TED演讲抑郁,我们各自隐藏秘密

下面是小编为大家整理的TED演讲抑郁,我们各自隐藏秘密,供大家参考。

00:14

"I felt a Funeral, in my Brain, and Mourners to and fro kept treading -- treading -- till [it seemed] that Sense was breaking through -- And when they all were seated, a Service, like a Drum -- kept beating -- beating -- till I [thought] my Mind was going numb -- And then I heard them lift a Box and creak across my Soul with those same Boots of Lead, again, then Space -- began to toll, As [all] the Heavens were a Bell, and Being, [but] an Ear, and I, and Silence, some strange Race, wrecked, solitary, here -- [And] then a Plank in Reason, broke, and I fell down and down -- and hit a World, at every plunge, and Finished knowing -- then --"

“我的脑海中，进行着一场葬礼，悼念者络绎不绝不停的走着, 踩踏着直到仪式的氛围渐浓当所有人入座仪式开始，敲鼓的声音沉重有力，敲打着, 敲打着直到我的意识变得麻木我听见他们抬起棺材沉重的脚步，摇摇晃晃我的灵魂，吱呀作响四周，丧钟响起天堂，就像一个铃铛存在，那么就是一只耳朵安静的我，如同异类在此孤独，在此腐朽失去依靠，理性开始崩塌我从高处坠落跌入一个又一个世界终于，看清

01:11

We know depression through metaphors. Emily Dickinson was able to convey it in language, Goya in an image. Half the purpose of art is to describe such iconic states.

我们能够在一些文学作品中看到抑郁的影子艾米莉·迪金森（美国十九世纪著名女诗人）通过诗歌诠释它戈雅（西班牙画家）通过绘画表达许多艺术作品产生的初衷就是为了表达这充满象征意义的状态

01:26

As for me, I had always thought myself tough, one of the people who could survive if I"d been sent to a concentration camp.

就我自己来说，我一度认为自己非常坚强认为自己是那一类即使被送去集中营也可以存活下来的人

01:35

In 1991, I had a series of losses. My mother died, a relationship I"d been in ended, I moved back to the United States from some years abroad, and I got through all of those experiences intact.

1991年，我经历了一连串的不幸母亲去世爱情终结我也在几年的海外生活之后回到了美国我在经历了这一切之后依旧安然无恙

01:49

But in 1994, three years later, I found myself losing interest in almost everything. I didn"t want to do any of the things I had previously wanted to do, and I didn"t know why. The opposite of depression is not happiness, but vitality. And it was vitality that seemed to seep away from me in that moment. Everything there was to do seemed like too much work. I would come home and I would see the red light flashing on my answering machine, and instead of being thrilled to hear from my friends, I would think, "What a lot of people that is to have to call back." Or I would decide I should have lunch, and then I would think,

but I"d have to get the food out and put it on a plate and cut it up and chew it and swallow it, and it felt to me like the Stations of the Cross.

然而在1994年，也就是三年之后我突然发现自己对几乎所有的事情都失去了兴趣甚至不愿意去做那些我曾经很想去做的事情我不知道这是为什么抑郁的反面并非快乐，而是活力而正是这样的活力似乎就在那段时间从我的身体中慢慢消失了所有需要完成的事情都感觉那么麻烦回到家的时候看着电话留言机上闪烁的红灯我不但不会因为听到朋友们的声音感到兴奋反而会想怎么有这么多人等我回电话有时该吃午饭了我却开始想，我还得把食物拿出来放到盘子里得切，得嚼，得咽让我感觉就像耶稣受难一样

02:44

And one of the things that often gets lost in discussions of depression is that you know it"s ridiculous. You know it"s ridiculous while you"re experiencing it. You know that most people manage to listen to their messages and eat lunch and organize themselves to take a shower and go out the front door and that it"s not a big deal, and yet you are nonetheless in its grip and you are unable to figure out any way around it. And so I began to feel myself doing less and thinking less and feeling less. It was a kind of nullity.

人们在谈论抑郁时时常忽略了一点那就是你知道这一切都很荒谬即使你正处在抑郁之中，你也知道这一切都很荒谬你知道多数人都可以让自己去听语音留言，去吃午餐紧接着让自己冲个澡然后出门你知道这根本不是什么大不了的事情然而你已经被它掌控并且无法找到任何解决的方式于是我开始感到自己事情做得越来越少思考得越来越少感知得越来越少就好像整个人已经没什么价值了

03:21

And then the anxiety set in. If you told me that I"d have to be depressed for the next month,

I would say, "As long I know it"ll be over in November, I can do it." But if you said to me, "You have to have acute anxiety for the next month," I would rather slit my wrist than go through it. It was the feeling all the time like that feeling you have if you"re walking and you slip or trip and the ground is rushing up at you, but instead of lasting half a second, the way that does, it lasted for six months. It"s a sensation of being afraid all the time but not even knowing what it is that you"re afraid of. And it was at that point that I began to think that it was just too painful to be alive, and that the only reason not to kill oneself was so as not to hurt other people.

紧接着焦虑就来了如果你告诉我我会在接下来的一个月里一直抑郁我会说，“只要一个月之后不抑郁了我就可以接受。” 但如果你告诉我“你会在接下来的一个月里严重焦虑。” 那么我宁可割腕也不愿意忍受这是一种持续的感觉就好像你走在路上滑倒了或者绊倒了地面猛冲向你的感觉但这种感觉不是半秒钟而是持续6个月这是一种时时刻刻感到惧怕却不知道自己在惧怕什么的感觉就在那时我开始想活着太痛苦了人不自杀的唯一原因是因为不想伤害身边的人

04:08

And finally one day, I woke up and I thought perhaps I"d had a stroke, because I lay in bed completely frozen, looking at the telephone, thinking, "Something is wrong and I should call for help," and I couldn"t reach out my arm and pick up the phone and dial. And finally, after four full hours of my lying and staring at it, the phone rang, and somehow I managed to pick it up, and it was my father, and I said, "I"m in serious trouble. We need to do something."

