Essentials: Understanding & Healing the Mind | Dr. Karl Deisseroth

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. And now, my conversation with Dr. Karl Deisseroth. Well, thanks for being here.

Thanks for having me.

So for people that might not be so familiar with the fields of neuroscience, et cetera, what is the difference between neurology and psychiatry?

Psychiatry focuses on disorders where we can't see something that's physically wrong, where we don't have a measurable, where there's no blood test that makes the diagnosis, there's no brain scan that tells us this is schizophrenia, this is depression for an individual patient. And so psychiatry is, is much more mysterious and the only tools we have are words. Neurologists are, uh, fantastic physicians. They see the stroke on brain scans, they see the seizure and the pre-seizure activity with an EEG, uh, and they can measure and treat based on those measurables. In psychiatry, we have a harder job. We use words, we have rating scales for symptoms, we can measure depression and autism with rating scales, but those are words still and ultimately that's what psychiatry is built around. It's, it's an odd situation because we've got the most complex, beautiful, mysterious, incredibly engineered, uh, object in the universe and yet all we have are words to, to find our way in.

So do you find that if a patient is very verbal or hyper-verbal that you have an easier time diagnosing them as opposed to somebody who's, um, more quiet and reserved or it's, I could imagine, the opposite might be true as well?

Well, it, because we only have words, you've put your finger on a key point. If they don't speak that much, in principle it's harder. The lack of speech can be a symptom. We can see that in depression, we can see that in the negative symptoms of schizophrenia, we can see that in autism. Sometimes by itself that is a symptom of reduced speech, but ultimately you do need something. You need, uh, some, some words to help guide you and that, in fact, and there's, there's challenges that I, I can tell you about where patients with depression who are so depressed they can't speak, that makes it a bit of a challenge to distinguish depression from some of the other reasons they might not be speaking. And this is, uh, sort of the art and the science of psychiatry.

Do you think we will ever have a blood test for depression or schizophrenia or autism and would that be a good or a bad thing?

I think, uh, ultimately there will be quantitative tests. Uh, already efforts are being made to look at certain rhythms in the brain using external EEGs, uh, to look at brain waves effectively, but ultimately what's going on in the brain, in psychiatric diseases, physical, uh, and it's due to the circuits and the connections and the projections in the brain that are, um, not working as they would in a typical situation. And I- I do think we'll have those measurables at some point. Could it be abused or misused? Uh, certainly, but that's, I think, true for all of medicine.