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Alcohol can cause a lot of problems.
酒精会引起很多问题。
Just drinking too much can poison and kill you,
喝太多可能会让你中毒或被杀，
but so can the impaired judgment while driving, or the diseases it puts you at greater risk for.
它也会损害你开车时的判断力或者增大你患病的危险。
Lots of people drink fairly regularly without any of these problems, though.
尽管如此，很多人还是很有规律地喝酒，完全没有这些问题。
And not everyone who has a little too much once in a while is an alcoholic.
而且偶尔喝太多酒的人并不都是酒鬼。
So how do you know when drinking becomes a problem?
所以你怎么知道什么时候喝酒会成问题呢？
It mostly has to do with symptoms of addiction like tolerance and withdrawal,
这主要与上瘾症状如忍受折磨和戒断症状，
along with how your drinking affects your relationships and responsibilities.
以及酗酒如何影响人际关系和责任有关。
Even though the amount you drink is a big health risk on its own and a super important part of the problem,
即使你的饮酒量本身就有很大的健康风险，而且在问题中占比极重，
diagnosing alcohol use disorder, the clinical term for alcoholism isn't really about hard numbers.
但用酒精中毒的临床术语诊断酒精使用障碍并不确切。
For that, most psychiatrists turn to the Diagnostic and Statistical Manual of Mental Disorders, or DSM,
为此，大多数精神病学家求助于《精神疾病诊断和统计手册》（DSM）
which lists two main types of symptoms.
上面列出了两种主要症状。
First, there are the signs that have to do with the physical aspects of dependence,
第一，有迹象表明，酒精使用障碍与身体依赖有关，
like addiction, tolerance and withdrawal.
比如上瘾，忍受折磨和戒断。
For example, if you find yourself needing more alcohol to get the same effect,
比如，你发现自己需要更多的酒精来达到同样的效果，
drinking a lot more than you intended, or failing to cut back on drinking when you've tried.
比预期喝得多很多，或者在减量时尝试失败。
Other symptoms are more about how your drinking affects your home life and responsibilities.
其他症状更多的与酗酒如何影响你的家庭生活和责任有关。
Like if your drinking has interfered with your relationships or responsibilities at work or at home,
比如酗酒已经妨碍了你在工作或家庭中的关系或责任，
or has put you or others at risk, but you still don't stop.
或者已经把你或其他人置于危险之中，但你仍然停止不了。
The DSM lists 11 symptoms in all, and if you have any two of them,
DSM总共列出了11种症状，如果你有任意两种，
that's enough to be diagnosed with alcohol use disorder.
都足以被诊断为酒精使用障碍了。
The more symptoms someone has, the more severe it gets.
一个人的症状越多，问题就越严重。
But no matter where they fall on the spectrum,
但无论他们的问题有多严重，
people with alcohol use disorder are drinking so much
患有酒精使用障碍的人都喝的太多，
that it puts their relationships, responsibilities, and maybe even their life at risk.
以至于将他们的关系、责任甚至生命置于危险之中。
There are a thousand different ways to get to that point, but they all come down to one thing:
要得出这一结果有上千种不同的方法，但它们都归结为一点：
alcohol has a sedative effect, which makes you less anxious and more relaxed.
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,
你越是把喝酒和那种放松的感觉联系在一起，
the more your brain's reward system gets involved.
你大脑的奖励系统参与得就越多。
If thinking about a drink makes your brain release a lot of dopamine,
如果你想着喝酒能让大脑释放大量的多巴胺，
the neurotransmitter that's involved in the motivation to seek rewards,
后者是参与寻求奖励的神经递质，
you're going to have a very strong urge to satisfy that thought.
那么你就会有强烈的欲望去满足这个想法。
It's the same basic process that drives most addictions.
这是驱动大多数上瘾的基本过程。
But alcohol doesn't affect everyone in exactly the same way.
但是酒精影响每个人的方式并不完全相同。
From studies and statistics, we know that things like your genetics and experiences
从研究和统计学中我们知道，遗传和经验等
can make you more or less likely to develop a disorder.
会使你有或多或少患上一种障碍的可能性。
For example, certain genes seem to change how enzymes that metabolize alcohol work,
例如，某些基因似乎改变了代谢酒精酶的工作方式，
which changes how it affects your brain.
这将改变该酶影响你大脑的方式。
Everyone has enzymes in their liver called alcohol dehydrogenases,
每个人的肝脏中都有一种叫做醇脱氢酶的酶，
which convert alcohol into acetaldehyde, a chemical that won't affect the brain the same way.
它会把酒精转化成乙醛，即一种不会对大脑产生同样影响的化学物质。
But some people have genes that make those enzymes faster at their job, compared to other variants of those genes.
