评论
打印
If you've ever experienced anxiety and depression— in the clinical sense, I mean —
如果你曾经经历过焦虑和抑郁——从临床意义上讲，我的意思是——
you'll know that they can feel really different.
你会知道焦虑和抑郁的感觉很不一样。
With anxiety, you're all ramped up.
焦虑会让你情绪高涨。
And with depression, you're very, very down.
而抑郁会让你非常非常沮丧。
Yet they tend to go together.
然而，二者往往是同时存在的。
And a lot of medications, especially certain types of antidepressants, can be used to treat both.
很多药物，尤其是某些抗抑郁药，可以同时用来治疗焦虑和抑郁。
We still don't know a ton about how exactly anxiety and depression work in the brain — or how antidepressants work to treat them.
我们仍然不清楚焦虑和抑郁到底是如何在大脑中起作用的，也不知道抗抑郁药是如何治疗它们的。
But over time, psychologists have come to realize that the two types of conditions are surprisingly similar.
但随着时间的推移，心理学家逐渐意识到焦虑和抑郁惊人地相似。
They may feel very different in the moment.
焦虑和抑郁可能感觉很不一样。
But they actually have a lot of symptoms in common, and involve some very similar thought patterns.
但实际上，他们有很多共同的症状，包括一些非常相似的思维模式。
They might even have similar brain chemistries.
甚至它们的大脑化学成分可能相似。
So if you're looking to understand a little more about how anxiety and depression manifest themselves — whether for yourself or for someone else in your life — those connections are a good place to start.
所以，如果你想了解更多关于焦虑和抑郁是如何表现出来的——无论是对你自己还是对你生命中的其他人——这些连接关系会是一个很好的切入点。
Depression and anxiety aren't really specific disorders — they're generic terms for types of disorders.
抑郁和焦虑并不是特定的疾病——而是各种疾病的统称。
But the most common, and most closely linked, are major depressive disorder, or MDD, and generalized anxiety disorder, or GAD.
但最常见、联系最紧密的是重度抑郁症或MDD和广泛性焦虑症或GAD。
In any given year in the U.S., where it's easiest to find detailed statistics, about 7% of the population will have MDD, and about 3% will have GAD.
在最容易找到详细统计数据的美国，任一年中约7%的人口患有重度抑郁症，约3%患有广泛性焦虑症。
Lots of those people have both:
很多人两者兼而有之：
About 2/3 of people with major depression also have some kind of anxiety disorder, and about 2/3 of people with generalized anxiety disorder also have major depression.
大约2/3的重度抑郁症患者同时患有某种焦虑症，2/3的广泛性焦虑症患者同时患有重度抑郁症。
And whether you have one or the other or both, the same medications are often at the top of the list to help treat it — usually antidepressants.
不管你有其中一种还是另外一种疾病，或者两者兼而有之，相同的药物——抗抑郁药通常都是治疗抑郁症的首选药物。
Unsurprisingly, psychologists have noticed these statistics.
心理学家一点都不惊讶，他们已经注意到了这些数据。
But for a long time, we've thought of generalized anxiety and major depression as very different things, and understandably so.
但是很长一段时间以来，我们认为广泛性焦虑和重度抑郁症是两码事，这是可以理解的。
Probably the most noticeable symptom of anxiety is arousal, which in psychology is a technical term rather than a specifically sexual thing.
也许焦虑最明显的症状是觉醒，这在心理学上是一个专业术语，而不是具体的性行为。
It basically just means being on high alert — whether psychologically, with increased awareness, or physically, with things like a racing heart and sweaty palms.
大体上来说，它的意思是保持高度警惕——无论是心理上意识的增强，还是身体上心跳加速和手掌出汗。
Arousal isn't part of major depression, though.
然而，觉醒并不是抑郁症的一部分。
And there's a key symptom of MDD that doesn't usually show up in generalized anxiety:
重度抑郁症的一个关键症状通常不会出现在广泛性焦虑症中：
low positive affect, which is the technical term for not getting much pleasure out of life and feeling lethargic and just kind of … blah.