终于有一天，我醒来的时候我觉得我可能中风了因为我躺在床上整个人是完全僵硬的我

看着电话，心想“不好了，我该打电话求助。” 但我没办法伸出手去没有办法拿到电话来拨号终于，在我躺在那盯着电话整整四小时之后电话铃响了我不记得自己怎么拿到的电话是我父亲打来的我说，“我现在遇到大麻烦了，我们必须做点什么。”

04:40

The next day I started with the medications and the therapy. And I also started reckoning with this terrible question: If I"m not the tough person who could have made it through a concentration camp, then who am I? And if I have to take medication, is that medication making me more fully myself, or is it making me someone else? And how do I feel about it if it"s making me someone else?

第二天我开始吃药开始接受治疗与此同时我开始思考一个可怕的问题如果我不是那种坚强到即使被送去集中营也可以存活下来的人那么我是谁呢？如果我需要吃药的话那么药物是让我变得更像自己还是让我更不像自己？如果会让我变得像别人那么我又如何感觉到这点呢？

05:09

I had two advantages as I went into the fight. The first is that I knew that, objectively speaking, I had a nice life, and that if I could only get well, there was something at the other end that was worth living for. And the other was that I had access to good treatment. 在这个抗争的过程中我有两个优势首先是我很清楚，客观地说我有一个不错的生活条件如果我能好起来那么最终是会有一些东西值得我去为之而活的另外一点就是我能接受好的治疗

05:25

But I nonetheless emerged and relapsed, and emerged and relapsed, and emerged and

relapsed, and finally understood I would have to be on medication and in therapy forever. And I thought, "But is it a chemical problem or a psychological problem? And does it need a chemical cure or a philosophical cure?" And I couldn"t figure out which it was. And then I understood that actually, we aren"t advanced enough in either area for it to explain things fully. The chemical cure and the psychological cure both have a role to play, and I also figured out that depression was something that was braided so deep into us that there was no separating it from our character and personality.

但我却不知为何,好转了又复发又好转，又复发再好转，再复发最后我才意识到我必须一辈子依赖药物以及治疗于是我想，“但这到底是一个化学问题还是一个心理问题？这到底需要化学疗法还是心理疗法（原话为“哲学”）呢？” 我无法找到问题的答案然后我明白了事实上我们对这两个领域的了解都还不够都还不足以完全弄清真相化学治疗和心理治疗都发挥着重要的作用我也发现抑郁是这样一个东西深深的嵌入在我们的体内我们无法将它彻底剥离它已经嵌入到我们的性格和个性中了

06:12

I want to say that the treatments we have for depression are appalling. They"re not very effective. They"re extremely costly. They come with innumerable side effects. They"re a disaster. But I am so grateful that I live now and not 50 years ago, when there would have been almost nothing to be done. I hope that 50 years hence, people will hear about my treatments and be appalled that anyone endured such primitive science.

我想说现在我们所用的治疗抑郁症的方法太可怕了这些方法没有什么效果还非常昂贵并且伴随着无数的副作用它们简直就是灾难但我很感激我活在当下而不是50年前那个时候还不存在有效的方法我希望50年后人们听到我接受的治疗方法会震惊于竟然有人

愿意忍受如此原始简单的科学

06:41

Depression is the flaw in love. If you were married to someone and thought, "Well, if my wife dies, I"ll find another one," it wouldn"t be love as we know it. There"s no such thing as love without the anticipation of loss, and that specter of despair can be the engine of intimacy.

抑郁是爱的附属品如果你跟一个人结婚了，然后想“好吧，如果我的妻子去世了，我会找一个新的，” 那么据我们所知这不叫爱没有这样一种爱情可以只感受幸福而不体验失去这种绝望的幽灵会成为亲密关系的动力

07:07

There are three things people tend to confuse: depression, grief and sadness. Grief is explicitly reactive. If you have a loss and you feel incredibly unhappy, and then, six months later, you are still deeply sad, but you"re functioning a little better, it"s probably grief, and it will probably ultimately resolve itself in some measure. If you experience a catastrophic loss, and you feel terrible, and six months later you can barely function at all, then it"s probably a depression that was triggered by the catastrophic circumstances. The trajectory tells us a great deal. People think of depression as being just sadness. It"s much, much too much sadness, much too much grief at far too slight a cause.

有三种东西是人们容易混淆的抑郁，悲伤，难过悲伤是一种明确的反应如果你遭遇了不幸并感到极度不快乐紧接着六个月以后你还是非常难过，但是生活大致正常了这很有可能是悲伤而且它很有可能在最终一定程度地自我恢复如果你经历了一次灾难性的打击然后感觉非常糟糕并且六个月之后你依然无法正常生活那么很有可能就是你的抑郁被这

种灾难性的情形触发了这中变化的过程告诉我们很多信息人们往往认为抑郁只是难过而已只是太多太多的难过太多的悲伤起因却微不足道

07:56

As I set out to understand depression, and to interview people who had experienced it, I found that there were people who seemed, on the surface, to have what sounded like relatively mild depression who were nonetheless utterly disabled by it. And there were other people who had what sounded as they described it like terribly severe depression who nonetheless had good lives in the interstices between their depressive episodes. And I set out to find out what it is that causes some people to be more resilient than other people. What are the mechanisms that allow people to survive? And I went out and I interviewed person after person who was suffering with depression.

