 Did you get that urgent email that I sent you? No? A surge of anxiety may have increased in the room. Now imagine, imagine that that anxiety didn't go away and became so excessive that it affected your work and relationships. This is what it's like to have anxiety disorders, the most common mental illnesses worldwide. The World Health Organization reports that globally one in 13 individuals will suffer from an anxiety disorder. And as a psychiatrist and a scientist, I'm delighted to share with you advances we're making in novel medications for those not helped by standard treatments. But there are challenges in psychiatry drug development. For every 11 compounds being tested in cancer and every 8 compounds being tested in neurology, only one is being tested in psychiatry. Yet there are scientific breakthroughs in our understanding of mental illnesses and neurobiology that make now the time to make the greatest investment. Investment in our patients like John, who entered college and was plagued and tormented by intrusive thoughts that he needed to have everything feel just right. He spent hours at night writing and rewriting his homework in the morning changing and changing his shirt until it felt right. He was unable to attend his classes, his girlfriend broke up with him and he couldn't function. He suffered from one of these anxiety disorders called obsessive-compulsive disorder. OCD is characterized by intrusive thoughts that increase anxiety and repetitive behaviors that decrease anxiety. And OCD is severe, one in seven adults with OCD will attempt suicide in their lifetime. Standard treatments like medications and cognitive behavioral therapy help about half of our patients. Unfortunately, there's a long lag time of two to three months before patients experience significant benefit and complete benefit is not common. John was not helped by these standard treatments. Converging lines of evidence suggests that there's a hyperactive brain circuit comprised of regions of the brain in blue that generate thoughts and pictured here in yellow generating motor behavior. And it causes this hyperactive thought control circuit without a stop signal. Patients like John without a stop signal are bombarded with these thoughts. My work focuses on glutamate, the main chemical messenger that's involved in nerve scale communication. It's not that too much glutamate may lead to cell hyperactivity. And I wanted to find out how can we modulate the effects of glutamate in the brain. There's a compound called ketamine, it's pictured here, and it blocks glutamate docking ports. Testing the hypothesis that I had that ketamine might decrease OCD symptoms proved challenging because a lot of people had negative associations to ketamine. Despite the fact that at low doses it had been shown to be safe and effective in major depression. But three amazing women made it possible. First, a generous donor to fund the study. Second, a generous anesthesia colleague who administered ketamine. And third, a brave study participant who joined in the study. He conducted the first study comparing ketamine to placebo in adults with OCD. And found that after a single low dose of ketamine, patients reported complete cessation of their OCD symptoms in hours. This was remarkable. And in half of those patients, these effects lasted up to one week. John turned to me and said, I feel as if the weight of OCD has been lifted. This is exciting because this is the first time a drug has had rapid effects in OCD. And because ketamine works differently from standard OCD medications, it opens up new lines of investigation for drug development. With NIH funding, my lab at Stanford is seeking to understand the mechanism of ketamine's rapid effects using non-invasive neuroimaging. And because there are challenges with ketamine, we're also testing next-generation compounds that don't have ketamine side effects and have longer lasting effects. In parallel, we're also using devices and using the principles of precision psychiatry in order to be able to use non-invasive transcranial pulsed magnetic stimulation in very superficial parts of the node to turn down hyperactivity. We partner with neurosurgeons to be able to surgically implant deep brain stimulation devices to be able to target deeper nodes. Seeing the smile on John's face as he returned to college classes and described that experience gives me hope that with greater investment in precision psychiatry research, we can do better for our patients today. And if you're interested in this research or finding out how you can do more, I'd love to talk to you further. Thank you.