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为什么焦虑总是伴随着忧郁 – 译学馆
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为什么焦虑总是伴随着忧郁

Why Do Depression and Anxiety Go Together?

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心理科学秀
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如果你曾经历过临床意义上的焦虑和抑郁
If you’ve ever experienced anxiety and depression — in the clinical sense, I mean.
你就会知道它们两者的感觉完全不同
You will know that they can feel really different.
焦虑时 你的情绪会非常高涨
With anxiety, you’re all ramped up.
而抑郁会让你非常非常低落
And with depression, you’re very, very down.
然而 它们往往同时出现
Yet they tend to go together.
而且很多药物 尤其是几个特定的抗抑郁药物
And a lot of medications, especially certain types of antidepressants,
可以同时用来治疗两者
can be used to treat both.
我们仍然不太了解
We still don’t know a ton
焦虑和抑郁在脑中到底是如何运作的
about how exactly anxiety and depression work in the brain — or
或者抗抑郁药物是如何治疗它们的
how antidepressants work to treat them.
但随着时间流逝 心理学家逐渐意识到
But over time, psychologists have come to realize
焦虑和抑郁这两种情况惊人地相似
that the two types of conditions are surprisingly similar.
在情绪上它们可能表现出完全的不同
They may feel very different in the moment.
但实际它们有很多共同的症状
But they actually have a lot of symptoms in common,
包括一些非常相似的思维模式
and involve some very similar thought patterns.
它们甚至可能有相似的大脑化学反应
They might even have similar brain chemistries.
所以如果你想了解更多
So if you’re looking to understand a little more
关于焦虑和抑郁在日常中的表现
about how anxiety and depression manifest themselves
无论是对你自己或是你生活中的其他人
whether for yourself or themselves for someone else in your life
这些联系是一个很好的开始
those connections are a good place to start.
抑郁和焦虑并非特定的疾病
Depression and anxiety aren’t really specific disorders
它们是各类疾病的统称
They’re generic terms for types of disorders.
但是最常见的 也是联系最密切的
But the most common, and most closely linked,
是重度抑郁症 简称MDD
are major depressive disorder, or MDD, and
和广泛性焦虑症 简称GAD
generalized anxiety disorder, or GAD.
在美国 任何一年的详细数据都能轻而易举地找到
In any given year in the U.S., where it’s easiest to find detailed statistics,
大约7%的人口患有重度抑郁症
about 7 % of the population will have MDD,
大约3%的人患有广泛性焦虑症
and about 3 % will have GAD.
其中许多人同时患有两种病症
Lots of those people have both:
大约2/3患有重度抑郁症的人同样患有某种焦虑症
About 2/3 of people with major depression also have some kind of anxiety disorder,
并且 大约2/3广泛性焦虑症的患者同时患有重度抑郁症
and about 2/3 of people with generalized anxiety disorder also have major depression.
无论你患有焦虑症 或是抑郁症 或是两者都有
And whether you have one or the other or both,
治疗首选方法首选这种药物
the same medications are often at the top
——通常是抗抑郁药物
of the list to help treat it — usually antidepressants.
不出所料 心理学家们已经注意到了这些数据
Unsurprisingly,psychologists have noticed these statistics.
但是很长一段时间
But for a long time,
我们都认为广泛性焦虑症和重度抑郁症是完全不同的
we’ve thought of generalized anxiety and major depression as very different things,
这也是可以理解的
and understandably so.
也许焦虑最明显的症状是冲动
Probably the most noticeable symptom of anxiety is arousal,
这是一个心理学中的专有名词
which in psychology is a technical term
而不是某种特定的性行为
rather than a specifically sexual thing.
无论是心理上的敏感度提升
It basically just means being on high alert
还是生理上 心跳加速 手心出汗
whether psychologically, with increased awareness,or physically,
它基本上只表现为“保持高度警觉”
with things like a racing heart and sweaty palms.
然而冲动并不是重度抑郁症的一部分
Arousal isn’t part of major depression,though.
“低积极情绪”这种重度抑郁症的关键症状
And there’s a key symptom of MDD that
通常不会在广泛性焦虑症中表现出来
doesn’t usually show up in generalized anxiety: low positive affect,
作为专业术语 它表现为无法从生活中收获快乐
which is the technical term for not getting much pleasure out of life
