The psychology of post-traumatic stress disorder - Joelle Rabow Maletis

翻译人员: Yuntao Li 校对人员: Lipeng Chen

Many of us will experience some kind of trauma during our lifetime.

Sometimes, we escape with no long-term effects.

But for millions of us, those experiences linger,

causing symptoms like flashbacks,

nightmares,

很多人都会在生命中经历某种创伤。

and negative thoughts that interfere with everyday life.

This phenomenon, called post-traumatic stress disorder,

有时，我们能毫发无伤地从中脱离，

or PTSD,

但是，成千上万的人会难以脱身，

isn’t a personal failing;

rather, it’s a treatable malfunction of certain biological mechanisms

并伴有许多后遗症， 像是往事突然重现，

噩梦，

以及困扰我们每天生活的负面情绪。

that allow us to cope with dangerous experiences.

这种现象就是创伤后应激障碍，

To understand PTSD,

we first need to understand how the brain processes a wide range of ordeals,

或者PTSD，

这个不是个人的失败；

这其实是可以治愈的生理机制失调，

including the death of a loved one,

domestic violence,

这种生理机制一般来说 帮助我们应对危险的经历。

injury or illness,

abuse,

rape,

war,

想要了解PTSD，

car accidents,

我们首先要了解脑部 是如何处理一系列的严酷考验，

and natural disasters.

These events can bring on feelings of danger and helplessness,

包括爱人之死、

which activate the brain’s alarm system,

家庭暴力、

known as the “fight-flight-freeze” response.

受伤或是疾病、

虐待、

When this alarm sounds,

强奸、

战争、

the hypothalamic, pituitary, and adrenal systems,

车祸、

以及自然灾害。

这些事件都能带来危险和无助的感觉，

known as the HPA axis,

work together to send signals to the autonomic nervous system.

使得激活脑部的警觉系统，

这就是大家知道的 “战斗，逃跑或冻结”反应。

That’s the network that communicates with adrenal glands and internal organs

当这个警报响起时，

to help regulate functions like heart rate,

下丘脑，脑垂体和肾上腺系统，

digestion, and respiration.

也就是 “下丘脑-垂体-肾上腺轴”，

These signals start a chemical cascade

通过协同工作将信号 送达副交感神经系统。

that floods the body with several different stress hormones,

就是沟通肾上腺和体内器官的网络，

causing physiological changes that prepare the body to defend itself.

来帮助调节身体机能，像是心率、

Our heart rate speeds up,

breathing quickens,

消化、

以及呼吸。

and muscles tense.

这些信号引发了化学物质的联动反应，

Even after a crisis is over,

伴随着几种不同的压力荷尔蒙 流向身体，

escalated levels of stress hormones may last for days,

导致生理变化， 使得身体进入防御准备状态。

contributing to jittery feelings,

nightmares,

and other symptoms.

我们的心跳加速，

For most people, these experiences disappear within a few days to two weeks

呼吸加快，

肌肉紧绷。

甚至在危机结束之后，

as their hormone levels stabilize.

压力荷尔蒙在数日之内仍然持续保持一个高值，

But a small percentage of those who experience trauma

导致神经过敏的感觉、

have persistent problems

噩梦、

—sometimes vanishing temporarily only to resurface months later.

以及其它症状。

对于多数人，这些体验会在几天到两周内消失，

We don’t completely understand what’s happening in the brain,

他们荷尔蒙水平慢慢趋于稳定。

but one theory is that the stress hormone cortisol

但是一小部分经历心理创伤的人

may be continuously activating the “fight-flight-freeze” response

就有着难以摆脱的问题——

有时症状短暂消失，却在几个月后又重新发作。

while reducing overall brain functioning, leading to a number of negative symptoms.

我们不完全知道我们的脑子里发生了什么，

These symptoms often fall into four categories:

但是有一个理论是压力荷尔蒙皮质醇

intrusive thoughts, like dreams and flashbacks,

也许会持续激活 “战斗，逃跑或冻结”反应，

avoiding reminders of the trauma,

negative thoughts and feelings, like fear, anger, and guilt,

于此同时，大脑的功能被降低， 导致很多负面反应。

and “reactive” symptoms like irritability and difficulty sleeping.

