TED演讲抑郁,我们各自隐藏的秘密

00:14

-- treading -- till [it

seemed] that Sense was breaking through -- And when they all were seated, a Service,

like a Drum -- kept beating -- beating -- till I [thought] my Mind was going numb -- And then

I heard them lift a Box and creak across my Soul with those same Boots of Lead, again,

then Space -- began to toll, As [all] the Heavens were a Bell, and Being, [but] an Ear, and I,

and Silence, some strange Race, wrecked, solitary, here -- [And] then a Plank in Reason,

broke, and I fell down and down -- and hit a World, at every plunge, and Finished knowing

-- then --

“我的脑海中，进行着一场葬礼，

悼念者络绎不绝

不停的走着

,

踩踏着

直到仪式的氛围渐

浓

当所有人入座

仪式开始，

敲鼓的声音

沉重有力，敲打着

,

敲打着

直到我的意识变得

麻木

我听见他们抬起棺材

沉重的脚步，

摇摇晃晃

我的灵魂，

吱呀作响

四周，

丧钟响

起

天堂，

就像一个铃铛

存在，

那么就是一只耳朵

安静的我，

如同异类

在此孤独，

在

此腐朽

失去依靠，

理性开始崩塌

我从高处坠落

跌入一个又一个世界

终于，

看清

01:11

We

know

depression

through

metaphors.

Emily

Dickinson

was

able

to

convey

it

in

language, Goya in an image. Half the purpose of art is to describe such iconic states.

我们能够在一些文学作品中看到抑郁的影子

< br>艾米莉·迪金森

（美国十九世纪著名女诗人）

通

过诗歌诠释它

戈雅（西班牙画家）通过绘画表达

许多艺术作品产生的初衷

就是为了表达

这充满象征意义的状态

01:26

As for me, I had always thought myself tough, one of the people who could survive if I'd

been sent to a concentration camp.

就我自己来说，

我 一度认为自己非常坚强

认为自己是那一类即使被送去集中营

也可以存活

下来的人

01:35

In

1991,

I

had

a

series

of

losses.

My

mother

died,

a

relationship

I'd

been

in

ended,

I

moved back to the United States from some years abroad, and I got through all of those

experiences intact.

1991

年，我经历了一连串的不幸

母亲去世

爱情终结

我也在几年的海外生活之后

回到了

美国

我在经历了这一切之后依旧安然无恙

01:49

But in 1994, three years later, I found myself losing interest in almost everything. I didn't

want to do any of the things I had previously wanted to do, and I didn't know why. The

opposite

of

depression

is

not

happiness, but

vitality.

And

it

was

vitality

that

seemed

to

seep away from me in that moment. Everything there was to do seemed like too much

work. I would come home and I would see the red light flashing on my answering machine,

and instead of being thrilled to hear from my friends, I would think,

that is to have to call back.

but I'd have to get the food out and put it on a plate and cut it up and chew it and swallow it,

and it felt to me like the Stations of the Cross.

然而在

1994

年，

也就是三年之后

我突然发现自己对几乎所有的事情都失去了兴趣

甚至不

愿意去做那些

我曾经很想去做的事情

我不知道这是为什么

抑郁的反面

并非快乐，

而是活

力

而正是这样的活力

似乎就在那段时间从我的身体中慢慢消失了

所有需要完成的事情

都感觉那么麻烦

回到家的时候

看着电话留言机上闪烁的红灯

我不但 不会因为听到朋友们

的声音感到兴奋

反而会想

怎么有这么多人等我回电话

有时该吃午饭了

我却开始想，

我还

得把食物拿出来

放到盘子里

得切，得嚼，得咽

让我感觉就像耶稣受难一样

02:44

And one of the things that often gets lost in discussions of depression is that you know it's

ridiculous.

You

know

it's

ridiculous

while

you're

experiencing

it.

You

know

that

most

people manage to listen to their messages and eat lunch and organize themselves to take

a shower and go out the front door and that it's not a big deal, and yet you are nonetheless

in its grip and you are unable to figure out any way around it. And so I began to feel myself

doing less and thinking less and feeling less. It was a kind of nullity.

