笔记百科酷炫脑
时而情绪高昂，觉得自己无所不能；
时而抑郁寡欢，情绪极度低落…….
双相情感障碍到底是怎么一回事？
来听听脑科学怎么说 ~
– 本期视频 –
双相情感障碍（躁郁症）是什么？
What is bipolar disorder
双相意味着两个极端，对全世界数百万躁郁症患者而言，他们的生命被撕裂成两个不同的现实：情绪高昂和抑郁寡欢。
The wordbipolar means two extremes.For the many millions experiencing bipolar disorder around the world, elation and depression.
尽管躁郁症有很多型态，让我们先来看其中的两种。
Although there are many variations of bipolardisorder，let’sconsider a couple.
第 1 型表现为极度高昂与极度低落并存。
Type1 has extreme highs alongside the lows.
第 2 型有的则是较短且较轻的高昂期，这种高昂期穿插在长期的抑郁中。
Type 2 involves briefer,less extreme periods of elation.For someone seesawing between emotional states.
对于这两种情绪起起伏伏的人来说，要找到健康生活必须的平衡点也许很难。
For someone seesawing between emotional states,it can feel impossible to find the balance necessary to lead a healthy life.
第 1 型的极度高昂过程称为“躁期”，期间人会感到狂躁或是认为自己无所不能。但这种极度兴奋的体验超过了一般的愉快感觉，并会造成恼人的症状如快速思维模式、失眠、语速过快、语速过快、及危险行为。
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, sleeplessness,and risky behaviors.
如果没有接受治疗这些发作会变得愈发频繁，变得愈发严重，也需要更多时间才能平息。
Without treatment, these episodes become more frequent,and take longer to subside.
躁郁症的“郁期”会以多种方式表现，如情绪低落、兴趣减弱、食欲改变、感到没有价值或过分内疚、睡眠时间过长或过短、坐立不安或反应迟钝或持续产生自杀的念头。
The depressed phase of bipolar disorder manifests in many ways,low mood,dwindling interest in hobbies,changes in appetite,restlessness or slownessor persistent thoughts of suicide.
在全世界范围内大约有 1-3% 的成年人，正经历着这些广泛的躁郁症症状。这其中大多数都是对社会运作有着贡献的人，他们的生活、决策、人际关系虽然不会受制于躁郁症，但对很多人来说躁郁的后果仍相当严重。
Worldwide, about one to three percent of adultsexperiencethe broad range of symptoms that indicate bipolar disorder.Most of those people are functional, contributing members of society,and their lives, choices and relationshipsand their lives, choices and relationshipsbut still, for many, the consequences are serious.
这种疾病会破坏人们的学业及专业表现、人际关系、财务状况及人生安全。
The illness can undermine educational and professional performance,financial securityand personal safety.
那么究竟是什么原因引发了躁郁症？研究人员认为大脑复杂的回路是一个关键。
So what causes bipolar disorderResearchers think a key player is the brain’s intricatewiring.
健康的大脑维持着神经元间强有力的连结，这都要感谢大脑持续地努力修剪自己并移除没有使用或已损坏的神经连结。这个过程很重要因为我们的神经路径就像张地图，为我们指引方向。
Healthy brains maintain strong connections between neurons.Thanks to the brain’s continuous efforts to prune itselfand remove unused or faulty neural connections.This process is important because our neural pathways serve as a mapfor everything we do.
利用功能磁共振造影技术，大脑的修剪功能在躁郁症病人身上受到了干扰。这就意味着他们的神经元路线混乱，他们的神经元网络无法导航。
Using functional magnetic resonance imaging,scientists have discovered that the brain’s pruning ability is disruptedin people with bipolar disorder.That means their neurons go haywireand create a network that’s impossible to navigate.
