TEDxMet
Andrew Solomon: Depression, the secret we share
安德鲁·所罗门: 抑郁, 我们各自隐藏的秘密
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"抑郁的反面不是快乐, 而是活力. 而抑郁的时候, 我们变得死气沉沉." 在这次深刻而颠覆性地演讲中, 作家安德鲁·所罗门将我们带入了与抑郁抗争的那段日子中, 他思想中最深谙的角落. 抑郁的经历让他开始环游世界寻找并采访其他的抑郁症患者——结果他发现, 随着他演讲次数的增多, 越来越多的人开始跟他分享自己的故事. (录制于 TEDxMet.)
Double-click the English transcript below to play the video.
00:15
"I felt a funeral in my brain,
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“我的脑海中，进行着一场葬礼，
00:19
and mourners to and fro
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悼念者络绎不绝
00:22
kept treading, treading till I felt
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不停的走着, 踩踏着
00:24
that sense was breaking through.
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直到仪式的氛围渐浓
00:27
And when they all were seated,
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当所有人入座
00:29
a service, like a drum,
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仪式开始， 敲鼓的声音
00:31
kept beating, beating, till I felt
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沉重有力，敲打着, 敲打着
00:34
my mind was going numb.
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直到我的意识变得麻木
00:37
And then I heard them lift a box
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我听见他们抬起棺材
00:39
and creak across my soul
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沉重的脚步， 摇摇晃晃
00:41
with those same boots of lead again,
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我的灵魂， 吱呀作响
00:45
then space began to toll,
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四周， 丧钟响起
00:48
as if the heavens were a bell
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天堂， 就像一个铃铛
00:50
and being were an ear,
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存在， 那么就是一只耳朵
00:52
and I, and silence, some strange race
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安静的我， 如同异类
00:55
wrecked, solitary, here.
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在此孤独， 在此腐朽
00:58
Just then, a plank in reason broke,
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失去依靠， 理性开始崩塌
01:01
and I fell down and down
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我从高处坠落
01:05
and hit a world at every plunge,
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跌入一个又一个世界
01:07
and finished knowing then."
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终于， 看清
01:12
We know depression through metaphors.
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我们能够在一些文学作品中看到抑郁的影子
01:15
Emily Dickinson was able to convey it in language,
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艾米莉·迪金森（美国十九世纪著名女诗人）通过诗歌诠释它
01:19
Goya in an image.
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戈雅（西班牙画家）通过绘画表达
01:22
Half the purpose of art
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许多艺术作品产生的初衷
01:24
is to describe such iconic states.
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就是为了表达这充满象征意义的状态
01:27
As for me, I had always thought myself tough,
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就我自己来说，我一度认为自己非常坚强
01:31
one of the people who could survive
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认为自己是那一类即使被送去集中营
01:33
if I'd been sent to a concentration camp.
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也可以存活下来的人
01:36
In 1991, I had a series of losses.
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1991年，我经历了一连串的不幸
01:39
My mother died,
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母亲去世
01:41
a relationship I'd been in ended,
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爱情终结
01:43
I moved back to the United States
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我也在几年的海外生活之后
01:45
from some years abroad,
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回到了美国
01:47
and I got through all of those experiences intact.
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我在经历了这一切之后依旧安然无恙
01:50
But in 1994, three years later,
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然而在1994年，也就是三年之后
01:53
I found myself losing interest in almost everything.
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我突然发现自己对几乎所有的事情都失去了兴趣
01:57
I didn't want to do any of the things
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甚至不愿意去做那些
01:59
I had previously wanted to do,
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我曾经很想去做的事情
02:01
and I didn't know why.
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我不知道这是为什么
02:03
The opposite of depression
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抑郁的反面
02:05
is not happiness, but vitality,
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并非快乐，而是活力
02:08
and it was vitality
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而正是这样的活力
02:10
that seemed to seep away from me in that moment.
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似乎就在那段时间从我的身体中慢慢消失了
02:14
Everything there was to do
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所有需要完成的事情
02:16
seemed like too much work.