人们在谈论抑郁时

时常忽略了一点

那就是你知道这一切都很荒谬

即使你正处在抑郁之中，

你也知道这一切都很荒谬

你知道多数人都可以让自己

去听语音留言，去吃午餐

紧接着让

自己冲个澡

然后出门

你知道这根本不是什么大不了的事情

然而你已经被它掌控

并且无

法找到任何解决的方式

于是我开始感到自己事情做得越来越少

思考得越来越少

感知得越

来越少

就好像整个人已经没什么价值了

03:21

And then the anxiety set in. If you told me that I'd have to be depressed for the next month,

I would say,

through it. It was the feeling all the time like that feeling you have if you're walking and you

slip or trip and the ground is rushing up at you, but instead of lasting half a second, the

way that does, it lasted for six months. It's a sensation of being afraid all the time but not

even knowing what it is that you're afraid of. And it was at that point that I began to think

that it was just too painful to be alive, and that the only reason not to kill oneself was so as

not to hurt other people.

紧接着焦虑就来了

如果你告诉我

我会在接下来的一个月里一直抑郁

我 会说，

“只要一个月

之后不抑郁了我就可以接受。”

但如果你告诉我

“你会在接下来的一个月里严重焦虑。”

那

么我宁可割腕也不愿意忍受

这是一种持续的感觉

就好像你走在路上

滑倒了或者绊倒了

地面猛冲向你的感觉

但这种感觉不是半秒钟

而是持续

6

个月

这是一种时时刻刻感到惧怕

却不知道自己在惧怕什么的感觉

就在那时我开始想

活着太痛苦了

人不自杀的唯一原因

是因为不想伤害身边的人

04:08

And finally one day, I woke up and I thought perhaps I'd had a stroke, because I lay in bed

completely frozen, looking at the telephone, thinking,

call for help,

after four full hours of my lying and staring at it, the phone rang, and somehow I managed

to

pick

it

up,

and

it

was

my

father,

and

I

said,

in

serious

trouble.

We

need

to

do

something.

终于有一 天，我醒来的时候

我觉得我可能中风了

因为我躺在床上整个人是完全僵硬的

我

看着电话，心想

“不好了，我该打电话求助。”

但我没办法伸出手去

没有办法拿到电话来

拨号

终于，在我躺在那盯着电话整整四小时之后

电话铃响了

我不记得自己怎么拿到的电

话

是我父亲打来的

我说，“我现在遇到大麻烦了，

我们必须做点什么。”

04:40

The next day I started with the medications and the therapy. And I also started reckoning

with this terrible question: If I'm not the tough person who could have made it through a

concentration camp, then who am I? And if I have to take medication, is that medication

making me more fully myself, or is it making me someone else? And how do I feel about it

if it's making me someone else?

第二天我开始吃药

开始接受治疗

与此同时我开始思考

一个可怕的问题

如果我不是那种

坚强到

即使被送去集中营也可以存活下来的人

那么我是谁呢？

如果我需要吃药的话

那

么药物是让我变得更像自己

还是让我更不像自己？

如果会让我变得像别人

那么我又如何

感觉到这点呢？

05:09

I

had

two

advantages

as

I

went

into

the

fight.

The

first

is

that

I

knew

that,

objectively

speaking, I had a nice life, and that if I could only get well, there was something at the

other end that was worth living for. And the other was that I had access to good treatment.

在这个抗争的过程中我有两个优势

首先是我很清楚，客观地说

我有一个不错的生活条件

如果我能好起来

那么最终是会有一些东西

值得我去为之而活的

另外一点就是我能接受好

的治疗

05:25

But I nonetheless emerged and relapsed, and emerged and relapsed, and emerged and

relapsed, and finally understood I would have to be on medication and in therapy forever.

And I thought,

a chemical cure or a philosophical cure?

understood that actually, we aren't advanced enough in either area for it to explain things

fully. The chemical cure and the psychological cure both have a role to play, and I also

figured out that depression was something that was braided so deep into us that there

was no separating it from our character and personality.

但我却 不知为何

,

好转了又复发

又好转，又复发

再好转，再复发

最后我才意识到

我必须

一辈子

依赖药物以及治疗

于是我想，“但这到底是一个化学问题

还是一个心理问题？

这

到底需要化学疗法还是心理疗法

（原话为“哲学”）

呢？”

我无法找到问题的答案

然后我明白

了

事实上我们对这两个领域的了解都还不够

都还不足以完全弄清真相

化学治疗和心理治

疗

都发挥着重要的作用

我也发现抑郁是这样一个东西

深深的嵌入在我们的体内

我们无

法将它彻底剥离

它已经嵌入到我们的性格和个性中了

06:12

I want to say that the treatments we have for depression are appalling. They're not very

effective. They're extremely costly. They come with innumerable side effects. They're a

disaster. But I am so grateful that I live now and not 50 years ago, when there would have

been almost nothing to be done. I hope that 50 years hence, people will hear about my

treatments and be appalled that anyone endured such primitive science.

