What is depression? - Helen M. Farrell

翻译人员: Siyue Wang 校对人员: Shanshan (Alice) Lin

Depression is the leading cause of disability in the world.

抑郁症是造成全球残疾类疾病的主要原因

In the United States,

在美国

close to 10% of adults struggle with depression.

大约有10%的成年人被抑郁症所困扰

But because it's a mental illness,

但是作为一种精神疾病

it can be a lot harder to understand than, say, high cholesterol.

抑郁症比类似高胆固醇等概念更难被理解

One major source of confusion is the difference between having depression

其中最容易被混淆的概念在于

and just feeling depressed.

区分患有抑郁症与只是简单的情绪低落

Almost everyone feels down from time to time.

几乎所有人都有情绪低落的时候

Getting a bad grade,

考试失利

losing a job,

被炒鱿鱼

having an argument,

与人发生争执

even a rainy day can bring on feelings of sadness.

甚至只是雨天都有可能导致心情低落

Sometimes there's no trigger at all.

有时可能根本就是没来由的消沉

It just pops up out of the blue.

伤感就那么不经意地来袭了

Then circumstances change,

但是渐渐地峰回路转

and those sad feelings disappear.

悲伤的感觉总会慢慢淡去

Clinical depression is different.

但是临床上所讲的抑郁症却是另一码事

It's a medical disorder,

抑郁症是一种医学上的情绪障碍

and it won't go away just because you want it to.

它无法靠意志来改变

It lingers for at least two consecutive weeks,

它会持续至少两周的时间

and significantly interferes with one's ability to work,

并且会严重影响患者的工作状态

play,

行为能力

or love.

以及情感生活

Depression can have a lot of different symptoms:

抑郁症有多种不同的症状

a low mood,

情绪低落

loss of interest in things you'd normally enjoy,

对平时的爱好失去以往的兴趣

changes in appetite,

食欲的改变

feeling worthless or excessively guilty,

自卑或者极度的负罪感

sleeping either too much or too little,

嗜睡或者失眠

poor concentration,

无法集中注意力

restlessness or slowness,

焦躁或迟钝

loss of energy,

浑身乏力

or recurrent thoughts of suicide.

或者反复的轻生念头

If you have at least five of those symptoms,

如果你符合以上所述的五项症状

according to psychiatric guidelines,

从精神学的角度讲

you qualify for a diagnosis of depression.

便可以被判定为患有抑郁症

And it's not just behavioral symptoms.

不止是行为上的这些症状

Depression has physical manifestations inside the brain.

抑郁症还会导致一些脑部的临床表现

First of all,

首先

there are changes that could be seen with the naked eye

有些变化可以通过肉眼

and X-ray vision.

以及X光检测观察到

These include smaller frontal lobes and hippocampal volumes.

其中包括检测出较小的额叶以及海马体(大脑的组成部分)

On a more microscale,

从更微观的角度讲

depression is associated with a few things:

抑郁症与以下几点有关:

the abnormal transmission or depletion of certain neurotransmitters,

以血清素, 去甲肾上腺素和多巴胺为主的

especially serotonin, norepinephrine, and dopamine,

某些神经传导物质的异常传递与消耗

blunted circadian rhythms,

生物钟节奏混乱

or specific changes in the REM and slow-wave parts of your sleep cycle,

或是睡眠状况的明显变化

and hormone abnormalities,

以及荷尔蒙紊乱

such as high cortisol and deregulation of thyroid hormones.

例如皮质醇(一种类激素)偏高以及甲状腺激素异常

But neuroscientists still don't have a complete picture

但是神经系统科学家始终未能完美诠释

of what causes depression.

导致抑郁症的原因

It seems to have to do with a complex interaction between genes and environment,

这可能和基因与环境的相互作用有关

but we don't have a diagnostic tool

但目前我们还没有有效的方法

that can accurately predict where or when it will show up.

来准确判断这种作用具体的发生机制

And because depression symptoms are intangible,

并且由于抑郁症的病症发生于无形

it's hard to know who might look fine but is actually struggling.

我们便很难发现那些正饱受抑郁症困扰的人

According to the National Institute of Mental Health,

根据美国心理健康研究中心数据表示

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年去寻求帮助

But there are very effective treatments.

但其实目前有很多有效的治疗方法来帮助抑郁症患者

Medications and therapy complement each other to boost brain chemicals.

药物治疗配合心理治疗可以促进脑内化学物质的产生

In extreme cases, electroconvulsive therapy,

在一些特殊的病例中，甚至电休克疗法

which is like a controlled seizure in the patient's brain,

即一种像是控制病患大脑进行休克的方法

is also very helpful.

也有一定疗效

Other promising treatments,

另外一些很有潜力的治疗方法

like transcranial magnetic stimulation,

比如经颅磁刺激（一种皮层刺激方法）

are being investigated, too.

也正在被广泛研究

So, if you know someone struggling with depression,

因此，如果你认识某位正饱受抑郁症折磨的人

encourage them, gently, to seek out some of these options.

请鼓励他们从以上的方法中寻求帮助

You might even offer to help with specific tasks,

你甚至可以进行更为具体的帮助

like looking up therapists in the area,

比如寻求一些此领域中的专业治疗师

or making a list of questions to ask a doctor.

又或者是帮忙列一个问题清单去请教医生

To someone with depression,

对于那些患有抑郁症的人来说

these first steps can seem insurmountable.

迈出这第一步尤为艰难

If they feel guilty or ashamed,

如果他们有负罪感或羞耻感

point out that depression is a medical condition,

请向他们指出抑郁症是一种医学疾病

just like asthma or diabetes.

就像哮喘或糖尿病一样常见

It's not a weakness or a personality trait,

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

and they shouldn't expect themselves to just get over it

而且他们不能只靠自己硬撑来克服这个疾病

anymore than they could will themselves to get over a broken arm.

这并不像伤筋动骨一样可以自愈

If you haven't experienced depression yourself,

如果你未曾受到抑郁症的困扰

avoid comparing it to times you've felt down.

请不要将他们的痛苦与你平日里的情绪低落进行比较

Comparing what they're experiencing to normal, temporary feelings of sadness

将他们所承受的困扰与常见的悲伤情绪相提并论

can make them feel guilty for struggling.

会使他们为自己的病情感到自责

Even just talking about depression openly can help.

哪怕只是单纯而诚恳地谈谈抑郁症都会对他们有所帮助

For example, research shows that asking someone about suicidal thoughts

例如，研究显示询问一些人关于自杀的看法

actually reduces their suicide risk.

实际上可以降低他们自杀的几率

Open conversations about mental illness help erode stigma

开诚布公地谈谈精神疾病有利于淡化患者的自卑意识

and make it easier for people to ask for help.

并且让他们更有勇气去寻求帮助

And the more patients seek treatment,

而越多的患者来积极寻求治疗

the more scientists will learn about depression,

对于抑郁症的研究才能有所突破

and the better the treatments will get.

从而使他们得到更有效的治疗