(单词翻译:单击)
Dealing with depression is not easy.
对付抑郁症并没那么容易。
And it doesn't help that it is really difficult to find effective treatments for it.
而且确实很难找到有效的治疗方法。
Your genetics, your environment, and various factors in your brain all seem to play a role in whether you develop depression and how you experience it.
遗传、环境以及大脑中的各种因素似乎都会在你是否会患抑郁症，以及你将如何经历抑郁症方面发挥作用。
So the most common treatments don't work for everyone.
因此，最常见的疗法并不适用于所有人。
Some researchers think that the solution to this is personalized medicine: using information about a patient's symptoms or even their genome to match them to drugs that actually help.
一些研究人员认为解决方法是采用个性化药物：利用病人症状的信息，甚至是基因组信息，让患者与对他们有效的药物相匹配。
"Personalized medicine" sometimes sounds like a futuristic buzzword, but there are already big projects looking into it — and they're making some progress.
“个性化医学”有时听起来像是个未来的词汇，但目前已有些大型项目在对它进行研究，而且这些研究正在取得一定进展。
So for depression, these kind of treatments might actually not be that far off.
所以对于抑郁症来说，这类治疗方法可能很快就能实现。
One of these projects is spearheaded by a group called CAN-BIND, short for Canadian Biomarker Integration Network in Depression.
其中一个项目是由名为CAN-BIND的小组领导的，CAN-BIND是加拿大抑郁症生物标记整合网络的缩写。
This team has already published a handful of studies and is working on many more, and they're mainly searching for biomarkers for depression.
这个研究小组已经发表了一些研究成果，他们正在进行更多的研究，主要是寻找抑郁症的生物标记。
Biomarkers are defined pretty broadly by the larger scientific community, but they're basically something a doctor or lab can reliably measure that tells them about your illness.
科学界给生物标记的定义相当宽泛，但从本质上讲，生物标记就是医生或实验室能够可靠测量的一些指标，这些指标可以让医生了解你所患的疾病。
Anything from your pulse to a specific hormone in your blood is fair game.
从脉搏到血液中特定的荷尔蒙含量，这是场公平的游戏。
Doctors can use biomarkers to learn how well a patient is responding to a specific treatment, or they can use them to predict how likely a patient is to respond to treatments in general.
医生可以使用生物标记来了解患者对特定治疗的反应如何，或者来预测患者对一般性治疗的反应。
But when it comes to depression, the most sought-after biomarkers by far are those that tie a specific drug to a patient's response.
但说到抑郁症，迄今为止最受欢迎的生物标记是将特定药物与患者反应相联结的标志物。
Basically, markers that take out the guesswork and say, "If you take this, here's what you can probably expect."
基本上，标记可以排除一切臆测，然后说，“如果你这么治疗，预后大概是这样的。”
If we could find a marker like this for depression, doctors could do something like a blood test, look for a certain result, and then match someone to an effective antidepressant based on that.
如果我们能发现抑郁症的标记，医生可以通过验血等方式找到确定的结果，再根据这个结果让患者服用某种有效的抗抑郁药。
Of course, we're nowhere near that yet.
当然，这个目标还远未实现。
But the CAN-BIND group is working on it, and even though there's a long way to go, they're learning a lot.
但CAN-BIND小组正在进行研究，尽管前路漫漫，但他们学到了很多东西。
For example, they've investigated whether or not people have gene expression markers that can predict how they'll respond to medication.
例如，他们调查了人们是否具有能够预测对药物反应的基因表达标记。
These markers would be things like messenger RNAs that tell scientists how much protein is being made by a cell.
这些标记就像RNA，告诉科学家一个细胞能生成多少蛋白质。
Which could, in turn, affect how the body processes or responds to a drug.
这反过来会影响身体对药物的反应。
Scientists have studied a ton of potential markers, but unfortunately, the CAN-BIND team concluded in a 2017 review that none of them are ready for primetime just yet.
科学家已经研究了大量潜在的标记，但不幸的是，CAN-BIND团队在2017年的一份评述中得出结论，还没有哪个标记比较适合。
The results are too inconclusive — maybe because we don't know enough about our genetic material.