当我开始着手了解抑郁并且采访那些有过这样经历的人时我发现有些人从表面上看来好像是比较轻微的抑郁却已经因此彻底丧失行为能力了另一些人从他们的描述中得知他们经历了非常严重的抑郁他们却能够在抑郁发作的间隙过着不错的生活于是我开始研究到底是什么使一些人比另一些人能更好地适应是什么样的机制让这些人能够幸免？于是我去探访了一个又一个经历过抑郁的人

08:37

One of the first people I interviewed described depression as a slower way of being dead, and that was a good thing for me to hear early on because it reminded me that that slow way of being dead can lead to actual deadness, that this is a serious business. It"s the leading disability worldwide, and people die of it every day.

我第一批采访的人中有一个人把抑郁描述为一种缓慢的死亡方式这种说法最初在我听来

是好的因为这告诉我缓慢的死亡方式是会以真正的死亡结束的这不是说着玩的这是世界上导致机能障碍的主要原因之一每天都有人因此死去

09:00

One of the people I talked to when I was trying to understand this was a beloved friend who I had known for many years, and who had had a psychotic episode in her freshman year of college, and then plummeted into a horrific depression. She had bipolar illness, or manic depression, as it was then known. And then she did very well for many years on lithium, and then eventually, she was taken off her lithium to see how she would do without it, and she had another psychosis, and then plunged into the worst depression that I had ever seen in which she sat in her parents" apartment, more or less catatonic, essentially without moving, day after day after day. And when I interviewed her about that experience some years later -- she"s a poet and psychotherapist named Maggie Robbins -- when I interviewed her, she said, "I was singing "Where Have All The Flowers Gone," over and over, to occupy my mind. I was singing to blot out the things my mind was saying, which were, "You are nothing. You are nobody. You don"t even deserve to live." And that was when I really started thinking about killing myself."

在我试图了解这些的时候其中一个我采访的人是我的挚友我们已经相识很多年了她曾经在她大学入学的那一年有过精神病发作之后陷入了可怕的抑郁她患有双相情感障碍当时叫做躁郁症她经过多年的化学治疗病情控制得很好于是后来，她尝试停止化学治疗想看看能够独立的支撑下来她却精神病复发并且陷入了我所见过的最严重的抑郁她在父母的公寓里坐着多少有些紧张症的样子，几乎一动不动日复一日都是如此当我几年之后采访她那段经历时她叫玛吉·罗宾斯，诗人，精神治疗医师当我采访她的时候她说“我

一遍一遍地唱着‘花儿去向何处’来占据我的头脑来清除我头脑中不停重复的话语‘你一文不值，你这个无名小辈，你根本不配活在这世上。’ 那时候我真正开始有了自杀的想法。”10:14

You don"t think in depression that you"ve put on a gray veil and are seeing the world through the haze of a bad mood. You think that the veil has been taken away, the veil of happiness, and that now you"re seeing truly. It"s easier to help schizophrenics who perceive that there"s something foreign inside of them that needs to be exorcised, but it"s difficult with depressives, because we believe we are seeing the truth.

你没有意识到自己抑郁，但是你已经戴上了一层灰色的面纱并且是透过这层坏情绪的薄纱来看待这个世界的你认为是快乐的面纱被摘掉了这样你可以看得更加真实相对而言帮助精神分裂症患者更容易他们认为自己身体里面有某些异质需要被驱除但对于抑郁症患者来说这很难因为我们坚信自己看到的是事实

10:42

But the truth lies. I became obsessed with that sentence: "But the truth lies." And I discovered, as I talked to depressive people, that they have many delusional perceptions. People will say, "No one loves me." And you say, "I love you, your wife loves you, your mother loves you." You can answer that one pretty readily, at least for most people. But people who are depressed will also say, "No matter what we do, we"re all just going to die in the end." Or they"ll say, "There can be no true communion between two human beings. Each of us is trapped in his own body." To which you have to say, "That"s true, but I think we should focus right now on what to have for breakfast."

但事实是会说谎的我非常喜欢这句话“事实是会说谎的。” 当我与抑郁症患者交谈时我发

现他们有很多妄想出来的念头人们会说，“没人爱我。” 然后你说，“我爱你，你的妻子爱你，你的母亲爱你。” 你可以很快给出这个答案至少对大多数人是如此但是抑郁的人还会说“不论我们做什么，最终都是要死的。” 或者他们说，“两个人之间是不可能有真正的亲密交往的，我们每个人都被自己的身体所束缚了。“ 对于这个你只有回应说”这点没错，但我觉得我们眼下要考虑的是早上该吃什么。“

11:23

(Laughter)

11:25

A lot of the time, what they are expressing is not illness, but insight, and one comes to think what"s really extraordinary is that most of us know about those existential questions and they don"t distract us very much. There was a study I particularly liked in which a group of depressed and a group of non-depressed people were asked to play a video game for an hour, and at the end of the hour, they were asked how many little monsters they thought they had killed. The depressive group was usually accurate to within about 10 percent, and the non-depressed people guessed between 15 and 20 times as many little monsters --

（笑声）许多时候困扰他们的不是疾病本身，而是对一些事实的偏执他们会对一些事实超乎常人的在意但是对于我们绝大多数人而言并不在意这些有关存在的问题我有一个特别喜欢的研究是要一组抑郁症患者和一组非抑郁症患者分别打一小时的电子游戏一小时结束的时候问他们他们认为自己杀了多少只小怪兽抑郁组的答案往往准确误差不超过百分之十而非抑郁组的人估计的小怪兽数量却是实际杀掉的15到20倍

12:02

(Laughter)

12:03

as they had actually killed.

