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什么是抑郁症

What is depression? - Helen M. Farrell

抑郁症是造成全球残疾类疾病的主要原因在美国
Depression is the leading causeof disability in the world.
大约有10%的成年人被抑郁症所困扰
In the United States, close to 10 % of adults struggle with depression.
但是作为一种精神疾病
But because it’s a mental illness,
抑郁症比类似高胆固醇等概念更难被理解
it can be a lot harder to understand than, say, high cholesterol.
其中最容易被混淆的概念在于
One major source of confusion isthe difference between having depression
区分患有抑郁症与只是简单的情绪低落
and just feeling depressed.
几乎所有人都有情绪低落的时候
Almost everyone feels downfrom time to time.
考试失利
Getting a bad grade, losing a job,
被炒鱿鱼与人发生争执
having an argument, even a rainy
甚至只是雨天都有可能导致心情低落
day can bring on feelings of sadness.
有时可能根本就是没来由的消沉
Sometimes there’s no trigger at all.
伤感就那么不经意地来袭了
It just pops up out of the blue.
但是渐渐地峰回路转 悲伤的感觉总会慢慢淡去
Then circumstances change, and those sad feelings disappear.
但是临床上所讲的抑郁症却是另一码事
Clinical depression is different.
抑郁症是一种医学上的情绪障碍
It’s a medical disorder,
它无法靠意志来改变
and it won’t go away just because you want it to.
它会持续至少两周的时间
It lingers for at leasttwo consecutive weeks,
并且会严重影响患者的工作状态
and significantly interfereswith one’s ability to work, play,
行为能力 以及情感生活
or love.
抑郁症有多种不同的症状
Depression can have a lotof different symptoms:
情绪低落 对平时的爱好失去以往的兴趣
a low mood, loss of interest in thingsyou’d normally enjoy,
食欲的改变 自卑或者极度的负罪感
changes in appetite, feeling worthless or excessively guilty,
嗜睡或者失眠
sleeping either too much or too little,
无法集中注意力 焦躁或迟钝
poor concentration, restlessness or slowness, loss of energy,
浑身乏力或者反复的轻生念头
or recurrent thoughts of suicide.
如果你符合以上所述的五项症状
If you have at least fiveof those symptoms,
从精神学的角度讲 便可以被判定为患有抑郁症
according to psychiatric guidelines, you qualify for a diagnosis of depression.
不止是行为上的这些症状
And it’s not just behavioral symptoms.
抑郁症还会导致一些脑部的临床表现
Depression has physical manifestationsinside the brain.
首先
First of all,
有些变化可以通过肉眼
there are changes that could be seen with the naked eye
以及X光检测观察到
and X-ray vision.
其中包括检测出较小的额叶以及海马体(大脑的组成部分)
These include smaller frontal lobesand hippocampal volumes.
从更微观的角度讲
On a more microscale,
抑郁症与以下几点有关:
depression is associatedwith a few things:
以血清素 去甲肾上腺素和多巴胺为主的
the abnormal transmission or depletionof certain neurotransmitters,
某些神经传导物质的异常传递与消耗
especially serotonin, norepinephrine,and dopamine,
生物钟节奏混乱
blunted circadian rhythms,
或是睡眠
or specific changes
状况的明显变化
in the REM and slow-wave parts of your sleep cycle,
以及荷尔蒙紊乱 例如皮质醇(一种类激素)偏高以及甲状腺激素异常
and hormone abnormalities, such as high cortisol and deregulation of thyroid hormones.
但是神经系统科学家始终未能完美诠释
But neuroscientists still don’t havea complete picture
导致抑郁症的原因
of what causes depression.
这可能和基因
It seems to have to do
与环境的相互作用有关
with a complex interaction between genes and environment,
但目前我们还没有有效的方法
but we don’t have a diagnostic tool
来准确判断这种作用具体的发生机制
that can accurately predict where or when it will show up.
并且由于抑郁症的病症发生于无形
And because depression symptomsare intangible,
我们便很难发现那些正饱受抑郁症困扰的人
it’s hard to know who might look fine but is actually struggling.
根据美国心理健康研究中心数据表示
According to the National Instituteof Mental Health,
平均每一位患有精神疾病的患者
it takes the average personsuffering with a mental illness
需要花至少10年去寻求帮助
over ten years to ask for help.
但其实目前有很多有效的治疗方法来帮助抑郁症患者
But there are very effective treatments.
药物治疗配合心理治疗可以促进脑内化学物质的产生
Medications and therapy complementeach other to boost brain chemicals.
在一些特殊的病例中 甚至电休克疗法
In extreme cases,electroconvulsive therapy,
即一种像是控制病患大脑进行休克的方法
which is like a controlled seizurein the patient’s brain,
也有一定疗效
is also very helpful.
另外一些很有潜力的治疗方法 比如经颅磁刺激(一种皮层刺激方法)
Other promising treatments, like transcranial magnetic stimulation,
也正在被广泛研究因此
are being investigated, too. So,
如果你认识某位正饱受抑郁症折磨的人
if you know someonestruggling with depression,
请鼓励他们从以上的方法中寻求帮助
encourage them, gently, to seek outsome of these options.
你甚至可以进行更为具体的帮助
You might even offer to helpwith specific tasks,
比如寻求一些此领域中的专业治疗师
like looking up therapists in the area,
又或者是帮忙列一个问题清单去请教医生
or making a list of questionsto ask a doctor.
对于那些患有抑郁症的人来说 迈出这第一步尤为艰难
To someone with depression, these first steps can seem insurmountable.
如果他们有负罪感或羞耻感
If they feel guilty or ashamed,
请向他们指出抑郁症是一种医学疾病
point out that depressionis a medical condition,
就像哮喘或糖尿病一样常见
just like asthma or diabetes.
告诉他们抑郁症并不能成为他们的弱点或代表他们的人格
It’s not a weaknessor a personality trait,
而且他们不能只靠自己硬撑来克服这个疾病
and they shouldn’t expect themselvesto just get over it
这并不像伤筋动骨一样可以自愈
anymore than they could will themselves to get over a broken arm.
如果你未曾受到抑郁症的困扰
If you haven’t experienceddepression yourself,
请不要将他们的痛苦与你平日里的情绪低落进行比较
avoid comparing it to timesyou’ve felt down.
将他们所承受的困扰与常见的悲伤情绪相提并论
Comparing what they’re experiencingto normal, temporary feelings of sadness
会使他们为自己的病情感到自责
can make them feel guilty for struggling.
哪怕只是单纯而诚恳地谈谈抑郁症都会对他们有所帮助例如
Even just talking aboutdepression openly can help.
研究显示询问一些人关于自杀的看法
For example, research shows that askingsomeone about suicidal thoughts
实际上可以降低他们自杀的几率
actually reduces their suicide risk.
开诚布公地谈谈精神疾病有利于淡化患者的自卑意识
Open conversations about mental illnesshelp erode stigma
并且让他们更有勇气去寻求帮助
and make it easierfor people to ask for help.
而越多的患者来积极寻求治疗
And the more patients seek treatment,
对于抑郁症的研究才能有所突破
the more scientists will learn about depression,
从而使他们得到更有效
and the better the treatments will get.

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