What is depression? - Helen M. Farrell

譯者: nr chan 審譯者: Max Chern

Depression is the leading cause of disability in the world.

憂鬱症在世界上是造成失能的主要原因

In the United States,

在美國

close to 10% of adults struggle with depression.

近 10% 的成人為憂鬱所苦

But because it's a mental illness,

但由於它是心理上的疾病

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

所以它比像高膽固醇之類的疾病 還要讓人難以理解

One major source of confusion is the difference between having depression

一個主要令人困惑的是「憂鬱症」

and just feeling depressed.

和「只是感覺沮喪」的差別

Almost everyone feels down from time to time.

每個人都有失落的時候

Getting a bad grade,

成績考壞

losing a job,

被炒魷魚

having an argument,

發生爭執

even a rainy day can bring on feelings of sadness.

甚至是下雨天都可能使人憂傷

Sometimes there's no trigger at all.

有時根本沒有什麼誘因

It just pops up out of the blue.

沮喪就會憑空出現

Then circumstances change,

接著情境改變

and those sad feelings disappear.

而沮喪的心情也隨之消散

Clinical depression is different.

臨床上的憂鬱症是不同的

It's a medical disorder,

它是一種疾病

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

正因為你要它如此，所以揮之不去

It lingers for at least two consecutive weeks,

它至少會持續兩個星期

and significantly interferes with one's ability to work,

並嚴重地干擾一個人的工作能力

play,

遊玩意願

or love.

或情感生活

Depression can have a lot of different symptoms:

憂鬱症可以有很多不同的症狀：

a low mood,

心情低落、

loss of interest in things you'd normally enjoy,

對平常喜愛的事物興趣缺缺、

changes in appetite,

胃口改變、

feeling worthless or excessively guilty,

覺得無用或過度的罪惡感、

sleeping either too much or too little,

睡太多或太少、

poor concentration,

難以專注、

restlessness or slowness,

躁動或遲鈍、

loss of energy,

沒有活力、

or recurrent thoughts of suicide.

或反覆興起自殺念頭

If you have at least five of those symptoms,

如果你有至少5項症狀

according to psychiatric guidelines,

根據精神科的準則

you qualify for a diagnosis of depression.

你會被診斷為憂鬱症

And it's not just behavioral symptoms.

它不只是行為上的症狀而已

Depression has physical manifestations inside the brain.

憂鬱症在腦部還會有實質的表徵

First of all,

首先

there are changes that could be seen with the naked eye

有些改變可透過肉眼

and X-ray vision.

或 X 光觀察發現

These include smaller frontal lobes and hippocampal volumes.

包括額葉和海馬體的容量變小

On a more microscale,

從更細微的來說

depression is associated with a few things:

憂鬱症和有些事物有所關連：

the abnormal transmission or depletion of certain neurotransmitters,

某些神經傳導物質 不正常地傳遞或耗損

especially serotonin, norepinephrine, and dopamine,

特別是血清素、去甲腎上腺素，和多巴胺

blunted circadian rhythms,

使得生理節奏失調

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

或睡眠週期中的快速動眼期及 慢波睡眠的特定改變

and hormone abnormalities,

以及賀爾蒙異常

such as high cortisol and deregulation of thyroid hormones.

例如皮質醇過高和甲狀腺賀爾蒙失常

But neuroscientists still don't have a complete picture

但神經學家還尚未全面瞭解

of what causes depression.

掌握造成憂鬱症的原因

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

似乎與基因和環境間 複雜的交互作用有關

but we don't have a diagnostic tool

但目前沒有診斷的工具

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

可以精確地預測在何地或何時會發病

And because depression symptoms are intangible,

也因為憂鬱症的症狀是變化莫測的

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

我們很難知道看起來好端端的人 其實正處於掙扎中

According to the National Institute of Mental Health,

根據美國國家心理健康研究院 (National Institute of Mental Health)

it takes the average person suffering with a mental illness

通常罹患心理疾病的病患

over ten years to ask for help.

都拖了超過10年才尋求協助

But there are very effective treatments.

但現在有非常有效的治療方法

Medications and therapy complement each other to boost brain chemicals.

藥物和治療相輔相成 來強化大腦化學物質

In extreme cases, electroconvulsive therapy,

在一些極端的個案，「電痙攣療法」

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

它是一種在患者腦部 以可控制的電擊來誘發痙攣的療法

is also very helpful.

也非常有幫助

Other promising treatments,

其他有前景的療法

like transcranial magnetic stimulation,

像是「經顱磁刺激法」 (transcranial magnetic stimulation)

are being investigated, too.

也都在研究中

So, if you know someone struggling with depression,

所以，如果你認識為憂鬱症所苦的人

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

溫和地鼓勵他，去尋求其中幾項的幫助

You might even offer to help with specific tasks,

你甚至也可提供特別的協助

like looking up therapists in the area,

像幫他找附近的治療師

or making a list of questions to ask a doctor.

或是列出一張要問醫師問題的清單

To someone with depression,

對憂鬱症患者來說

these first steps can seem insurmountable.

踏出尋求治療的最初幾步 都可謂舉步難難

If they feel guilty or ashamed,

如果他們會覺得罪惡或羞恥

point out that depression is a medical condition,

點醒他們：憂鬱是一種疾病

just like asthma or diabetes.

就像氣喘或糖尿病

It's not a weakness or a personality trait,

不是弱點或人格特質

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

也不應該認為自己有辦法熬過去

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

這正如不能光靠自己的意志力 就治好手骨折一樣

If you haven't experienced depression yourself,

如果你沒有得過憂鬱症

avoid comparing it to times you've felt down.

要避免拿它來和自己失意時比較

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

將他們的憂鬱症 和自己平常短暫的沮喪相比

can make them feel guilty for struggling.

會讓他們對掙扎有罪惡感

Even just talking about depression openly can help.

就算只是公開談論憂鬱症也會有幫助

For example, research shows that asking someone about suicidal thoughts

舉例來說，研究顯示問某人對自殺的看法

actually reduces their suicide risk.

真的可降低他們的自殺風險

Open conversations about mental illness help erode stigma

公開談論心理疾病可以削弱它的壞名聲

and make it easier for people to ask for help.

讓人們能更無拘束地去尋求協助

And the more patients seek treatment,

而就診的病患越多

the more scientists will learn about depression,

科學家對憂鬱症的瞭解就越多

and the better the treatments will get.

治療方式就會越來越好

翻譯： nr Chan