12:06

A lot of people said, when I chose to write about my depression, that it must be very difficult to be out of that closet, to have people know. They said, "Do people talk to you differently?" I said, "Yes, people talk to me differently. They talk to me differently insofar as they start telling me about their experience, or their sister"s experience, or their friend"s experience. Things are different because now I know that depression is the family secret that everyone has.

当我决定写下自己的抑郁经历时，许多人说要揭开这个秘密让别人知道一定非常不容易他们说，”人们会用不一样的口吻跟你说话吗？“ 我说，”是的，人们用不一样的口吻跟我说话。这种不一样体现在人们会告诉我他们自己的经历或是他们的兄弟姐妹的经历或是他们朋友的经历我现在明白，每个家庭都埋藏着一个抑郁的故事着改变了我的看法

12:34

I went a few years ago to a conference, and on Friday of the three-day conference, one of the participants took me aside, and she said, "I suffer from depression and I"m a little embarrassed about it, but I"ve been taking this medication, and I just wanted to ask you what you think?" And so I did my best to give her such advice as I could. And then she

said, "You know, my husband would never understand this. He"s really the kind of guy to whom this wouldn"t make any sense, so, you know, it"s just between us." And I said, "Yes, that"s fine." On Sunday of the same conference, her husband took me aside,

几年前我去参加一个学术会议连开三天，第一天是周五一个与会者把我叫到一边，她说“我有抑郁症我为此有点难为情而且我一直在吃某种药物我只是想问问看你的意见？” 我但是尽我所能给了一些建议之后她说，“其实，我的丈夫并不知道这件事情他是那种无法理解这种事情的人所以，嗯，我们的谈话能否保密。” 我说，“好，没有问题。” 周日开会的时候她的丈夫把我叫到了一边13:13

(Laughter)

13:14

and he said, "My wife wouldn"t think that I was really much of a guy if she knew this, but I"ve been dealing with this depression and I"m taking some medication, and I wondered what you think?" They were hiding the same medication in two different places in the same bedroom.

And I said that I thought communication within the marriage might be triggering some of their problems.

对我说，“我的妻子并不知道我跟她了解的那个我之间的不同我有抑郁症，有一段时间了我现在需要吃一些药物维持我想听听你的看法？” 他们两个人服用同一种药物，并且将药物藏在同一个卧室的不同的地方于是我对他说我觉得婚姻内部的沟通问题可能是他抑郁的原因之一

13:41

But I was also struck by the burdensome nature of such mutual secrecy. Depression is so exhausting. It takes up so much of your time and energy, and silence about it, it really does make the depression worse.

让我感到震惊的是人们想要保守这样的秘密并因此成熟的沉重负担抑郁让人精疲力尽它会消耗掉你几乎全部的时间和精力而对此保持沉默只会让抑郁的症状变得更加严重13:56

And then I began thinking about all the ways people make themselves better. I"d started off as a medical conservative. I thought there were a few kinds of therapy that worked, it was clear what they were -- there was medication, there were certain psychotherapies, there was possibly electroconvulsive treatment, and that everything else was nonsense. But then I discovered something. If you have brain cancer, and you say that standing on your head for 20 minutes every morning makes you feel better, it may make you feel better, but you still have brain cancer, and you"ll still probably die from it. But if you say that you have depression, and standing on your head for 20 minutes every day makes you feel better, then it"s worked, because depression is an illness of how you feel, and if you feel better, then you are effectively not depressed anymore. So I became much more tolerant of the vast world of alternative treatments.

我开始考虑所有可能的途径帮助抑郁的人们变得好一些我在治疗方法上，一开始是很保守的我觉得只有少数几种疗法是有效的就那么几种——药物治疗几类特定的精神疗法电休克疗法有时候有效果其它所有的方法都是扯淡但是后来我的看法变了如果你的脑子里长了肿瘤然后你觉得自己每天早晨倒立20分钟会让自己感觉好一些或许让你自己感觉

好一些但是你的脑瘤还在那里你还是可能因此死去但是如果你患上了抑郁然后你觉因为每天倒立20分钟感觉好一些，那是有一定效果的因为抑郁是你的感觉和情绪出了问题如果你感觉好一些了那么你的抑郁就会少一些所以我现在变得非常的宽容各种奇怪的偏门疗法我都能接受了

14:46

And I get letters, I get hundreds of letters from people writing to tell me about what"s worked for them. Someone was asking me backstage today about meditation. My favorite of the letters that I got was the one that came from a woman who wrote and said that she had tried therapy, medication, she had tried pretty much everything, and she had found a solution and hoped I would tell the world, and that was making little things from yarn. She sent me some of them. And I"m not wearing them right now. I suggested to her that she also should look up obsessive compulsive disorder in the DSM.

