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

3,500,926 views ・ 2021-07-01

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00:00
We live in a culture that doesn't take mental health
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譯者: 童寧 張 審譯者: Thomas Tam
我們生活在一個
不重視心理健康
00:03
issues seriously.
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00:05
There's a lot of stigma.
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還有許多誤解的社會裡
有些人只會叫你撐下去
00:07
Some people tell you to just suck it up, or get it together, or to stop worrying,
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振作起來,不要太擔心
00:11
or that it's all in your head.
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或說只是你在胡思亂想
00:13
But I'm here to tell you that anxiety disorders,
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但我想告訴你
00:15
they're as real as diabetes.
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焦慮症和糖尿病一樣真實
00:18
(Music) [Body Stuff with dr.
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(音樂)
[與珍醫師了解你身體]
哈囉
00:23
Jen Gunter] Hi again.
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我是珍醫師
00:24
It's Dr. Jen, and I've noticed something
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我發現我的病患有個共同問題
00:25
with my patients.
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00:26
They often describe to me some classic symptoms
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他們時常向我描述
一些典型的焦慮症症狀
00:28
of an anxiety disorder.
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00:30
Constant worry, trouble sleeping, tense muscles and struggle
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持續性擔憂和睡眠障礙
肌肉緊繃以及無法專注
00:34
with concentrating.
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00:35
But they aren't getting treatment.
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但他們卻沒有任何治療
00:37
There's a lot of issues with mental-health care in this country.
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我們國家的心理保健有許多問題
00:40
Some people don't have insurance that would cover it.
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有些人因為沒有保險而無法負擔醫藥費
00:42
Some have been dismissed or minimized in the past,
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有些人曾被人小看或打發
00:45
and don't think seeking help will do any good.
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因此不認為尋求幫助是有效的
有些人顧慮別人的眼光
00:48
Some worry about the stigma and whether it could affect
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怕會影響工作和人際關係
00:50
future jobs or relationships.
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00:52
But severe anxiety isn't a moral or personal failing.
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但嚴重的焦慮不是道德或個人的失敗
00:55
It's a health problem, just like strep throat or diabetes.
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它是健康問題
就像咽喉炎或糖尿病一樣
00:59
It needs to be treated with the same kind of seriousness.
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它必須被同等嚴肅看待
01:03
Before we can talk about anxiety disorders,
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在我們談論焦慮症之前
我們先談談焦慮本身
01:06
let's talk about anxiety itself.
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01:08
Anxiety is the very real and normal emotion
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當我們處於有壓力的情況時
01:10
we feel in a stressful situation.
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焦慮是很真實和正常的情緒
01:13
It's related to fear.
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它和恐懼有關
01:14
But while fear is a response to an immediate threat
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但恐懼是對即刻威脅的反映
01:17
that quickly subsides, anxiety is a response
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很快就能平息
而焦慮反映的是更加不明確的威脅
01:20
to more uncertain threats that tends to last much longer.
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持續的時間更長
01:24
It's all part of the threat detection system,
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這是威脅偵測系統的一部分
01:26
which all animals have to some degree, to help protect us from predators.
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所有動物或多或少都有
它能幫助我們遠離危險
焦慮源自大腦中的杏仁核
01:31
Anxiety starts in the brain's amygdala, a pair of almond-sized nerve bundles
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一對杏仁大小的神經束
01:35
that alert other areas of the brain to be ready for defensive action.
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它警告大腦中的其他區域做好防禦準備
01:39
Next, the hypothalamus relays the signal, setting off what we call
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接著,下視丘會傳遞這個訊號
我們的身體就開始出現壓力反應
01:43
the stress response in our body.
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01:45
Our muscles tense, our breathing and heart rate increase
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肌肉變得緊繃
呼吸和心跳加速
01:48
and our blood pressure rises.
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血壓升高
01:50
Areas in the brain stem kick in and put you in a state of high alertness.
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腦幹中部分區域開始作用
讓你處於高度警覺狀態
01:54
This is the fight-or-flight response.
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這就是「戰鬥或逃走」反應
01:57
There are ways the fight-or-flight response
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有些方法能使這些反應
01:59
is kept somewhat in check, with an area of higher-level thinking
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維持於控制範圍內
哪就是能提供更高階思考的 腹內側前額葉皮質
02:03
called the ventromedial prefrontal cortex.
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02:06
It works like this.
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它是這樣運作的
02:07
If a person sees something they think is dangerous, like a tiger,
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如果人類處於危險的情況, 比如看見老虎
02:11
that sends a signal to the amygdala, saying "it's time to run."
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杏仁核就會收到應該逃跑的訊號
02:14
The ventromedial prefrontal cortex can say to the amygdala,
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腹內側前額葉皮質會通知杏仁核
02:17
"Hey, look.
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看!老虎被關在籠子裡
02:18
The tiger's in a cage.
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02:19
You know what a cage is?
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你知道籠子是什麼? 牠們無法從籠子逃走
02:20
They can't escape from a cage.
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所以你可以冷靜下來了
02:22
It's OK to calm down."