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都感觉那么麻烦
02:18
I would come home
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回到家的时候
02:20
and I would see the red light
flashing on my answering machine,
flashing on my answering machine,
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看着电话留言机上闪烁的红灯
02:23
and instead of being thrilled to hear from my friends,
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我不但不会因为听到朋友们的声音感到兴奋
02:25
I would think,
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反而会想
02:27
"What a lot of people that is to have to call back."
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怎么有这么多人等我回电话
02:30
Or I would decide I should have lunch,
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有时该吃午饭了
02:32
and then I would think, but
I'd have to get the food out
I'd have to get the food out
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我却开始想，我还得把食物拿出来
02:35
and put it on a plate
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放到盘子里
02:37
and cut it up and chew it and swallow it,
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得切，得嚼，得咽
02:41
and it felt to me like the Stations of the Cross.
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让我感觉就像耶稣受难一样
02:45
And one of the things that often gets lost
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人们在谈论抑郁时
02:47
in discussions of depression
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时常忽略了一点
02:49
is that you know it's ridiculous.
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那就是你知道这一切都很荒谬
02:51
You know it's ridiculous while you're experiencing it.
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即使你正处在抑郁之中， 你也知道这一切都很荒谬
02:54
You know that most people manage
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你知道多数人都可以让自己
02:56
to listen to their messages and eat lunch
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去听语音留言，去吃午餐
02:58
and organize themselves to take a shower
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紧接着让自己冲个澡
03:00
and go out the front door
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然后出门
03:02
and that it's not a big deal,
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你知道这根本不是什么大不了的事情
03:03
and yet you are nonetheless in its grip
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然而你已经被它掌控
03:06
and you are unable to figure out any way around it.
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并且无法找到任何解决的方式
03:10
And so I began to feel myself doing less
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于是我开始感到自己事情做得越来越少
03:15
and thinking less
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思考得越来越少
03:17
and feeling less.
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感知得越来越少
03:19
It was a kind of nullity.
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就好像整个人已经没什么价值了
03:22
And then the anxiety set in.
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紧接着焦虑就来了
03:24
If you told me that I'd have to be
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如果你告诉我
03:26
depressed for the next month,
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我会在接下来的一个月里一直抑郁
03:28
I would say, "As long I know it'll be
over in November, I can do it."
over in November, I can do it."
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我会说，“只要一个月之后不抑郁了我就可以接受。”
03:31
But if you said to me,
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但如果你告诉我
03:32
"You have to have acute anxiety for the next month,"
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“你会在接下来的一个月里严重焦虑。”
03:35
I would rather slit my wrist than go through it.
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那么我宁可割腕也不愿意忍受
03:38
It was the feeling all the time
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这是一种持续的感觉
03:40
like that feeling you have if you're walking
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就好像你走在路上
03:42
and you slip or trip
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滑倒了或者绊倒了
03:43
and the ground is rushing up at you,
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地面猛冲向你的感觉
03:45
but instead of lasting half a
second, the way that does,
second, the way that does,
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但这种感觉不是半秒钟
03:48
it lasted for six months.
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而是持续6个月
03:50
It's a sensation of being afraid all the time
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这是一种时时刻刻感到惧怕
03:53
but not even knowing what it is that you're afraid of.
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却不知道自己在惧怕什么的感觉
03:57
And it was at that point that I began to think
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就在那时我开始想
03:59
that it was just too painful to be alive,
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活着太痛苦了
04:03
and that the only reason not to kill oneself
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人不自杀的唯一原因
04:06
was so as not to hurt other people.
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是因为不想伤害身边的人
04:09
And finally one day, I woke up
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终于有一天，我醒来的时候
04:12
and I thought perhaps I'd had a stroke,
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我觉得我可能中风了
04:14
because I lay in bed completely frozen,
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因为我躺在床上整个人是完全僵硬的
04:16
looking at the telephone, thinking,
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我看着电话，心想
04:18
"Something is wrong and I should call for help,"
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“不好了，我该打电话求助。”
04:22
and I couldn't reach out my arm
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但我没办法伸出手去
04:24
and pick up the phone and dial.
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没有办法拿到电话来拨号
04:26
And finally, after four full hours
of my lying and staring at it,
of my lying and staring at it,
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终于，在我躺在那盯着电话整整四小时之后
04:30
the phone rang,
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电话铃响了
04:32
and somehow I managed to pick it up,
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我不记得自己怎么拿到的电话
04:34
and it was my father,
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是我父亲打来的
04:36
and I said, "I'm in serious trouble.