我收到了成百上千的邮件人们写信跟我分享他们使用的治疗方法就在刚才还有人在幕后问我关于药物治疗的事情有一封邮件提供的方法我很喜欢是一位女士写给我的她尝试过心理疗法，不管用药物疗法，也不行，各种方法都尝试了，还是不行最后她自己发现了一个方法，她希望我告诉全世界她认为最好的疗法是用纱线做一些小制品（笑声）她还给我邮寄了一些（笑声）我现在没穿在身上我建议她再去医院查查看看有没有强迫症（译注：演讲者在开玩笑）

15:27

And yet, when I went to look at alternative treatments, I also gained perspective on other treatments. I went through a tribal exorcism in Senegal that involved a great deal of ram"s

blood and that I"m not going to detail right now, but a few years afterwards I was in Rwanda, working on a different project, and I happened to describe my experience to someone, and he said, "Well, that"s West Africa, and we"re in East Africa, and our rituals are in some ways very different, but we do have some rituals that have something in common with what you"re describing." And he said, "But we"ve had a lot of trouble with Western mental health workers, especially the ones who came right after the genocide." I said, "What kind of trouble did you have?" And he said, "Well, they would do this bizarre thing. They didn"t take people out in the sunshine where you begin to feel better. They didn"t include drumming or music to get people"s blood going. They didn"t involve the whole community. They didn"t externalize the depression as an invasive spirit. Instead what they did was they took people one at a time into dingy little rooms and had them talk for an hour about bad things that had happened to them." He said, "We had to ask them to leave the country."

当我去了解其它偏门疗法时我也接触到了其它疗法的不同的视角我研究过塞内加尔一个部落的净化仪式他们在仪式中使用了大量的公羊血这里我就不详细讲了但是几年之后，当我去卢旺达参与另一个项目时我向一个当地人介绍了那个仪式他说，“嗯，你知道那是西非，我们这里是东非我们的宗教仪式有一些不同的地方但是我们也有一些地方是共通的（我们的方法）跟你描述的那种有些相似然后我说，“哦”。他说，“是的”，然后他继续说道但是西方世界跑过来的心理治疗师给我们添了不少麻烦尤其是那些大屠杀之后跑来的心理医生们（译注：指1990年代卢旺达大屠杀）于是我问他，“什么麻烦？” 他说，“是这样的他们做的事情很古怪他们并不会让人去阳光下活动虽然这会让人感觉舒服他们不使用音乐或打鼓的方式激发人们的情绪他们不会让整个社区参与其中他们也没有将抑

郁外显化为一种恶灵进行驱逐相反的，他们将那些（抑郁的）人单独地带到一个昏暗的小房间花一个小时让他们回忆发生在他们身上的悲惨的事情。” （笑声）（掌声）他说，“我们只能请他们离开这个国家了。” （笑声）

16:41

Now at the other end of alternative treatments, let me tell you about Frank Russakoff. Frank Russakoff had the worst depression perhaps that I"ve ever seen in a man. He was constantly depressed. He was, when I met him, at a point at which every month, he would have electroshock treatment. Then he would feel sort of disoriented for a week. Then he would feel okay for a week. Then he would have a week of going downhill. And then he would have another electroshock treatment. And he said to me when I met him, "It"s unbearable to go through my weeks this way. I can"t go on this way, and I"ve figured out how I"m going to end it if I don"t get better." "But," he said to me, "I heard about a protocol at Mass General for a procedure called a cingulotomy, which is a brain surgery, and I think I"m going to give that a try." And I remember being amazed at that point to think that someone who clearly had so many bad experiences with so many different treatments still had buried in him, somewhere, enough optimism to reach out for one more. And he had the cingulotomy, and it was incredibly successful.

现在，我想分享另外一种替代的疗法弗兰克·若萨克夫接受了这种替代疗法弗兰克的抑郁症可能是我见过的最严重的抑郁症之一他一直处于抑郁状态当我刚见到他的时候他每

个月都要接受电休克治疗所以他每个月第一周会被电的迷迷糊糊第二周变得正常起来第三周开始情绪又开始走下坡路然后他就会寻求下一次电休克治疗当我开始见到他的时候，他说“这种（电休克的）周期对于我而言是无法避免的我不能这么下去了我知道如果我不能够变好起来意味着什么“但是”，他对我说，“我听说麻省总院最近在进行医疗实验，实验一种脑手术，叫扣带回切开术我想我会去尝试一下。” 我至今都记得当时我听到后的惊喜的心情想想这样一个人经历了如此多的悲惨经历忍受了那么多的治疗方法骨子里依然有一种与生俱来的乐观要去尝试新的东西后来他做了扣带回切开术出乎意料地成功17:44

He"s now a friend of mine. He has a lovely wife and two beautiful children. He wrote me a letter the Christmas after the surgery, and he said, "My father sent me two presents this year, First, a motorized CD rack from The Sharper Image that I didn"t really need, but I knew he was giving it to me to celebrate the fact that I"m living on my own and have a job I seem to love. And the other present was a photo of my grandmother, who committed suicide. As I unwrapped it, I began to cry, and my mother came over and said, "Are you crying because of the relatives you never knew?" And I said, "She had the same disease I have." I"m crying now as I write to you. It"s not that I"m so sad, but I get overwhelmed, I think, because I could have killed myself, but my parents kept me going, and so did the doctors, and I had the surgery. I"m alive and grateful. We live in the right time, even if it doesn"t always feel like it."

他跟我现在成为了朋友他有一个可爱的妻子和两个漂亮的小孩那次手术的圣诞节后，他写了一封信给我他说“我的父亲今年寄给我两件礼物一个是某个品牌的车载CD架我不是很需要但是我知道他是给我这个的目的是想要庆祝一下，我可以重新开始并且有了一份

喜欢的工作另外一件礼物是我外婆的一张照片她自杀了当我拆开包装的时候，我开始哭泣我的妈妈过来问道‘你哭是因为你从来没有见过外婆么？’ 我说，‘不，是因为她的痛苦，我同样经历过。’ 写这封信的现在，我又忍不住哭泣不是因为悲伤，而是因为我再也无法承受我想我曾经也可能会自杀但是我的父母给了我勇气还有治疗我的医生们还有这个手术我活着，心怀感恩我们活在美好的时代虽然有时候看起来很糟。”

18:46

I was struck by the fact that depression is broadly perceived to be a modern, Western, middle-class thing, and I went to look at how it operated in a variety of other contexts, and one of the things I was most interested in was depression among the indigent. And so I went out to try to look at what was being done for poor people with depression. And what I discovered is that poor people are mostly not being treated for depression. Depression is the result of a genetic vulnerability, which is presumably evenly distributed in the population, and triggering circumstances, which are likely to be more severe for people who are impoverished. And yet it turns out that if you have a really lovely life but feel miserable all the time, you think, "Why do I feel like this? I must have depression." And you set out to find treatment for it. But if you have a perfectly awful life, and you feel miserable all the time, the way you feel is commensurate with your life, and it doesn"t occur to you to think, "Maybe this is treatable."

