Why Broken Hearts Hurt — and What Heals Them | Yoram Yovell | TED

Translator: Luz Leirós Reviewer: traduceTED USC

I'm Yoram Youvel.

Chámome Yoram Youvel.

I'm a psychiatrist and neuroscientist at the Hebrew University of Jerusalem.

Son psiquiatra e neurocientífico na Universidade Hebrea de Xerusalén.

And when I was 14 years old, my father died.

Cando tiña 14 anos, faleceu o meu pai.

I was sitting in class

Eu estaba sentado na clase

when my mother and my grandfather knocked on the door

cando a miña nai e o meu avó chamaron á porta

and asked me out to the corridor.

e pedíronme que saíse ao corredor.

"Your father's very sick," my mother said.

“O teu pai estaba moi enfermo”, díxome a miña nai.

"Your father is dead."

“O teu pai morreu”.

And then I felt it.

Entón sentina.

A crushing pain in my chest.

Unha dor esmagadora no peito.

I can still feel a glimpse of it whenever I think of my father.

Aínda a sinto un pouco sempre que penso no meu pai.

He was a doctor, a scientist, a paratrooper.

Era médico, científico, paracaidista.

He was a young, strong, happy, healthy man.

Era un home novo, forte, feliz e san.

He was my hero.

Era o meu heroe.

And his death broke my heart.

A súa morte rompeume o corazón.

Do you remember the pain you felt when someone broke your heart?

Lembrades a dor que sentistes cando alguén vos rompeu o corazón?

When your best friend or your mother died?

Cando o voso mellor amigo o a vosa nai morreron?

Or the man you loved told you that he doesn't love you anymore.

Ou o home que amabades vos dixo que xa non vos quería?

You probably do.

Seguro que o lembrades.

But why do we feel mental pain at all?

Pero por que sentimos dor mental?

And what's the relationship between physical and mental pain?

E cal é a relación entre dor física e mental?

And most importantly, how can we make mental pain better?

E o máis importante: como podemos aliviar a dor mental?

Together with many scientists and physicians,

Xunto con moitos científicos e médicos,

I spent years searching for answers to these questions.

pasei anos buscando respostas a estas preguntas.

Now, growing up, I never heard the words,

De pequeno, nunca escoitei as palabras

"We want you to be a doctor and a brain scientist like your father."

“queremos que sexas doutor e científico do cerebro coma o teu pai”.

But somehow that's what happened.

Porén, dalgún xeito, iso foi o que pasou.

Doce anos despois da súa morte,

Twelve years after my father died,

I was a graduate student at Dr. Eric Kandel’s lab

eu era estudante de posgrao no laboratorio do Dr. Eric Kandel

at Columbia University.

na Universidade de Columbia.

Eric, who won the Nobel Prize

Eric, que gañou o Premio Nobel polo seu traballo

for his work on the molecular basis of memory,

sobre as bases moleculares da memoria,

was the ultimate mentor.

foi o mentor definitivo.

Passionate, energetic and inspiring.

Apaixonado, enérxico e inspirador.

Under his guidance, I studied a receptor.

Baixo a súa dirección, estudei un receptor.

It's a protein that's part of a synapse.

É unha proteína que forma parte dunha sinapse.

And synapses are structures through which nerve cells communicate with each other.

As sinapses son estruturas a través das cales

as células nerviosas se comunican entre si.

Now that receptor was a GPCR.

Ese receptor era un GPCR,

That's a G protein coupled receptor.

que é un receptor acoplado a unha proteína G.

I'll explain what this means in a minute

Vou explicar o que significa nun minuto

and then you'll understand what this stack of markers is doing here.

e entón entenderedes que fai aquí esta pía de rotuladores.

And when I did that,

Cando facía iso,

I didn't really realize that work on that receptor,

non me decatei realmente de que o traballo sobre ese receptor,

which seemed completely unrelated to my future work

que parecía completamente alleo ao meu futuro traballo

as a clinical psychiatrist,

como psiquiatra clínico,

would one day help us in our search for better treatments

nos axudaría algún día na procura de mellores tratamentos

for physical and mental pain.

para a dor física e mental.

Now a big step along that way was the work of Jaak Panksepp,

Agora ben, un gran paso nese camiño foi o traballo de Jaak Panksepp,

my other great scientific mentor.

o meu outro gran mentor científico.

In a classical experiment,

Nun experimento clásico,

Panksepp separated puppies from their mothers for 15 minutes.

Panksepp separou cachorros das súas nais durante 15 minutos.

Never more than that because he loved animals.

Nunca máis diso porque amaba os animais.

