「
No snowflake in an valanche ever feels responsible
雪崩中，沒有一片雪花覺得自己有責任
——斯坦尼斯洛
」
What is depression?
瀏覽器版本過低，暫不支持視頻播放
Transcript(English to Chinese):
Depression is the leading cause of disability in the world.
抑鬱症是造成全球殘疾類疾病的主要原因
In the United States,
在美國
close to 10% of adults struggle with depression.
大約有10%的成年人被抑鬱症所困擾
But because it's a mental illness,
但是作為一種精神疾病
it can be a lot harder to understand than, say, high cholesterol.
抑鬱症比類似高膽固醇等概念更難被理解
One major source of confusion is the difference between having depression
其中最容易被混淆的概念在於
and just feeling depressed.
區分患有抑鬱症與只是簡單的情緒低落
Almost everyone feels down from time to time.
幾乎所有人都有情緒低落的時候
Getting a bad grade,
考試失利
losing a job,
被炒魷魚
having an argument,
與人發生爭執
even a rainy day can bring on feelings of sadness.
甚至只是雨天都有可能導致心情低落
Sometimes there's no trigger at all.
有時可能根本就是沒來由的消沉
It just pops up out of the blue.
傷感就那麼不經意地來襲了
Then circumstances change,
但是漸漸地峰迴路轉
and those sad feelings disappear.
悲傷的感覺總會慢慢淡去
Clinical depression is different.
但是臨床上所講的抑鬱症卻是另一碼事
It's a medical disorder,
抑鬱症是一種醫學上的情緒障礙
and it won't go away just because you want it to.
它無法靠意志來改變
It lingers for at least two consecutive weeks,
它會持續至少兩周的時間
and significantly interferes with one's ability to work,
並且會嚴重影響患者的工作狀態
play,
行為能力
or love.
以及情感生活
Depression can have a lot of different symptoms:
抑鬱症有多種不同的症狀
a low mood,
情緒低落
loss of interest in things you'd normally enjoy,
對平時的愛好失去以往的興趣
changes in appetite,
食慾的改變
feeling worthless or excessively guilty,
自卑或者極度的負罪感
sleeping either too much or too little,
嗜睡或者失眠
poor concentration,
無法集中注意力
restlessness or slowness,
焦躁或遲鈍
loss of energy,
渾身乏力
or recurrent thoughts of suicide.
或者反覆的輕生念頭
If you have at least five of those symptoms,
如果你符合以上所述的五項症狀
according to psychiatric guidelines,
從精神學的角度講
you qualify for a diagnosis of depression.
便可以被判定為患有抑鬱症
And it's not just behavioral symptoms.
不止是行為上的這些症狀
Depression has physical manifestations inside the brain.
抑鬱症還會導致一些腦部的臨床表現
First of all,
首先
there are changes that could be seen with the naked eye
有些變化可以通過肉眼
and X-ray vision.
以及X光檢測觀察到
These include smaller frontal lobes and hippocampal volumes.
其中包括檢測出較小的額葉以及海馬體(大腦的組成部分)
On a more microscale,
從更微觀的角度講
depression is associated with a few things:
抑鬱症與以下幾點有關:
the abnormal transmission or depletion of certain neurotransmitters,
以血清素, 去甲腎上腺素和多巴胺為主的
especially serotonin, norepinephrine, and dopamine,
某些神經傳導物質的異常傳遞與消耗
blunted circadian rhythms,
生物鐘節奏混亂
or specific changes in the REM and slow-wave parts of your sleep cycle,
或是睡眠狀況的明顯變化
and hormone abnormalities,
以及荷爾蒙紊亂
such as high cortisol and deregulation of thyroid hormones.
例如皮質醇(一種類激素)偏高以及甲狀腺激素異常
But neuroscientists still don't have a complete picture
但是神經系統科學家始終未能完美詮釋
of what causes depression.
導致抑鬱症的原因
It seems to have to do with a complex interaction between genes and environment,
這可能和基因與環境的相互作用有關
but we don't have a diagnostic tool
但目前我們還沒有有效的方法
that can accurately predict where or when it will show up.
來準確判斷這種作用具體的發生機制
And because depression symptoms are intangible,
並且由於抑鬱症的病症發生於無形
it's hard to know who might look fine but is actually struggling.
我們便很難發現那些正飽受抑鬱症困擾的人
According to the National Institute of Mental Health,
根據美國心理健康研究中心數據表示
it takes the average person suffering with a mental illness
平均每一位患有精神疾病的患者
over ten years to ask for help.
需要花至少10年去尋求幫助
But there are very effective treatments.
但其實目前有很多有效的治療方法來幫助抑鬱症患者
Medications and therapy complement each other to boost brain chemicals.
藥物治療配合心理治療可以促進腦內化學物質的產生
In extreme cases, electroconvulsive therapy,
在一些特殊的病例中，甚至電休克療法
which is like a controlled seizure in the patient's brain,
即一種像是控制病患大腦進行休克的方法
is also very helpful.
也有一定療效
Other promising treatments,
另外一些很有潛力的治療方法
like transcranial magnetic stimulation,
比如經顱磁刺激（一種皮層刺激方法）
are being investigated, too.
也正在被廣泛研究
So, if you know someone struggling with depression,
因此，如果你認識某位正飽受抑鬱症折磨的人
encourage them, gently, to seek out some of these options.
請鼓勵他們從以上的方法中尋求幫助
You might even offer to help with specific tasks,
你甚至可以進行更為具體的幫助
like looking up therapists in the area,
比如尋求一些此領域中的專業治療師
or making a list of questions to ask a doctor.
又或者是幫忙列一個問題清單去請教醫生
To someone with depression,
對於那些患有抑鬱症的人來說
these first steps can seem insurmountable.
邁出這第一步尤為艱難
If they feel guilty or ashamed,
如果他們有負罪感或羞恥感
point out that depression is a medical condition,
請向他們指出抑鬱症是一種醫學疾病
just like asthma or diabetes.
就像哮喘或糖尿病一樣常見
It's not a weakness or a personality trait,
告訴他們抑鬱症並不能成為他們的弱點或代表他們的人格
and they shouldn't expect themselves to just get over it
而且他們不能只靠自己硬撐來克服這個疾病
anymore than they could will themselves to get over a broken arm.
這並不像傷筋動骨一樣可以自愈
If you haven't experienced depression yourself,
如果你未曾受到抑鬱症的困擾
avoid comparing it to times you've felt down.
請不要將他們的痛苦與你平日裡的情緒低落進行比較
Comparing what they're experiencing to normal, temporary feelings of sadness
將他們所承受的困擾與常見的悲傷情緒相提並論
can make them feel guilty for struggling.
會使他們為自己的病情感到自責
Even just talking about depression openly can help.
哪怕只是單純而誠懇地談談抑鬱症都會對他們有所幫助
For example, research shows that asking someone about suicidal thoughts
例如，研究顯示詢問一些人關於自殺的看法
actually reduces their suicide risk.
實際上可以降低他們自殺的機率
Open conversations about mental illness help erode stigma
開誠布公地談談精神疾病有利於淡化患者的自卑意識
and make it easier for people to ask for help.
並且讓他們更有勇氣去尋求幫助
And the more patients seek treatment,
而越多的患者來積極尋求治療
the more scientists will learn about depression,
對於抑鬱症的研究才能有所突破
and the better the treatments will get.
從而使他們得到更有效的治療
END