视听｜什么是双相障碍？
What Is Bipolar Disorder?
什么是双相障碍？
里面一The word bipolar means two extremes. For the many millions experiencing bipolar disorder around the world, life is split between two different realities--elation and depression. Although there are many variations of bipolar disorder, let’s consider a couple. Type 1 has extreme highs alongside the lows, while Type 2 involves briefer, less extreme periods of elation interspersed with long periods of depression. For someone seesawing between emotional states, it can feel impossible to find the balance necessary to lead a healthy life.
“双相”一词有两方极端之意。全世界有数百万双相障碍患者，他们的生活分裂为两种状态——时而情绪激昂，时而郁郁寡欢。尽管双相障碍变种很多，但这里只关注其中两种。双相障碍I型中存在极端的情绪激昂和程度与之相当的情绪低落，双相障碍II型的抑郁期较长，其中交错着时间较短且不那么极端的兴奋期。对于在两种情绪状态之间来回转换的人而言，要找到平衡、健康生活似乎是不可能的。
Type 1’s extreme highs are known as manic episodes, and they can make a person range from feeling irritable to invincible. But these euphoric episodes exceed ordinary feelings of joy, causing troubling symptoms like racing thoughts, sleeplessness, rapid speech, impulsive actions, and risky behaviors. Without treatment, these episodes become more frequent, intense, and take longer to subside.
双相障碍I型中情绪极端高昂的状态被称为躁狂发作，会使人感觉烦躁不安乃至不可战胜。但这种躁狂发作远非普通的愉悦情绪可比，会导致令人不安的症状，如思维奔逸、失眠、言语急促、行事冲动和危险行为。如果不加以治疗，这种发作会更加频繁、更加强烈，消退所需时间也会更长。
The depressed phase of bipolar disorder manifests in many ways--a low mood, dwindling interest in hobbies, changes in appetite, feeling worthless or excessively guilty, sleeping either too much or too little, restlessness or slowness, or persistent thoughts of suicide.
双相障碍抑郁期的表现是多方面的——情绪低落，对爱好的兴趣减退，食欲变化，感到没有价值或过度内疚，睡眠过多或睡眠过少，坐立不安或思维迟钝，甚至产生挥之不去的自杀之念。
Worldwide, about one to three percent of adults experience the broad range of symptoms that indicate bipolar disorder. Most of those people are functional, contributing members of society, and their lives, choices, and relationships aren’t defined by the disorder, but still, for many, the consequences are serious. The illness can undermine educational and professional performance, relationships, financial security, and personal safety.
世界范围内，约有1%到3%的成年人有各种双相障碍症状。尽管这些社会成员大多数能正常生活、有所作为，其日常生活、人生选择和人际关系也不受双相障碍影响，但是，对许多人而言，后果仍然严重。这种疾病可能影响学业和职业表现、人际关系、经济保障和个人安全。
So what causes bipolar disorder? Researchers think a key player is the brain’s intricate wiring. Healthy brains maintain strong connections between neurons thanks to the brain’s continuous efforts to prune itself and remove unused or faulty neural connections. This process is important because our neural pathways serve as a map for everything we do. Using functional magnetic resonance imaging, scientists have discovered that the brain’s pruning ability is disrupted in people with bipolar disorder. That means their neurons go haywire and create a network that’s impossible to navigate. With only confusing signals as a guide, people with bipolar disorder develop abnormal thoughts and behaviors.
那么，双相障碍的成因是什么？研究人员认为，大脑错综复杂的神经通路是关键因素。健康大脑的神经元之间连接稳固，这要归功于大脑不断自我修剪，去除无用的、故障的神经连接。这个过程很重要，因为神经通路是我们做所有事情的地图。科学家们利用功能磁共振成像发现，双相障碍患者大脑的修剪能力遭到破坏。这意味着他们的神经元陷入混乱，形成的网络无法导航。由于只能以混乱的信号为指导，双相障碍患者会产生异常想法，作出异常行为。
Also, psychotic symptoms, like disorganized speech and behavior, delusional thoughts, paranoia, and hallucinations can emerge during extreme phases of bipolar disorder. This is attributed to the overabundance of a neurotransmitter called dopamine.