较低的正面影响，这是一个专业术语，指的是没有从生活中获得多少乐趣，感觉昏昏欲睡，等等。
So there are important differences between anxiety and depression, which is part of why they're still considered separate classes of disorders.
所以焦虑和抑郁之间有重要的区别，这也是为什么它们仍然被认为是不同类别疾病的原因。
But when you look at the other symptoms, you start to realize that major depression and generalized anxiety have almost everything else in common.
但是当你看到其他症状时，你开始意识到重度抑郁和广泛性焦虑几乎有很多的共同点。
There's restlessness, fatigue, irritability, problems with concentration, sleep disturbances … the list goes on.
坐立不安、疲劳、易怒、注意力不集中、睡眠障碍等等。
And that's just in the official diagnostic criteria.
这只是官方的诊断标准。
So for decades, psychologists have been examining the models they use to describe anxiety and depression in the brain to see if they point to a similar source for both types of disorders.
因此，几十年来，心理学家一直在研究模型用来描述大脑中的焦虑和抑郁，看它们的病源是否相似。
They've come up with lots of different ideas, as researchers do, but the most common ones tend to center around the fight or flight response to stress.
和研究人员一样，他们提出了很多不同的想法，但最常见的想法往往集中于对抗或逃避压力的反应。
Fight or flight kicks in when you're confronted with something your mind sees as a threat, and it automatically prepares you to either fight or run away.
当你面对你认为是威胁的东西时，对抗或逃避压力的反应就会出现，它会自动地让你做好对抗或逃避的准备。
And when you think about it, anxiety and depression are just different types of flight.
细想一下，焦虑和抑郁只是不同类型的逃避反应。
Psychologists often characterize anxiety as a sense of helplessness, at its core, and depression as a sense of hopelessness.
心理学家通常将焦虑的本质描述为一种无助感，而将抑郁的本质描述为一种无望感。
Anxiety might feel like you're looking for ways to fight back.
焦虑可能会让你觉得你在寻找反击的方法。
But part of what makes it a disorder is that it's not a short-lived feeling that's easily resolved once you have a plan.
但它之所以成为一种障碍，部分原因在于它不是一种通过计划能轻易解决的短暂性感觉。
Of course, as with all things mental health, anxiety disorders can be deeply personal and won't feel the same for everybody.
当然，和所有的精神健康问题一样，焦虑症可能是非常个人化的，每个人的感觉都不同。
But clinical anxiety does tend to be more pervasive.
但焦虑往往在临床上更普遍。
The worry sticks around and starts to take over your life because it doesn't feel like something you can conquer.
忧虑挥之不去，开始占据你的生活，因为它不像是你能征服的东西。
So anxiety and depression might just be slightly different ways of expressing the same flight response: helplessness or hopelessness.
所以焦虑和抑郁本质上都是逃跑反应，只是方式不同而已：一个是无助，一个是无望。
And maybe that's part of why they so often go together.
也许这就是它们经常相伴出现的部分原因。
That connection also shows up on the biochemical side of the stress response.
这种联系也体现在压力反应的生化方面。
There are a lot of hormones involved in this response, and their effects interact in super complex ways that scientists still don't fully understand.
压力反应中会涉及到很多的荷尔蒙，以超级复杂的方式交互影响，科学家还没有完全理解。
But both depressive and anxiety disorders are closely associated with an oversensitive stress response system.
但抑郁症和焦虑症都与过度敏感的压力反应系统密切相关。
Researchers think that's one reason both of these types of disorders are so much more common in people who've experienced major stresses like trauma or childhood abuse.
研究人员认为，这是这两种类型的障碍在经历过创伤或童年虐待等重大压力的人群中如此普遍的原因之一。
Those stressors could make their stress response system more sensitive.
这些压力源可以使他们的压力反应系统更加敏感。
The main hormones involved aren't always the same, but the changes can cause some of the same symptoms — problems with sleep, for example.
主要涉及的荷尔蒙并不总是相同的，但是这些变化会导致一些相同的症状——例如睡眠问题。
So anxiety and depression seem to be two sides of a similar reaction to stress, in terms of both thought processes and hormones.