When puppies lose their mothers,

Cando os cachorriños perden as súas nais,

they make a sound which is called the separation distress cry.

emiten un son chamado pranto de angustia por separación.

And it goes like this.

É algo así.

(Imitates puppy wailing)

(Imita os choros dun cachorro)

Puppies do it,

Os cachorros fano,

kittens do it, babies do it.

os gatiños fano, os bebés fano.

All young mammals do it

Todos os mamíferos novos o fan

when they're in pain or when they miss their mothers.

cando teñen dor ou cando estrañan as súas nais.

And we all know how this cry makes us feel inside.

E todos sabemos como nos fai sentir ese choro por dentro.

Panksepp and his colleagues then traced the brain circuits

A continuación, Panksepp e os seus colegas rastrexaron os circuítos cerebrais

that produce these cries in guinea pigs,

que producen eses choros nas cobaias

and they made a startling discovery.

e fixeron un descubrimento sorprendente:

That these are the very same circuits that are active when humans feel sad

son eses mesmos circuítos os que se activan

cando os humanos sentimos tristeza e cando sufrimos unha depresión.

and when they experience depression.

And these circuits are also part of the brain's pain matrix

Estes circuítos tamén forman parte da matriz de dor do cerebro

that mediates our sensations of physical and mental pain.

que media nas nosas sensacións de dor física e mental.

But why are we born with this terrible gift

Pero por que nacemos con ese terrible don

hardwired into our brains?

conectado ao noso cerebro?

Well, probably because like any pain, mental pain is an alarm system.

Porque probablemente, como calquera dor, a dor mental é un sistema de alarma.

Its task is to prevent damage.

A súa tarefa é evitar danos.

When babies lose their mothers, they hurt and they cry.

Cando os bebés perden as súas nais, dóelles e choran,

Which brings their mothers back,

o que lles trae de volta as súas nais

and it also makes them seek their mothers.

e tamén fai que eles busquen as súas nais.

In the wild, this is life-saving.

En estado salvaxe, isto salva vidas.

Puppies and babies cannot survive without their mothers.

Os cachorros e os bebés non poden sobrevivir sen as súas nais.

So now we know why we have mental pain.

Agora xa sabemos por que temos dor mental.

It is the glue that keeps us together in couples, in families and communities.

É o pegamento que nos mantén unidos en parellas, familias e comunidades.

And when someone we love goes away or is taken away from us,

Cando alguén que amamos marcha ou se nos quita,

it's this pain which draws us back together.

é esta dor a que nos volve unir.

And once we realize this,

Unha vez que nos demos conta disto,

then we can answer an age-old question

podemos responder a unha pregunta milenaria

that poets and philosophers have been asking for thousands of years.

que os poetas e filósofos levan facendo miles de anos:

Does love always hurt?

o amor sempre doe?

What do you think?

Que opinades?

Does love always hurt?

O amor sempre doe?

Yes, love always hurts, of course.

Si, o amor doe sempre, por suposto.

Because that's what it's supposed to do.

Porque iso é o que se supón que ten que facer.

Mental pain is simply the high price,

A dor mental é simplemente o alto prezo,

the very high price, that we pay for our ability to love.

o moi alto prezo, que pagamos pola nosa capacidade de amar.

Persoalmente,

And personally,

and, you know, I've been around the block a couple of times,

e xa sabedes que vivín a experiencia un par de veces,

personally, I think it's worth it.

persoalmente, creo que paga a pena.

But we're not entirely defenseless against pain

Pero non estamos totalmente indefensos contra a dor

because our brains produce endorphins

porque o noso cerebro produce endorfinas

or endogenous opioids,

ou opiáceos endóxenos,

our very own feel-good molecules,

as nosas propias moléculas para sentirnos ben,

the natural remedy for both physical and mental pain.

o remedio natural tanto para a dor física como para a dor mental.

Endorphins are released in the brain during aerobic exercise

As endorfinas libéranse no cerebro durante o exercicio aerobio

or when we're close to someone we love,

ou cando estamos preto de alguén a quen amamos,

and immediately after severe injuries.

e inmediatamente despois de feridas graves.

Agora sabemos o que fan as endorfinas:

And we now know what endorphins do,

they attach to special receptors in the brain,

únense a receptores especiais do cerebro.

and the most important among them are mu opioid receptors.

Os máis importantes son os receptores opiáceos mu.

And just like the receptor I worked on in Kandel's lab,

Igual que o receptor co que traballei no laboratorio de Kandel,

mu opioid receptors are GPCR.

os receptores opiáceos mu son GPCR.

Here's how they work.

Así é como funcionan.

