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Alcohol can cause … a lot of problems.
酒精会引发很多问题。
Just drinking too much can poison and kill you, but so can the impaired judgment while driving, or the diseases it puts you at greater risk for.
仅仅是饮酒过量就会导致中毒和致命，开车时判断力下降或患病风险也会增加。
Lots of people drink fairly regularly without any of these problems, though.
不过，很多人喝酒相当规律，没有这些问题。
And not everyone who has a little too much once in a while is an alcoholic.
并非每个偶尔饮酒过量的人都是酒鬼。
So how do you know when drinking becomes a problem?
那么你怎么知道什么时候喝酒会出问题呢?
It mostly has to do with symptoms of addiction like tolerance and withdrawal, along with how your drinking affects your relationships and responsibilities.
这主要与成瘾症状有关，如耐受性和戒断，加上饮酒对人际关系和责任的影响。
Even though the amount you drink is a big health risk on its own and a super important part of the problem, diagnosing alcohol use disorder — the clinical term for alcoholism— isn't really about hard numbers.
尽管饮酒本身就是一个很大的健康风险，也是问题中一个非常重要的部分，但诊断酒精使用障碍——酒精中毒的临床术语——并不是硬数据。
For that, most psychiatrists turn to the Diagnostic and Statistical Manual of Mental Disorders, or DSM, which lists two main types of symptoms.
为此，大多数精神病学家求助于《精神疾病诊断与统计手册》(DSM)，它列出了两种主要症状。
First, there are the signs that have to do with the physical aspects of dependence, like addiction, tolerance, and withdrawal.
首先，有迹象表明，这与生理方面的依赖有关，如成瘾、耐受性和戒断。
For example, if you find yourself needing more alcohol to get the same effect, drinking a lot more than you intended, or failing to cut back on drinking when you've tried.
例如，如果你发现自己需要更多的酒精来达到同样的效果，喝的比你想喝的多，或者当你试过之后没有减少饮酒。
Other symptoms are more about how your drinking affects your home life and responsibilities.
其他症状更多的是关于饮酒如何影响你的家庭生活和责任。
Like if your drinking has interfered with your relationships or responsibilities at work or at home, or has put you or others at risk, but you still don't stop.
比如，如果喝酒影响了你在工作或家庭中的关系或责任，或让你或其他人处于危险之中，但你仍然没有停止。
The DSM lists 11 symptoms in all, and if you have any two of them, that's enough to be diagnosed with alcohol use disorder.
DSM列出了11种症状，如果你有其中任一两种，那就足以被诊断为酒精使用障碍。
The more symptoms someone has, the more severe it gets.
症状越多越严重。
But no matter where they fall on the spectrum, people with alcohol use disorder are drinking so much that it puts their relationships, responsibilities, and maybe even their life at risk.
但无论属于哪一类，有酒精使用障碍的人都喝得太多，这使得他们的关系、责任，甚至他们的生命都处于危险之中。
There are a thousand different ways to get to that point, but they all come down to one thing: alcohol has a sedative effect, which makes you less anxious and more relaxed.
原因有上千种，但都可以归结为一件事：酒精有镇静作用，能让你不那么焦虑，更加放松。
And the more you associate drinking alcohol with that relaxed feeling, the more your brain's reward system gets involved.
你越是把喝酒和放松的感觉联系在一起，大脑的奖励系统就会参与得越多。
If thinking about a drink makes your brain release a lot of dopamine, the neurotransmitter that's involved in the motivation to seek rewards,
一想到饮酒会让你的大脑释放大量多巴胺——一种参与寻求奖励动机的神经递质，
you're going to have a very strong urge to satisfy that thought.
你就会有强烈的冲动去满足喝酒的想法。
It's the same basic process that drives most addictions.
这是导致多数人喝酒上瘾的基本过程。
But alcohol doesn't affect everyone in exactly the same way.
但酒精对每个人的影响并不完全相同。
From studies and statistics, we know that things like your genetics and experiences can make you more or less likely to develop a disorder.
从研究和统计数据来看，我们知道像遗传和经历这样的事情很可能或多或少会让你患上疾病。
For example, certain genes seem to change how enzymes that metabolize alcohol work, which changes how it affects your brain.
例如，某些基因似乎会改变代谢酒精的酶，从而改变酒精对大脑的影响。
Everyone has enzymes in their liver called alcohol dehydrogenases, which convert alcohol into acetaldehyde, a chemical that won't affect the brain the same way.
每个人的肝脏中都有一种被称为醇脱氢酶的酶类物质，它能将酒精转化为乙醛，这种化学物质影响大脑的方式并不一样。
But some people have genes that make those enzymes faster at their job, compared to other variants of those genes.
但是与这些基因的其它变体相比，有些人的基因能使这些酶更快地发挥作用。
People with the genes that make the enzymes faster tend not to drink as much and are at a lower risk of alcoholism,
具有使酶发挥更快的基因的人往往喝酒不那么多，酒精中毒的风险也较低，
probably because less alcohol gets a chance to interfere with their neurotransmitters.
