Our lives on this planet have improved in so many amazing ways over the last century. On average, we are now healthier, more affluent and literate, less violent and longer living. Despite these unprecedented positive changes, clear signs exist that we are in the midst of an emerging crisis — one that has not yet been recognized in its full breadth, even though it lurks just beneath the surface of our casual conversations and swims in the undercurrents of our news feeds. This is not the well-known crisis that we’ve induced upon the earth’s climate, but one that is just as threatening to our future. This is a crisis of our minds. A cognition crisis.
A cognition crisis is not defined by a lack of information, knowledge or skills. We have done a fine job in accumulating those and passing them along across millennia. Rather, this a crisis at the core of what makes us human: the dynamic interplay between our brain and our environment — the ever-present cycle between how we perceive our surroundings, integrate this information, and act upon it.
This ancient perception-action cycle ensured our earliest survival by allowing our primordial predecessors to seek nutrients and avoid toxins. It is from these humble beginnings that the human brain evolved to pursue more diverse resources and elude more inventive threats. It is from here that human cognition emerged to support our success in an increasingly complex and competitive environment: attention, memory, perception, creativity, imagination, reasoning, decision making, emotion and aggression regulation, empathy, compassion, and wisdom. And it is here that our crisis exists.
Today, hundreds of millions of people around the world seek medical assistance for serious impairments in their cognition: major depressive disorder, anxiety, schizophrenia, autism, post-traumatic stress disorder, dyslexia, obsessive-compulsive disorder, bipolar disorder, attention deficit hyperactivity disorder (ADHD), addiction, dementia, and more. In the United States alone, depression affects 16.2 million adults, anxiety 18.7 million, and dementia 5.7 million — a number that is expected to nearly triple in the coming decades.
American teens have experienced a 33% increase in depressive symptoms, with 31% more having died by suicide between 2010 and 2015.
The immense personal, societal and economic impact of cognitive dysfunction warrants heightened consideration because the crisis is growing, not receding. Despite substantial investment in research and treatments by governments, foundations, and companies around the world, the prevalence and impact of these conditions are escalating. Between 2005 and 2015, the number of people worldwide with depression and anxiety increased by 18.4% and 14.9% respectively, while individuals with dementia exhibited a 93% increase over those same years.
To some degree, these trends reflect the overall growth and aging of the world’s population. This will only continue to increase in the future: the global population of seniors is predicted to swell to 1.5 billion by 2050. Although there are clear benefits to living longer, an unfortunate negative consequence is the burden it places on many aspects of cognition.
There are signs something else is going on, too. Over the last several decades, worrying tears have appeared in the cognitive fabric of our youth, notably in terms of emotional regulation and attentional deployment. American teens have experienced a 33% increase in depressive symptoms, with 31% more having died by suicide in 2015 than in 2010. ADHD diagnoses have also increased dramatically. While a growing awareness of these conditions — and with it, more frequent diagnoses — are likely factors, it does not seem this is the whole story; the magnitude of this escalation points to a deeper problem.
This has been better studied in the U.S. than abroad, but it is clear that this crisis is truly global, with the number of people suffering debilitating impairments in cognition exceeding half a billion worldwide, coupled with a financial toll in the trillions of dollars in lost productivity, healthcare costs and more.
[O]ur brains simply have not kept pace with the dramatic and rapid changes in our environment — specifically the introduction and ubiquity of information technology.
Even if an individual’s cognition problems do not result in a medical diagnosis, subclinical deficits in attention, emotional regulation and memory have been found to confer a real risk. Creative thinking and empathic concern also appear to be declining in children and teens. Even the so-called Flynn Effect, which refers to a world-wide increase in intelligence over the last century, now shows signs of stagnation — and sometimes reversal — in developed countries.
While the sources fracturing our cognition are many, we are faced with the realization that our brains simply have not kept pace with the rapid changes in our environment — specifically the introduction and ubiquity of information technology. At our core, we humans are inherently information-seeking creatures. As a result, a profound shift in the flow of information will inevitably have major effects; and as we have come to see, many of these are negative.
While the many aspects of cognition — such as memory, attention, perception and emotional regulation — appear distinct on the surface, there are common threads that suggest their dysfunction are manifestations of a larger, more fundamental crisis. For instance, the prefrontal cortex, the most evolved region of the human brain, has been shown to support the full breadth of our cognition, and its dysfunction has been associated with symptoms of virtually every neuropsychiatric condition, from depression to ADHD. Simply put: what affects the prefrontal cortex can affect cognition more broadly.
It is a disservice to construct silos around each aspect of cognition and its accompanying dysfunction. We must see the forest for the trees.
Neuroscientists and leadership in the medical world now appreciate that much more unites seemingly disparate aspects of cognition than divide them. For example, attention deficits are now recognized to be a prominent feature of major depressive disorder, and are included in the most recent diagnostic criteria — the bible used by mental health experts — as a “diminished ability to concentrate.” The reality is that each of us has one mind, and embracing this will foster our ability to nurture it.