我很不能理解为什么人们普遍的把抑郁症看成是现代西方中产阶级特有的一种病于是我开始寻找抑郁症与其它社会因素的关联在可能相关的社会因素中我对贫困和抑郁的关系特别感兴趣于是我做了一些研究尝试去了解穷人是如何治疗抑郁的我发现大多数情况下穷人的抑郁症不会得到治疗抑郁属于基因的缺陷这意味着在不同的人群中容易抑郁的人

的比例应该是一样的生活环境的不同导致了发病率的不同而当人们处于贫困的生活环境中时抑郁症的发病率更高, 也更严重但是, 如果你的生活一帆风顺然后你觉得自己一直都不开心你会反思, "我为什么不开心?" "我一定是抑郁了." 然后你会去找医生给你治疗但是如果你的生活本来就很糟糕然后你一直都不开心你的感觉和你的生活状态是相称的于是你就不会想到这个是病"或许这个可以治疗一下" 19:43

And so we have an epidemic in this country of depression among impoverished people that"s not being picked up and that"s not being treated and that"s not being addressed, and it"s a tragedy of a grand order. And so I found an academic who was doing a research project in slums outside of D.C., where she picked up women who had come in for other health problems and diagnosed them with depression, and then provided six months of the experimental protocol. One of them, Lolly, came in, and this is what she said the day she came in. She said, and she was a woman, by the way, who had seven children. She said, "I used to have a job but I had to give it up because I couldn"t go out of the house. I have nothing to say to my children. In the morning, I can"t wait for them to leave, and then I climb in bed and pull the covers over my head, and three o"clock when they come home, it just comes so fast." She said, "I"ve been taking a lot of Tylenol, anything I can take so that I can sleep more. My husband has been telling me I"m stupid, I"m ugly. I wish I could stop the pain."

所以实际上我们这个国家的低收入人群中抑郁症像是传染病一样流行但是却一直没有被人注意过, 没有人评估过患病的规模也没有人为这些低收入者提供治疗这是非常大的一个悲剧后来我发现了一位研究人员她当时正在华盛顿特区周边的贫民窟中做与之相关的一项研究当有妇女前来看其它的疾病时, 她会邀请这些妇女做一个抑郁症的诊断同时提

供一份六个月的实验协议其中有一位女士, 名叫洛莉以下是她第一天到诊所来的自述她说她是一位母亲7个孩子的母亲, 她说, "我曾经有一份工作, 但是不得不辞掉了" "因为我无法离开我的屋子" 我一句话都不想跟我的孩子们说早晨, 我迫不及待的让孩子们出门上学然后立刻爬上床蒙头大睡然后下午三点他们就陆续回家了时间过得太快了她说, "我已经吃了很多的泰诺(一种止痛药)" 以及其它所有能够让我多睡一会儿的东西我的丈夫一直说我蠢, 说我令人讨厌我真希望能够结束这痛苦

20:47

Well, she was brought into this experimental protocol, and when I interviewed her six months later, she had taken a job working in childcare for the U.S. Navy, she had left the abusive husband, and she said to me, "My kids are so much happier now." She said, "There"s one room in my new place for the boys and one room for the girls, but at night, they"re just all up on my bed, and we"re doing homework all together and everything. One of them wants to be a preacher, one of them wants to be a firefighter, and one of the girls says she"s going to be a lawyer. They don"t cry like they used to, and they don"t fight like they did. That"s all I need now, is my kids. Things keep on changing, the way I dress, the way I feel, the way I act. I can go outside not being afraid anymore, and I don"t think those bad feelings are coming back, and if it weren"t for Dr. Miranda and that, I would still be at home with the covers pulled over my head, if I were still alive at all. I asked the Lord to send me an angel, and He heard my prayers."

然后她接受了实验协议开始进行治疗六个月之后当我去采访她的时候她有了一份新工作, 在美国海军(的幼儿园) 照看孩子, 她离开了以前那个虐待她的丈夫她对我说我的孩子们现在比以前开心多了她说, 现在我的新家有两个孩子的卧室男孩子们一间, 女孩子们一

间到了晚上的时候, 他们都会来到我的房间我们一直做家庭作业, 做其它的事情一个儿子立志做一名牧师另一个想要做消防队员我的一个女儿想要做一名律师他们不像以前那样哭得那么频繁也不再像以前那样相互打来打去了看着这些孩子, 我现在觉得很满足一切都在不断的变好我的穿着, 我的情绪, 我的言行我不会再像以前那样害怕出门也不会再担心糟糕的心情会卷土重来如果没有米兰达医生(那位研究人员)的帮助我现在可能还我在家里, 用被子蒙住头呼呼大睡或许我已经死了我曾祈祷上帝为我下凡一位天使而上帝听到了我的声音." (译注: 指米兰达博士)

22:01

I was really moved by these experiences, and I decided that I wanted to write about them not only in a book I was working on, but also in an article, and I got a commission from The New York Times Magazine to write about depression among the indigent.