所以就思维过程和荷尔蒙方面而言，焦虑和抑郁似乎是压力反应的两个方面。
Still, that doesn't really explain why some antidepressants can treat both anxiety and depression.
然而，这并不能完全解释为什么一些抗抑郁药可以同时治疗焦虑和抑郁症。
Because those medications primarily affect neurotransmitters, the molecules your brain cells use to send messages to each other.
因为这些药物主要影响神经递质——脑细胞用来相互传递信息的分子。
If you thought we had a lot left to learn about how the stress response works,
如果你认为我们还有很多要学习压力反应的工作原理，
we know even less about what the brain chemistry of anxiety and depression looks like, or how antidepressants help.
我们甚至不知道焦虑和抑郁的大脑化学物质是什么样子的，也不知道抗抑郁药是如何起作用的。
But if the thought processes and physical responses that go along with these disorders aren't quite as different as they seem on the surface,
但如果伴随这些障碍而来的思维过程和身体反应并没有表面上看起来那么不同，
it makes sense that the brain chemistry would be similar, too.
大脑的化学成分也会相似，这是有道理的。
And that's exactly what scientists have found.
这正是科学家们的发现。
More specifically, lots of studies have pointed to lower levels of the neurotransmitter known as serotonin as a major factor in both anxiety and depression.
更具体地说，许多研究指出，较低水平的神经递质血清素是焦虑和抑郁的主要因素。
Researchers have even identified some more specific cellular receptors that seem to be involved in both.
研究人员甚至发现了一些特异性细胞，它们似乎参与了这两个过程。
There's also some evidence that the way the brain handles another neurotransmitter, norepinephrine, can be similar in both anxiety and depression.
也有证据表明，大脑处理另一种神经递质去甲肾上腺素的方式在焦虑和抑郁中都是相似的。
Since most antidepressants work by increasing serotonin levels, and some of them also affect norepinephrine,
因为大多数抗抑郁药是通过增加血清素水平起作用的，其中一些药物还会影响去甲肾上腺素，
that could explain why they're so helpful for both anxiety and depression.
这可以解释为什么这些药物对焦虑和抑郁有这么大的帮助。
Although again, there's a lot we don't know about their exact mechanisms.
尽管我们仍然不知道它们的确切原理。
Ultimately, there's no denying that in the moment, anxiety and depression can seem like very different feelings.
最后，不可否认的是，此时此刻，焦虑和抑郁看起来是完全不同的感觉。
And if someone has both types of disorders — well, it's easy to see how that could feel overwhelming.
如果一个人同时患有这两种疾病，可想而知这是多么的难以承受。
Like, it's hard enough treating generalized anxiety or major depression on their own.
比如，单独治疗广泛性焦虑或重度抑郁症已经够难的了。
And it's true that it is often harder to treat these conditions when someone has both.
的确，当一个人同时患有这两种疾病时，往往更难治疗。
But maybe not twice as hard.
但难度不会那么大。
After all, anxiety and depressive disorders have a lot in common, from their symptoms to the basic brain chemistry behind them to some of the treatments that can help.
毕竟，从症状到背后的基本脑化学物质，再到一些能有所帮助的治疗方法，焦虑和抑郁症有很多共同之处，
The fact that they often go together can be really tough.
事实上，焦虑和抑郁一起出现的时候是很难治愈的。
But understanding more about why that is has also pointed us toward better treatments and more effective therapies, that really can help.
但是，了解更多关于这一现象的原因也为我们指出了更好、更有效的治疗方法。
Thanks for watching this episode of SciShow Psych.
感谢收看本期心理科学秀节目。
If you're looking for someone to talk to about your mental health, we left a few resources in this video's description.
如果你想找人谈谈你的心理健康，我们有一些视频资源。
And if you'd like to learn more general info about treatments, you can watch our episode on misconceptions about antidepressants.
如果你想了解更多关于治疗的一般信息，可以看我们关于抗抑郁药误解的剧集。