我想说现在我们所用的

治疗抑郁症的方法太可怕了

这些方法没有什么效果

还非常昂贵

并且伴随着无数的副作用

它们简直就是灾难

但我很感激我活在当下

而不是

50

年前

那个

时候还不存在

有效的方法

我希望

< br>50

年后

人们听到我接受的治疗方法

会震惊于竟然有人

愿意忍受

如此原始简单的科学

06:41

Depression is the flaw in love. If you were married to someone and thought,

wife dies, I'll find another one,

love

without

the

anticipation

of

loss,

and

that

specter

of

despair

can

be

the

engine

of

intimacy.

抑郁是爱的附属品

如果你跟一个人结婚了，然后想

“好吧，如果我的妻子去世了，我会找

一个新的，”

那么据我们所知这不叫爱

没有这样一种爱情

可以只感受幸福而不体验失去

这种绝望的幽灵

会成为亲密关系的动力

07:07

There are three things

people tend

to

confuse: depression, grief and

sadness. Grief is

explicitly

reactive.

If

you

have

a

loss

and

you

feel

incredibly

unhappy,

and

then,

six

months later, you are still deeply sad, but you're

functioning

a little

better, it's

probably

grief, and it will probably ultimately resolve itself in some measure. If you experience a

catastrophic loss, and you feel terrible, and six months later you can barely function at all,

then it's probably a depression that was triggered by the catastrophic circumstances. The

trajectory tells us a great deal. People think of depression as being just sadness. It's much,

much too much sadness, much too much grief at far too slight a cause.

有三种东西是人们容易混淆的

抑郁，悲伤，难过

悲伤是一种明确的反应

如果你遭遇了不

幸并感到极度不快乐

紧接着六个月以后

你还是非常难过，但是生活大致正常了

这很有可

能是悲伤

而且它很有可能在最终

一定程度地自我恢复

如果你经历了一次灾难性的打击

然后感觉非常糟糕

并且六个月之后你依然无法正常生活

那么很有可能就是你的抑郁

被这

种灾难性的情形触发了

这中变化的过程告诉我们很多信息

人们往往认为抑郁只是难过而

已

只是太多太多的难过

太多的悲伤

起因却微不足道

07:56

As I set out to understand depression, and to interview people who had experienced it, I

found

that

there were

people

who

seemed,

on

the

surface,

to

have

what sounded

like

relatively

mild

depression

who

were

nonetheless

utterly

disabled

by

it.

And

there

were

other people who had what sounded as they described it like terribly severe depression

who nonetheless had good lives in the interstices between their depressive episodes. And

I set out to find out what it is that causes

some

people

to

be

more resilient than

other

people.

What

are

the

mechanisms

that

allow

people

to

survive?

And

I

went

out

and

I

interviewed person after person who was suffering with depression.

当我开始着手了解抑郁

并且采访那些有过这样经历的人时

我发现有些人

从表面上看来

好像是比较轻微的抑郁

却已经因此彻底丧失行为能力了

另一些人

从他们的描述中得知他

们

经历了非常严重的抑郁

他们却能够在抑郁发作的间隙

过着不错的生活

于是我开始研

究

到底是什么

使一些人比另一些人能更好地适应

是什么样的机制

让这些人能够幸免？

于是我去探访了一个又一个

经历过抑郁的人

08:37

One of the first people I interviewed described depression as a slower way of being dead,

and that was a good thing for me to hear early on because it reminded me that that slow

way of being dead can lead to actual deadness, that this is a serious business. It's the

leading disability worldwide, and people die of it every day.

我第一批采访的人中有一个人

把抑郁描述为

一种缓慢的死亡方式

这种说法最初在我听来

是好的

因为这告诉我

缓慢的死亡方式

是会以真正的死亡结束的

这不是说着玩的

这是世

界上导致机能障碍的主要原因之一

每天都有人因此死去

09:00

One of the people I talked to when I was trying to understand this was a beloved friend

who I had known for many years, and who had had a psychotic episode in her freshman

year of college, and then plummeted into a horrific depression. She had bipolar illness, or

manic depression, as it was then known. And then she did very well for many years on

lithium,

and

then

eventually,

she

was

taken

off

her

lithium

to

see

how

she

would

do

without it, and she had another psychosis, and then plunged into the worst depression

that I had ever seen in which she sat in her parents' apartment, more or less catatonic,

essentially without moving, day after day after day. And when I interviewed her about that

experience some years later -- she's a poet and psychotherapist named Maggie Robbins

-- when I interviewed her, she said,

over and over, to occupy my mind. I was singing to blot out the things my mind was saying,

which were, 'You are nothing. You are nobody. You don't even deserve to live.' And that

was when I really started thinking about killing myself.