我被这些真实的故事深深打动了我之前计划只是写一本书来记录但是现在我觉得远远不够我还要写一篇文章(让更多的人知道) 所以我跟纽约时报杂志说好写一篇有关低收入群里中抑郁症的报告

22:14

And I turned in my story, and my editor called me and said, "We really can"t publish this." 当我写好之后我的编辑打电话给我说我们真的没办法发表这个

22:19

And I said, "Why not?"

然后我问, "为什么?"

22:20

And she said, "It just is too far-fetched. These people who are sort of at the very bottom

rung of society and then they get a few months of treatment and they"re virtually ready to run Morgan Stanley? It"s just too implausible." She said, "I"ve never even heard of anything like it."

她说, "故事太牵强了" 这些人生活在接近社会底层的地方然后他们经过了六个月的治疗然后他们就可以去管理摩根史坦利了? (译注: 一家知名投资机构) 太没有说服力了她说, "我从来没有听过这样的事情"

22:35

And I said, "The fact that you"ve never heard of it is an indication that it is news."

然后我说, "你从没有听说过" 恰恰说明这个是一个"新闻" (笑声)(掌声) 而且你们是一家新闻媒体啊

22:40

(Laughter)

22:44

(Applause)

22:48

"And you are a news magazine."

22:50

So after a certain amount of negotiation, they agreed to it. But I think a lot of what they said was connected in some strange way to this distaste that people still have for the idea

of treatment, the notion that somehow if we went out and treated a lot of people in indigent communities, that would be exploitative, because we would be changing them. There is this false moral imperative that seems to be all around us, that treatment of depression, the medications and so on, are an artifice, and that it"s not natural. And I think that"s very misguided. It would be natural for people"s teeth to fall out, but there is nobody militating against toothpaste, at least not in my circles.

来回协商了几次之后他们同意发表了但是他们说的话让我想了很多他们这种态度跟另外一个观点多少有点关系即很多人还是反感抑郁症需要治疗这个观点好像这就意味着我们会开始大规模的开始治疗低收入者这将是一件带有剥削性质的事情因为我们是在改造他们看起来我们所有的人都受到一种教条的影响即治疗抑郁的疗法也好, 药物也好, 都是人造的产物并不是自然的结果我觉得这完全是使入歧途了虽然人老了掉牙是很自然的时候但是这并不影响任何人使用牙膏至少我的周围没有

23:32

People then say, "But isn"t depression part of what people are supposed to experience? Didn"t we evolve to have depression? Isn"t it part of your personality?" To which I would say, mood is adaptive. Being able to have sadness and fear and joy and pleasure and all of the other moods that we have, that"s incredibly valuable. And major depression is something that happens when that system gets broken. It"s maladaptive.

人们可能会接着问, "那么, 抑郁本身不应该是我们注定需要经历的一个过程么难道抑郁不是我们的演化的结果么难道这不是你个性的一部分么对此我的看法是, 情绪是有适应性的对于我们而言能够感受喜怒哀乐以及其它丰富的情感意义重大而当一个人总是抑郁的时候, 那一定是他的情绪系统出问题了不再能够适应环境了

23:59

People will come to me and say, "I think, though, if I just stick it out for another year, I think I can just get through this."

有些人会跟我这样说, "即便如此, 我想如果我自己再多熬一年" 我就可以走出抑郁了

24:05

And I always say to them, "You may get through it, but you"ll never be 37 again. Life is short, and that"s a whole year you"re talking about giving up. Think it through."

对此我总是这样回答, "或许你能够自己走出来, 但是失去的青春你再也找不回了人生苦短, 你现在却在跟我说要浪费一年的时间(自己挺过抑郁) 你再想想

24:16

It"s a strange poverty of the English language, and indeed of many other languages, that we use this same word, depression, to describe how a kid feels when it rains on his birthday, and to describe how somebody feels the minute before they commit suicide.

关于抑郁这种情感, 英语中用来形容的词出奇地少当然别的语言也多不到哪里去我们用"depression"这一个单词(译注: 中文可以翻译成"沮丧"或"抑郁") 即用来描述一个小孩子生日那天下大雨的心情也用来描述一个自杀者自杀前一分钟的感觉

24:32

People say to me, "Well, is it continuous with normal sadness?" And I say, in a way it"s continuous with normal sadness. There is a certain amount of continuity, but it"s the same way there"s continuity between having an iron fence outside your house that gets a little rust spot that you have to sand off and do a little repainting, and what happens if you leave the house for 100 years and it rusts through until it"s only a pile of orange dust. And it"s

that orange dust spot, that orange dust problem, that"s the one we"re setting out to address.

人们会问, "这是不是就是长时间的悲伤?" 某种意义上可以这么理解悲伤和抑郁之间有一定的连续性但是他们之间的连续性就像是悲伤可以看成是你房子周围的铁栅栏有一点生锈了你需要用沙纸打磨一下重新喷漆但是如果你的房子100年没有人住了那么铁栅栏会锈蚀到只剩下一堆黄锈悲伤和抑郁的差别就好比生了一点锈和锈蚀到什么都没有了后者是我们要解决的问题

25:03

So now people say, "You take these happy pills, and do you feel happy?" And I don"t. But I don"t feel sad about having to eat lunch, and I don"t feel sad about my answering machine, and I don"t feel sad about taking a shower. I feel more, in fact, I think, because I can feel sadness without nullity. I feel sad about professional disappointments, about damaged relationships, about global warming. Those are the things that I feel sad about now. And I said to myself, well, what is the conclusion? How did those people who have better lives even with bigger depression manage to get through? What is the mechanism of resilience?

