What causes panic attacks, and how can you prevent them? - Cindy J. Aaronson

翻译人员: Boyu Yang 校对人员: Yolanda Zhang

The body becomes its own corset.

身体成为了它自己的盔甲。

Past, present, and future exist as a single force.

过去，现在和未来 凝聚成同一股力量。

A swing without gravity soars to a terrifying height.

就像没有重力约束的秋千 翱翔到了令人恐怖的高度。

The outlines of people and things dissolve.

人与物的边界线开始融化。

Countless poets and writers have tried to put words

无数的诗人与作家 试图将急性焦虑症的症状

to the experience of a panic attack—

用文字描绘下来——

a sensation so overwhelming, many people mistake it for a heart attack, stroke,

这是一种排山倒海的感觉， 许多人误把它当成

心脏病发作、中风， 或其他致命的危机。

or other life-threatening crisis.

Though panic attacks don’t cause long-term physical harm,

虽然急性焦虑症不会对身体 造成长期危害，

afterwards, the fear of another attack can limit someone’s daily life—

但是，对于下一次病情复发的恐惧 会限制一个人的日常生活——

and cause more panic attacks.

并且会使急性焦虑症多次复发。

Studies suggest that almost a third of us

研究表明， 我们当中近三分之一的人

will experience at least one panic attack in our lives.

在一生中都会至少 体验一次急性焦虑症。

And whether it’s your first, your hundredth,

无论这是你第一次， 还是第一百次，

or you’re witnessing someone else go through one,

还是你正在目睹别人的一次经历，

no one wants to repeat the experience.

没人想要重复这种经历。

Even learning about them can be uncomfortable, but it’s necessary—

即使学习关于它的点点滴滴 会使我们不安，但这是必须的 ——

because the first step to preventing panic attacks is understanding them.

因为阻止急性焦虑症的第一步 就是了解它们。

At its core, a panic attack is an overreaction to the body’s

急性焦虑症的本质， 是身体面对危险时

normal physiological response to the perception of danger.

正常的生理状态。

This response starts with the amygdala,

这种生理反应开始于杏仁核，

the brain region involved in processing fear.

它是大脑内负责处理恐惧的区域。

When the amygdala perceives danger,

杏仁核感受到恐惧的时候，

it stimulates the sympathetic nervous system,

它会刺激交感神经系统，

which triggers the release of adrenaline.

从而使身体释放出肾上激素。

Adrenaline prompts an increase in the heart and breathing rate

肾上激素会加快心跳和呼吸频率，

to get blood and oxygen to the muscles of the arms and legs.

使血液和氧气更快地 抵达手臂和腿的肌肉。

This also sends oxygen to the brain, making it more alert and responsive.

同时，大脑也会接收更多氧气， 让它变得更加警惕和敏捷。

During a panic attack,

当急性焦虑症发作时，

this response is exaggerated well past what would be useful

这种反应被夸大了，

远远超过了在危险情况下 必要的程度，

in a dangerous situation,

causing a racing heart, heavy breathing, or hyperventilation.

使得心脏快速跳动， 呼吸沉重或过度换气。

The changes to blood flow cause lightheadedness

血液流动的变化会造成晕眩

and numbness in the hands and feet.

和手脚的麻木。

A panic attack usually peaks within 10 minutes.

急性焦虑症的症状通常 会在十分钟内到达顶峰。

Then, the prefrontal cortex takes over from the amygdala

随后，前额叶皮层将取代杏仁核，

and stimulates the parasympathetic nervous system.

并刺激周边神经系统。

This triggers the release of a hormone called acetylcholine

这会刺激大脑释放一种 叫乙酰胆碱的荷尔蒙，

that decreases the heart rate and gradually winds down the panic attack.

它会降低心率， 并逐渐减缓急性焦虑症。

In a panic attack, the body’s perception of danger

在急性焦虑症发作时， 身体对于危险的感知

is enough to trigger the response we would have to a real threat— and then some.

