以及注意力。
This is really exciting because what it means is that children with ADHD adults with ADHD or people with normal levels of focus that want to improve their ability to focus can do so through a training that involves learning how often to blink and when and how to keep their visual focus on a given target and it turns out this study has actually been done entitled improvement of attention in elementary school students through fixation focus training activity.
这真是令人兴奋，因为这意味着患有多动症的儿童和成人，或者那些专注力正常但希望提高专注能力的人，可以通过一项训练来做到这一点。该训练包括学习如何调整眨眼的频率和时机，以及如何保持视线专注于某个目标。事实证明，已经有一项名为《通过固定专注训练活动提高小学生注意力》的研究证明了这种方法的有效性。
I won't go through all the details but what they found was a short period of focusing on a visual target allowed these school children to greatly enhance their ability to focus on other types of information and a significant component of the effect was due to the way that they were controlling the shutters on their eyes their eyelids and controlling their blinks.
我不会详细展开，但是他们发现，当这些小学生在短时间内专注于一个视觉目标时，他们极大提高了专注于其他类型信息的能力。这个效果的一个重要原因是他们通过控制眼睑和眨眼方式来调节视觉注意力。
So what they did in the study is they had these kids focus their visual attention on some object that was relatively close like their hand for a minute or so which actually takes some effort if you try and do that they were allowed to blink it only took a few minutes each day to do this 30 seconds in one condition or maybe a minute and then at another station of looking a little bit further out and a little bit further out.
在这项研究中，研究人员让孩子们将注意力集中在他们手头的一些相对较近的物体上，比如他们的手，大约持续一分钟。这实际上需要一些努力，如果你尝试这样做，他们可以眨眼。每天只需要花几分钟时间在这种状态下看30秒或者一分钟，然后在另一个位置再看远一点的物体。
However, there was an important feature of this study that is definitely worth mentioning which is before they did this visual focus task or training they did a series of physical movements with the kids so that the kids could sort of eliminate or move out some of their desire to move and would thereby enhance their ability to sit still.
然而，这项研究有一个值得一提的重要特点：在进行视觉专注任务或训练之前，他们让孩子们先做了一系列的身体运动。这样可以帮助孩子们释放多余的精力，从而提高他们坐着不动的能力。
Now it should make perfect sense that these shutters on the front of your eyes they aren't just there for winking and they aren't just there for cosmetic purposes they are there to regulate the amount of information going into your nervous system and they're there to regulate how long you are bringing information into your nervous system and in what bins how widely or finally you are beginning time except by how often you blink and how widely or specifically you are doing.
现在应该很明白，你眼前的这些"窗帘"不只是用来眨眼或是装饰的，它们实际上用于调节进入你神经系统的信息量。它们还能控制你接收信息的时长，以及以何种方式和频率接收信息。简单来说，你眨眼的频率和幅度决定了你如何接收和处理这些信息。
So, grabbing attention from the visual world is set by whether or not you're viewing things very specifically like across here through a soda straw view like this or whether or not you are in this panoramic sort of whole environment mode this kind of fisheye lens or wide angle lens mode.
因此，能否抓住视觉世界中的注意力，取决于你观看事物的方式：是像通过狭窄的苏打水吸管视角那样聚焦于特定事物，还是处于全景模式，就像使用鱼眼镜头或广角镜头那样，看到整个环境。
So, now I want to switch back to talking about some of the drugs that are typically used to access those systems prescription drugs and I want to talk about some of the new and emerging non prescription approaches to increasing the levels of dopamine acetylcholine and serotonin in the brain using various supplement type compounds because several of them are showing really remarkable efficacy in excellent peer reviewed studies.
现在，我想回到有关通常用于作用于这些系统的处方药的话题。同时，我还想讨论一些新兴的非处方方法，这些方法使用各种补充剂来提高大脑中多巴胺、乙酰胆碱和血清素的水平。因为其中几种在优秀的同行评审研究中显示出显著的效果。
So, before moving to some of the newer atypical compounds and things sold over the counter I'd like to just briefly return to the classic drugs that are used to treat ADHD. These are the ones I mentioned earlier methylphenidate also called ridolin modaphanil armodaphanil is another one and at all.
在介绍一些新的非典型化合物和非处方药之前，我想简要地回顾一下用于治疗多动症的经典药物。这些药物包括我之前提到的哌醋甲酯，也叫利他林，还有莫达非尼、右旋莫达非尼等等。
Again, all of these work by increasing levels of dopamine and norepinephrine. I think it is important to understand the extent to which they all carry more or less the same side effect such as high propensity for addiction and abuse and fetamines of any kind as well as cocaine can cause sexual side effects because they're vasoconstrictors.
