原味人文風(fēng)情：Depression is the leading cause of disability in the world. In the United States, close to 10 percent of adults struggle with depression. But because it's a mental illness, it can be a lot harder to understand than, say, high cholesterol.One major source of confusion is the difference between having depression and just feeling depressed.
憂(yōu)郁癥是世界上造成人類(lèi)失能的首要原因。在美國(guó)，有近百分之十的成人受憂(yōu)郁癥之苦。但因?yàn)閼n(yōu)郁癥是種心理疾病，要了解它會(huì)比高膽固醇之類(lèi)的困難許多。一個(gè)主要困惑是抑郁癥和單純情緒低落之間的區(qū)別。
Almost everyone feels down from time to time.Getting a bad grade, losing a job, having an argument, even a rainy day can bring on feelings of sadness. Sometimes there's no trigger at all. It just pops up out of the blue. Then circumstances change, and those sad feelings disappear.Clinical depression is different. It's a medical disorder, and it won't go away just because you want it to. It lingers for at least two consecutive weeks and significantly interferes with one's ability to work, play, or love.
幾乎每個(gè)人都會(huì)偶爾心情不好?？荚嚳疾睢⑹I(yè)、吵架，甚至下雨天也會(huì)引起悲傷的感覺(jué)。有時(shí)候甚至沒(méi)有誘因。難過(guò)的感覺(jué)就那樣突然冒出來(lái)。然后情況改變，那些悲傷的感覺(jué)也消失了。臨床憂(yōu)郁癥不同，它是一種疾病，不會(huì)因?yàn)槟阋Ь拖?。低落的情緒會(huì)持續(xù)至少兩周，且會(huì)嚴(yán)重影響一個(gè)人工作、玩樂(lè)或愛(ài)人的能力。
Depression can have a lot of different symptoms: a low mood, loss of interest in things you'd normally enjoy, changes in appetite,feeling worthless or excessively guilty, sleeping either too much or too little, poor concentration,restlessness or slowness, loss of energy, or recurrent thoughts of suicide. If you have at least five of those symptoms, according to psychiatric guidelines, you qualify for a diagnosis of depression.
憂(yōu)郁癥可能會(huì)有許多不同的病征：情緒低落、對(duì)平常喜歡的事物失去興趣、胃口改變、覺(jué)得自己沒(méi)價(jià)值或過(guò)度罪惡感、睡太多或太少、注意力不集中、焦慮或遲滯、失去活力，或反覆出現(xiàn)自殺念頭。如果你有其中至少五個(gè)癥狀，根據(jù)精神病學(xué)指南，你就符合憂(yōu)郁癥診斷。
And it's not just behavioral symptoms.Depression has physical manifestations inside the brain. First of all, there are changes that could be seen with the naked eye and X-ray vision. These include smaller frontal lobes and hippocampal volumes. On a more micro scale, depression is associated with a few things: the abnormal transmission or depletion of certain neurotransmitters, especially serotonin, norepinephrine, and dopamine; blunted circadian rhythms, or specific changes in the REM and slow-wave parts of your sleep cycle;and hormone abnormalities, such as high cortisol and deregulation of thyroid hormones.
憂(yōu)郁癥不僅是行為上的癥狀，在大腦中也有具體表現(xiàn)。首先，有能用肉眼及X光觀察到的變化。這些包含額葉和海馬體積縮小。更微觀的水平上，憂(yōu)郁癥和幾樣?xùn)|西有關(guān)：特定神經(jīng)傳導(dǎo)物質(zhì)的反常傳遞或減少，特別是血清素、去甲基腎上腺素以及多巴胺的減少；生理時(shí)鐘變遲鈍，或睡眠周期中快速動(dòng)眼期和慢波期的明顯改變；以及荷爾蒙失調(diào)，例如皮質(zhì)醇過(guò)高和甲狀腺激素異常。
But neuroscientists still don't have a complete picture of what causes depression. It seems to have to do with a complex interaction between genes and environment, but we don't have a diagnostic tool that can accurately predict where or when it will show up. And because depression symptoms are intangible, it's hard to know who might look fine but is actually struggling. According to the National Institute of Mental Health, it takes the average person suffering with a mental illness over 10 years to ask for help.