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我说，“我现在遇到大麻烦了，
04:39
We need to do something."
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我们必须做点什么。”
04:41
The next day I started with the medications
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第二天我开始吃药
04:44
and the therapy.
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开始接受治疗
04:47
And I also started reckoning
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与此同时我开始思考
04:49
with this terrible question:
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一个可怕的问题
04:51
If I'm not the tough person
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如果我不是那种坚强到
04:53
who could have made it
through a concentration camp,
through a concentration camp,
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即使被送去集中营也可以存活下来的人
04:56
then who am I?
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那么我是谁呢？
04:57
And if I have to take medication,
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如果我需要吃药的话
04:59
is that medication making me more fully myself,
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那么药物是让我变得更像自己
05:03
or is it making me someone else?
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还是让我更不像自己？
05:05
And how do I feel about it
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如果会让我变得像别人
05:07
if it's making me someone else?
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那么我又如何感觉到这点呢？
05:09
I had two advantages as I went in to the fight.
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在这个抗争的过程中我有两个优势
05:13
The first is that I knew that, objectively speaking,
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首先是我很清楚，客观地说
05:16
I had a nice life,
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我有一个不错的生活条件
05:17
and that if I could only get well,
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如果我能好起来
05:19
there was something at the other end
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那么最终是会有一些东西
05:21
that was worth living for.
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值得我去为之而活的
05:23
And the other was that I had
access to good treatment.
access to good treatment.
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另外一点就是我能接受好的治疗
05:26
But I nonetheless emerged and relapsed,
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但我却不知为何,好转了又复发
05:29
and emerged and relapsed,
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又好转，又复发
05:32
and emerged and relapsed,
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再好转，再复发
05:35
and finally understood
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最后我才意识到
05:37
I would have to be on medication
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我必须一辈子
05:39
and in therapy forever.
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依赖药物以及治疗
05:41
And I thought, "But is it a chemical problem
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于是我想，“但这到底是一个化学问题
05:44
or a psychological problem?
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还是一个心理问题？
05:45
And does it need a chemical cure
or a philosophical cure?"
or a philosophical cure?"
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这到底需要化学疗法还是心理疗法（原话为“哲学”）呢？”
05:49
And I couldn't figure out which it was.
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我无法找到问题的答案
05:51
And then I understood that actually,
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然后我明白了
05:54
we aren't advanced enough in either area
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事实上我们对这两个领域的了解都还不够
05:56
for it to explain things fully.
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都还不足以完全弄清真相
05:58
The chemical cure and the psychological cure
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化学治疗和心理治疗
06:01
both have a role to play,
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都发挥着重要的作用
06:03
and I also figured out that depression was something
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我也发现抑郁是这样一个东西
06:06
that was braided so deep into us
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深深的嵌入在我们的体内
06:09
that there was no separating it
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我们无法将它彻底剥离
06:10
from our character and personality.
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它已经嵌入到我们的性格和个性中了
06:13
I want to say that the treatments we have
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我想说现在我们所用的
06:15
for depression are appalling.
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治疗抑郁症的方法太可怕了
06:17
They're not very effective.
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这些方法没有什么效果
06:19
They're extremely costly.
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还非常昂贵
06:21
They come with innumerable side effects.
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并且伴随着无数的副作用
06:24
They're a disaster.
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它们简直就是灾难
06:25
But I am so grateful that I live now
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但我很感激我活在当下
06:28
and not 50 years ago,
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而不是50年前
06:30
when there would have been almost nothing
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那个时候还不存在
06:32
to be done.
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有效的方法
06:33
I hope that 50 years hence,
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我希望50年后
06:36
people will hear about my treatments
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人们听到我接受的治疗方法
06:37
and be appalled that anyone endured
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会震惊于竟然有人愿意忍受
06:40
such primitive science.
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如此原始简单的科学
06:42
Depression is the flaw in love.
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抑郁是爱的附属品
06:47
If you were married to someone and thought,
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如果你跟一个人结婚了，然后想
06:50
"Well, if my wife dies, I'll find another one,"
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“好吧，如果我的妻子去世了，我会找一个新的，”
06:54
it wouldn't be love as we know it.