这些药物都是通过提高多巴胺和去甲肾上腺素的水平来起作用的。我认为，了解这些药物在多大程度上具有相似的副作用是很重要的，比如容易导致成瘾和滥用。此外，任何类型的苯丙胺类药物和可卡因都可能引起性方面的副作用，因为它们会导致血管收缩。
So, these drugs are not without their consequences. In addition, they almost all carry cardiac effects. They increase heart rate but they also have effects on constriction of blood vessels and arteries and veins and so forth in ways that can create cardiovascular problems.
因此，这些药物并非没有后果。此外，它们几乎都会对心脏产生影响。它们会增加心率，同时还会导致血管、动脉和静脉的收缩，这样可能会引发心血管问题。
The best use of things like atyrol modaphanil armodaphanil and ridolin is going to be to combine those treatments with behavioral exercises that actively engage the very circuits that you're trying to train up and enhance and then perhaps I want to highlight perhaps tapering off those drugs so that then one can use those circuits without any need for chemical intervention.
对于像Atyrol、Modafinil、Armodafinil和Ritalin这样的药物，最好的使用方式是将它们与行为训练相结合，积极锻炼和增强你想要强化的脑部回路。或许之后可以逐渐减少药物的使用，这样你就可以在不需要药物干预的情况下使用这些脑部回路。
So, despite any controversy that might be out there, I think it's fair to say that the consumption of omega-3 fatty acids can positively modulate the systems for attention and focus. So, then the question becomes how much EPA, how much DHA does that differ for what's helpful for depression, etc.
因此，尽管有一些争议，我认为可以公平地说，摄入欧米伽-3脂肪酸可以正面调节注意力和专注力系统。那么，接下来的问题是：需要摄入多少EPA（即二十碳五烯酸）和DHA（即二十二碳六烯酸）？这些数量在改善抑郁症方面是否有所不同？
And actually it does differ. In reviewing the studies for this, it appears that a threshold level of 300 milligrams of DHA turns out to be an important inflection point. So, typically, fish oils or other sources of omega-3s will have DHA and EPA, and typically it's the EPA that's harder to get at sufficient levels. Meaning you have to take quite a lot of fish oil in order to get above that 1000 milligram or 2000 milligram threshold to improve mood and other functions. But for sake of attention, there are 10 studies that have explored this in detail. And while the EPA component is important, the most convincing studies point to the fact that getting above 300 milligrams per day of DHA is really where you start to see the attentional effects. Now, fortunately, if you're getting sufficient EPA for sake of mood and other biological functions, almost without question, you're getting 300 milligrams or more of DHA.
实际上，这确实有区别。根据对相关研究的审阅，发现300毫克的DHA是一个重要的临界点。通常，鱼油或其他Omega-3来源中含有DHA和EPA，而EPA通常较难达到足够的含量。这意味着你需要摄入大量的鱼油，才能超过1000毫克或2000毫克，以改善情绪和其他功能。然而，对于注意力来说，有10项详细研究探讨了这一点。虽然EPA成分很重要，但最有说服力的研究表明，摄入超过300毫克的DHA后才开始显现出对注意力的影响。幸运的是，如果您已经为情绪和其他生理功能摄取了足够的EPA，可以几乎肯定地说，您同时也摄入了300毫克或更多的DHA。
What's interesting is that there's another compound, phosphodidyl steering, that has been explored for its capacity to improve the symptoms of ADHD. Phosphodidyl steering, taken for two months, for 200 milligrams per day, was able to reduce the symptoms of ADHD in children. It has not been looked at in adults yet, at least as far as I know, but that this effect was greatly enhanced by the consumption of omega-3 fatty acids. So now we're starting to see synergistic effects of omega-3 fatty acids and phosphodidyl steering.
有趣的是，还有另一种化合物，叫做磷脂酰丝氨酸，被研究用来改善多动症（ADHD）的症状。每天服用200毫克的磷脂酰丝氨酸，持续两个月，可以减少儿童多动症的症状。至于成年人，目前还没有研究（至少据我所知）。不过，这种效果在摄入欧米伽-3脂肪酸后得到了显著增强。因此，我们开始看到欧米伽-3脂肪酸和磷脂酰丝氨酸的协同作用。
So I'd like to talk about the drug Modaphanil and the closely related drug, Armodaphanil. That's AR Modaphanil. Because Modaphanil and Armodaphanil are gaining popularity out there both for treatment of ADHD and narcolepsy, but also for communities of people that are trying to stay awake long periods of time. So it's actively used in the military by first responders. It's gaining popularity on college campuses, and people are using it more and more as an alternative to Adderall and Riddlein and excessive amounts of coffee.
