Depression is the leading cause of disability in the world.

抑郁癥是造成全球殘疾類疾病的主要原因。

In the United States,close to 10% of adults struggle with depression.

在美國，接近10%的成年人都被抑郁癥所困擾。

But because it's a mental illness,it can be a lot harder to understand than,say,high cholesterol.

但是作為一種精神疾病，抑郁癥遠比像高膽固醇等概念更難理解。

One major source of confusion is the difference between having depression and just feeling depressed.

其中最容易讓人混淆的的一點，是患有抑郁癥和僅僅只是情緒低落之間的差別。

Almost everyone feels down from time to time.

幾乎所有人都有情緒低落的時候。

Getting a bad grade,losing?a job,having an argument,even a rainy day can bring on feelings of sadness.

考試失利、被炒魷魚、與人爭執(zhí)，甚至一個下雨天都可能會引發(fā)情緒失落。

Sometimes there's no trigger at all.

有時甚至是無厘頭地消沉。

It just?pops up out of?the blue.

感傷的情緒就會突然縈繞在心頭。

Then?sircumstances change,and those sad feelings disappear.

然后柳暗花明，悲傷的情感慢慢褪去。

Clinical depression is different.

但是臨床上所講的抑郁癥卻截然不同。

It's a medical disorder,and it won't go away just because you want it to.

抑郁癥是一種醫(yī)學上的情緒障礙，它無法通過個人的意志來治愈。

It lingers for at least two consecutive weeks,and significantly interferes with one's ability to work,play,or love.

它會持續(xù)至少兩周時間，并嚴重地影響患者的工作狀態(tài)、行為能力以及情感生活。

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.

抑郁癥有很多種不同的癥狀：情緒低落、對事物失去原有的興趣、改變食欲、讓人自備或者感到極度的負罪感、嗜睡或者失眠、無法集中注意力、焦躁不安、反應(yīng)遲鈍、渾身乏力或者反復(fù)升起輕生的念頭。

If you have at least five of those symptoms,according to?psychiatric guidelines,you qualify for a diagnosis of depression.

如果你有上述癥狀中的五項甚至更多，依據(jù)精神病學，你就可以被判定為患有抑郁癥。

And it's not just behavioral symptoms.

不只是行為上的改變。

Depression haas physical manifestations inside the brain.

抑郁癥還會導(dǎo)致一些腦部的臨床表現(xiàn)。

First of all,there are changes that could be seen with the naked eye and X-ray vision.

?首先，有些變化可以用肉眼以及X光片觀察到。

This include smaller frontal lobes and hippocampal volumes.

其中包括較小的額葉以及海馬體。

On amore microscale,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.

從更微觀的角度來看，抑郁癥與以下幾點有關(guān)：

• 某些神經(jīng)傳導(dǎo)物質(zhì)的異常傳遞和消耗，尤其是血清素、去甲腎上腺素和多巴胺。

這打亂了生物鐘，使睡眠狀況發(fā)生明顯變化

• 激素分泌紊亂，例如皮質(zhì)醇偏高以及甲狀腺素異常。

But?neurosscientists still don't have a complete picture of what cause depression.

但是神經(jīng)學家仍未能全美詮釋導(dǎo)致抑郁癥的原因。

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.

這可能和基因與環(huán)境的相互作用有關(guān)，但我們目前還沒有有效的方法來準確判斷這種作用具體發(fā)生的機制。

And because depression symptoms are intangible,it's hard to know who might look fine but is actually struggling.

并且由于抑郁癥的病癥發(fā)生于無形，我們便很難發(fā)現(xiàn)那些正為抑郁癥所困擾的人們。

According to National Institute of Mental Health,it takes the average person suffering with a mental illness over ten years to ask for help.

根據(jù)美國心理健康研究中心的數(shù)據(jù)，平均每一位患有精神疾病的患者需要花至少10年去尋求幫助。

But there are very effective treatments.

但其實目前有很多有效的治療方法來幫助抑郁癥患者。

Medications and therapy complement each other to boost brain chemicals.

藥物治療配合心理治療可以促進腦內(nèi)化學物質(zhì)的產(chǎn)生。

In extreme cases,electroconvulsive therapy,which is like a controlled seizure in the patient's brain is also very helpful.

在一些特殊的病例中，電休克療法，即一種類似控制患者大腦進行休克的方法，也對患者很有幫助。

Other promising tratments,like transcranial magnetic stimulation,are being investigated?too.

另外，一些很有潛力的治療方法，比如經(jīng)顱磁刺激也正在被廣泛研究。

So if you know someone struggling with depression,encourage them,gently,to seek out some of these options.

因此，如果你認識某位正飽受抑郁癥折磨的人，請鼓勵他們從以上的方法中尋求幫助。

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 docotor.

你甚至可以提供更為具體的幫助，比如尋求一些此領(lǐng)域中的專業(yè)治療師又或者是幫忙列一個問題清單去請教醫(yī)生。

To someone with depression,these first steps can seem insurmountable.

對于那些抑郁癥患者來說，邁出這第一步尤為艱難。

If they feel guilty or ashamed,point out that depression is a medical condition,just like asthma or diabetes.

如果他們有負罪感或者羞恥感，請向他們指出，抑郁癥是一種醫(yī)學疾病，就像哮喘或糖尿病一樣常見。

It's not a weakness or?a personality trait,and they shouldn't expect themselves to just get over it anymore than they could will themselves to get over a broken arm.

告訴他們抑郁癥并非他們的弱點或者代表他們的人格，而且他們不能只靠自己硬撐來克服這個疾病，這不像傷筋動骨一樣可以自愈。

If you haven't experienced depression yourself,avoid comparing it to times you've felt down.

如果你未曾受到抑郁癥的困擾，請不要將他們的痛苦與你平日里的情緒低落進行比較。

Comparing what they're experiencing to normal,temporary feelings of sadness can make them feel guilty for struggling.

也不要將他們所承受的困擾與常見的悲傷情緒相提并論。因為這會加深他們對病情的負罪感。

Even just talking about depression openly can help.

哪怕只是單純而誠懇地談?wù)勔钟舭Y都會對他們有所幫助。

For example,research shows that asking someone about suicidal thoughts actually reduces their suicide risk.

例如，研究表明，詢問一些人關(guān)于自殺的看法，實際上可以降低他們自殺的幾率。

Open conversations about mental illness help erode stigma and make it easier for people to ask for help.

開誠布公地談?wù)劸窦膊∮欣诘颊叩淖员耙庾R并且讓他們更有勇氣去尋求幫助。

And the more patients seek treatment,the more scientists will learn about depression,and the better the treatments will get.

而只有越多的患者積極尋求治療，科學家對抑郁癥的認知才會更深入，從而使患者得到更有效的治療。

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