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那么据我们所知这不叫爱
06:57
There's no such thing as love
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没有这样一种爱情
06:59
without the anticipation of loss,
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可以只感受幸福而不体验失去
07:01
and that specter of despair
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这种绝望的幽灵
07:04
can be the engine of intimacy.
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会成为亲密关系的动力
07:08
There are three things people tend to confuse:
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有三种东西是人们容易混淆的
07:11
depression, grief and sadness.
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抑郁，悲伤，难过
07:14
Grief is explicitly reactive.
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悲伤是一种明确的反应
07:18
If you have a loss and you feel incredibly unhappy,
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如果你遭遇了不幸并感到极度不快乐
07:21
and then, six months later,
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紧接着六个月以后
07:22
you are still deeply sad, but
you're functioning a little better,
you're functioning a little better,
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你还是非常难过，但是生活大致正常了
07:25
it's probably grief,
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这很有可能是悲伤
07:27
and it will probably ultimately resolve itself
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而且它很有可能在最终
07:29
in some measure.
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一定程度地自我恢复
07:31
If you experience a catastrophic loss,
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如果你经历了一次灾难性的打击
07:34
and you feel terrible,
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然后感觉非常糟糕
07:35
and six months later you can barely function at all,
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并且六个月之后你依然无法正常生活
07:38
then it's probably a depression that was triggered
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那么很有可能就是你的抑郁
07:40
by the catastrophic circumstances.
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被这种灾难性的情形触发了
07:43
The trajectory tells us a great deal.
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这中变化的过程告诉我们很多信息
07:47
People think of depression as being just sadness.
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人们往往认为抑郁只是难过而已
07:50
It's much, much too much sadness,
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只是太多太多的难过
07:52
much too much grief
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太多的悲伤
07:54
at far too slight a cause.
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起因却微不足道
07:57
As I set out to understand depression,
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当我开始着手了解抑郁
08:00
and to interview people who had experienced it,
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并且采访那些有过这样经历的人时
08:02
I found that there were people who seemed
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我发现有些人
08:05
on the surface to have what sounded like
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1705
从表面上看来
08:07
relatively mild depression
185
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2062
好像是比较轻微的抑郁
08:09
who were nonetheless utterly disabled by it.
186
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3447
却已经因此彻底丧失行为能力了
08:13
And there were other people who had what sounded
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1858
另一些人
08:15
as they described it
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1312
从他们的描述中得知他们
08:16
like terribly severe depression
189
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2251
经历了非常严重的抑郁
08:18
who nonetheless had good lives in the interstices
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2815
他们却能够在抑郁发作的间隙
08:21
between their depressive episodes.
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2155
过着不错的生活
08:23
And I set out to find out what it is
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2685
于是我开始研究
08:26
that causes some people
193
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1603
到底是什么
08:27
to be more resilient than other people.
194
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2253
使一些人比另一些人能更好地适应
08:30
What are the mechanisms
195
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1559
是什么样的机制
08:31
that allow people to survive?
196
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1844
让这些人能够幸免？
08:33
And I went out and I interviewed person after person
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3169
于是我去探访了一个又一个
08:36
who was suffering with depression.
198
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2175
经历过抑郁的人
08:38
One of the first people I interviewed
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1951
我第一批采访的人中有一个人
08:40
described depression
200
508825
1881
把抑郁描述为
08:42
as a slower way of being dead,
201
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3261
一种缓慢的死亡方式
08:45
and that was a good thing for me to hear early on
202
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2124
这种说法最初在我听来是好的
08:48
because it reminded me
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1366
因为这告诉我
08:49
that that slow way of being dead
204
517457
1999
缓慢的死亡方式
08:51
can lead to actual deadness,
205
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2035
是会以真正的死亡结束的
08:53
that this is a serious business.
206
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2004
这不是说着玩的
08:55
It's the leading disability worldwide,
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2659
这是世界上导致机能障碍的主要原因之一
08:58
and people die of it every day.