足够触发我们面对 真正威胁时的反应。

We don't know for sure why this happens,

我们目前还不了解它发生的原因，

but sometimes cues in the environment that remind us

有时，环境中的一些线索 会让我们想起

of traumatic past experience can trigger a panic attack.

过去那些创伤性的经历， 从而引发急性焦虑症。

Panic attacks can be part of anxiety disorders

急性焦虑症是焦虑症的一种，

like PTSD, social anxiety disorder, OCD, and generalized anxiety disorder.

后者还包括创伤后遗症、社交恐惧、 强迫症和广泛性焦虑障碍。

Recurring panic attacks, frequent worry about new attacks,

反复发作的急性焦虑症， 频繁担心新的发作，

and behavioral changes to avoid panic attacks

甚至为避免发作 而做出的行为改变，

can lead to a diagnosis of a panic disorder.

都可能导致恐慌症的诊断。

The two main treatments for panic disorder

针对恐慌症， 两种主要的治疗手段有

are antidepressant medication and cognitive behavioral therapy, or CBT.

使用抗抑郁药物， 和认知行为疗法（CBT）。

Both have about a 40% response rate—

两者的有效率都大约为 40 %——

though someone who responds to one may not respond to the other.

然而对其中一种治疗方法产生反应的人 不一定会对另一种做出反应。

However, antidepressant medications carry some side effects,

不过，抗抑郁药物 有一些副作用，

and 50% of people relapse when they stop taking them.

而且 50 %的人 会在停止服用后复发。

CBT, meanwhile, is more lasting, with only a 20% relapse rate.

但是，认知行为疗法会更加持久， 只有 20 % 的复发率。

The goal of CBT treatment for panic disorder is to help people learn

认知行为疗法的目的 是帮助人们学习和练习具体的方法，

and practice concrete tools to exert physical, and in turn mental,

从而在身体上和精神上

control over the sensations and thoughts associated with a panic attack.

控制与急性焦虑症相关的 感觉和想法。

CBT begins with an explanation of the physiological causes of a panic attack,

认知行为疗法从解释 急性焦虑症的心理原因开始，

followed by breath and muscle exercises designed to help people

然后通过一些设计好的 呼吸和肌肉练习来帮助人们

consciously control breathing patterns.

有意识地控制呼吸规律。

Next comes cognitive restructuring,

下一步是重构认知，

which involves identifying and changing the thoughts

这包括识别和改变

that are common during attacks—

在发作中常见的想法——

such as believing you’ll stop breathing, have a heart attack, or die—

例如觉得你会停止呼吸、 心脏病发作，或者死亡——

and replacing them with more accurate thoughts.

并且把它们替换成 更加确切的想法。

The next stage of treatment is exposure to the bodily sensations and situations

下一个阶段的治疗，是暴露于 通常会引发恐慌症的

that typically trigger a panic attack.

身体感觉和状况下。

The goal is to change the belief, through experience,

我们的目标是通过经验 来改变这种信念，

that these sensations and situations are dangerous.

即这些感觉和情况是危险的。

Even after CBT, taking these steps isn’t easy in the grip of an attack.

即使在使用认知疗法后， 面对发作时采取这些步骤也不容易。

But with practice, these tools can both prevent and de-escalate attacks,

但反复练习后，这些方法可以 防止和缓解发作，

and ultimately reduce the hold of panic on a person’s life.

并最终减少一个人生活中的恐慌。

Outside formal therapy,

在正式治疗之外，

many panickers find relief from the same beliefs CBT aims to instill:

许多恐慌者也从认知行为疗法 旨在灌输的信念中找到了解脱：

that fear can’t hurt you, but holding on to it will escalate panic.

那就是恐惧不会伤害你， 但抓住恐惧不放会加剧恐慌。

Even if you’ve never had a panic attack,

即使你从未经历过急性焦虑症，

understanding them will help you identify one in yourself or someone else—

了解它们也能帮助你在自己 或别人身上识别出急性焦虑症——

and recognizing them is the first step in preventing them.

正确辨别， 是防止急性焦虑症的第一步。