What is depression
什么是抑郁症
（老叶英文演讲）
Depression is the leading cause of disability in the world, in the United States, close to ten 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.
抑郁症是造成全球残疾类疾病的主要原因。在美国，大约有10%的成年人被抑郁症所困扰。但是作为一种精神疾病，抑郁症比类似高胆固醇等概念更难被理解。
One major source of confusion is the difference between having depression and just feeling depressed. 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.
其中最容易被混淆的概念在于区分患有抑郁症与只是简单的情绪低落。几乎所有的人都有情绪低落的时候。考试失利，被解雇，与人发生争执，甚至只是雨天都有可能导致情绪低落。
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.
有时可能根本就是没有由头的消沉。伤感就那么不经意的来了。但是渐渐地峰回路转，悲伤的感觉总会慢慢的淡去。但是临床上所讲的抑郁症却是另外一回事。抑郁症是一种医学上的情绪障碍，它无法靠意志去改变。它会持续至少两周的时间，并且会严重影响患者的工作状态，行为能力以及感情生活。
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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.
抑郁症有多种不同的症状：情绪低落，对平时的爱好失去以往的兴趣，食欲的改变，自卑或者极度的负罪感，嗜睡或者失眠，无法集中注意力，焦躁或迟钝，浑身乏力，或者反复的轻生念头。如果你符合以上所述的五项症状，从精神学的角度来讲，便可以被判定为患有抑郁症。
And it's not just behavioral symptoms. Depression has physical manifestations inside the brain. first of all, thereare changes that could be seen with the naked eye, and x-ray vision. these includes smaller frontal lobes and hippocampus 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.
不止是行为上的这些症状，抑郁症还会导致一些脑部的临床表现。首先，有些变化可以通过肉眼以及X光检测观察到。其中包括检测出较小的额叶以及海马体。从更细微的角度讲，抑郁症与以下几点有关：以血清素，去甲肾上腺素和多巴胺为主的某些神经传导物质的异常传递与消耗，生物钟节奏混乱，或是睡眠状况的明显变化，以及荷尔蒙的紊乱。
But Neuro scientists still don't have a complete picture of what causes depression. it seems to have to do with a complex inteaction 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.
例如皮质醇偏高以及甲状腺激素异常始终没能得到完美的解释。导致抑郁症的坏境，这可能和基因与坏境的相互作用有关，但目前我们还没有有效的方法来准确的判断这种作用具体的发生机制。并且由于抑郁症的病症发生于无形，我们便很难发现那些正在饱受抑郁困扰的人。
According to the National Institute of mental health, it takes the average person suffering with a mental illness over ten years to ask for help. But there are very effective treatments, medications and therapy compliment each other to boost brain chemicals. In extreme cases, electro convulsive 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.
根据美国心理健康研究中心数据表示，平均每一位患有精神疾病的患者需要至少十年去选找帮助。但其实目前很多有效的治疗方法来帮助抑郁症患者。药物治疗配合心理治疗可以促进脑内化学物质的产生。在一些特殊的病例中，甚至电休克疗法，即一种像是控制病患大脑进行休克的方法，也有一定的疗效。另外一种很有潜力的治疗方法，比如经颅磁刺激，也正在被广泛研究。
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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 therapist in thearea, or making a list of questions to ask a doctor, to someone with depression, these first steps can seem insurmountable. 
因此，如果你认识某位正在饱受抑郁症折磨的人，请鼓励他们从以上的方法中寻求帮助。你甚至可以进行更为具体的帮助，比如寻找一些此领域中的专业治疗师，又或者是帮助列一个问题清单去请教医生。对于那些患有抑郁症的人来说，迈出这第一步尤为艰难。
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. If you haven't experienced depression yourself, avoid comparing it to times you've felt down. Comparing what they are experiencing to normal, temporary feelings of sadness can make them feel guilty for struggling.
如果他们有负罪感或羞耻感，请向他们指出抑郁症是一种医学疾病，就像哮喘或糖尿病一样常见。告诉他们抑郁症并不能成为他们的弱点或代表他们的人格，而且他们不能只靠自己硬撑来克服有这个疾病，这不像是伤筋动骨一样可以自愈。如果你不曾受到抑郁症的困扰，请不要将他们的痛苦与你平日里的情绪低落惊醒比较。将他们所承受的困扰与常见悲伤情绪相提并论会使他们为自己的病情感到自责。
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 erodes stigma and make it easier for people to ask for help. And morepatients seek treatment, the more scientists will learn about depression, and the better the treatments will get.
哪怕只是单纯而诚恳地谈谈抑郁症都会对他们有所帮助。例如，研究表明询问一些人关于自杀的看法实际上可以降低他们自杀的几率。开诚布公地谈论精神疾病有利于淡化患者的自卑意识并且让他们更有勇气去寻求帮助。而越多的患者来积极地寻求治疗，对于抑郁症的研究才能有所突破，从而使他们得到更有效的治疗。
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