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3030
每天都有人因此死去
09:01
One of the people I talked to
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1769
在我试图了解这些的时候
09:02
when I was trying to understand this
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530953
1974
其中一个我采访的人
09:04
was a beloved friend
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1668
是我的挚友
09:06
who I had known for many years,
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2018
我们已经相识很多年了
09:08
and who had had a psychotic episode
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2542
她曾经在她大学入学的那一年
09:11
in her freshman year of college,
214
539155
1904
有过精神病发作
09:13
and then plummeted into a horrific depression.
215
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3056
之后陷入了可怕的抑郁
09:16
She had bipolar illness,
216
544115
1426
她患有双相情感障碍
09:17
or manic depression, as it was then known.
217
545541
2643
当时叫做躁郁症
09:20
And then she did very well
218
548184
2044
她经过多年的化学治疗
09:22
for many years on lithium,
219
550228
1708
病情控制得很好
09:23
and then eventually,
220
551936
1375
于是后来，
09:25
she was taken off her lithium
221
553311
1960
她尝试停止化学治疗
09:27
to see how she would do without it,
222
555271
1835
想看看能够独立的支撑下来
09:29
and she had another psychosis,
223
557106
1975
她却精神病复发
09:31
and then plunged into the worst depression
224
559081
2338
并且陷入了我所见过的
09:33
that I had ever seen
225
561419
1872
最严重的抑郁
09:35
in which she sat in her parents' apartment,
226
563291
3015
她在父母的公寓里坐着
09:38
more or less catatonic, essentially without moving,
227
566306
3077
多少有些紧张症的样子，几乎一动不动
09:41
day after day after day.
228
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2482
日复一日都是如此
09:43
And when I interviewed her about
that experience some years later --
that experience some years later --
229
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3217
当我几年之后采访她那段经历时
09:47
she's a poet and psychotherapist
named Maggie Robbins —
named Maggie Robbins —
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3331
她叫玛吉·罗宾斯，诗人，精神治疗医师
09:50
when I interviewed her, she said,
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3233
当我采访她的时候她说
09:53
"I was singing 'Where Have All The Flowers Gone'
232
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3384
“我一遍一遍地唱着‘花儿去向何处’
09:57
over and over to occupy my mind.
233
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3210
来占据我的头脑
10:00
I was singing to blot out the
things my mind was saying,
things my mind was saying,
234
588240
3135
来清除我头脑中不停重复的话语
10:03
which were, 'You are nothing. You are nobody.
235
591375
4490
‘你一文不值，你这个无名小辈，
10:07
You don't even deserve to live.'
236
595865
2826
你根本不配活在这世上。’
10:10
And that was when I really started thinking
237
598691
2178
那时候我真正开始
10:12
about killing myself."
238
600869
2213
有了自杀的想法。”
10:15
You don't think in depression
239
603082
1908
你没有意识到自己抑郁， 但是
10:16
that you've put on a gray veil
240
604990
2137
你已经戴上了一层灰色的面纱
10:19
and are seeing the world through the haze
241
607127
1980
并且是透过这层坏情绪的薄纱
10:21
of a bad mood.
242
609107
1894
来看待这个世界的
10:23
You think that the veil has been taken away,
243
611001
2720
你认为是快乐的面纱
10:25
the veil of happiness,
244
613721
1922
被摘掉了
10:27
and that now you're seeing truly.
245
615643
2424
这样你可以看得更加真实
10:30
It's easier to help schizophrenics who perceive
246
618067
2964
相对而言帮助精神分裂症患者更容易
10:33
that there's something foreign inside of them
247
621031
1811
他们认为自己身体里面有某些异质
10:34
that needs to be exorcised,
248
622842
2187
需要被驱除
10:37
but it's difficult with depressives,
249
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2164
但对于抑郁症患者来说这很难
10:39
because we believe we are seeing the truth.
250
627193
3847
因为我们坚信自己看到的是事实
10:43
But the truth lies.
251
631040
2947
但事实是会说谎的
10:45
I became obsessed with that sentence:
252
633987
1998
我非常喜欢这句话
10:47
"But the truth lies."
253
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2375
“事实是会说谎的。”
10:50
And I discovered, as I talked to depressive people,
254
638360
2453
当我与抑郁症患者交谈时我发现
10:52
that they have many delusional perceptions.
