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Alcohol can cause a lot of problems.
酒精會引起很多問題。
Just drinking too much can poison and kill you,
喝太多可能會讓你中毒或被殺，
but so can the impaired judgment while driving, or the diseases it puts you at greater risk for.
它也會損害你開車時的判斷力或者增大你患病的危險。
Lots of people drink fairly regularly without any of these problems, though.
盡管如此，很多人還是很有規律地喝酒，完全沒有這些問題。
And not everyone who has a little too much once in a while is an alcoholic.
而且偶爾喝太多酒的人并不都是酒鬼。
So how do you know when drinking becomes a problem?
所以你怎么知道什么時候喝酒會成問題呢？
It mostly has to do with symptoms of addiction like tolerance and withdrawal,
這主要與上癮癥狀如忍受折磨和戒斷癥狀，
along with how your drinking affects your relationships and responsibilities.
以及酗酒如何影響人際關系和責任有關。
Even though the amount you drink is a big health risk on its own and a super important part of the problem,
即使你的飲酒量本身就有很大的健康風險，而且在問題中占比極重，
diagnosing alcohol use disorder, the clinical term for alcoholism isn't really about hard numbers.
但用酒精中毒的臨床術語診斷酒精使用障礙并不確切。
For that, most psychiatrists turn to the Diagnostic and Statistical Manual of Mental Disorders, or DSM,
為此，大多數精神病學家求助于《精神疾病診斷和統計手冊》（DSM）
which lists two main types of symptoms.
上面列出了兩種主要癥狀。
First, there are the signs that have to do with the physical aspects of dependence,
第一，有跡象表明，酒精使用障礙與身體依賴有關，
like addiction, tolerance and withdrawal.
比如上癮，忍受折磨和戒斷。
For example, if you find yourself needing more alcohol to get the same effect,
比如，你發現自己需要更多的酒精來達到同樣的效果，
drinking a lot more than you intended, or failing to cut back on drinking when you've tried.
比預期喝得多很多，或者在減量時嘗試失敗。
Other symptoms are more about how your drinking affects your home life and responsibilities.
其他癥狀更多的與酗酒如何影響你的家庭生活和責任有關。
Like if your drinking has interfered with your relationships or responsibilities at work or at home,
比如酗酒已經妨礙了你在工作或家庭中的關系或責任，
or has put you or others at risk, but you still don't stop.
或者已經把你或其他人置于危險之中，但你仍然停止不了。
The DSM lists 11 symptoms in all, and if you have any two of them,
DSM總共列出了11種癥狀，如果你有任意兩種，
that's enough to be diagnosed with alcohol use disorder.
都足以被診斷為酒精使用障礙了。
The more symptoms someone has, the more severe it gets.
一個人的癥狀越多，問題就越嚴重。
But no matter where they fall on the spectrum,
但無論他們的問題有多嚴重，
people with alcohol use disorder are drinking so much
患有酒精使用障礙的人都喝的太多，
that it puts their relationships, responsibilities, and maybe even their life at risk.
以至于將他們的關系、責任甚至生命置于危險之中。
There are a thousand different ways to get to that point, but they all come down to one thing:
要得出這一結果有上千種不同的方法，但它們都歸結為一點：
alcohol has a sedative effect, which makes you less anxious and more relaxed.
酒精有鎮靜作用，能讓你不那么焦慮，更加放松。
And the more you associate drinking alcohol with that relaxed feeling,
你越是把喝酒和那種放松的感覺聯系在一起，
the more your brain's reward system gets involved.
你大腦的獎勵系統參與得就越多。
If thinking about a drink makes your brain release a lot of dopamine,
如果你想著喝酒能讓大腦釋放大量的多巴胺，
the neurotransmitter that's involved in the motivation to seek rewards,
后者是參與尋求獎勵的神經遞質，
you're going to have a very strong urge to satisfy that thought.
那么你就會有強烈的欲望去滿足這個想法。
It's the same basic process that drives most addictions.
這是驅動大多數上癮的基本過程。
But alcohol doesn't affect everyone in exactly the same way.
但是酒精影響每個人的方式并不完全相同。
From studies and statistics, we know that things like your genetics and experiences
從研究和統計學中我們知道，遺傳和經驗等
can make you more or less likely to develop a disorder.
會使你有或多或少患上一種障礙的可能性。
For example, certain genes seem to change how enzymes that metabolize alcohol work,
例如，某些基因似乎改變了代謝酒精酶的工作方式，
which changes how it affects your brain.
這將改變該酶影響你大腦的方式。
Everyone has enzymes in their liver called alcohol dehydrogenases,
每個人的肝臟中都有一種叫做醇脫氫酶的酶，
which convert alcohol into acetaldehyde, a chemical that won't affect the brain the same way.
它會把酒精轉化成乙醛，即一種不會對大腦產生同樣影響的化學物質。
But some people have genes that make those enzymes faster at their job, compared to other variants of those genes.
但是有些人的基因與其他變異基因相比，能使這些酶工作得更快，
People with the genes that make the enzymes faster tend not to drink as much and are at a lower risk of alcoholism,
有該基因的人往往不會喝多，并且酒精中毒風險的較低，
probably because less alcohol gets a chance to interfere with their neurotransmitters.