感到昏昏欲睡 毫无生气
and feeling lethargic and just kind of … blah.
所以焦虑和抑郁之间有着重要的区别
So there are important differences between anxiety and depression,
这也是为什么它们仍然被认为是不同类别的疾病
which is part of why they’re still considered separate classes of disorders.
但是当你关注到其他症状时 你就会开始意识到
But when you look at the other symptoms, you start to realize that
重度抑郁症和广泛性焦虑症在几乎其他所有方面都有共同点
major depression and generalized anxiety have almost everything else in common.
有躁动 疲劳 易怒 注意力不集中
There’s restlessness, fatigue, irritability, problems with concentration,
睡眠障碍…… 还有很多
sleep disturbances … the list goes on.
这还仅仅是官方的诊断标准
And that’s just in the official diagnostic criteria.
因此 几十年来 心理学家一直在研究
So for decades, psychologists have been examining the models
用来描述大脑中焦虑和抑郁的模型
they use to describe anxiety and depression in the brain to see
观察是否能在模型中找到两种疾病的相似来源
if they point to a similar source for both types of disorders.
他们和研究人员一样 提出了很多不同的观点
They’ve come up with lots of different ideas,as researchers do,
但最普遍的观点 以面临压力时的“抵抗或逃避”反应为主
but the most common ones tend to center around the fight or flight response to stress.
在你意识到自己面临威胁时
Fight or flight kicks in when you’re confronted
“抵抗或逃避”反应就会开始作祟
with something your mind sees as a threat,
这会让你在无意识中抵抗或者逃避威胁
and it automatically prepares you to either fight or run away.
如果你仔细想一想
And when you think about it,
其实焦虑和抑郁只是逃避反应的不同类型
anxiety and depression are just different types of flight.
心理学家经常把焦虑的本质描述为无助感
Psychologists often characterize anxiety as a sense of helplessness, at its core
把抑郁的本质描述为无望感
and depression as a sense of hopelessness.
焦虑可能会让你觉得你在寻找反击的方法
Anxiety might feel like you’re looking for ways to fight back.
但使它成为一种障碍的部分原因是
But part of what makes it a disorder is
它不是那种一旦有了计划
that it’s not a short-lived feeling
就可以轻而易举解决的短暂感觉
that’s easily resolved once you have a plan.
当然 就像所有的精神健康问题一样
Of course, as with all things mental health,
焦虑症的状况可能与个人有密切关联
anxiety disorders can be deeply personal and
每个人的感受都不尽相同
won’t feel the same for everybody.
但临床焦虑确实往往让人感到无处不在
But clinical anxiety does tend to be more pervasive.
担忧会萦绕在你身边 并开始占据你的生活
The worry sticks around and starts to take over your life
因为它会让你觉得无法克服
because it doesn’t feel like something you can conquer.
因此 焦虑和抑郁可能都是逃避反应 只是方式不同
So anxiety and depression might just be slightly different ways of expressing the same flight response:
一个是无助 一个是无望
helplessness or hopelessness.
也许这就是它们经常同时出现的原因
And maybe that’s part of why they so often go together.
这种联系也出现在应激反应的生化方面
That connection also shows up on the biochemical side of the stress response.
有很多激素参与了这种反应
There are a lot of hormones involved in this response,
它们以超复杂的方式相互作用
and their effects interact in super complex ways
科学家们还没有完全理解
that scientists still don’t fully understand.
但抑郁症和焦虑症都与
But both depressive and anxiety disorders
过度敏感的压力反应系统密切相关
are closely associated with an oversensitive stress response system.
研究者认为 这是这两种疾病
Researchers think that’s one reason both of these types of disorders are so much more
在经历过创伤或童年虐待等重大压力的人身上更为常见的原因之一
common in people who’ve experienced major stresses like trauma or childhood abuse.
这些压力源使他们的压力反应系统更加敏感。
Those stressors could make their stress response system more sensitive.
所涉及的主要激素并不总是相同的
The main hormones involved aren’t always the same,
但这些变化可能导致一些相同的症状
but the changes can cause some of the same symptoms
例如睡眠问题
problems with sleep,for example.
因此 无论是在思维过程还是激素方面
So anxiety and depression seem to be two sides of a similar reaction to stress,
