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.
憂鬱症是世界上造成人類失能的首要原因。在美國，有近百分之十的成人受憂鬱症所苦。但因為憂鬱症是種心理疾病，要了解它會比，好比說，高膽固醇困難許多。其中最常造成混淆的地方，就是罹患憂鬱症和單純感到情緒低落的不同。
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.
幾乎每個人偶爾都會心情不好。考試考差、失業、吵架，甚至下雨天也會引起悲傷的感覺。有時候完全沒有誘發原因。難過的感覺就那樣突然冒出來。然後情況改變，而那些悲傷的感覺就消失了。臨床憂鬱症不一樣。那是一種疾病，它不會因為你要它消失就消失。低落的情緒會持續至少兩週，且會嚴重影響一個人工作、玩樂或愛人的能力。
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.
憂鬱症可能會有許多不同的病徵：情緒低落、對平常喜歡的事物失去興趣、胃口改變、覺得自己沒價值或過度有罪惡感、睡太多或太少、注意力不集中、焦慮或遲滯、失去活力，或反覆出現自殺念頭。如果你有其中至少五個症狀，根據精神病學指南，你就符合憂鬱症診斷。
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.
而不僅是行為上的症狀。憂鬱症在大腦中也有具體表現。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迴體積較小。更微觀來看，憂鬱症和幾件事有關：特定神經傳導物質的不正常傳遞或減少，特別是血清素、去甲基腎上腺素以及多巴胺；生理時鐘變遲鈍，或睡眠週期中快速動眼期和慢波期的明顯改變；以及荷爾蒙失調，例如皮質醇過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.
不過神經科學家對憂鬱症的成因仍未完全理解。那似乎和基因與環境間的複雜交互作用有關，但我們尚未有能精準預測憂鬱症發作的時地的診斷工具。且因為憂鬱症病徵捉摸不定，很難得知哪些看起來好好的人其實正在受憂鬱症所苦。根據美國國家心理衛生研究院表示，一般心理疾病患者要拖十年以上才會尋求協助。
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.
但現在有十分有效的治療方法。藥物和療法相互輔助來激發腦內化學物質生成。在極端案例中，電療法，那就像是一種在患者腦部控制痙攣發作的方法，這也極有幫助。其它備受看好的治療方法，像是穿顱磁刺激法，也在研究當中。
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.
如果你認識某個受憂鬱症所困的人，溫柔地鼓勵他們尋求這其中一些方法。你甚至可能可以幫忙一些事，像是搜尋附近的心理治療師，或是列出要問醫生的問題清單。對一個有憂鬱症的人來說，這些第一步看起來可能難以跨越。如果他們感到有罪惡感或羞愧，點出憂鬱症是種疾病這項事實，就像氣喘或糖尿病一樣。這不是種懦弱或人格特質，他們不該指望自己能就好起來，就像他們也沒辦法用意志力來讓斷臂復原一樣。
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憂鬱症，避免拿憂鬱症和你心情不好時作比較。將他們的遭遇和一般短暫的難過情緒相提並論，會讓患者對自己的掙扎感到罪惡。就算只是公開討論憂鬱症都有幫助。舉例來說，研究顯示詢問一個人有無自殺念頭真的能降低他們自殺的風險。開誠佈公地討論心理疾病有助消弭汙名，並讓人們更容易尋求協助。而有越多病患尋求治療，科學家就能越了解憂鬱症，治療方法就能變得更進步。
- 「偶爾、有時」- From Time To Time
Almost everyone feels down from time to time.
幾乎每個人偶爾都會心情不好。 - 「引起、帶來」- Bring On
Getting a bad grade, losing a job, having an argument, even a rainy day can bring on feelings of sadness.
考試考差、失業、吵架，甚至下雨天也會引起悲傷的感覺。 - 「完全、根本」- At All
Sometimes there's no trigger at all.
有時候完全沒有誘發原因。 - 「出現、發生」- Pop Up
It just pops up out of the blue.
難過的感覺就那樣突然冒出來。 - 「突然、出乎意料地」- Out Of The Blue
It just pops up out of the blue.
難過的感覺就那樣突然冒出來。 - 「消失、離開」- Go Away
Clinical depression is different. It's a medical disorder, and it won't go away just because you want it to.
臨床憂鬱症不一樣。那是一種疾病，它不會因為你要它消失就消失。 - 「根據、按照」- According To
If you have at least five of those symptoms, according to psychiatric guidelines, you qualify for a diagnosis of depression.
如果你有其中至少五個症狀，根據精神病學指南，你就符合憂鬱症診斷。 - 「首先、第一」- First Of All
First of all, there are changes that could be seen with the naked eye and X-ray vision.
首先，有能用肉眼及 X 光觀察到的變化。