這可能是因為酒精有較少的機會干擾他們的神經遞質。
But people with genes that make the enzyme slower have a higher chance of developing a disorder.
但是擁有讓酶效率變慢的基因的人更有可能發展成一種障礙。
Those genetic differences help explain what researchers have known for years:
這些基因差異有助于解釋研究人員多年來的研究：
that a family history of alcoholism puts people at higher risk.
家族酗酒史讓人們面臨更高的風險。
But as usual, genes aren't the whole story.
但與往常一樣，基因不能說明全部問題。
Researchers have also found that just living with alcoholics can put people at a greater risk,
研究人員還發現，與酗酒者生活在一起的人面臨更大的風險，
both through additional stresses and being exposed to that kind of drinking behavior.
它是由額外壓力和接觸這種飲酒行為引起的。
For example, a study published in the Journal of Abnormal Psychology in 1991 looked at 454 adolescents,
例如，1991年發表在《變態心理學雜志》上的一項研究調查了454名青少年，
since that's a stage of life when you're at a high risk for starting to develop an unhealthy relationship with alcohol.
因為這一生命階段是你開始與酒精建立不健康關系的高發期。
In the study, having alcoholic parents made people more likely to report dependence themselves.
在這項研究中，有酗酒父母的青少年更有可能報告自己的自我依賴。
But it mattered whether their parents' alcoholism was in remission or not, meaning, whether they got sober.
但父母的酗酒問題是否緩解或者說他們是否清醒很重要。
Children of sober alcoholics drank less overall,
與那些父母仍在酗酒的孩子相比，保持清醒者的孩子喝得更少，
and were less likely to report negative consequences or dependence, than those whose parents still drank.
并且不太可能報告負面結果或依賴。
Even though the genetic risk factors were still there, their environment made a difference, too.
盡管遺傳風險因素仍然存在，但他們的環境也產生了影響。
But risk factors are just that risk factors. They don't determine your fate.
但風險因素就是風險因素，他們不會決定你的命運。
For a lot of people with alcohol use disorder,
對于很多酒精使用障礙患者來說，
recognizing and admitting that they have a problem is incredibly difficult, and getting help can seem even harder.
察覺并承認他們有問題非常困難，尋求幫助似乎更加困難。
That's part of what the disorder does to your brain, it takes away your control.
部分原因是障礙對你大腦的影響，它帶走了你的控制權。
But you can still choose to get help to regain that control.
但是你仍然可以選擇獲得幫助來重獲控制權。
The most common treatments are mutual-help groups, like Alcoholics Anonymous.
最常見的治療方法是互幫互助小組，比如匿名戒酒互助社。
These programs can be helpful because you have peer support available when you need it the most.
這些項目可能有用，因為你在最需要的時候，可以獲得同伴的支持。
And research has found that people participating in AA for the first time have more days where they don't drink.
研究發現，第一次參加嗜酒者互誡協會的人喝酒的天數會減少。
Rehab also tends to work well, partly because it's designed to remove the triggers that might encourage you to drink.
康復治療也有很好的效果，部分原因在于它的設計目的是消除可能鼓勵你喝酒的誘因。
People who check into inpatient rehab programs report longer periods of abstinence,
那些參與住院康復項目的人報告說長時間的禁欲有效果，
and the longer the stay, the more helpful it seems to be.
而且待的時間越長，似乎越有幫助。
Some medications can help too,
一些藥物也有幫助，
especially when people just need to get alcohol out of their system so they can start on long-term treatments.
特別是當人們需要擺脫酒精的時候，這樣他們就可以開始長期治療了。
A drug called Naltrexone, for example, can reduce cravings for alcohol,
例如，一種叫做環丙甲羥二羥嗎啡酮的藥物可以人們減少對酒精的渴望，
and studies have found that people who take the drug end up drinking less,
研究發現吃此藥的人會減少酗酒，
and on fewer days, compared to a placebo.
與安慰劑相比，它的時間更短。
There's also evidence that cognitive behavioral therapy can be effective.
還有證據表明認知行為療法可能有效。
That's where you work with a therapist to identify things that trigger you to drink and find healthier ways to cope.
你要和治療師一起協作確定那些激發你喝酒的誘因，并找到更健康的方法來應對。
Not everyone will respond to every kind of treatment,
不是每個人都會對每一種治療有反應，
but doctors and psychologists have so many tools in their arsenal
但是醫生和心理學家的武器庫中有這么多的工具，
that if you realize you want help, odds are you'll find one that makes sense for you.
如果你意識到自己需要幫助，總會發現一種對你有效的方法。
Thanks for watching this episode of SciShow Psych,
感謝您收看本期的心理科學秀！
which was brought to you by our patrons on Patreon.
它是由Patreon贊助的。
If you want to learn more about what makes our weird human brains do the things they do,
如果你想了解更多關于“什么讓我們的神奇人類大腦工作”，
you can go to youtube.com/scishowpsych to subscribe.
可以登錄youtube.com/scishowpsych點擊訂閱。