255
640813
2682
他们有很多妄想出来的念头
10:55
People will say, "No one loves me."
256
643495
1667
人们会说，“没人爱我。”
10:57
And you say, "I love you,
257
645162
1651
然后你说，“我爱你，
10:58
your wife loves you, your mother loves you."
258
646813
2522
你的妻子爱你，你的母亲爱你。”
11:01
You can answer that one pretty readily,
259
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1923
你可以很快给出这个答案
11:03
at least for most people.
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1665
至少对大多数人是如此
11:04
But people who are depressed will also say,
261
652923
2267
但是抑郁的人还会说
11:07
"No matter what we do,
262
655190
1705
“不论我们做什么，
11:08
we're all just going to die in the end."
263
656895
2273
最终都是要死的。”
11:11
Or they'll say, "There can be no true communion
264
659168
2203
或者他们说，“两个人之间
11:13
between two human beings.
265
661371
1653
是不可能有真正的亲密交往的，
11:15
Each of us is trapped in his own body."
266
663024
2576
我们每个人都被自己的身体所束缚了。“
11:17
To which you have to say,
267
665600
1849
对于这个你只有回应说
11:19
"That's true,
268
667449
1321
”这点没错，
11:20
but I think we should focus right now
269
668770
1818
但我觉得我们眼下要考虑的
11:22
on what to have for breakfast."
270
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1896
是早上该吃什么。“
11:24
(Laughter)
271
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2185
（笑声）
11:26
A lot of the time,
272
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1669
许多时候
11:28
what they are expressing is not illness, but insight,
273
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2896
困扰他们的不是疾病本身， 而是对一些事实的偏执
11:31
and one comes to think what's really extraordinary
274
679234
2657
他们会对一些事实超乎常人的在意
11:33
is that most of us know about
those existential questions
those existential questions
275
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2934
但是对于我们绝大多数人而言
11:36
and they don't distract us very much.
276
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2290
并不在意这些有关存在的问题
11:39
There was a study I particularly liked
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687115
2159
我有一个特别喜欢的研究
11:41
in which a group of depressed
278
689274
1680
是要一组抑郁症患者
11:42
and a group of non-depressed people
279
690954
1901
和一组非抑郁症患者
11:44
were asked to play a video game for an hour,
280
692855
2623
分别打一小时的电子游戏
11:47
and at the end of the hour,
281
695478
1813
一小时结束的时候问他们
11:49
they were asked how many little monsters
282
697291
1651
他们认为自己
11:50
they thought they had killed.
283
698942
1864
杀了多少只小怪兽
11:52
The depressive group was usually accurate
284
700806
2212
抑郁组的答案往往准确
11:55
to within about 10 percent,
285
703018
2058
误差不超过百分之十
11:57
and the non-depressed people
286
705076
1471
而非抑郁组的人
11:58
guessed between 15 and 20 times as many
287
706547
3545
估计的小怪兽数量
12:02
little monsters — (Laughter) —
288
710092
1742
却是实际杀掉的
12:03
as they had actually killed.
289
711834
4111
15到20倍
12:07
A lot of people said, when I chose
to write about my depression,
to write about my depression,
290
715945
3066
当我决定写下自己的抑郁经历时，许多人说
12:11
that it must be very difficult
291
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1769
要揭开这个秘密让别人知道
12:12
to be out of that closet, to have people know.
292
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3124
一定非常不容易
12:15
They said, "Do people talk to you differently?"
293
723904
2200
他们说，”人们会用不一样的口吻跟你说话吗？“
12:18
And I said, "Yes, people talk to me differently.
294
726104
2072
我说，”是的，人们用不一样的口吻跟我说话。
12:20
They talk to me differently insofar
295
728176
1914
这种不一样体现在
12:22
as they start telling me about their experience,
296
730090
2790
人们会告诉我他们自己的经历
12:24
or their sister's experience,
297
732880
1835
或是他们的兄弟姐妹的经历
12:26
or their friend's experience.
298
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1774
或是他们朋友的经历
12:28
Things are different because now I know
299
736489
2292
我现在明白， 每个家庭
12:30
that depression is the family secret
300
738781
2681
都埋藏着一个抑郁的故事
12:33
that everyone has.