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02:23
It's a feedback loop that can help keep the response in check.
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這是一個讓反應可控的反饋迴路
02:27
The hippocampus is also involved.
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海馬體也在此反應中運作
02:29
It provides context, saying things like, "Hey, we've seen tigers in cages before.
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它能提供一些情境,像是:
「嘿,你曾看過老虎在籠子裡
02:34
We're in a zoo.
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在動物園裡是非常安全的。」
02:35
You are extra safe."
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02:37
With anxiety, these threat-detection systems
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當焦慮產生時
這些威脅偵測系統與機制會被抑制
02:39
and mechanisms that reduce or inhibit them are functioning incorrectly
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並且錯誤地運作
使我們對自身安危感到擔心
02:44
and cause us to worry about the future and our safety in it.
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02:48
But for many people, it goes into overdrive.
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但對某部分人來說它運作過度
02:50
They experience persistent pervasive anxiety
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他們的焦慮症狀持續不斷
02:54
that disrupts work, school, and relationships
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並干擾到工作、課業與人際關係
02:57
and leads them to avoid situations that may trigger symptoms.
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使他們避開所有會觸發焦慮症狀的情境
03:01
Anxiety disorders are not at all uncommon.
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焦慮症一點也不少見
03:04
Based on data from the World Mental Health Survey,
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根據世界精神衛生調查的數據顯示
03:07
researchers estimate that about 16% of individuals
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約有百分之十六的人
03:10
currently have or have had an anxiety disorder.
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患有或曾患有焦慮症
03:13
These include social anxiety disorder, panic disorder, agoraphobia and phobias.
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包含社交恐懼症
恐慌症、廣場恐懼症及特殊恐懼症
03:18
Studies have shown that people with anxiety disorders
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研究顯示患有焦慮症者
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don't just have a different way of reacting to stress.
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不只是對於壓力的反應與常人有異
03:24
There may be actual differences in how their brain is working.
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他們的大腦運作也可能與常人不同
03:28
One model describes possible mix-ups in the connections between the amygdala
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這個模型說明大腦產生混亂的原因
杏仁核與大腦其他部分連結
03:32
and other parts of the brain.
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03:33
The pathways that signal anxiety become stronger.
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傳送焦慮的路徑會逐漸增強
03:37
And the more anxiety you have, the stronger the pathways become,
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且越是焦慮,連結越強
03:41
and it becomes a vicious cycle.
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然後成為惡性循環
03:43
The good news is there's treatment for anxiety,
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值得慶幸的是焦慮是可以治療的
03:47
and that you don't have to suffer.
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不需要一直受其所苦
03:49
Remember, this isn't about weakness.
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記住,焦慮並不是你的軟弱
03:52
It's about changing brain patterns, and research shows that our brains
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只是你要改變大腦運作模式
研究顯示
03:56
have the ability to reorganize and form new connections
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我們的大腦有能力構成新的連結方式
04:00
all throughout our lives.
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且一生都有機會轉變
04:01
A good first step is to do the basics.
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第一步要維持基本的良好生活習慣
04:04
Eat a balanced diet, exercise regularly
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均衡飲食
規律運動
04:06
and get plenty of sleep, as your mind is part of your body.
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保持睡眠充足
畢竟腦部也是身體的一部分
04:10
It might also help to try meditation.
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冥想可能也會有所幫助
04:12
Instead of our heart rate rising and our body tensing,
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放鬆肌肉並使心跳平穩
04:16
with mindfulness and breathing, we can slow down
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保持正念和平穩呼吸
我們可以減緩戰鬥或逃走反應
04:19
the fight-or-flight response and improve how we feel in the moment.
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好好感受當下
04:24
Cognitive behavioral therapy, a form of talk therapy,
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「認知行為治療」是其中一種的談話療法
04:27
can also be fantastic.
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效果也很不錯
04:29
In it, you learn to identify upsetting thoughts
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在治療中你學識哪些使你心煩的想法
04:31
and determine whether they're realistic.
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並判斷它們是否切實
04:33
Over time, cognitive behavioral therapy can rebuild those neural pathways
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認知行為治療可以慢慢重建神經路徑
04:38
that tamp down the anxiety response.
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並抑制焦慮反應
短期或長期服藥
04:41
Medication can also give relief, in both the short-term and the long-term.
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也可以使症狀獲得緩解
04:45
In the short-term, anti-anxiety drugs can down-regulate
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短期服用抗焦慮藥物
可以抑制威脅偵測機制
04:49
the threat-detection mechanisms that are going into overdrive.
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避免它過度運作
04:52
Studies have shown that both long-term medications
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而研究顯示長期用藥
04:55
and cognitive behavioral therapy can reduce that overreactivity
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以及認知行為治療
可以降低杏仁核的活躍程度
04:59
of the amygdala we see an anxiety disorders.
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也就是我們所說的焦慮症
05:02
High blood pressure and diabetes, they can be treated or managed over time.
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就像高血壓與糖尿病
可以受控制或被治癒
焦慮症也一樣可以
05:07
And the same is true for an anxiety disorder too.
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