Debunking the myths of OCD - Natascha M. Santos

破解對强迫症的迷思－納塔莎．山杜斯

譯者: Sue Chen 審譯者: Harry Chen

There's a common misconception

人們常有這樣的誤解－

that if you like to meticulously organize your things,

如果你喜歡一絲不苟地 擺設自己的東西、

keep your hands clean,

保持雙手乾淨、

or plan out your weekend to the last detail,

或是巨細靡遺地計畫好週末

you might have OCD.

你可能有了「OCD」吧！

In fact, OCD, which stands for obsessive compulsive disorder,

事實上OCD代表的是「强迫症」

is a serious psychiatric condition

是一種極端的精神官能狀況

that is frequently misunderstood by society

經常被社會和像心理醫師的人所誤解

and mental health professionals alike.

So let's start by debunking some myths.

讓我們先從破解幾項迷思做開端

Myth one: repetitive or ritualistic behaviors are synonymous with OCD.

迷思一、重複或例行公事般的行為 就等同於强迫症

As its name suggests,

一如其名強迫症有兩方面－

obsessive compulsive disorder has two aspects:

the intrusive thoughts, images, or impulses, known as obsessions,

擾人的念頭、影像， 和被叫做執迷的強烈衝動

and the behavioral compulsions people engage in

以及有強迫症的人遂行了行為上的 強烈衝動以舒解執迷所引發的焦慮

to relieve the anxiety the obsessions cause.

The kinds of actions that people often associate with OCD,

人們時常把某幾類作為牽扯上强迫症

like excessive hand washing, or checking things repeatedly,

像是太常洗手或是反覆檢查東西

may be examples of obsessive or compulsive tendencies

或者是我們之中多數人不時表現出來 執迷或是強烈衝動傾向的例子

that many of us exhibit from time to time.

But the actual disorder is far more rare and can be quite debilitating.

但是真正的病症極為罕見 而且相當折騰人

People affected have little or no control over their obsessive thoughts

得病的人不太能或根本無法 控制執迷的念頭和衝動的行為

and compulsive behaviors,

which tend to be time consuming

那是會耗費時間而且干擾工作、 上學與社交生活

and interfere with work, school or social life

to the point of causing significant distress.

甚至會引發嚴重的憂鬱

This set of diagnostic criteria is what separates people suffering from OCD

這類診斷標準區分出受强迫症所苦的人

from those who may just be a bit more meticulous

和可能不過是比一般人有點過於 一絲不茍或是執迷於衛生的那些人

or hygiene obsessed than usual.

Myth two: the main symptom of OCD is excessive hand washing.

迷思二、强迫症的主要症狀是太常洗手

Although hand washing is the most common image of OCD in popular culture,

雖然洗手是普眾文化中 最常見的強迫症畫面

obsessions and compulsions can take many different forms.

不過執迷與強烈的衝動卻能夠 用許多不同的方式體現

Obsessions can manifest as fears of contamination and illness,

執迷可以當成對感染與疾病的恐懼、

worries about harming others,

擔心傷害到其他人、

or preoccupations with numbers, patterns, morality, or sexual identity.

或是滿腦子只在乎數字、 形式、道義、性別認定等

And compulsions can range from excessive cleaning or double checking,

而强烈的衝動可以從 過度清潔或反覆檢查

to the fastidious arrangement of objects,

甚至到過分嚴謹的擺設物品

or walking in predetermined patterns.

或是以既定的方式、規矩在走路

Myth three:

迷思三、患有強迫症的人在當下 並不曉得他們是非理性地在做事

individuals with OCD don't understand that they are acting irrationally.

Many individuals with OCD actually understand the relationship

很多强迫症患者事實上清楚知道

between their obsessions and compulsions quite well.

執迷與強烈衝動之間的關聯

Being unable to avoid these thoughts and actions

儘管意識到他們的不合理性

despite being aware of their irrationality

但無法避開這些念頭和動作

is part of the reason why OCD is so distressing.

就是強迫症為什麼這麼令人 憂鬱的部分原因

OCD sufferers report feeling crazy

強迫症患者們說基於不合理的想法 和控制不住的反應

for experiencing anxiety based on irrational thoughts

所經歷的焦慮令其覺得像發瘋了一樣

and finding it difficult to control their responses.

So what exactly causes OCD?

那到底是什麽引起强迫症呢？

The frustrating answer is we don't really know.

令人灰心的答案是我們並不清楚

However, we have some important clues.

然而我們是有一些重要的線索

OCD is considered a neurobiological disorder.

强迫症被認爲是神經生理失調

In other words, research suggests that OCD sufferers brains

換言之研究顯示强迫症患者的大腦

are actually hardwired to behave in a certain fashion.

事實上早被限定了 要做出特定風格之舉動

Research has implicated three regions of the brain

研究指向大腦的三個區塊

variously involved in social behavior and complex cognitive planning,

分別涉入了社交行為、複雜的認知建立、

voluntary movement,

自主性動作以及情緒與幹勁的反應

and emotional and motivational responses.

The other piece of the puzzle

其他費解的地方是強迫症與 低水平的血清素有關

is that OCD is associated with low levels of serotonin,

a neurotransmitter that communicates between brain structures

一種在大腦組織之間 傳遞資訊的神經傳遞素

and helps regulate vital processes,

幫助管制極重要的過程

such as mood, aggression, impulse control,

例如心情、犯意、脈搏控制、

sleep, appetite, body temperature and pain.

睡眠、食慾、體溫和疼痛

But are serotonin and activity in these brain regions the sources of OCD

是否血清素和這些大腦區塊中的 活動就是强迫症的根源？

or symptoms of an unknown underlying cause of the disorder.

或者某種未知的症狀 暗藏了精神不正常的成因？

We probably won't know until

直到我們更通曉大腦前 我們可能不得而知

we have a much more intimate understanding of the brain.

The good news is there are effective treatments for OCD,

好消息是對強迫症有效的療法是存在的

including medications, which increase serotonin in the brain

包括了增加大腦內血清素的藥物

by limiting its reabsorption by brain cells,

阻止血清素被大腦細胞再吸收回去

behavioral therapy that gradually desensitizes patients to their anxieties,

以及使病人對焦慮逐漸 感到麻木的行為療法

and in some cases, electroconvulsive therapy,

當強迫症對其他療法沒反應時

or surgery, when OCD doesn't respond to other forms of treatment.

部分案例中就用電療或是做手術

Knowing that your own brain is lying to you

知道自己的大腦正在説謊

while not being able to resist its commands can be agonizing.

這時候又無法抗拒它的指令 會是非常痛苦的事

But with knowledge and understanding comes the power to seek help,

不過有了知識和理解它 就能得到求救的力量

and future research into the brain

而未來對大腦內的研究

may finally provide the answers we're looking for.

也許最終會提供給我們 此時正在尋找的解答