301
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2077
着改变了我的看法
12:35
I went a few years ago to a conference,
302
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3628
几年前我去参加一个学术会议
12:39
and on Friday of the three-day conference,
303
747167
2653
连开三天， 第一天是周五
12:41
one of the participants took me aside, and she said,
304
749820
2891
一个与会者把我叫到一边， 她说
12:44
"I suffer from depression and
305
752711
3405
“我有抑郁症
12:48
I'm a little embarrassed about it,
306
756116
2769
我为此有点难为情
12:50
but I've been taking this medication,
307
758885
2103
而且我一直在吃某种药物
12:52
and I just wanted to ask you what you think?"
308
760988
2948
我只是想问问看你的意见？”
12:55
And so I did my best to give
her such advice as I could.
her such advice as I could.
309
763936
2834
我但是尽我所能给了一些建议
12:58
And then she said, "You know,
310
766770
1720
之后她说， “其实，
13:00
my husband would never understand this.
311
768490
2791
我的丈夫并不知道这件事情
13:03
He's really the kind of guy to whom
this wouldn't make any sense,
this wouldn't make any sense,
312
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2573
他是那种无法理解这种事情的人
13:05
so I just, you know, it's just between us."
313
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2867
所以， 嗯， 我们的谈话能否保密。”
13:08
And I said, "Yes, that's fine."
314
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1786
我说， “好， 没有问题。”
13:10
On Sunday of the same conference,
315
778507
2109
周日开会的时候
13:12
her husband took me aside,
316
780616
3044
她的丈夫把我叫到了一边
13:15
and he said, "My wife wouldn't think
317
783660
1694
对我说， “我的妻子并不知道
13:17
that I was really much of a guy if she knew this,
318
785354
2435
我跟她了解的那个我之间的不同
13:19
but I've been dealing with this depression
319
787789
2466
我有抑郁症， 有一段时间了
13:22
and I'm taking some medication,
320
790255
1354
我现在需要吃一些药物维持
13:23
and I wondered what you think?"
321
791609
2505
我想听听你的看法？”
13:26
They were hiding
322
794114
1423
他们两个人
13:27
the same medication in two different places
323
795537
2215
服用同一种药物， 并且将药物藏在
13:29
in the same bedroom.
324
797752
2645
同一个卧室的不同的地方
13:32
And I said that I thought
325
800397
2021
于是我对他说
13:34
communication within the marriage
326
802418
1684
我觉得婚姻内部的沟通问题
13:36
might be triggering some of their problems.
327
804102
2014
可能是他抑郁的原因之一
13:38
(Laughter)
328
806116
4191
（笑声）
13:42
But I was also struck
329
810307
1655
让我感到震惊的
13:43
by the burdensome nature
330
811962
1806
是人们想要保守这样的秘密
13:45
of such mutual secrecy.
331
813768
2373
并因此成熟的沉重负担
13:48
Depression is so exhausting.
332
816141
1885
抑郁让人精疲力尽
13:50
It takes up so much of your time and energy,
333
818026
2768
它会消耗掉你几乎全部的时间和精力
13:52
and silence about it,
334
820794
1504
而对此保持沉默
13:54
it really does make the depression worse.
335
822298
2731
只会让抑郁的症状变得更加严重
13:57
And then I began thinking about all the ways
336
825029
1733
我开始考虑所有可能的途径
13:58
people make themselves better.
337
826762
1966
帮助抑郁的人们变得好一些
14:00
I'd started off as a medical conservative.
338
828728
2439
我在治疗方法上，一开始是很保守的
14:03
I thought there were a few
kinds of therapy that worked,
kinds of therapy that worked,
339
831167
2372
我觉得只有少数几种疗法是有效的
14:05
it was clear what they were --
340
833539
1809
就那么几种——
14:07
there was medication,
341
835348
1644
药物治疗
14:08
there were certain psychotherapies,
342
836992
1476
几类特定的精神疗法
14:10
there was possibly electroconvulsive treatment,
343
838468
2445
电休克疗法有时候有效果
14:12
and that everything else was nonsense.
344
840913
2675
其它所有的方法都是扯淡
14:15
But then I discovered something.
