What is bipolar disorder? - Helen M. Farrell

譯者: Regina Chu 審譯者: Shelley Krishna Tsang

What is bipolar disorder?

什麼是雙極性情感障礙（躁鬱症）？

The word bipolar means two extremes.

雙極性意指兩個極端

For the many millions experiencing bipolar disorder around the world,

對全世界數百萬躁鬱症患者而言

life is split between two different realities -

生命被撕裂成兩個不同的現實

elation and depression.

興高采烈和抑鬱寡歡

Although there are many variations of bipolar disorder,

雖然躁鬱症有很多型態

let's consider a couple.

讓我們先看兩種

Type 1 has extreme highs alongside the lows,

第一型是極度高昂伴隨著極度低潮

while Type 2 involves briefer, less extreme periods of elation

第二型則是較短較輕的高昂期

interspersed with long periods of depression.

穿插在長期的抑鬱期間

For someone seesawing between emotional states,

這兩種情緒起起伏伏的人

it can feel impossible to find the balance necessary to lead a healthy life.

會覺得不可能找到 健康生活所需的平衡點

Type 1's extreme highs are known as manic episodes,

第一型的極度高昂稱為躁期

and they can make a person range from feeling irritable to invincible.

會讓人覺得暴躁易怒到無所不能

But these euphoric episodes exceed ordinary feelings of joy,

但是這些精神愉快的發作期 超過一般的喜悅感覺

causing troubling symptoms like racing thoughts,

造成令人擔憂的症狀 如快速不連續的思考

sleeplessness,

失眠

rapid speech,

講話飛快

impuslive actions,

衝動

and risky behaviors.

及危險行為

Without treatment, these episodes become more frequent,

如果不治療，發作會愈來愈頻繁

intense,

愈嚴重

and take longer to subside.

要花更多時間才能平息

The depressed phase of bipolar disorder manifests in many ways -

躁鬱症的鬱期會以很多方式表現

a low mood,

情緒低落

dwindling interest in hobbies,

對嗜好減低興趣

changes in appetite,

食慾改變

feeling worthless or excessively guilty,

覺得一無是處或過分內疚

sleeping either too much or too little,

睡眠太多或太少

restlessness or slowness,

不安或遲緩

or persistent thoughts of suicide.

或持續的自殺念頭

Worldwide, about one to three percent of adults

全世界約有 1-3 % 成人

experience the broad range of symptoms that indicate bipolar disorder.

經歷廣泛的躁鬱症徵狀

Most of those people are functional, contributing members of society,

這些人大多數都是對社會 有功用有貢獻的人

and their lives, choices, and relationships

他們的生活、選擇及人際關係

aren't defined by the disorder,

不會被躁鬱症限制

but still, for many, the consequences are serious.

即使如此，對很多人而言 後果仍然很嚴重

The illness can undermine educational and professional performance,

這種疾病會腐蝕教育及專業表現

relationships,

人際關係

financial security,

財務穩定

and personal safety.

及個人的安全

So what causes bipolar disorder?

那麼是什麼原因造成躁鬱症？

Researchers think a key player is the brain's intricate wiring.

研究人員認為大腦 複雜的迴路是一個關鍵

Healthy brains maintain strong connections between neurons

健康的大腦會在神經元間 維持強有力的連結

thanks to the brain's continuous efforts to prune itself

這要感謝大腦不斷努力修剪自己

and remove unused or faulty neural connections.

並移除沒有使用或壞掉的神經連結

This process is important because our neural pathways serve as a map

這個過程很重要 因為我們的神經路徑

就是我們所作所為的地圖

for everything we do.

Using functional magnetic resonance imaging,

利用功能磁共振造影

scientists have discovered that the brain's pruning ability is disrupted

科學家發現大腦的修剪功能

在躁鬱症病人身上被打斷

in people with bipolar disorder.

That means their neurons go haywire

這意味著他們的神經元路線混亂

and create a network that's impossible to navigate.

而且產生無法導航的網路

With only confusing signals as a guide,

在只有混亂信號的指引下

people with bipolar disorder develop abnormal thoughts and behaviors.