这些研究结果都不太确定，可能是因为我们对遗传物质知之甚少。
But that doesn't mean we should give up on this method yet.
但这并不意味着我们应该放弃这种方法。
It likely just means there's more to learn.
而可能是说我们还有更多东西要学习。
In the meantime, though, the CAN-BIND team has also been looking at other kinds of biomarkers.
与此同时，CAN-BIND团队也在研究其他类型的生物标记。
In 2018, they published a review that looked at brain imaging rather than molecular markers.
2018年，他们发表了一篇关于大脑成像而不是分子标记的评论。
This time, they looked at how all kinds of treatments — including psychotherapy — could affect the brain, not just drugs.
这一次，他们不仅只是考察药物，还研究了包括心理治疗在内的各种治疗方法对大脑的影响。
And this time, they found some promising results.
他们这次发现了一些可喜的成果。
In this review, the team found studies that suggested that things like size and shape changes in several brain regions could be tied to specific treatments.
在这篇评述中，该团队发现研究表明，几个大脑区域的大小和形状变化等因素可能与特定治疗相关。
For example, they cited previous research where both increased activity in the prefrontal cortex, and decreased activity in a handful of other regions, were associated with better symptom improvement in patients who underwent cognitive behavioral therapy.
例如，他们引用了以往的研究，在这些研究中，前额叶皮层的活动增加，以及其他一些区域的活动减少，都与接受认知行为治疗的患者症状改善有关。
In other words, there were specific brain features that predicted how well someone would respond to treatment.
换句话说，某些特定的脑部特征可以预测人们对治疗的反应。
These results do need to be validated, but if they're true, this essentially means a doctor could look at someone's brain for things like increased prefrontal cortex activity.
这些结果确实还需要验证，但如果它们是真的，这就意味着医生可以通过观察某人的大脑寻找前额叶皮层活动增强的迹象。
And if they found it, they could use that knowledge to recommend someone for therapy.
如果发现了这些迹象，他们就能利用这些知识为患者推荐治疗方法。
At the end of the day, CAN-BIND still has a lot to do, but they're paving the way for some major advances in medicine.
归根结底，CAN-BIND还有很多工作要做，但他们为医学方面将取得的一些重大进展铺平了道路。
Looking for biomarkers isn't the only way to approach personalized medicine, though.
然而，寻找生物标记并不是进行个性化治疗的唯一方法。
Another approach is to look for actual differences in the gene sequences among people.
另一种方法是寻找人与人之间基因序列的实际差异。
We're talking differences in those famous four DNA bases that make up someone's genetic code.
我们所说的是构成某人遗传密码的四个有名的DNA碱基的差异。
This approach has become more feasible in recent years as personal gene sequencing has become widely available, and as we've begun to understand how these gene variants function.
近年来，随着个人基因测序的广泛应用，以及我们开始了解这些基因变体的功能，这种方法也变得更加可行。
For example, there's a liver enzyme that processes certain medications, including some used to treat depression, before they ever reach the brain.
例如，有一种肝酶可以在某些药物（包括治疗抑郁症的药物）到达大脑之前，对它们进行处理。
It's called CYP2D6, I'm sure you'll remember that and the gene that codes for it has over a hundred different variants, which might make chemical changes to medications that render them more or less effective.
这种肝酶称为CYP2D6，我相信你能记住，编码它的基因有超过一百种不同的变体，可能会使药物发生化学变化，从而改变药效。
If we could track down all of these genetic changes, we could start to figure out how to tailor medications to someone's personal genetic code.
如果我们能追踪到所有这些基因变化，我们就可以找出如何根据某人的个人基因密码来定制药物。
And another major research effort, called the GUIDED study, was a big step forward in that.
另一项主要的研究工作，被称为指导性研究，它在这方面取得了很大进展。
The study was published online in January 2019, and it split over a thousand patients with depression into two groups.