我想谈谈药物莫达非尼（Modaphanil）和与之密切相关的药物阿莫达非尼（Armodaphanil）。阿莫达非尼的英文是AR Modaphanil。由于莫达非尼和阿莫达非尼在治疗多动症（ADHD）和嗜睡症方面变得越来越受欢迎，同时这些药物还受到一些长期需要保持清醒的群体的青睐。这些药物被军队和急救人员积极使用，也在大学校园中越来越流行，人们越来越多地将其作为替代阿得拉（Adderall）、利他林（Ritalin）和过量咖啡的选择。
It does increase focus and to a dramatic extent when I emphasize that unlike Riddlein and Adderall, Modaphanil and Armodaphanil are weak dopamine reuptake inhibitors, and that's how they lead to increases in dopamine. Now you may notice that I haven't talked much about acetylcholine. Acetylcholine is a neurotransmitter that at the neuron to muscle connections, this is called neuromuscular junctions, is involved in generating muscular contractions of all kinds for all movements. Acetylcholine is also released from two sites in the brain. There is a collection of neurons in your brainstem that send projections forward, kind of like a sprinkler system that's very diffuse, to release acetylcholine.
它确实能显著提高注意力。当我强调，与Ritalin（利他林）和Adderall（艾德拉）不同的是，Modafinil（莫达非尼）和Armodafinil（阿莫达非尼）是弱的多巴胺再摄取抑制剂，这正是它们如何提高多巴胺水平的方式时，它的作用就更为突出。您可能注意到我没有多谈乙酰胆碱。乙酰胆碱是一种神经递质，在神经与肌肉的连接处——即神经肌肉接合处——参与产生所有运动类型的肌肉收缩。乙酰胆碱还从大脑的两个部位释放。大脑干中有一群神经元，就像一个非常分散的洒水系统一样，向前发出投射，以释放乙酰胆碱。
And those neurons reside in an area or a structure that's called the pedunculopontine nucleus, the PPN. And then there's a separate collection of neurons in the basal four brain called unimaginatively nucleus basalus, the nucleus at the base. And they also hose the brain with acetylcholine, but in a much more specific way. So one is sort of like a sprinkler system and the other one is more like a fire hose to a particular location. And those two sources of acetylcholine collaborate to activate particular locations in the brain and really bring about a tremendous degree of focus to whatever is happening at those particular synapses.
这些神经元位于一个叫做脚桥核（PPN）的区域或结构中。此外，在大脑基底部还有另一组神经元，称为基底核。它们同样释放乙酰胆碱到大脑中，但方式更加具体。所以，一个就像洒水系统，而另一个则更像是对特定位置的消防水管。乙酰胆碱的这两种来源共同作用，激活大脑中特定的位置，并在那些特定的突触处带来极高的专注度。
So now you have an example and you have an understanding and hopefully a picture in your mind of how all this is working, not surprisingly, then drugs that increase colonergic or acetylcholine transmission will increase focus and cognition. One such compound is so called alpha GPC, which is a form of colon and increases acetylcholine transmission. Doses is as high as 1200 milligrams per day, which is a very high dosage spread out. Typically it's 300 or 400 milligrams spread out throughout the day. Have been shown to offset some of the effects of age relay, cognitive decline, improve cognitive functioning people that don't have age relay, cognitive decline, typically when people are using alpha GPC to study or to enhance learning of any kind, they will take somewhere between 300 and 600 milligrams.
现在你有了一个例子，并且对这个机制有了理解，可能在脑海中也有了一个画面：不出所料，增加胆碱能或乙酰胆碱传递的药物会提高注意力和认知能力。一个这样的化合物就是所谓的α-GPC，它是一种胆碱形式，可以增加乙酰胆碱的传递。每天高达1200毫克的高剂量可能会分次服用，通常是300或400毫克分散在一天中。研究显示，这可以抵消一些与年龄相关的认知衰退影响，并改善认知功能。在没有年龄相关认知衰退的人群中同样有效。通常，当人们使用α-GPC来学习或增强任何形式的学习效果时，他们会服用大约300到600毫克。
That's more typical. Again, you have to check with your doctor, you have to decide if the safety margins are appropriate for you. And there are some over-the-counter compounds that are in active use out there for treatment of ADHD and in use for simply trying to improve focus. El tyrosine, it's an amino acid that acts as a precursor to the neuromodulator dopamine. The dosaging can be very tricky to dial in. Sometimes it makes people feel too euphoric or too jittery or too alert that they are then unable to focus well. So the dosage ranges are huge. You see evidence for 100 milligrams all the way up to 1200 milligrams. It's something that really should be approached with caution, especially for people that have any kind of underlying psychiatric or mood disorder because this regulation of the dopamine system is central to many of the mood disorders such as depression, but also especially mania, mania bipolar disorder, schizophrenia, things of that sort.
