What's normal anxiety -- and what's an anxiety disorder? | Body Stuff with Dr. Jen Gunter | TED

We live in a culture that doesn't take mental health

翻译人员: Lily Xu 校对人员: Yanyan Hong

我们如今生活在一个

很不重视心理健康的文化中。

issues seriously.

There's a lot of stigma.

现实中有许多难以启齿的状况。

有些人告诉你把事自己消化了就好，

Some people tell you to just suck it up, or get it together, or to stop worrying,

或振作起来，或别担心，

or that it's all in your head.

或说你想太多了。

But I'm here to tell you that anxiety disorders,

但我在这告诉你，

焦虑症就像糖尿病般真实存在。

they're as real as diabetes.

(Music) [Body Stuff with dr.

（音乐）

【与詹·冈特博士聊聊身体里的那些事】

大家好，

Jen Gunter] Hi again.

我是詹博士，

It's Dr. Jen, and I've noticed something

我从我的病人身上发现了一个现象。

with my patients.

They often describe to me some classic symptoms

他们经常向我描述

一些焦虑症的典型症状。

of an anxiety disorder.

Constant worry, trouble sleeping, tense muscles and struggle

不断担心，难以入睡，

肌肉紧张和难以集中注意力，

with concentrating.

But they aren't getting treatment.

但他们并没有寻求治疗。

There's a lot of issues with mental-health care in this country.

这个国家存在着许多 心理健康的保健问题。

Some people don't have insurance that would cover it.

有些人没有这方面的医疗保险，

Some have been dismissed or minimized in the past,

有些人的症治曾被忽略不计，

and don't think seeking help will do any good.

有些则认为治疗也不会有好转。

有些人担心心理问题 将会成为未来的绊脚石，

Some worry about the stigma and whether it could affect

为以后的工作和生活增加麻烦。

future jobs or relationships.

But severe anxiety isn't a moral or personal failing.

但重度焦虑并不是 一个人的挫折或失败，

It's a health problem, just like strep throat or diabetes.

而是一个健康隐患，

就像咽喉炎或糖尿病一样，

It needs to be treated with the same kind of seriousness.

焦虑症也应该被一视同仁。

Before we can talk about anxiety disorders,

在讨论焦虑症之前，

我们先了解一下焦虑本身。

let's talk about anxiety itself.

Anxiety is the very real and normal emotion

焦虑是一种普遍和正常的情绪，

we feel in a stressful situation.

我们在压力下都会感到焦虑。

It's related to fear.

它跟恐惧有所关联。

But while fear is a response to an immediate threat

但恐惧是当我们受到短暂的威胁时

that quickly subsides, anxiety is a response

做出的反应，

而焦虑是当我们 受到不明确的威胁时

to more uncertain threats that tends to last much longer.

做出的长久的反应。

It's all part of the threat detection system,

这都是我们身体 监测危险系统的一部分，

which all animals have to some degree, to help protect us from predators.

所有动物身上都有这个系统，

来保护我们免受掠食者的威胁。

焦虑始于大脑的杏仁核，

Anxiety starts in the brain's amygdala, a pair of almond-sized nerve bundles

一对杏仁大小的神经

that alert other areas of the brain to be ready for defensive action.

提醒大脑的其他区域 做好防御行动的准备。

Next, the hypothalamus relays the signal, setting off what we call

然后，下丘脑传递信号，

引发我们所谓的身体压力反应。

the stress response in our body.

Our muscles tense, our breathing and heart rate increase

导致肌肉紧张，

呼吸和心跳加速，

and our blood pressure rises.

并且血压升高。

Areas in the brain stem kick in and put you in a state of high alertness.

脑干区域开始启动，

使人处于高度警觉状态。

This is the fight-or-flight response.

这就是所谓的“战斗或逃跑 (fight-or-flight) 反应”。

There are ways the fight-or-flight response

有一些方法可以控制

is kept somewhat in check, with an area of higher-level thinking

战斗或逃跑的反应，

利用一个称为 前额叶皮层的高级思维区域。

called the ventromedial prefrontal cortex.

It works like this.

举一个例子：

If a person sees something they think is dangerous, like a tiger,

假如一个人看见 一个危险的东西，比如老虎，

that sends a signal to the amygdala, saying "it's time to run."

那将向大脑杏仁核发送信号， 告诉它说 “赶快跑”。

The ventromedial prefrontal cortex can say to the amygdala,

而大脑前额叶片层则说：

"Hey, look.

“你看，这老虎被关在一个笼子里。

The tiger's in a cage.

You know what a cage is?

你知道笼子是什么吧？ 它是逃不出来的。

They can't escape from a cage.