躁鬱症患者發展出 不正常的思想及行為

Also, psychotic symptoms,

而且，精神性症狀

like disorganized speech and behavior,

像是解構的語言及行為

delusional thoughts,

妄想

paranoia,

偏執

and hallucinations

及幻覺

can emerge during extreme phases of bipolar disorder.

都可能在躁鬱症的極端期間出現

This is attributed to the overabundance of a neurotransmitter called dopamine.

這要歸因於過度分泌的 神經傳遞質多巴胺

But despite these insights, we can't pin bipolar disorder down to a single cause.

但是即使有這些見解

我們仍不能把躁鬱症歸咎於單一成因

In reality, it's a complex problem.

現實情況是這個問題很複雜

For example, the brain's amygdala is involved in thinking,

譬如說，大腦的杏仁核與思考

long-term memory,

長期記憶

and emotional processing.

及情緒處理有關

In this brain region, factors as varied as genetics and social trauma

大腦這塊區域，可能因為 不同的因子如遺傳及社會創傷

may create abnormalities and trigger the symptoms of bipolar disorder.

而產生異常並引發躁鬱症的症狀

The condition tends to run in families,

這種情況往往在家族中發生

so we do know that genetics have a lot to do with it.

所以我們的確知道 遺傳跟此疾病大有關係

But that doesn't mean there's a single bipolar gene.

但是這不代表有一個躁鬱症基因

In fact, the likelihood of developing bipolar disorder

事實上發展出躁鬱症的可能性

is driven by the interactions between many genes

受到許多基因 在複雜的情況下互動所驅使

in a complicated recipe we're still trying to understand.

我們仍然在試圖找出答案

The causes are complex,

由於成因複雜

and consequently, diagnosing and living with bipolar disorder is a challenge.

因此要診斷出躁鬱症 並與之共處是一大挑戰

Despite this, the disorder is controllable.

儘管如此這種疾病是可以控制的

Certain medications like lithium can help manage risky thoughts and behaviors

某些藥物如鋰鹽可以協助 控制高危險性的思想及行為

by stabilizing moods.

因為它能穩定情緒

These mood stabilizing medications work by decreasing abnormal activity in the brain,

這種情緒穩定劑的成效 來自降低腦部不正常的活動

thereby strengthening the viable neural connections.

從而增強有效的神經連結

Other frequently used medications include antipsychotics,

另外常用的治療法如抗精神病藥物

which alter the effects of dopamine,

會改變多巴胺的作用

and electroconvulsive therapy,

還有電擊痙攣休克治療法

which works like a carefully controlled seizure in the brain,

就是人為精心控制的大腦癲癇

is sometimes used as an emergency treatment.

有時候也會當作緊急處理使用

Some bipolar patients reject treatment

某些躁鬱症患者拒絕治療

because they're afraid it will dim their emotions

因為他們害怕療法會使情緒低落

and destroy their creativity.

並摧毀創造力

But modern psychiatry is actively trying to avoid that.

但是現代精神科 積極試圖避免這種情況

Today, doctors work with patients on a case-by-case basis

今天，醫師會根據個別病患的狀況

to administer a combination of treatments and therapies

開立處方及治療法

that allows them to live to their fullest possible potential.

讓病患的生命充分發揮潛力

And beyond treatment, people with bipolar disorder can benefit

除了治療之外，躁鬱症病患

from even simpler changes.

做出簡單的改變也會對生活有幫助

Those include regular exercise,

包括規律的運動

good sleep habits,

良好的睡眠習慣

and sobriety from drugs and alcohol,

節制使用藥物及酒精飲料

not to mention the acceptance and empathy of family and friends.

更不用說親朋好友的接受與同情了

Remember, bipolar disorder is a medical condition,

要記得，躁鬱症是一種疾病

not a person's fault,

不是個人的錯

or their whole identity,

也不是他們整體身分的問題

and it's something that can be controlled

而且這種疾病能受控制

through a combination of medical treatments doing their work internally,

透過藥物及治療在體內發揮功效

friends and family fostering acceptance and understanding on the outside,

加上外在親朋好友 抱著接受與瞭解的心態

and people with bipolar disorder empowering themselves

躁鬱症患者能讓自己

to find balance in their lives.

找到生命的平衡點