可能是因为较少有酒精干扰神经递质。
But people with genes that make the enzyme slower have a higher chance of developing a disorder.
但是拥有酶活性较慢基因的人更有可能发展成疾病。
Those genetic differences help explain what researchers have known for years: that a family history of alcoholism puts people at higher risk.
这些基因差异有助于解释研究人员多年来所知道的事实：有酗酒家族史的人患病风险更高。
But as usual, genes aren't the whole story.
但通常情况下，基因并不能决定一切。
Researchers have also found that just living with alcoholics can put people at a greater risk, both through additional stresses and being exposed to that kind of drinking behavior.
研究人员还发现，仅仅与酗酒者生活在一起就会使人们面临更大的风险，包括额外的压力和暴露在这种饮酒行为中。
For example, a study published in the Journal of Abnormal Psychology in 1991 looked at 454 adolescents,
例如，1991年发表在《变态心理学杂志》上的一项研究调查了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.
因为在青少年阶段，你很有可能开始和酒精建立一种不健康的关系。
In the study, having alcoholic parents made people more likely to report dependence themselves.
经研究，父母酗酒的孩子更有可能对酒精产生依赖。
But it mattered whether their parents' alcoholism was in remission or not — meaning, whether they got sober.
但重要的是，他们酗酒的父母是否得到了缓解——也就是说，他们是否清醒。
Children of sober alcoholics drank less overall, and were less likely to report negative consequences or dependence, than those whose parents still drank.
总体上来说，酗酒清醒父母的孩子饮酒较少，并且与那些未清醒父母的孩子相比，有负面影响或依赖酒精的可能性较小。
Even though the genetic risk factors were still there, their environment made a difference, too.
尽管遗传风险因素依然存在，但所处的环境也很重要。
But risk factors are just that — risk factors.
但是危险因素就是——危险因素，
They don't determine your fate.
并不能决定你的命运。
For a lot of people with alcohol use disorder, recognizing and admitting that they have a problem is incredibly difficult, and getting help can seem even harder.
对于很多有酒精使用障碍的人来说，发现并承认自己有问题是非常困难的，而寻求帮助似乎更加困难。
That's part of what the disorder does to your brain — it takes away your control.
这就是这种疾病对你的大脑造成的影响——夺走了你的控制权。
But you can still choose to get help to regain that control.
但是你仍然可以选择寻求帮助来重新获得控制权。
The most common treatments are mutual-help groups, like Alcoholics Anonymous.
最常见的治疗方法是互助群体，比如慝名戒毒会。
These programs can be helpful because you have peer support available when you need it the most.
这些方法非常有用，因为您可以在最需要的时候获得同伴支持。
And research has found that people participating in AA for the first time have more days where they don't drink.
研究发现，第一次参加AA的人有更多的时间不喝酒。
Rehab also tends to work well, partly because it's designed to remove the triggers that might encourage you to drink.
康复治疗往往也很有效果，部分原因是因为它旨在消除可能鼓励你喝酒的诱因。
People who check into inpatient rehab programs report longer periods of abstinence, and the longer the stay, the more helpful it seems to be.
据说入住康复中心的病人戒酒时间更长，而且时间越长似乎越有帮助。
Some medications can help too, especially when people just need to get alcohol out of their system so they can start on long-term treatments.
有些药物也能有所帮助，尤其是当人们只需要将酒精排出体内就可以开始长期治疗的时候。
A drug called Naltrexone, for example, can reduce cravings for alcohol,
例如，一种叫做纳曲酮的药物可以减少对酒精的渴望，
and studies have found that people who take the drug end up drinking less, and on fewer days, compared to a placebo.
研究发现，与服用安慰剂的人相比，服用该药的人最终喝酒喝得更少，喝的天数也更短。
There's also evidence that cognitive behavioral therapy can be effective.
也有证据表明，认知行为疗法是有效的。
That's where you work with a therapist to identify things that trigger you to drink and find healthier ways to cope.
你需要和治疗师一起找出促使你喝酒的因素，找到更健康的应对方法。
Not everyone will respond to every kind of treatment,
不是人人都会对每种治疗都有反应，
but doctors and psychologists have so many tools in their arsenal that if you realize you want help, odds are you'll find one that makes sense for you.
但是医生和心理学家有很多方法，如果你意识到你需要帮助，很可能你会找到一个对你有意义的方法。
Thanks for watching this episode of SciShow Psych, which was brought to you by our patrons on Patreon.
感谢收看本期心理科学秀节目，感谢Patreon对本节目的支持。
If you want to learn more about what makes our weird human brains do the things they do, you can go to youtube.com/scishowpsych and subscribe.
如果您想了解更多是什么让我们奇怪的大脑控制我们的行为，可以访问youtube.com/scishowpsych并订阅我们的节目。