焦虑和抑郁似乎是压力反应的两个方面
in terms of both thought processes and hormones.
然而 这并不能真正解释
Still,that doesn’t really explain
为什么一些抗抑郁药物可以同时治疗焦虑和抑郁
why some antidepressants can treat both anxiety and depression.
这是因为这些药物主要影响神经递质
Because those medications primarily affect neurotransmitters,
也就是脑细胞相互传递信息的分子
the molecules your brain cells use to send messages to each other.
如果你认为关于压力反应是如何工作的 我们还有很多需要学习
If you thought we had a lot left to learn about how the stress response works,
那么我们对焦虑和抑郁的大脑化学成分
we know even less about what the brain chemistry of anxiety and depression looks like,
以及抗抑郁药物是如何起作用的了解就少之又少了
or how antidepressants help.
但是 如果伴随这些疾病而来的思维过程和身体反应
But if the thought processes and physical responses
并不像表面上看起来那么不同
that go along with these disorders aren’t quite as different as they seem on the surface,
那么大脑的化学反应也会是相似的
it makes sense that the brain chemistry would be similar, too.
科学家们正是发现了这一点
And that’s exactly what scientists have found.
更具体而言 许多研究表明 神经递质血清素水平较低
More specifically, lots of studies have pointed to lower levels of the neurotransmitter known
是导致焦虑和抑郁的一个主要因素
as serotonin as a major factor in both anxiety and depression.
研究者甚至发现了一些具有特异性的细胞受体
Researchers have even identified some more specific cellular
它们似乎在焦虑和抑郁两种症状中都出现了
receptors that seem to be involved in both.
另有证据表明 大脑处理另一种神经递质 去甲肾上腺素的方式
There’s also some evidence that the way the brain handles another neurotransmitter, norepinephrine,
在焦虑和抑郁中可能是相似的
can be similar in both anxiety and depression.
由于大多数抗抑郁药物都是通过增加血清素水平来起作用的
Since most antidepressants work by increasing serotonin levels,
其中一些还会影响去甲肾上腺素
and some of them also affect norepinephrine,
这就可以解释为什么它们对治疗焦虑和抑郁 都有这么大的帮助
that could explain why they’re so helpful for both anxiety and depression.
尽管我们对它们的确切机制还有很多不了解。
Although again, there’s a lot we don’t know about their exact mechanisms.
最后 不可置否的是
Ultimately,there’s no denying that in the moment,
在当下 焦虑和抑郁似乎确是两种截然不同的感觉
anxiety and depression can seem like very different feelings.
如果一个人同时患有这两种疾病
And if someone has both types of disorders — well,
可想而知他将会感到濒临奔溃
it’s easy to see how that could feel overwhelming.
毕竟单独治疗广泛性焦虑或重度抑郁症
Like,it’s hard enough treating
已经够难的了
generalized anxiety or major depression on their own.
所以当一个人同时患有这两种疾病时 往往更难治疗
And it’s true that it is often harder to treat these conditions when someone has both.
但是也不会难度翻一番
But maybe not twice as hard.
毕竟从症状到背后的大脑基本化学成分
After all, anxiety and depressive disorders have a lot in common,
再到一些能有所帮助的治疗方法
from their symptoms to the basic brain chemistry behind them
焦虑症和抑郁症有很多共同之处
to some of the treatments that can help.
其实这两个症状总是一起出现 的确很难治疗
The fact that they often go together can be really tough.
但更多地了解这一现象的原因
But understanding more about why that is
也为我们指明了更好更有效的治疗方法
has also pointed us toward better treatments and
这真的会有所帮助
more effective therapies, that really can help.
感谢收看本期《心理科学秀》
Thanks for watching this episode of SciShow Psych.
如果你想找人聊聊你的心理健康
If you’re looking for someone to talk toabout your mental health,
我们在视频详情中留下了一些资源
we left a few resources in this video’s description.
如果你想要了解更多关于治疗的信息
And if you’d like to learn more general info about treatments,
你可以观看我们关于抗抑郁药物误解的节目
you can watch our episode on misconceptions about antidepressants.
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视频概述

焦虑和忧郁看似是两种完全不同的疾病,却有着千丝万缕的联系。它们成双出没的原因到底是什么?

听录译者

收集自网络

翻译译者

路痴

审核员

审核员_BY

视频来源

https://www.youtube.com/watch?v=xdAjGRvxGPM

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