There is also, as I’ve said, a common, underlying aggravator that has exerted an impact across all domains of cognition: the dramatic plunge we’ve taken into the information age on the back of the digital revolution. Every way we interact with our environment, as well as with each other and ourselves, has been radically transformed by technology.
The old environment, where our cognition evolved, is long gone. The new environment, where multidimensional information flows like water (from a firehose!), challenges our brain and behavior at a fundamental level.
This has been shown in the laboratory, where scientists have documented the influence of information overload on attention, perception, memory, decision making, and emotional regulation. And it has also been shown in the real world, where we see strong associations between the use of technology and rising rates of depression, anxiety, suicide, and attention deficits, especially in children.
There is a common, underlying aggravator that has exerted an impact across all domains of cognition: the information age.
Although the exact mechanism is still under exploration, a complex story is emerging. We are seeing accelerating reward cycles associated with intolerance to delayed gratification and sustained attention; excessive information exposure connected with stress, depression, and anxiety (e.g., fear of missing out and being non-productive); and, of course, multitasking has been linked to safety issues (such as texting while driving) and a lack of focus (which impacts our relationships, our studies, and our work).
What’s more, our constant engagement with technology interferes with the pursuit of other behaviors critical for maintaining a healthy mind, such as nature exposure, physical movement, face-to-face contact, and restorative sleep. Its negative influence on empathy, compassion, cooperation, and social bonding are just beginning to be understood.
The relatively young wellness movement, with ambitious goals of fostering and maintaining cognition throughout our lives, seems to understand this. Unfortunately, it’s largely been marginalized as “alternative” and not given the benefit of mainstream concern.
There’s cause for alarm, but it’s not all doom and gloom. The information age has offered us a tremendous opportunity to expand our consciousness and connect with one another like never before. It has helped reduce inequities arising from lack of resources by providing training and education to people who may not have access to high-quality teachers or institutions.
Fortunately, the negative consequences of information technology are increasingly being recognized by both entrepreneurs who’ve created them and consumers who ravenously devour them. Fresh ideas have emerged regarding how we might modify our behavior to foster healthier habits of engagement with software and devices so that we are the ones in control and not the other way around.
We should think about the consumption of information in a similar manner to how we view the consumption of food. Still, behavioral change alone will not be enough, because the stakes will only get higher in the future, where we may very well find ourselves immersed in virtual and augmented realities, with our interactions being guided by artificial intelligence.
We are not putting the tech genie back in the bottle.
We are coming to realize that we need to get out in front of this by designing new technologies in a manner that is informed by a deeper understanding of how our brain functions — its limitations and vulnerabilities.
We are not putting the tech genie back in the bottle. Next-generation information technology, even when thoughtfully designed and well-intentioned, will likely continue to stress our brains. That’s why we need to recognize the full extent of its influence — and explore creative approaches to addressing it.
So, what do we do? We must also enhance cognition itself.
We need better brains to manage the deluge of information we consume on the internet, on social media, on our smartphones today — as well as the new technologies we’ll surely encounter tomorrow. We need to elevate the maturity of our collective consciousness in order to thrive in this new environment.
This calls for something big: coordinated effort by major actors, from the White House and the National Institutes of Health to the United Nations and the power brokers at Davos. Indeed, addressing the cognition crisis should be positioned as a grand challenge, on par with other pressing global priorities, such as eradicating infectious diseases and disseminating clean water.
Success in solving such global challenges depends upon us having the mental capacity to actually solve them: high-level attention, reasoning, creativity, decision making, compassion, and wisdom are required. If we can’t focus our attention and make creative, wise, and more future-oriented decisions, we will never effectively deal with complex, time-delayed crises like the one affecting our climate, no matter how much information we acquire.
The idea of a global enterprise directed at enhancing ourselves should not seem foreign. We humans have long been obsessed with biological self-optimization. When it comes to our physical bodies, abilities such as strength, endurance, power, speed, balance, flexibility and coordination have all been targeted for improvement with specialized technologies and programs delivered by trained practitioners.
We have developed these approaches to yield physical enhancements with benefits aimed toward entertainment, fitness, athletics, sports, and rehabilitation. But we are tragically lacking when it comes to optimizing our cognition. The price for this neglect is tough to overstate.
To have a consequential and enduring impact, a grand challenge of cognitive enhancement needs to be positioned as a broad pursuit, directed at enhancing cognition in those of us who are healthy, as well as those suffering from incapacitating deficits in cognition. At the boundaries, these groups blur. Fortunately, we have two major institutions — our education and medical systems — that parse the population in this manner and seem well positioned to tackle a challenge like this one.
To that end: developing and enhancing cognition for healthy brains should be a core mission of our educational institutions, and remediating cognitive deficits should be a major goal of our medical system. Right now, neither of these incumbents are effectively doing so. From teachers to therapists to psychiatrists to neurologists, our cognition practitioners are simply not equipped with the tools or training needed to face the challenges that our brains now endure.
Professor of Neurology, Psychiatry Physiology at UCSF, Founder & Director of Neuroscape, CoFounder of Akili Interactive, JAZZ VP, Sensync. https://gazzaley.com