可以放松了。”

It's OK to calm down."

It's a feedback loop that can help keep the response in check.

这是一个循环的反馈， 可以帮助控制我们的反应，

The hippocampus is also involved.

脑部的海马体也参与其中。

It provides context, saying things like, "Hey, we've seen tigers in cages before.

它们可以判断情况，比如：

“我们之前也见过老虎被关在笼子里，

We're in a zoo.

我们现在在动物园，你非常安全。”

You are extra safe."

With anxiety, these threat-detection systems

由于焦虑，

这些减少或抑制威胁的检测系统

and mechanisms that reduce or inhibit them are functioning incorrectly

无法正常运行，

导致我们担心未来和我们的安全。

and cause us to worry about the future and our safety in it.

But for many people, it goes into overdrive.

但是对于很多人来说， 他们将经历疲劳过度。

They experience persistent pervasive anxiety

他们经历持续的焦虑，

that disrupts work, school, and relationships

扰乱他们的工作、学校和人际关系，

and leads them to avoid situations that may trigger symptoms.

并导致他们刻意避免 可能引发焦虑的场合。

Anxiety disorders are not at all uncommon.

焦虑症并不罕见。

Based on data from the World Mental Health Survey,

根据世界心理健康调查的数据，

researchers estimate that about 16% of individuals

研究人员估计大约 16% 的人

currently have or have had an anxiety disorder.

目前患有或曾经患有焦虑症。

These include social anxiety disorder, panic disorder, agoraphobia and phobias.

这包括社交焦虑症，

恐慌症，空间恐惧症 和其他的恐惧症。

Studies have shown that people with anxiety disorders

研究表明那些患有焦虑症的人

don't just have a different way of reacting to stress.

不仅面对压力会有不同的反应。

There may be actual differences in how their brain is working.

他们大脑运转的方式 可能存在差异。

One model describes possible mix-ups in the connections between the amygdala

这种模型描述了

杏仁核和大脑其他部分之间 连接中可能出现的混淆。

and other parts of the brain.

The pathways that signal anxiety become stronger.

发出焦虑信号的路径变得更强，

And the more anxiety you have, the stronger the pathways become,

他越焦虑，路径就越强，

and it becomes a vicious cycle.

最终变成一个恶性循环。

The good news is there's treatment for anxiety,

好消息是有治疗焦虑症的方法，

and that you don't have to suffer.

确保你不必经历苦难。

Remember, this isn't about weakness.

请记住，这与弱点无关。

It's about changing brain patterns, and research shows that our brains

这是关于改变大脑模式，

研究表明，我们的大脑

have the ability to reorganize and form new connections

具有能力重组并在我们的一生中

all throughout our lives.

建立新的联系。

A good first step is to do the basics.

一个好的开始是做好基础工作。

Eat a balanced diet, exercise regularly

饮食均衡，

经常锻炼，

and get plenty of sleep, as your mind is part of your body.

并且保持睡眠充足，

因为大脑也是身体的一部分。

It might also help to try meditation.

尝试冥想也可能有所帮助。

Instead of our heart rate rising and our body tensing,

与其心率上升和身体紧张，

with mindfulness and breathing, we can slow down

不如通过呼吸

来减缓 “战斗或逃跑反应”，

the fight-or-flight response and improve how we feel in the moment.

并改善我们当下的感受。

Cognitive behavioral therapy, a form of talk therapy,

认知行为疗法是一种谈话疗法，

can also be fantastic.

也是很有帮助的一种。

In it, you learn to identify upsetting thoughts

在其中，你将学会 如何识别令人不安的想法

and determine whether they're realistic.

并确认他们是否符合现实。

Over time, cognitive behavioral therapy can rebuild those neural pathways

随着时间的推移， 认知行为疗法可以重建

that tamp down the anxiety response.

这些抑制焦虑反应的神经通路。

药剂也能缓解焦虑，

Medication can also give relief, in both the short-term and the long-term.

无论是短期还是长期。

In the short-term, anti-anxiety drugs can down-regulate

在短期内，当体内威胁检测系统

超速运转时，抗焦虑药物

the threat-detection mechanisms that are going into overdrive.

可以帮助缓解。

Studies have shown that both long-term medications

研究表明，长期药物治疗

and cognitive behavioral therapy can reduce that overreactivity

和认知行为治疗

都可以减少我们在焦虑症中

of the amygdala we see an anxiety disorders.

看到的脑部杏仁核的过度反应。

High blood pressure and diabetes, they can be treated or managed over time.

高血压和糖尿病

都可以循序渐进慢慢治疗或控制，

那么焦虑症也是如此。

And the same is true for an anxiety disorder too.