现在人们会问你吃了这些快乐丸(指抗抑郁药), 你快乐么不但是我不会因为要吃饭而不开心不会因为要回电话而不开心不会因为要洗澡而感到不开心事实上我觉得自己的感受比以前更多因为我现在能够体会到悲伤, 但是不会感到虚无我会因为工作上的不如意而悲伤会因为破碎的爱情悲伤会因为全球变暖而悲伤这些是我当下能够体会到的悲伤最后我问自己, "结论是什么呢?" 为什么有些人的生活条件更好却需要去战胜更严重的抑郁?

又为什么我们能够康复?

25:45

And what I came up with over time was that the people who deny their experience, and say, "I was depressed a long time ago, I never want to think about it again, I"m not going to look at it and I"m just going to get on with my life," ironically, those are the people who are most enslaved by what they have. Shutting out the depression strengthens it. While you hide from it, it grows. And the people who do better are the ones who are able to tolerate the fact that they have this condition. Those who can tolerate their depression are the ones who achieve resilience.

我总是一次次地遇见抑郁之后的康复者不愿意接受这段经历他们会说, "我很久之前抑郁过, 我再也不想回忆那段时光了我也不会再去分析它我只希望继续自己当下的生活讽刺的是, 恰恰是这些人最容易被他们过往经历的纠缠不放回避抑郁, 只会让它更凶猛你越躲, 它越强而另外一些人他们承认并接纳自己有抑郁这个事实他们表现得更好一些能够接纳自己抑郁的人最终会康复起来

26:19

So Frank Russakoff said to me, "If I had a do-over, I suppose I wouldn"t do it this way, but in a strange way, I"m grateful for what I"ve experienced. I"m glad to have been in the hospital 40 times. It taught me so much about love, and my relationship with my parents and my doctors has been so precious to me, and will be always."

弗兰克对我说如果一切重新来过那么我可能会换种处理方式但是很奇怪地, 我很感激感激我经历过的一切我很高兴住了40次医院这段经历让我深刻的理解了什么是爱我的

爱人, 我的父母, 以及我的医生这对我而言都是巨大的恩赐, 过去是, 将来也是.

26:41

And Maggie Robbins said, "I used to volunteer in an AIDS clinic, and I would just talk and talk and talk, and the people I was dealing with weren"t very responsive, and I thought, "That"s not very friendly or helpful of them.""

玛吉·罗宾斯说我在艾滋诊所做过志愿者我跟自己负责的病人不断的说话, 但是他们的反应并不积极, 然后我想"是不是对他们来说这样不太友好, 或不管用." 26:56 (Laughter)

26:57

"And then I realized, I realized that they weren"t going to do more than make those first few minutes of small talk. It was simply going to be an occasion where I didn"t have AIDS and I wasn"t dying, but could tolerate the fact that they did and they were. Our needs are our greatest assets. It turns out I"ve learned to give all the things I need."

后来我意识到我意识到在第一次见面的简短聊天中他们只要能够坐在那里就好第一次的聊天实际上是一个机会让他们认识到虽然我没有艾滋病, 我没有等待死亡, 但是我能够接受他们有艾滋病并不断恶化的事实我们的需求是我们最宝贵的财富后来我学会了如何尽我所能(去帮助他人)

27:23

Valuing one"s depression does not prevent a relapse, but it may make the prospect of relapse and even relapse itself easier to tolerate. The question is not so much of finding great meaning and deciding your depression has been very meaningful. It"s of seeking

that meaning and thinking, when it comes again, "This will be hellish, but I will learn something from it." I have learned in my own depression how big an emotion can be, how it can be more real than facts, and I have found that that experience has allowed me to experience positive emotion in a more intense and more focused way. The opposite of depression is not happiness, but vitality, and these days, my life is vital, even on the days when I"m sad. I felt that funeral in my brain, and I sat next to the colossus at the edge of the world, and I have discovered something inside of myself that I would have to call a soul that I had never formulated until that day 20 years ago when hell came to pay me a surprise visit.

28:37

I think that while I hated being depressed and would hate to be depressed again, I"ve found a way to love my depression. I love it because it has forced me to find and cling to joy. I love it because each day I decide, sometimes gamely, and sometimes against the moment"s reason, to cleave to the reasons for living. And that, I think, is a highly privileged rapture.

正视抑郁的价值并不能保证不再复发但是却能改变看待抑郁复发的态度甚至会减弱抑郁复发的程度我们要解决的问题并不是要去找到伟大的意义和决策让你的抑郁看起来意义非凡而是要去寻找这样的意义能够让你思考, 当抑郁卷土重来"这会向下地狱般痛苦, 但是我会受益良多我从自己的抑郁中看到情绪的作用能够如此之大甚至能够盖过客观存在而且我发现我的这段经历让我能够更加强烈和专注的去感受和体会积极向上的情绪抑郁的反面不是快乐而是活力现在这段时间, 我的生活充满活力即便我有时会悲伤, 也是如

此我看到自己的脑海中也进行着一场葬礼我坐在世界的边缘挨着一个巨人我发现身体里的一些东西称为灵魂的东西在20年前尚未真正的成型直到地狱的使者突然出现我想, 虽然我很厌恶抑郁时候的状态也很厌恶抑郁旧病复发我还是会寻到一种方法接受并爱抑郁的自己我爱它, 因为他迫使我去寻找快乐并牢牢抓住我爱它, 因为它让我在生活中牢牢抓住让我活下去的理由, 虽然有时候也会不那么理性虽然偶尔也会游戏人生而这, 我想, 是非常值得高兴和赞赏的事情.