What is bipolar disorder? - Helen M. Farrell

13,775,637 views ・ 2017-02-09

TED-Ed


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譯者: Regina Chu 審譯者: Shelley Krishna Tsang
00:06
What is bipolar disorder?
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什麼是雙極性情感障礙(躁鬱症)?
00:08
The word bipolar means two extremes.
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雙極性意指兩個極端
00:12
For the many millions experiencing bipolar disorder around the world,
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對全世界數百萬躁鬱症患者而言
00:16
life is split between two different realities -
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生命被撕裂成兩個不同的現實
00:20
elation and depression.
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興高采烈和抑鬱寡歡
00:22
Although there are many variations of bipolar disorder,
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雖然躁鬱症有很多型態
00:25
let's consider a couple.
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讓我們先看兩種
00:27
Type 1 has extreme highs alongside the lows,
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第一型是極度高昂伴隨著極度低潮
00:31
while Type 2 involves briefer, less extreme periods of elation
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第二型則是較短較輕的高昂期
00:36
interspersed with long periods of depression.
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穿插在長期的抑鬱期間
00:39
For someone seesawing between emotional states,
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這兩種情緒起起伏伏的人
00:42
it can feel impossible to find the balance necessary to lead a healthy life.
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會覺得不可能找到 健康生活所需的平衡點
00:48
Type 1's extreme highs are known as manic episodes,
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第一型的極度高昂稱為躁期
00:52
and they can make a person range from feeling irritable to invincible.
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會讓人覺得暴躁易怒到無所不能
00:56
But these euphoric episodes exceed ordinary feelings of joy,
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但是這些精神愉快的發作期 超過一般的喜悅感覺
01:01
causing troubling symptoms like racing thoughts,
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造成令人擔憂的症狀 如快速不連續的思考
01:03
sleeplessness,
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失眠
01:05
rapid speech,
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講話飛快
01:06
impuslive actions,
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衝動
01:07
and risky behaviors.
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及危險行為
01:10
Without treatment, these episodes become more frequent,
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如果不治療,發作會愈來愈頻繁
01:12
intense,
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愈嚴重
01:13
and take longer to subside.
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要花更多時間才能平息
01:16
The depressed phase of bipolar disorder manifests in many ways -
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躁鬱症的鬱期會以很多方式表現
01:20
a low mood,
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情緒低落
01:21
dwindling interest in hobbies,
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對嗜好減低興趣
01:23
changes in appetite,
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食慾改變
01:25
feeling worthless or excessively guilty,
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覺得一無是處或過分內疚
01:27
sleeping either too much or too little,
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睡眠太多或太少
01:30
restlessness or slowness,
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不安或遲緩
01:32
or persistent thoughts of suicide.
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或持續的自殺念頭
01:35
Worldwide, about one to three percent of adults
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全世界約有 1-3 % 成人
01:38
experience the broad range of symptoms that indicate bipolar disorder.
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經歷廣泛的躁鬱症徵狀
01:43
Most of those people are functional, contributing members of society,
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這些人大多數都是對社會 有功用有貢獻的人
01:46
and their lives, choices, and relationships
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他們的生活、選擇及人際關係
01:49
aren't defined by the disorder,
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不會被躁鬱症限制
01:52
but still, for many, the consequences are serious.
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即使如此,對很多人而言 後果仍然很嚴重
01:55
The illness can undermine educational and professional performance,
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這種疾病會腐蝕教育及專業表現
01:59
relationships,
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人際關係
02:00
financial security,
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財務穩定
02:01
and personal safety.
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及個人的安全
02:05
So what causes bipolar disorder?
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那麼是什麼原因造成躁鬱症?
02:08
Researchers think a key player is the brain's intricate wiring.
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研究人員認為大腦 複雜的迴路是一個關鍵
02:12
Healthy brains maintain strong connections between neurons
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健康的大腦會在神經元間 維持強有力的連結
02:15
thanks to the brain's continuous efforts to prune itself
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這要感謝大腦不斷努力修剪自己
02:19
and remove unused or faulty neural connections.
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並移除沒有使用或壞掉的神經連結
02:24
This process is important because our neural pathways serve as a map
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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
02:28
for everything we do.
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02:31
Using functional magnetic resonance imaging,
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利用功能磁共振造影
02:33
scientists have discovered that the brain's pruning ability is disrupted
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科學家發現大腦的修剪功能
在躁鬱症病人身上被打斷
02:38
in people with bipolar disorder.
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02:40
That means their neurons go haywire
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這意味著他們的神經元路線混亂
02:43
and create a network that's impossible to navigate.
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而且產生無法導航的網路
02:46
With only confusing signals as a guide,
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在只有混亂信號的指引下
02:49
people with bipolar disorder develop abnormal thoughts and behaviors.
