原味人文风情：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.
忧郁症是世界上造成人类失能的首要原因。在美国，有近百分之十的成人受忧郁症之苦。但因为忧郁症是种心理疾病，要了解它会比高胆固醇之类的困难许多。一个主要困惑是抑郁症和单纯情绪低落之间的区别。
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.
几乎每个人都会偶尔心情不好。考试考差、失业、吵架，甚至下雨天也会引起悲伤的感觉。有时候甚至没有诱因。难过的感觉就那样突然冒出来。然后情况改变，那些悲伤的感觉也消失了。临床忧郁症不同，它是一种疾病，不会因为你要它消失就消失。低落的情绪会持续至少两周，且会严重影响一个人工作、玩乐或爱人的能力。
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.
忧郁症可能会有许多不同的病征：情绪低落、对平常喜欢的事物失去兴趣、胃口改变、觉得自己没价值或过度罪恶感、睡太多或太少、注意力不集中、焦虑或迟滞、失去活力，或反覆出现自杀念头。如果你有其中至少五个症状，根据精神病学指南，你就符合忧郁症诊断。
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.
忧郁症不仅是行为上的症状，在大脑中也有具体表现。首先，有能用肉眼及X光观察到的变化。这些包含额叶和海马体积缩小。更微观的水平上，忧郁症和几样东西有关：特定神经传导物质的反常传递或减少，特别是血清素、去甲基肾上腺素以及多巴胺的减少；生理时钟变迟钝，或睡眠周期中快速动眼期和慢波期的明显改变；以及荷尔蒙失调，例如皮质醇过高和甲状腺激素异常。
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.
不过神经科学家对忧郁症的成因仍未完全理解。它似乎和基因与环境间的复杂交互作用有关，但我们尚未有精准预测忧郁症发作时地的诊断工具。而且因为忧郁症病征捉摸不定，很难知道哪些看起来好好的人其实正在遭受忧郁症。根据美国国家心理卫生研究院的研究，一般心理疾病患者要拖十年以上才会寻求协助。
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.
但忧郁症有十分有效的治疗方法。药物和疗法相互辅助来激发脑内化学物质的生成。在极端案例中，电疗法，即像是一种在患者脑部控制痉挛发作的方法也极有帮助。其它备受看好的治疗方法，比如穿颅磁刺激法，也在研究当中。
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.
如果你认识某个遭受忧郁症的人，温柔地鼓励他们寻求一些方法。你甚至可以帮忙做一些事，比如搜寻附近的心理治疗师，或是列出要问医生的问题清单。对一个有忧郁症的人来说，第一步可能难以跨越。如果他们感到罪恶或羞愧，指出忧郁症是疾病的事实，它就像气喘或糖尿病一样。这不是懦弱或人格特质，他们不该指望自己就能好起来，就像他们也没办法用意志力让断臂复原一样。
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.
如果你自己不曾得过忧郁症，避免拿忧郁症和心情不好作比较。将他们的遭遇和一般短暂的难过情绪相提并论，会让患者对自己的挣扎感到罪恶。就算只是公开讨论忧郁症都有帮助。举例来说，研究显示，询问一个人有无自杀念头真的能降低他们自杀的风险。开诚布公地讨论心理疾病有助消弭污名，并让人们更容易寻求协助。而有更多的病患寻求治疗，科学家就能越了解忧郁症，治疗方法就会变得更进步。
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