但是有些人的基因与其他变异基因相比，能使这些酶工作得更快，
People with the genes that make the enzymes faster tend not to drink as much and are at a lower risk of alcoholism,
有该基因的人往往不会喝多，并且酒精中毒风险的较低，
probably because less alcohol gets a chance to interfere with their neurotransmitters.
这可能是因为酒精有较少的机会干扰他们的神经递质。
But people with genes that make the enzyme slower have a higher chance of developing a disorder.
但是拥有让酶效率变慢的基因的人更有可能发展成一种障碍。
Those genetic differences help explain what researchers have known for years:
这些基因差异有助于解释研究人员多年来的研究：
that a family history of alcoholism puts people at higher risk.
家族酗酒史让人们面临更高的风险。
But as usual, genes aren't the whole story.
但与往常一样，基因不能说明全部问题。
Researchers have also found that just living with alcoholics can put people at a greater risk,
研究人员还发现，与酗酒者生活在一起的人面临更大的风险，
both through additional stresses and being exposed to that kind of drinking behavior.
它是由额外压力和接触这种饮酒行为引起的。
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.
因为这一生命阶段是你开始与酒精建立不健康关系的高发期。
In the study, having alcoholic parents made people more likely to report dependence themselves.
在这项研究中，有酗酒父母的青少年更有可能报告自己的自我依赖。
But it mattered whether their parents' alcoholism was in remission or not, meaning, whether they got sober.
但父母的酗酒问题是否缓解或者说他们是否清醒很重要。
Children of sober alcoholics drank less overall,
与那些父母仍在酗酒的孩子相比，保持清醒者的孩子喝得更少，
and were less likely to report negative consequences or dependence, than those whose parents still drank.
并且不太可能报告负面结果或依赖。
Even though the genetic risk factors were still there, their environment made a difference, too.
尽管遗传风险因素仍然存在，但他们的环境也产生了影响。
But risk factors are just that risk factors. They don't determine your fate.
但风险因素就是风险因素，他们不会决定你的命运。
For a lot of people with alcohol use disorder,
对于很多酒精使用障碍患者来说，
recognizing and admitting that they have a problem is incredibly difficult, and getting help can seem even harder.
察觉并承认他们有问题非常困难，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.
部分原因是障碍对你大脑的影响，它带走了你的控制权。
But you can still choose to get help to regain that control.
但是你仍然可以选择获得帮助来重获控制权。
The most common treatments are mutual-help groups, like Alcoholics Anonymous.
最常见的治疗方法是互帮互助小组，比如匿名戒酒互助社。
These programs can be helpful because you have peer support available when you need it the most.
这些项目可能有用，因为你在最需要的时候，可以获得同伴的支持。
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，第一次参加嗜酒者互诫协会的人喝酒的天数会减少。
Rehab also tends to work well, partly because it's designed to remove the triggers that might encourage you to drink.
康复治疗也有很好的效果，部分原因在于它的设计目的是消除可能鼓励你喝酒的诱因。
People who check into inpatient rehab programs report longer periods of abstinence,
那些参与住院康复项目的人报告说长时间的禁欲有效果，
and the longer the stay, the more helpful it seems to be.
而且待的时间越长，似乎越有帮助。
Some medications can help too,
一些药物也有帮助，
especially when people just need to get alcohol out of their system so they can start on long-term treatments.
特别是当人们需要摆脱酒精的时候，这样他们就可以开始长期治疗了。
A drug called Naltrexone, for example, can reduce cravings for alcohol,
例如，一种叫做环丙甲羟二羟吗啡酮的药物可以人们减少对酒精的渴望，
and studies have found that people who take the drug end up drinking less,
研究发现吃此药的人会减少酗酒，
and on fewer days, compared to a placebo.
与安慰剂相比，它的时间更短。
There's also evidence that cognitive behavioral therapy can be effective.
还有证据表明认知行为疗法可能有效。
That's where you work with a therapist to identify things that trigger you to drink and find healthier ways to cope.
你要和治疗师一起协作确定那些激发你喝酒的诱因，并找到更健康的方法来应对。
Not everyone will respond to every kind of treatment,
不是每个人都会对每一种治疗有反应，
but doctors and psychologists have so many tools in their arsenal
但是医生和心理学家的武器库中有这么多的工具，
that if you realize you want help, odds are you'll find one that makes sense for you.
如果你意识到自己需要帮助，总会发现一种对你有效的方法。
Thanks for watching this episode of SciShow Psych,
感谢您收看本期的心理科学秀！
which was brought to you by our patrons on Patreon.
它是由Patreon赞助的。
If you want to learn more about what makes our weird human brains do the things they do,
如果你想了解更多关于“什么让我们的神奇人类大脑工作”，
you can go to youtube.com/scishowpsych to subscribe.
可以登录youtube.com/scishowpsych点击订阅。