Like all GPCRs, mu opioid receptors are made of seven spirals

Como todos os GPCR, os opiáceos mu están formados por sete espirais

ou bucles que se amontoan xuntos,

or loops that are stacked together,

sticking through both sides of the cell membrane.

pegándose por ambos os dous lados da membrana celular.

Like this, OK.

Xusto así.

And when endorphins attach to mu opioid receptors from the outside,

Cando as endorfinas se unen aos receptores opiáceos mu

desde o exterior, cambian a súa forma.

they cause them to change their shape.

Like this, OK?

Así, vale?

And this triggers a series of events inside the neurons

Isto desencadea unha serie de eventos dentro das neuronas

which eventually ease the pain.

que finalmente alivian a dor.

Now, forget the molecules for a second.

Agora esquecede as moléculas por un segundo.

When you hug someone you love

Cando abrazamos alguén a quen queremos

who is suffering from severe physical or mental pain,

que sofre unha dor física ou mental grave,

you actually cause her brain to release endorphins.

en realidade facemos que o seu cerebro libere endorfinas.

They attach to mu opioid receptors in her synapses and turn them on,

Estas únense aos receptores opiáceos mu nas súas sinapses e acéndenos,

and they soothe her pain.

e estes alivian a súa dor.

And yet, sometimes mental pain gets so intense

Aínda así, ás veces a dor mental faise tan intensa

that no amount of love can soothe it.

que ningún amor pode calmala.

But medicine has powerful drugs that can ease any physical pain.

Pero a medicina ten fármacos potentes que poden aliviar calquera dor física.

These are the narcotics or opioids like morphine.

Son narcóticos ou opiáceos como a morfina.

Os narcóticos actúan principalmente activando os receptores opiáceos mu.

Narcotics work mainly by activating mu opioid receptors.

But if so, can narcotics also treat the pain of separation?

Pero, se é así, poden os narcóticos tratar tamén a dor da separación?

It was Jaak Panksepp who found the answer.

Jaak Panksepp foi quen atopou a resposta.

Panksepp gave his puppies in a separation experiment

Panksepp deu aos seus cacharros nun experimento de separación

tiny, tiny doses of morphine,

doses moi moi pequenas de morfina

lower than the lowest doses that are used to treat physical pain,

inferiores ás doses máis baixas que se usan para tratar a dor física,

and his puppies immediately stopped crying

e os cachorros deixaron de chorar inmediatamente

and started playing with each other as if they no longer miss their mothers.

e comezaron a xogar entre eles coma se xa non estrañasen as súas nais.

Let's go to humans now.

Imos agora aos humanos.

When mental pain in humans becomes too intense to bear

Cando a dor mental nos humanos se fai demasiado intensa para soportala,

people, some people, will do anything to stop it,

algunhas persoas farían calquera cousa para detela,

even try to kill themselves.

incluso intentar matarse.

Indeed, and I'm saying this as a clinical psychiatrist,

De feito, e digo isto como psiquiatra clínico,

unbearable mental pain is a huge risk factor for suicide.

a dor mental insoportable é un factor de risco clave para o suicidio.

But if narcotics treat physical pain,

Pero se os narcóticos tratan a dor física

and if they can soothe the mental pain of separation,

e poden aliviar a dor mental da separación,

can they also help suicidal people become less suicidal?

poderían tamén axudar as persoas suicidas a ser menos suicidas?

A few years ago,

Hai uns anos,

together with Panksepp and other colleagues,

xunto con Panksepp e outros colegas,

my research team conducted a clinical trial.

o meu equipo de investigación levou a cabo un ensaio clínico.

We gave people who were severely suicidal very low doses of a narcotic drug,

Démoslles a persoas cun alto risco de suicidio doses moi baixas

dun estupefaciente, chamado buprenorfina, durante catro semanas.

called buprenorphine, for four weeks.

We discovered that tiny, tiny doses of buprenorphine,

Descubrimos que doses moi moi pequenas de buprenorfina,

which are too low to treat physical pain,

que son demasiado baixas para tratar a dor física,

helped many of them become less suicidal.

axudaban a moitos deles a evitar o suicidio.

But narcotics are extremely dangerous drugs.

Pero os narcóticos son medicamentos extremadamente perigosos.

They may cause addiction, and they're lethal in overdose.

Poden causar adicción e son letais en caso de sobredose.

In contrast, endorphins are not lethal in overdose,

Pola contra, as endorfinas non son letais en caso de sobredose

and they're much less likely to cause addiction.

e teñen moitas menos probabilidades de causar adicción.

So narcotics and endorphins probably activate mu opioid receptors

Así, os narcóticos e as endorfinas activan os receptores opiáceos mu

in different ways.

de diferentes xeitos.