在我试图了解这些的时候

其中一个我采访的人

是我的挚友

我们已经相识很多年了

她曾

经在她大学入学的那一年

有过精神病发作

之后陷入了可怕的抑郁

她患有双相情感障碍

当时叫做躁郁症

她经过多年的化学治疗

病情控制得很好

于是后来，

她尝试停止化学治疗

想看看能够独立的支撑下来

她却精神病复发

并且陷入了我所见过的

最严重的抑郁

她在

父母的公寓里坐着

多少有些紧张症的样子，几乎一动不动

日复一日都是如此

当我几年之

后采访她那段经历时

她叫玛吉·罗宾斯，诗人，精神治疗医师

当我采访她的时候她说

“我

一遍一遍地唱着‘花儿去向何处’

来占据我的头脑

来清除我头脑中不停重复的话语

‘你 一文

不值，

你这个无名小辈，

你根本不配活在这世上。

’

那时候我真正开始

有了自杀的想法。

”

10:14

You

don't

think

in

depression

that

you've

put

on

a

gray

veil

and

are

seeing

the

world

through the haze of a bad mood. You think that the veil has been taken away, the veil of

happiness,

and

that

now

you're

seeing

truly.

It's

easier

to

help

schizophrenics

who

perceive that there's something foreign inside of them that needs to be exorcised, but it's

difficult with depressives, because we believe we are seeing the truth.

你没有意识到自己抑郁，

但是

你已经戴上了一层灰色的面纱

并且是透过这层坏情绪的薄

纱

来看待这个世界的

你认为是快乐的面纱

被摘掉了

这样你可以看得更加真实

相对而言

帮助精神分裂症患者更容易

他们认为自己身体里面有某些异质

需要被驱除

但对于抑郁症

患者来说这很难

因为我们坚信自己看到的是事实

10:42

But

the

truth

lies.

I

became

obsessed

with

that

sentence:

the

truth

lies.

And

I

discovered, as I talked to depressive people, that they have many delusional perceptions.

People will say,

mother loves you.

people who are depressed will also say,

in the end.

Each of us is trapped in his own body.

we should focus right now on what to have for breakfast.

但事实是会说谎的

我非常喜欢这句话

“事实是会说谎的。”

当我与抑郁症患者交谈时我发

现

他们有很多妄想出来的念头

人们会说，“没人爱我。”

然后你说，“我爱你，

你的妻子爱< /p>

你，

你的母亲爱你。

”

你可以很快给出这个答案

至少对大多数人是如此

但是抑郁的人还会

说

“不论我们做什么，

最终都是要死的。

”

或者他们说，

“两个人之间

是不可能有真正的亲

密交往的，

我们每个人都被自己的身体所束缚了。

“

对于这个你只有回应说

”这点没错，

但

我觉得我们眼下要考虑的

是早上该吃什么。“

11:23

(Laughter)

11:25

A lot of the time, what they are expressing is not illness, but insight, and one comes to

think what's really extraordinary is that most of us know about those existential questions

and

they

don't

distract

us

very

much.

There was

a

study

I

particularly

liked

in

which

a

group of

depressed

and a

group

of

non-depressed

people

were

asked

to

play

a

video

game for an hour, and at the end of the hour, they were asked how many little monsters

they thought they had killed. The depressive group was usually accurate to within about

10 percent, and the non-depressed people guessed between 15 and 20 times as many

little monsters --

（笑声）

许多时候

困扰他们的不是疾病本身，

而是对一些事实的偏执

他们会对一些事实

超乎常人的在意

但是对于我们绝大多数人而言

并不在意这些有关存在的问题

我有一个特

别喜欢的研究

是要一组抑郁症患者

和一组非抑郁症患者

分别打一小时的电子游戏

一小

时结束的时候问他们

他们认为自己

杀了多少只小怪兽

抑郁组的答案往往准确

误差不超

过百分之十

而非抑郁组的人

估计的小怪兽数量

却是实际杀掉的

15

到

20

倍

12:02

(Laughter)

12:03

as they had actually killed.

12:06

A

lot

of

people

said,

when

I

chose

to

write

about

my

depression,

that

it

must

be

very

difficult to be out of that closet, to have people know. They said,

differently?

they start telling me about their experience, or their sister's experience, or their friend's

experience. Things are different because now I know that depression is the family secret

that everyone has.