不過(guò)神經(jīng)科學(xué)家對(duì)憂(yōu)郁癥的成因仍未完全理解。它似乎和基因與環(huán)境間的復(fù)雜交互作用有關(guān)，但我們尚未有精準(zhǔn)預(yù)測(cè)憂(yōu)郁癥發(fā)作時(shí)地的診斷工具。而且因?yàn)閼n(yōu)郁癥病征捉摸不定，很難知道哪些看起來(lái)好好的人其實(shí)正在遭受憂(yōu)郁癥。根據(jù)美國(guó)國(guó)家心理衛(wèi)生研究院的研究，一般心理疾病患者要拖十年以上才會(huì)尋求協(xié)助。
But there are very effective treatments.Medications and therapy complement each other to boost brain chemicals. In extreme cases, electroconvulsive therapy, which is like a controlled seizure in the patient's brain, is also very helpful. Other promising treatments, like transcranial magnetic stimulation, are being investigated, too.
但憂(yōu)郁癥有十分有效的治療方法。藥物和療法相互輔助來(lái)激發(fā)腦內(nèi)化學(xué)物質(zhì)的生成。在極端案例中，電療法，即像是一種在患者腦部控制痙攣發(fā)作的方法也極有幫助。其它備受看好的治療方法，比如穿顱磁刺激法，也在研究當(dāng)中。
So if you know someone struggling with depression, encourage them gently to seek out some of these options. You might even offer to help with specific tasks, like looking up therapists in the area or making a list of questions to ask a doctor. To someone with depression, these first steps can seem insurmountable. If they feel guilty or ashamed,point out that depression is a medical condition, just like asthma or diabetes. It's not a weakness or a personality trait, and they shouldn't expect themselves to just get over it, any more than they could will themselves to get over a broken arm.
如果你認(rèn)識(shí)某個(gè)遭受憂(yōu)郁癥的人，溫柔地鼓勵(lì)他們尋求一些方法。你甚至可以幫忙做一些事，比如搜尋附近的心理治療師，或是列出要問(wèn)醫(yī)生的問(wèn)題清單。對(duì)一個(gè)有憂(yōu)郁癥的人來(lái)說(shuō)，第一步可能難以跨越。如果他們感到罪惡或羞愧，指出憂(yōu)郁癥是疾病的事實(shí)，它就像氣喘或糖尿病一樣。這不是懦弱或人格特質(zhì)，他們不該指望自己就能好起來(lái)，就像他們也沒(méi)辦法用意志力讓斷臂復(fù)原一樣。
If you haven't experienced depression yourself, avoid comparing it to times you've felt down.Comparing what they're experiencing to normal, temporary feelings of sadness can make them feel guilty for struggling. Even just talking about depression openly can help. For example, research shows that asking someone about suicidal thoughts actually reduces their suicide risk. Open conversations about mental illness help erode stigma and make it easier for people to ask for help. And the more patients seek treatment, the more scientists will learn about depression, and the better the treatments will get.
如果你自己不曾得過(guò)憂(yōu)郁癥，避免拿憂(yōu)郁癥和心情不好作比較。將他們的遭遇和一般短暫的難過(guò)情緒相提并論，會(huì)讓患者對(duì)自己的掙扎感到罪惡。就算只是公開(kāi)討論憂(yōu)郁癥都有幫助。舉例來(lái)說(shuō)，研究顯示，詢(xún)問(wèn)一個(gè)人有無(wú)自殺念頭真的能降低他們自殺的風(fēng)險(xiǎn)。開(kāi)誠(chéng)布公地討論心理疾病有助消弭污名，并讓人們更容易尋求協(xié)助。而有更多的病患尋求治療，科學(xué)家就能越了解憂(yōu)郁癥，治療方法就會(huì)變得更進(jìn)步。
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