在混乱信号的指引下，躁郁症患者发展出了不正常的思想及行为躁郁症患者发展出了不正常的思想及行为，像是混乱的语言及行为、妄想、偏执及幻觉都可能在躁郁症的极端期间出现。
With only confusing signals as a guide,people with bipolar disorder develop abnormal thoughts and behaviors.Also, psychotic symptoms,like disorganized speech and behavior,delusional thoughts,paranoiaand hallucinationscan emerge during extreme phasesof bipolar disorder.
这要归因于一种过度分泌的神经传递质，多巴胺。但是即使有这些见解，我们仍旧不能把躁郁症归简单咎于单一成因。
This is attributed to the overabundance of a neurotransmittercalled dopamine.But despite these insights,we can’t pin bipolar disorder down to a single cause.
真实的情况是这个问题很复杂，比分说大脑的杏仁核与思考、长期记忆及情绪处理有关。
In reality, it’s a complex problem.For example, the brain’s amygdala is involved in thinking,long-termmemoryand emotional processing.
这一脑区可能会因各种因素如遗传及社会创伤，而出现异常并引发躁郁症的症状。这种情况通常会出现在家族中，因此我们的确了解到遗传跟此疾病大有关系。
In this brain region, factors as varied as genetics and social trauma may create abnormalities and trigger the symptoms of bipolar disorder.The condition tends to run in families,so we do know that genetics have a lot to do with it.
但这并不意味着存在着一个躁郁症基因，事实上一个人发展出躁郁症的可能性受到许多基因间的交互影响。情况复杂，我们仍在尝试着找出答案。
But that doesn’t mean there’s a single bipolar gene.In fact, the likelihood of developing bipolar disorderis driven by the interactions between many genesin a complicated recipe we’re still trying to understand.
由于成因复杂，因此诊断并与躁郁症共处是一大挑战。尽管如此，这种疾病仍是可控的。药物如锂盐，能帮助控制危险的思想及行为。因为它们能稳定情绪，这种情绪稳定剂的之所以有效是因为它们降低了脑部不正常的活动，从而增强有效的神经连结。
The causes are complex,and consequently, diagnosing and living with bipolar disorder is a challenge.Despite this, the disorder is controllable.Despite this, the disorder is controllablecan help manage risky thoughts and behaviorsby stabilizing moods.These mood stabilizing medicationswork by decreasing abnormal activity in the brain,thereby strengthening the viable neural connections.
另外常用的治疗法还有抗精神病药物，通过改变多巴胺的影响起效。还有电击痉挛休克治疗法，就好比人为谨慎控制的大脑癫痫，这种方法有时也会当作紧急手段使用。
Other frequently used medications include antipsychotics,which alter the effects of dopamineand electroconvulsive therapy,which works like a carefully controlled seizure in the brain,is sometimes used as an emergency treatment.
有的躁郁症患者会拒绝接收治疗，因为他们害怕疗法会使情绪低落并摧毁创造力。
Somebipolar patients reject treatmentbecause they’re afraid it will dim their emotionsand destroy their creativity.
但现代精神科学努力避免的正是这种情况，如今医师会根据病人的个人状况执行临床和心理治疗，让病人能在生活中充分发挥他们的潜力。
But modern psychiatry is actively trying to avoid that.Today,doctors work with patients on a case-by-case basisto administer a combination of treatments and therapiesthat allows them to live to their fullest possiblepotential.
除治疗之外，躁郁症病人还能从简单的改变中受益，收获如规律的运动，良好的睡眠习惯，对药物及酒精饮料的节制使用，更不用说亲朋好友的理解与同情。
And beyond treatment,people with bipolar disorder can benefit from even simpler changes.Those include regular exercise,good sleep habitsand sobriety from drugs and alcohol,not to mention the acceptance and empathy of family and friends.
要记得躁郁症是一种疾病，也不代表一个人的身份。这种疾病能被控制，药物及治疗能从人体内部发挥作用，加上外部亲友给予的接纳与理解。躁郁症患者因此能激励自己，找到生命的平衡点。
Remember, bipolar disorder is a medical condition,not a person’s faultor their whole identity,and it’s something that can be controlledthrough 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 themselvesto find balance in their lives.
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