这比较常见。不过，你还是得和医生商量一下，决定这种安全范围是否适合你。目前市面上确实有一些非处方药物正在被用于治疗多动症，或者单纯用于提高专注力。比如L-酪氨酸，它是一种作为神经调节剂多巴胺前体的氨基酸。但对其剂量的控制非常棘手。有时候，它会让人感到过于欣快、过于紧张或过于警觉，结果反而无法专心。因此，剂量的差异非常大，有从100毫克到1200毫克的说法。对此需要谨慎，特别是对于那些有精神或情绪障碍的人，因为多巴胺系统的调节对许多情绪障碍非常重要，比如抑郁症、躁症、双相情感障碍和精神分裂症等。
So it's something that really should be approached with caution. Everybody nowadays seems to have a smartphone. They grab our attention entirely, but within that small box of attention, there are millions of attentional windows scrolling by. Right. So just because it's one device that we look at does not mean that we are focused. We are focused on our phone. But because of the way in which context switches up so fast within the phone, it's thought that the brain is struggling now to leave that rapid turn. Rapid turnover of context, even though there are trillions, infinite number of bits of information in the actual physical world, your attentional window, that aperture of constriction and dilating that visual window is the way in which you cope with all that overwhelming information typically well within the phone.
所以，这件事情确实需要谨慎对待。如今，几乎每个人都有一部智能手机。它们完全吸引了我们的注意力，但在这个小小的注意力框架里，有成千上万个信息窗口不断滚动。因此，仅仅因为我们专注于一个设备，并不意味着我们真正专注于它。我们专注于手机，但由于手机内的情境变化非常迅速，据说大脑现在难以应对这种快速转换。尽管在现实世界中有无数的信息，但我们通常通过收缩和扩展注意力窗口的方式来应对，而这在手机中尤为明显。
Your visual aperture is set to a given width and within there, your attentional window is grabbing a near infinite number of bits of information. Colors, movies, and so the question is does that sort of interaction on a regular basis lead to deficits in the types of attention that we need in order to perform well in work and school relationships, etc. And the short answer is yes, we are inducing a sort of ADHD. I'm not here to tell you what to do, but I think whether or not you have ADHD or not, if you're an adolescent limiting your smartphone use to 60 minutes per day or less, and if you're an adult to two hours per day or less is going to be among the very best ways to maintain your ability to focus at whatever level you can now.
你的视觉窗口设定在一个特定的宽度范围内，在这个范围内，你的注意力窗口正在捕捉几乎无穷无尽的信息，比如颜色和动态影像。那么问题是，这种互动的频繁发生是否会导致我们在工作、学习和人际关系中所需的注意力出现缺陷。简单的回答是：会，这是一种类似于多动症（ADHD）的表现。我不是想告诉你该怎么做，但我认为无论你是否患有多动症，如果你是青少年，最好将每天使用智能手机的时间限制在60分钟以内；如果你是成年人，则最好限制在每天两小时以内。这将是保持你现有专注能力的最佳方法之一。
And now, and as I always say, most of the things that we get recognized for in life, success in life, in every endeavor, whether or not it's school relationships, sport, creative works of any kind are always proportional to the amount of focus that we can bring that activity. It is important to rest, of course, to get proper sleep, but I stand behind that statement and I leave you with that about attention and cell phones and how cell phones are indeed eroding our attentional capacities. So I realize I covered a lot of information about ADHD and the biology of focus and how to get better at focusing. We talked about the behavioral and psychological phenotypes of ADHD. We talked about the underlying neural circuitry. We also talked about the neurochemistry and we talked about the various prescription drug treatments that are aimed at that neurochemistry and aimed at increasing focus in children and adults with ADHD.
现在，就像我常说的，我们在生活中获得认可的大多数事情——无论是在学业、人际关系、运动，还是各种创作上的成功——都与我们能投入到这些活动中的专注程度成正比。当然，休息和充足的睡眠也很重要，但我依然坚持认为，注意力和手机之间的关系非常值得关注，因为手机的确在侵蚀我们的注意力。我意识到，我讨论了很多关于多动症（ADHD）和专注力生物学的问题以及如何提高专注力。我们谈到了ADHD的行为和心理特征，探讨了其背后的神经线路及神经化学，还讨论了旨在改善ADHD患者专注力的各种处方药治疗。