当我决定写下自己的抑郁经历时，许多人说

要揭开这个秘密让别人知道

一定非常不容易

他们说，”人们会用不一样的口吻跟你说话吗？“

我说，”是 的，人们用不一样的口吻跟我说

话。

这种不一样体现在

人们会告诉我他们自己的经历

或是他们的兄弟姐妹的经历

或是他

们朋友的经历

我现在明白，

每个家庭

都埋藏着一个抑郁的故事

着改变了我的看法

12:34

I went a few years ago to a conference, and on Friday of the three-day conference, one of

the

participants

took

me

aside,

and

she

said,

suffer

from

depression

and

I'm

a

little

embarrassed about it, but I've been taking this medication, and I just wanted to ask you

what you think?

said,

whom this wouldn't make any sense, so, you know, it's just between us.

that's fine.

几年前我去参加一个学术会议

连开三天，

第一天是周五

一个与会者把我叫到一边，

她说

“我有抑郁症

我为此有点难为情

而且我一直在吃某种药物

我只是想问问看你的意见？”

我但是尽我所能给了一些建议

之后她说，

“其实，

我的丈夫并不知道这件事情

他是那种

无法理解这种事情的人

所以，

嗯，

我们的谈话能否保密。

”

我说，

“好，

没有问题。

”

周

日开会的时候

她的丈夫把我叫到了一边

13:13

(Laughter)

13:14

and he said,

I've been dealing with this depression and I'm taking some medication, and I wondered

what

you

think?

They

were

hiding

the

same

medication

in

two

different

places

in

the

same bedroom.

And I said that I thought communication within the marriage might be triggering some of

their problems.

对我说，

“我的妻子并不知道

我跟她了解的那个我之间的不同

我有抑郁症，

有一段时间

了

我现在需要吃一些药物维持

我想听听你的看法？”

他们两个人

服用同一种药物，

并且

将药物藏在

同一个卧室的不同的地方

于是我对他说

我觉得婚姻内部的沟通问题

可能是

他抑郁的原因之一

13:41

But I was also struck by the burdensome nature of such mutual secrecy. Depression is so

exhausting. It takes up so much of your time and energy, and silence about it, it really

does make the depression worse.

让我感到震惊的

是人们想要保守这样的秘密

并因此成熟的沉重负担

抑郁让人精疲力尽

它会消耗掉你几乎全部的时间和精力

而对此保持沉默

只会让抑郁的症状变得更加严重

13:56

And then I began thinking about all the ways people make themselves better. I'd started

off as a medical conservative. I thought there were a few kinds of therapy that worked, it

was clear what they were -- there was medication, there were certain psychotherapies,

there was possibly electroconvulsive treatment, and that everything else was nonsense.

But then I discovered something. If you have brain cancer, and you say that standing on

your

head

for

20

minutes

every

morning

makes

you

feel

better,

it

may

make

you

feel

better, but you still have brain cancer, and you'll still probably die from it. But if you say

that you have depression, and standing on your head for 20 minutes every day makes you

feel better, then it's worked, because depression is an illness of how you feel, and if you

feel

better,

then

you

are

effectively

not

depressed

anymore.

So

I

became

much

more

tolerant of the vast world of alternative treatments.

我开始考虑所有可能的途径

帮助抑郁的人们变得好一些

我在治疗 方法上，

一开始是很保守

的

我觉得只有少数几种疗法是有效的

就那么几种——

药物治疗

几类特定的精神疗法

电

休克疗法有时候有效果

其它所有的方法都是扯淡

但是后来我的看法变了

如果你的脑子里

长了肿瘤

然后你觉得自己每天早晨

倒立

20

分钟会让自己感觉好一些

或许让你自己感觉

好一些

但是你的脑瘤还在那里

你还是可能因此死去

但是如果你患上了抑郁

然后你觉因< /p>

为每天倒立

20

分钟

感觉好一些，那是有一定效果的

因为抑郁是你的感觉和情绪出了问题

如果你感觉好一些了

那么你的抑郁就会少一些

所以我现在变得非常的宽容

各种奇怪的偏

门疗法我都能接受了

14:46

And

I

get

letters,

I

get

hundreds

of

letters

from

people

writing

to

tell

me

about

what's

worked for them. Someone was asking me backstage today about meditation. My favorite

of the letters that I got was the one that came from a woman who wrote and said that she

had tried therapy, medication, she had tried pretty much everything, and she had found a

solution and hoped I would tell the world, and that was making little things from yarn. She

sent me some of them. And I'm not wearing them right now. I suggested to her that she

also should look up obsessive compulsive disorder in the DSM.

我收到了成百上千的邮件

人们写信跟我分享他们使用的治疗方法

就在刚才还有人在幕后

问我

关于药物治疗的事情

有一封邮件提供的方法我很喜欢

是一位女士写给我的

她尝试

过心理疗法，不管用