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躁鬱症患者發展出 不正常的思想及行為
02:53
Also, psychotic symptoms,
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而且,精神性症狀
02:55
like disorganized speech and behavior,
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像是解構的語言及行為
02:57
delusional thoughts,
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妄想
02:59
paranoia,
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偏執
03:00
and hallucinations
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及幻覺
03:01
can emerge during extreme phases of bipolar disorder.
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都可能在躁鬱症的極端期間出現
03:05
This is attributed to the overabundance of a neurotransmitter called dopamine.
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這要歸因於過度分泌的 神經傳遞質多巴胺
03:11
But despite these insights, we can't pin bipolar disorder down to a single cause.
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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
03:17
In reality, it's a complex problem.
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現實情況是這個問題很複雜
03:20
For example, the brain's amygdala is involved in thinking,
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譬如說,大腦的杏仁核與思考
03:23
long-term memory,
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長期記憶
03:24
and emotional processing.
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及情緒處理有關
03:26
In this brain region, factors as varied as genetics and social trauma
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大腦這塊區域,可能因為 不同的因子如遺傳及社會創傷
03:31
may create abnormalities and trigger the symptoms of bipolar disorder.
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而產生異常並引發躁鬱症的症狀
03:36
The condition tends to run in families,
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這種情況往往在家族中發生
03:38
so we do know that genetics have a lot to do with it.
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所以我們的確知道 遺傳跟此疾病大有關係
03:42
But that doesn't mean there's a single bipolar gene.
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但是這不代表有一個躁鬱症基因
03:45
In fact, the likelihood of developing bipolar disorder
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事實上發展出躁鬱症的可能性
03:48
is driven by the interactions between many genes
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受到許多基因 在複雜的情況下互動所驅使
03:52
in a complicated recipe we're still trying to understand.
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我們仍然在試圖找出答案
03:55
The causes are complex,
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由於成因複雜
03:57
and consequently, diagnosing and living with bipolar disorder is a challenge.
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因此要診斷出躁鬱症 並與之共處是一大挑戰
04:02
Despite this, the disorder is controllable.
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儘管如此這種疾病是可以控制的
04:05
Certain medications like lithium can help manage risky thoughts and behaviors
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某些藥物如鋰鹽可以協助 控制高危險性的思想及行為
04:09
by stabilizing moods.
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因為它能穩定情緒
04:11
These mood stabilizing medications work by decreasing abnormal activity in the brain,
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這種情緒穩定劑的成效 來自降低腦部不正常的活動
04:17
thereby strengthening the viable neural connections.
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從而增強有效的神經連結
04:21
Other frequently used medications include antipsychotics,
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另外常用的治療法如抗精神病藥物
04:24
which alter the effects of dopamine,
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會改變多巴胺的作用
04:27
and electroconvulsive therapy,
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還有電擊痙攣休克治療法
04:29
which works like a carefully controlled seizure in the brain,
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就是人為精心控制的大腦癲癇
04:32
is sometimes used as an emergency treatment.
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有時候也會當作緊急處理使用
04:35
Some bipolar patients reject treatment
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某些躁鬱症患者拒絕治療
04:38
because they're afraid it will dim their emotions
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因為他們害怕療法會使情緒低落
04:40
and destroy their creativity.
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並摧毀創造力
04:42
But modern psychiatry is actively trying to avoid that.
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但是現代精神科 積極試圖避免這種情況
04:46
Today, doctors work with patients on a case-by-case basis
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今天,醫師會根據個別病患的狀況
04:49
to administer a combination of treatments and therapies
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開立處方及治療法
04:53
that allows them to live to their fullest possible potential.
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讓病患的生命充分發揮潛力
04:56
And beyond treatment, people with bipolar disorder can benefit
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除了治療之外,躁鬱症病患
05:00
from even simpler changes.
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做出簡單的改變也會對生活有幫助
05:02
Those include regular exercise,
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包括規律的運動
05:04
good sleep habits,
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良好的睡眠習慣
05:05
and sobriety from drugs and alcohol,
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節制使用藥物及酒精飲料
05:08
not to mention the acceptance and empathy of family and friends.
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更不用說親朋好友的接受與同情了
05:12
Remember, bipolar disorder is a medical condition,
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要記得,躁鬱症是一種疾病
05:15
not a person's fault,
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不是個人的錯
05:17
or their whole identity,
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也不是他們整體身分的問題
05:18
and it's something that can be controlled
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而且這種疾病能受控制
05:20
through a combination of medical treatments doing their work internally,
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透過藥物及治療在體內發揮功效
05:24
friends and family fostering acceptance and understanding on the outside,
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加上外在親朋好友 抱著接受與瞭解的心態
05:29
and people with bipolar disorder empowering themselves
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躁鬱症患者能讓自己
05:32
to find balance in their lives.
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找到生命的平衡點
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