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I was struck by the fact that depression
我很不能理解為什么
is broadly perceived to be a modern, Western, middle-class thing,
人們普遍的把抑郁癥看成是現代西方中產階級特有的一種病
and I went to look at how it operated in a variety of other contexts,
于是我開始尋找抑郁癥與其它社會因素的關聯
and one of the things I was most interested in was depression among the indigent.
在可能相關的社會因素中，我對貧困和抑郁的關系特別感興趣
And so I went out to try to look at what was being done for poor people with depression.
于是我做了一些研究，嘗試去了解窮人是如何治療抑郁的
And what I discovered is that poor people are mostly not being treated for depression.
我發現大多數情況下，窮人的抑郁癥不會得到治療
Depression is the result of a genetic vulnerability,
抑郁屬于基因的缺陷
which is presumably evenly distributed in the population,
這意味著在不同的人群中容易抑郁的人的比例應該是一樣的
and triggering circumstances,
生活環境的不同導致了發病率的不同
which are likely to be more severe for people who are impoverished.
而當人們處于貧困的生活環境中時，抑郁癥的發病率更高，也更嚴重
And yet it turns out that if you have a really lovely life but feel miserable all the time,
但是，如果你的生活一帆風順，然后你覺得自己一直都不開心
you think, "Why do I feel like this? I must have depression."
你會反思, "我為什么不開心? 我一定是抑郁了."
And you set out to find treatment for it.
然后你會去找醫生給你治療
But if you have a perfectly awful life, and you feel miserable all the time,
但是如果你的生活本來就很糟糕，然后你一直都不開心
the way you feel is commensurate with your life,
你的感覺和你的生活狀態是相稱的
and it doesn't occur to you to think, "Maybe this is treatable."
于是你就不會想到這個是病，"或許這個可以治療一下"
And so we have an epidemic in this country of depression among impoverished people
所以實際上我們這個國家的低收入人群中，抑郁癥像是傳染病一樣流行
that's not being picked up and that's not being treated
但是卻一直沒有被人注意過，沒有人評估過患病的規模
and that's not being addressed, and it's a tragedy of a grand order.
也沒有人為這些低收入者提供治療，這是非常大的一個悲劇
And so I found an academic who was doing a research project in slums outside of D.C.,
后來我發現了一位研究人員，她當時正在華盛頓特區周邊的貧民窟中做與之相關的一項研究
where she picked up women who had come in for other health problems and diagnosed them with depression,
當有婦女前來看其它的疾病時,她會邀請這些婦女做一個抑郁癥的診斷
and then provided six months of the experimental protocol.
同時提供一份六個月的實驗協議
One of them, Lolly, came in, and this is what she said the day she came in.
其中有一位女士，名叫洛莉，以下是她第一天到診所來的自述
She said, and she was a woman, by the way, who had seven children.
她說她是一位母親，7個孩子的母親,
She said, "I used to have a job but I had to give it up because I couldn't go out of the house.
她說，"我曾經有一份工作, 但是不得不辭掉了，因為我無法離開我的屋子。"
I have nothing to say to my children.
我一句話都不想跟我的孩子們說
In the morning, I can't wait for them to leave,
早晨，我迫不及待的讓孩子們出門上學
and then I climb in bed and pull the covers over my head,
然后立刻爬上床蒙頭大睡
and three o'clock when they come home, it just comes so fast."
然后下午三點他們就陸續回家了，時間過得太快了
She said, "I've been taking a lot of Tylenol, anything I can take so that I can sleep more.
她說, "我已經吃了很多的泰諾(一種止痛藥)，以及其它所有能夠讓我多睡一會兒的東西
My husband has been telling me I'm stupid, I'm ugly. I wish I could stop the pain."
我的丈夫一直說我蠢，說我令人討厭，我真希望能夠結束這痛苦
Well, she was brought into this experimental protocol,
然后她接受了實驗協議開始進行治療
and when I interviewed her six months later,
六個月之后當我去采訪她的時候
she had taken a job working in childcare for the U.S. Navy,
她有了一份新工作，在美國海軍(的幼兒園)照看孩子,
she had left the abusive husband, and she said to me,
她離開了以前那個虐待她的丈夫，她對我說
"My kids are so much happier now."
我的孩子們現在比以前開心多了
She said, "There's one room in my new place for the boys and one room for the girls,
她說，現在我的新家有兩個孩子的臥室，男孩子們一間，女孩子們一間
but at night, they're just all up on my bed,
到了晚上的時候，他們都會來到我的房間
and we're doing homework all together and everything.
我們一直做家庭作業，做其它的事情
One of them wants to be a preacher, one of them wants to be a firefighter,
一個兒子立志做一名牧師，另一個想要做消防隊員
and one of the girls says she's going to be a lawyer.
我的一個女兒想要做一名律師
They don't cry like they used to, and they don't fight like they did.
他們不像以前那樣哭得那么頻繁，也不再像以前那樣相互打來打去了
That's all I need now is my kids.
看著這些孩子，我現在覺得很滿足
Things keep on changing, the way I dress, the way I feel, the way I act.
一切都在不斷的變好，我的穿著，我的情緒，我的言行
I can go outside not being afraid anymore,
我不會再像以前那樣害怕出門
and I don't think those bad feelings are coming back,
也不會再擔心糟糕的心情會卷土重來
and if it weren't for Dr. Miranda and that,
如果沒有米蘭達醫生(那位研究人員)的幫助
I would still be at home with the covers pulled over my head, if I were still alive at all.
我現在可能還我在家里，用被子蒙住頭呼呼大睡，或許我已經死了
I asked the Lord to send me an angel, and he heard my prayers."
我曾祈禱上帝為我下凡一位天使，而上帝聽到了我的聲音."