Now, if we could find drugs that activate mu opioid receptors

Se puidésemos atopar fármacos que activasen os receptores opiáceos mu

in a way that resembles how endorphins activate them,

dun xeito similar a como os activan as endorfinas,

we might be able to treat physical and mental pain

seriamos capaces de tratar a dor física e mental

without some of the dangerous side effects of narcotics.

sen algúns dos perigosos efectos secundarios dos narcóticos.

And when my research team came to this conclusion,

Cando o meu equipo de investigación chegou a esta conclusión,

I suddenly remembered what I had learned in Kandel's lab many, many years ago.

de súpeto, lembrei o que aprendera no laboratorio de Kandel,

hai moitos moitos anos.

Some GPCRs can be activated by two different drugs at the same time.

Algúns GPCR poden activarse ao tempo con dous fármacos diferentes.

And when this happens,

Cando isto acontece,

the result may be different from what happens

o resultado pode ser diferente do que ocorre

when they're activated by just one drug.

cando se activan cun só fármaco.

So our research team then used molecular computing technologies

Entón, o noso equipo de investigación usou tecnoloxías de computación molecular

to create a detailed virtual model of the human mu opioid receptor.

para crear un modelo virtual detallado do receptor opiáceo mu humano.

And then, with the help of programs known as molecular docking algorithms,

Despois, coa axuda de programas

coñecidos como algoritmos de axuste molecular,

we screened thousands of existing drugs on a virtual model of the receptor.

analizamos miles de fármacos existentes nun modelo virtual do receptor.

Eventually, we found a way to teach an old dog,

Finalmente, atopamos unha forma de ensinarlle a un can vello,

that's the human mu opioid receptor,

o receptor opiáceo mu humano,

some new tricks.

algúns trucos novos.

We found two drugs that are not narcotics,

Atopamos dous fármacos, que non son narcóticos,

que funcionan xuntos en doses moi moi pequenas

and they work together in very, very small doses

to activate the human mu opioid receptor.

para activar o receptor opiáceo mu humano.

I'm not telling you their names,

Non vou dicir os seus nomes,

because we still have to run many tests and clinical trials

porque aínda temos que realizar moitas probas e ensaios clínicos

before we can be certain

para poder estar seguros

that their combination does exactly what we think it does.

de que a súa combinación fai exactamente o que pensamos que fai,

But both of these drugs have been around for many, many years,

pero estes dous fármacos existen desde hai moitos moitos anos

and they've been used by millions of people.

e utilízanos millóns de persoas.

So we know that they're safe for humans.

Por iso sabemos que son seguros para os humanos.

Here's our bottom line.

Este é o resultado final.

Let's summarize what we've seen.

Imos resumir o que vimos.

First and foremost, mental pain is real.

O primeiro e o máis importante: a dor mental é real.

It's hardwired into our brains.

Está conectada ao noso cerebro.

And mental pain is an essential part of mourning and depression and sadness.

A dor mental é unha parte esencial do loito, da depresión e da tristeza.

And when it gets severe enough, it can actually make people suicidal.

Cando se fai moi grave, pode levar a xente ao suicidio.

Endorphins are brain's natural remedy for physical and mental pain,

As endorfinas son o remedio natural do cerebro para a dor física e mental,

and they work mainly, not exclusively,

e funcionan principalmente, non exclusivamente,

but mainly by activating mu opioid receptors.

senón principalmente, activando os receptores opioides mu.

Now, narcotics also activate mu opioid receptors,

Os narcóticos tamén activan os receptores opiáceos mu,

but in a way that causes addiction and can lead to death.

pero dun xeito que provoca adicción e pode levar á morte.

And this is why narcotics are so dangerous.

Por iso os narcóticos son tan perigosos.

New computational technologies have helped us identify two existing drugs

As novas tecnoloxías informáticas axudáronnos a identificar dous fármacos

that together may treat physical and mental pain

existentes que, xuntos, poden tratar a dor física e mental

without some of the severe side effects of narcotics.

sen algúns dos graves efectos secundarios dos narcóticos.

However, this is still a work in progress.

Non obstante, este aínda é un traballo en curso.

It would be a few years before it may become an approved treatment.

Deberán pasar uns anos antes de converterse nun tratamento aprobado.

But, and this is the last thing I'm going to say,

Pero, e isto é o último que vou dicir,

regardless of drugs,

independentemente dos fármacos,

you have the ability to help family and friends

vós tedes a capacidade de axudar a familiares e amigos

who are in severe physical or mental pain.

que sofren unha dor física ou mental grave.

Thank you very much.

Moitas grazas.

(Applause)

(Aplausos)