We live in a culture that doesn't take mental health issues seriously. There's a lot of stigma. Some people tell you to just suck it up, or get it together, or to stop worrying, or that it's all in your head.?

我們?nèi)缃裆钤谝粋€很不重視心理健康的文化中?，F(xiàn)實(shí)中有許多難以啟齒的狀況。有些人告訴你把事自己消化了就好，或振作起來，或別擔(dān)心，或說你想太多了。
But I'm here to tell you that anxiety disorders, they're as real as diabetes.Body Stuff with Dr. Jen Gunter

但我在這告訴你，焦慮癥就像糖尿病般真實(shí)存在。

與詹·岡特博士聊聊身體里的那些事

Hi again. It's Dr. Jen, and I've noticed something with my patients. They often describe to me some classic symptoms of an anxiety disorder. Constant worry, trouble sleeping, tense muscles and struggle with concentrating. But they aren't getting treatment.

大家好，我是詹博士，我從我的病人身上發(fā)現(xiàn)了一個現(xiàn)象。他們經(jīng)常向我描述一些焦慮癥的典型癥狀。不斷擔(dān)心，難以入睡，肌肉緊張和難以集中注意力，但他們并沒有尋求治療。

There's a lot of issues with mental-health care in this country. Some people don't have insurance that would cover it. Some have been dismissed or minimized in the past, and don't think seeking help will do any good.

這個國家存在著許多心理健康的保健問題。有些人沒有這方面的醫(yī)療保險，有些人的癥治曾被忽略不計(jì)，有些則認(rèn)為治療也不會有好轉(zhuǎn)。

Some worry about the stigma and whether it could affect future jobs or relationships. But severe anxiety isn't a moral or personal failing. It's a health problem, just like strep throat or diabetes. It needs to be treated with the same kind of seriousness.

有些人擔(dān)心心理問題將會成為未來的絆腳石，為以后的工作和生活增加麻煩。但重度焦慮并不是一個人的挫折或失敗，而是一個健康隱患，就像咽喉炎或糖尿病一樣，焦慮癥也應(yīng)該被一視同仁。

Before we can talk about anxiety disorders, let's talk about anxiety itself. Anxiety is the very real and normal emotion we feel in a stressful situation. It's related to fear. But while fear is a response to an immediate threat that quickly subsides, anxiety is a response to more uncertain threats that tends to last much longer.

在討論焦慮癥之前，我們先了解一下焦慮本身。焦慮是一種普遍和正常的情緒，我們在壓力下都會感到焦慮。它跟恐懼有所關(guān)聯(lián)。但恐懼是當(dāng)我們受到短暫的威脅時做出的反應(yīng)，而焦慮是當(dāng)我們受到不明確的威脅時做出的長久的反應(yīng)。

It's all part of the threat detection system, which all animals have to some degree, to help protect us from predators. Anxiety starts in the brain's amygdala, a pair of almond-sized nerve bundles that alert other areas of the brain to be ready for defensive action.

這都是我們身體監(jiān)測危險系統(tǒng)的一部分，所有動物身上都有這個系統(tǒng)，來保護(hù)我們免受掠食者的威脅。焦慮始于大腦的杏仁核，一對杏仁大小的神經(jīng)提醒大腦的其他區(qū)域做好防御行動的準(zhǔn)備。

Next, the hypothalamus relays the signal, setting off what we call the stress response in our body. Our muscles tense, our breathing and heart rate increase and our blood pressure rises. Areas in the brain stem kick in and put you in a state of high alertness. This is the fight-or-flight response.

然后，下丘腦傳遞信號，引發(fā)我們所謂的身體壓力反應(yīng)。導(dǎo)致肌肉緊張，呼吸和心跳加速，并且血壓升高。腦干區(qū)域開始啟動，使人處于高度警覺狀態(tài)。這就是所謂的“戰(zhàn)斗或逃跑(fight-or-flight)反應(yīng)”。

There are ways the fight-or-flight response is kept somewhat in check, with an area of higher-level thinking called the ventromedial prefrontal cortex. It works like this. If a person sees something they think is dangerous, like a tiger, that sends a signal to the amygdala, saying "it's time to run."

有一些方法可以控制戰(zhàn)斗或逃跑的反應(yīng)，利用一個稱為前額葉皮層的高級思維區(qū)域。舉一個例子：假如一個人看見一個危險的東西，比如老虎，那將向大腦杏仁核發(fā)送信號，告訴它說“趕快跑”。

The ventromedial prefrontal cortex can say to the amygdala, "Hey, look. The tiger's in a cage. You know what a cage is? They can't escape from a cage. It's OK to calm down." It's a feedback loop that can help keep the response in check. The hippocampus is also involved. It provides context, saying things like, "Hey, we've seen tigers in cages before. We're in a zoo. You are extra safe."