这项研究于2019年1月在线发表，研究人员将一千多名抑郁症患者分为两组。
In one group, doctors were allowed to use the results of a genetic test to look for potential drug interactions — ones that could make those drugs either more or less effective.
在一组被试中，医生可以使用基因测试的结果寻找药物之间潜在的相互作用，那些可能使药物或多或少有效的药物间的相互作用。
In the other group, doctors couldn't use that knowledge, and made their drug choices the old-fashioned way.
在另一组中，医生不能使用这些信息，他们还是沿用老办法选择药物。
In the genetic testing group, both patients' response to treatment and the number of people who experienced remission of their depression symptoms were significantly higher than in the business-as-usual group.
在基因检测组中，患者对治疗的反应，以及抑郁症状缓解的人数均明显高于正常组。
And partway through the study, if patients were allowed to switch to a drug supported by their genetic tests, they also showed better rates of symptom improvement, treatment response, and remission.
在研究进行到一半时，如果允许患者使用有基因测试支持的药物，他们也会表现出更好的症状改善率、治疗反应率和抑郁缓解率。
Which is potentially awesome news — especially since this was a large, carefully-controlled study.
这可能是个很棒的消息，特别是因为这是一个进行精心控制的大型研究。
Scientists will always call for more research, but the GUIDED trial shows that knowledge of a patient's genes can potentially help them get better — especially if their depression has been otherwise tough to treat.
科学家们总是会呼吁进行更多的研究，但这项指导性试验表明，了解患者的基因信息可能有助于他们恢复健康——尤其是如果他们的抑郁症很难治疗的话。
So there is a lot of reason to be hopeful about the future of depression treatments, even if a lot more research is still needed.
所以，我们有理由对抑郁症的治疗抱有希望，尽管还需要进行更多的研究。
Whether it's through biomarkers or our actual genes, we're working on ways to know whether specific treatments will help specific people.
无论是通过生物标记还是基因，我们都在研究特定的治疗是否能帮助特定人群。
So maybe in the future, no one will ever need to go through three, four, or a dozen treatments to find something that works.
所以，也许在未来，没有人需要经过三、四或十几次治疗才能找到有效的方法。
We might figure out how to do it on the first try — and that's worth celebrating.
我们可能在第一次尝试治疗时就知道该怎么做，这真是值得庆祝。
If you want to learn more about psychology — or other topics in fields like history or science — we think we've found some videos you might enjoy.
如果你想了解更多有关心理学或其他领域的话题，比如历史或科学，我们找到了一些你可能会喜欢看的视频。
And that's why this episode is brought to you by CuriosityStream.
这也就是为什么本期节目是由CuriosityStream为您呈现的原因。
CuriosityStream is a subscription streaming service that offers over 2000 documentaries and nonfiction titles from some of the world's best filmmakers, including exclusive originals.
CuriosityStream是一项订阅流媒体服务，提供来自世界上一些最佳电影制作人制作的2000多部纪录片，包括一些独家原创作品。
They have videos on nature, history, technology — even society and lifestyles — which is one of the reasons we like them so much.
他们有关于自然、历史、技术甚至社会和生活方式的视频，这也是我们喜欢它的一个原因。
There's so much to learn!
值得学习的内容超多！
Like, Birth of the Internet is a show that can tell you about the internet you're using to watch this episode right now!
比如，互联网的诞生可以告诉你用来观看本集节目的互联网的故事！
Did you know the first Internet message was transmitted way back in 1969, or that the foundations of the Web grew out of the Cold War?
你知道首次用互联网传输信息是在1969年吗，还有网络的建立是源于冷战吗？
That's just one of the shows on offer.
这只是其中一个节目。
You can get unlimited access to content like this starting at $2.99 a month.
每月花2.99美元，就可以无限制地收看这些节目。
And as a special thanks to our SciShow Psych audience, you can get the first 30 days for free!
为了感谢心理科学秀的观众，你们可以免费收看30天！
You just have to sign up at curiositystream.com/psych and use the promo code “psych” during the sign-up process.
只需在curiositystream.com/psych注册，注册过程中使用促销代码“psych”就行了。