另外，双相障碍在极端阶段会出现精神病症状，如言语和行为紊乱、出现妄想、思想偏执和产生幻觉。出现这些症状的原因在于一种叫作多巴胺的神经递质过剩。
But despite these insights, we can’t pin bipolar disorder down to a single cause. In reality, it’s a complex problem. For example, the brain’s amygdala is involved in thinking, long-term memory, and emotional processing. In this brain region, factors as varied as genetics and social trauma may create abnormalities and trigger the symptoms of bipolar disorder.
但是，即使知道了这些，我们也不能认为双相障碍的成因是单一的。实际上，这是个复杂问题。例如，大脑杏仁核参与思考、长期记忆和情绪处理。在该区域，诸如遗传和社会创伤等各种因素都可能导致异常，引发双相障碍的症状。
The condition tends to run in families, so we do know that genetics have a lot to do with it. But that doesn’t mean there’s a single bipolar gene. In fact, the likelihood of developing bipolar disorder is driven by the interactions between many genes in a complicated recipe we’re still trying to understand.
由于这种情况往往是家族性的，所以我们确认它与遗传有很大关系。但是，这并不意味着存在单一的双相障碍基因。事实上，双相障碍的患病可能性由许多基因之间的相互作用驱动，其原理十分复杂，我们仍在努力了解。
The causes are complex, and consequently, diagnosing and living with bipolar disorder is a challenge. Despite this, the disorder is controllable. Certain medications like lithium can help manage risky thoughts and behaviors by stabilizing moods.
由于成因复杂，诊断双相障碍并与之共存极具挑战性。尽管如此，这种疾病是可以控制的。某些药物，如锂，可以稳定情绪，帮助控制危险的想法和行为。
These mood stabilizing medications work by decreasing abnormal activity in the brain, thereby strengthening the viable neural connections. Other frequently used medications include antipsychotics, which alter the effects of dopamine, and electroconvulsive therapy, which works like a carefully controlled seizure in the brain, is sometimes used as an emergency treatment.
这些情绪稳定药物抑制大脑中的异常活动，从而强化可行的神经连接。其他常用医学手段包括改变多巴胺作用的抗精神病药物，以及电休克疗法，后者的工作原理类似在大脑中引发精心控制的癫痫发作，有时被用于紧急治疗。
Some bipolar patients reject treatment because they’re afraid it will dim their emotions and destroy their creativity. But modern psychiatry is actively trying to avoid that. Today, doctors work with patients on a case-by-case basis to administer a combination of treatments and therapies that allows them to live to their fullest possible potential.
一些双相障碍患者因为担心治疗会导致情绪低落、破坏创造力而拒绝接受治疗。现代精神病学正在积极努力避免这种情况。今天，医生与病人一对一合作，将药物治疗与精神疗法相结合，使他们能尽可能发挥自己的潜力。
And beyond treatment, people with bipolar disorder can benefit from even simpler changes. Those include regular exercise, good sleep habits, and sobriety from drugs and alcohol, not to mention the acceptance and empathy of family and friends.
除了治疗，双相障碍患者还可以从更简单的改变中获益。这些改变包括定期锻炼、养成良好的睡眠习惯、远离毒品和酒精，以及（最重要的）获得家人和朋友的接纳和同情。
Remember, bipolar disorder is a medical condition, not a person’s fault, or their whole identity, and it’s something that can be controlled through a combination of medical treatments doing their work internally, friends and family fostering acceptance and understanding on the outside, and people with bipolar disorder empowering themselves to find balance in their lives.
请记住，双相障碍是一种疾病，不是个人过错，也不是个人身份的全部。医学治疗从内作用，朋友家人促进接受理解从外作用，加上患者自立自强、平衡生活，三者相结合，病情可以得到控制。
文章来源：TED-Ed官网
大连外国语大学高级翻译学院实习生
祁玥 整理
(Credit: healthjade.com)
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