而大腦前額葉片層則說：“你看，這老虎被關(guān)在一個籠子里。你知道籠子是什么吧？它是逃不出來的?？梢苑潘闪恕！边@是一個循環(huán)的反饋，可以幫助控制我們的反應(yīng)，腦部的海馬體也參與其中。它們可以判斷情況，比如：“我們之前也見過老虎被關(guān)在籠子里，我們現(xiàn)在在動物園，你非常安全?！?/p>

With anxiety, these threat-detection systems and mechanisms that reduce or inhibit them are functioning incorrectly and cause us to worry about the future and our safety in it. But for many people, it goes into overdrive. They experience persistent pervasive anxiety that disrupts work, school and relationships and leads them to avoid situations that may trigger symptoms. Anxiety disorders are not at all uncommon.

由于焦慮，這些減少或抑制威脅的檢測系統(tǒng)無法正常運(yùn)行，導(dǎo)致我們擔(dān)心未來和我們的安全。但是對于很多人來說，他們將經(jīng)歷疲勞過度。他們經(jīng)歷持續(xù)的焦慮，擾亂他們的工作、學(xué)校和人際關(guān)系，并導(dǎo)致他們刻意避免可能引發(fā)焦慮的場合。焦慮癥并不罕見。

Based on data from the World Mental Health Survey, researchers estimate that about 16 percent of individuals currently have or have had an anxiety disorder. These include social anxiety disorder, panic disorder, agoraphobia and phobias. Studies have shown that people with anxiety disorders don't just have a different way of reacting to stress. There may be actual differences in how their brain is working.

根據(jù)世界心理健康調(diào)查的數(shù)據(jù)，研究人員估計(jì)大約16%的人目前患有或曾經(jīng)患有焦慮癥。這包括社交焦慮癥，恐慌癥，空間恐懼癥和其他的恐懼癥。研究表明那些患有焦慮癥的人不僅面對壓力會有不同的反應(yīng)。他們大腦運(yùn)轉(zhuǎn)的方式可能存在差異。

One model describes possible mix-ups in the connections between the amygdala and other parts of the brain. The pathways that signal anxiety become stronger. And the more anxiety you have, the stronger the pathways become, and it becomes a vicious cycle.

這種模型描述了杏仁核和大腦其他部分之間連接中可能出現(xiàn)的混淆。發(fā)出焦慮信號的路徑變得更強(qiáng)，他越焦慮，路徑就越強(qiáng)，最終變成一個惡性循環(huán)。

The good news is there's treatment for anxiety, and that you don't have to suffer. Remember, this isn't about weakness. It's about changing brain patterns, and research shows that our brains have the ability to reorganize and form new connections all throughout our lives.

好消息是有治療焦慮癥的方法，確保你不必經(jīng)歷苦難。請記住，這與弱點(diǎn)無關(guān)。這是關(guān)于改變大腦模式，研究表明，我們的大腦具有能力重組并在我們的一生中建立新的聯(lián)系。

A good first step is to do the basics. Eat a balanced diet, exercise regularly and get plenty of sleep, as your mind is part of your body. It might also help to try meditation. Instead of our heart rate rising and our body tensing, with mindfulness and breathing, we can slow down the fight-or-flight response and improve how we feel in the moment.

一個好的開始是做好基礎(chǔ)工作。飲食均衡，經(jīng)常鍛煉，并且保持睡眠充足，因?yàn)榇竽X也是身體的一部分。嘗試冥想也可能有所幫助。與其心率上升和身體緊張，不如通過呼吸來減緩“戰(zhàn)斗或逃跑反應(yīng)”，并改善我們當(dāng)下的感受。

Cognitive behavioral therapy, a form of talk therapy, can also be fantastic. In it, you learn to identify upsetting thoughts and determine whether they're realistic. Over time, cognitive behavioral therapy can rebuild those neural pathways that tamp down the anxiety response. Medication can also give relief, in both the short-term and the long-term.

認(rèn)知行為療法是一種談話療法，也是很有幫助的一種。在其中，你將學(xué)會如何識別令人不安的想法并確認(rèn)他們是否符合現(xiàn)實(shí)。隨著時間的推移，認(rèn)知行為療法可以重建這些抑制焦慮反應(yīng)的神經(jīng)通路。藥劑也能緩解焦慮，無論是短期還是長期。

In the short-term, anti-anxiety drugs can down-regulate the threat-detection mechanisms that are going into overdrive. Studies have shown that both long-term medications and cognitive behavioral therapy can reduce that overreactivity of the amygdala we see an anxiety disorders.

在短期內(nèi)，當(dāng)體內(nèi)威脅檢測系統(tǒng)超速運(yùn)轉(zhuǎn)時，抗焦慮藥物可以幫助緩解。研究表明，長期藥物治療和認(rèn)知行為治療都可以減少我們在焦慮癥中看到的腦部杏仁核的過度反應(yīng)。

High blood pressure and diabetes, they can be treated or managed over time. And the same is true for an anxiety disorder too.

高血壓和糖尿病都可以循序漸進(jìn)慢慢治療或控制，那么焦慮癥也是如此。