这些症状通常被分为四类：

侵入式想法，像是做梦或者闪回，

Not everyone has all these symptoms,

or experiences them to the same extent and intensity.

逃避对于心理创伤的回忆，

负面想法和感觉，像是恐惧，愤怒和负罪感，

When problems last more than a month, PTSD is often diagnosed.

以及“反应的”症状，像是易怒以及难以入睡。

Genetics,

on-going overwhelming stress,

and many risk factors like preexisting mental illnesses

不是每个人都有这些症状，

或者有着相同程度或强度。

or lack of emotional support,

likely play a role in determining who will experience PTSD.

当这些问题持续长达一个月， 创伤后压力综合征就经常可以被确诊了。

But the underlying cause is still a medical mystery.

基因，

正在经历的过度紧张，

以及很多风险因素像是已经存在的心理疾病，

A major challenge of coping with PTSD is sensitivity to triggers,

或是缺少感情上的支持，

都在引发创伤后压力综合征种扮演着角色。

physical and emotional stimuli

that the brain associates with the original trauma.

但是直接原因一直是一个谜团。

These can be everyday sensations that aren’t inherently dangerous

解决创伤后压力综合征最大的挑战是它的敏感性，

but prompt powerful physical and emotional reactions.

For example, the smell of a campfire

当患者面临生理和心理的刺激时，

could evoke the memory of being trapped in a burning house.

大脑就把这些刺激与之前的创伤联系在一起。

这些刺激其实可以是日常并不危险的的感觉，

For someone with PTSD,

that memory activates the same neurochemical cascade

但是激起短暂而有力的生理和情绪反应。

as the original event.

比如，闻到篝火的气味时

That then stirs up the same feelings of panic and helplessness

可以唤起曾经被困在燃烧中的房子的经历。

as if they’re experiencing the trauma all over again.

对于创伤后压力综合征患者来说，

Trying to avoid these triggers, which are sometimes unpredictable,

这个记忆激活了相同的神经化学反应，

就跟一开始受到的创伤一样。

can lead to isolation.

然后，就激起了相同的慌张和无助感，

That can leave people feeling invalidated,

ignored,

or misunderstood,

就像再次经历这次创伤一样。

like a pause button has been pushed on their lives

while the rest of the world continues around them.

尝试去躲避这些有时难以预测的事件，

But, there are options.

会导致与世隔绝。

If you think you might be suffering from PTSD,

会让患者觉得无助、

the first step is an evaluation with a mental health professional

被忽视、

被误解，

就像是患者的人生被按了暂停键，

who can direct you towards the many resources available.

而周围的一切却在持续地运转。

Psychotherapy can be very effective for PTSD,

但是，还有别的选择。

helping patients better understand their triggers.

如果你认为你正在遭受创伤后压力综合征的折磨，

And certain medications can make symptoms more manageable,

你第一件要做的事是接受心理健康专家的评估，

as can self- care practices, like mindfulness and regular exercise.

他们能够给你很多资源。

心理治疗对于创伤后压力综合征是十分有效的，

What if you notice signs of PTSD in a friend or family member?

帮助患者理解是什么引起他们的症状。

Social support, acceptance, and empathy are key to helping and recovery.

有一些药物也可以使得症状更容易被控制，

Let them know you believe their account of what they’re experiencing,

自我保健也能有所帮助， 像是保持专注和锻炼身体。

and that you don’t blame them for their reactions.

如果你意识到了你的家人或朋友 可能患有创伤后压力综合征该怎么办呢？

If they’re open to it,

encourage them to seek evaluation and treatment.

社交支持，接受和同情 都很有可能帮助他们的恢复。

PTSD has been called “the hidden wound”

because it comes without outward physical signs.

让他们知道你重视他们的经历，

But even if it’s an invisible disorder, it doesn’t have to be a silent one.

以及你并不会责怪他们的行为。

如果他们对这个话题很开放，

那就鼓励他们去接受评估和治疗。

创伤后压力综合征也被叫做 “隐藏的伤口”，

因为它不会有明显的生理症状。

但是，虽然它是难以被看到的疾病， 并不意味着它是该被忽视的一个。