345
843588
1832
但是后来我的看法变了
14:17
If you have brain cancer,
346
845420
1752
如果你的脑子里长了肿瘤
14:19
and you say that standing on your head
347
847172
1472
然后你觉得自己每天早晨
14:20
for 20 minutes every morning makes you feel better,
348
848644
2995
倒立20分钟会让自己感觉好一些
14:23
it may make you feel better,
349
851639
1514
或许让你自己感觉好一些
14:25
but you still have brain cancer,
350
853153
1588
但是你的脑瘤还在那里
14:26
and you'll still probably die from it.
351
854741
2289
你还是可能因此死去
14:29
But if you say that you have depression,
352
857030
2512
但是如果你患上了抑郁
14:31
and standing on your head for 20 minutes every day
353
859542
2105
然后你觉因为每天倒立20分钟
14:33
makes you feel better, then it's worked,
354
861647
2484
感觉好一些，那是有一定效果的
14:36
because depression is an illness of how you feel,
355
864131
2360
因为抑郁是你的感觉和情绪出了问题
14:38
and if you feel better,
356
866491
1609
如果你感觉好一些了
14:40
then you are effectively not depressed anymore.
357
868100
2830
那么你的抑郁就会少一些
14:42
So I became much more tolerant
358
870930
2033
所以我现在变得非常的宽容
14:44
of the vast world of alternative treatments.
359
872963
2925
各种奇怪的偏门疗法我都能接受了
14:47
And I get letters, I get hundreds of letters
360
875888
2384
我收到了成百上千的邮件
14:50
from people writing to tell me
about what's worked for them.
about what's worked for them.
361
878272
2516
人们写信跟我分享他们使用的治疗方法
14:52
Someone was asking me backstage today
362
880788
2201
就在刚才还有人在幕后问我
14:54
about meditation.
363
882989
1463
关于药物治疗的事情
14:56
My favorite of the letters that I got
364
884452
2465
有一封邮件提供的方法我很喜欢
14:58
was the one that came from a woman
365
886917
1474
是一位女士写给我的
15:00
who wrote and said that she had tried therapy,
366
888391
2207
她尝试过心理疗法，不管用
15:02
she had tried medication,
she had tried pretty much everything,
she had tried pretty much everything,
367
890598
2387
药物疗法，也不行，各种方法都尝试了，还是不行
15:04
and she had found a solution
and hoped I would tell the world,
and hoped I would tell the world,
368
892985
2837
最后她自己发现了一个方法，她希望我告诉全世界
15:07
and that was making little things from yarn.
369
895822
3812
她认为最好的疗法是用纱线做一些小制品
15:11
(Laughter)
370
899634
2999
（笑声）
15:14
She sent me some of them. (Laughter)
371
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3524
她还给我邮寄了一些（笑声）
15:18
And I'm not wearing them right now.
372
906157
3688
我现在没穿在身上
15:21
I suggested to her that she also should look up
373
909845
2515
我建议她再去医院查查
15:24
obsessive compulsive disorder in the DSM.
374
912360
4048
看看有没有强迫症（译注：演讲者在开玩笑）
15:28
And yet, when I went to look
at alternative treatments,
at alternative treatments,
375
916408
3128
当我去了解其它偏门疗法时
15:31
I also gained perspective on other treatments.
376
919536
2908
我也接触到了其它疗法的不同的视角
15:34
I went through a tribal exorcism in Senegal
377
922444
2903
我研究过塞内加尔一个部落的净化仪式
15:37
that involved a great deal of ram's blood
378
925347
2013
他们在仪式中使用了大量的公羊血
15:39
and that I'm not going to detail right now,
379
927360
2062
这里我就不详细讲了
15:41
but a few years afterwards I was in Rwanda
380
929422
2000
但是几年之后，当我去卢旺达
15:43
working on a different project,
381
931422
1758
参与另一个项目时
15:45
and I happened to describe
my experience to someone,
my experience to someone,
382
933180
2796
我向一个当地人介绍了那个仪式
15:47
and he said, "Well, you know,
383
935976
1760
他说，“嗯，你知道
15:49
that's West Africa, and we're in East Africa,
384
937736
1820
那是西非，我们这里是东非
15:51
and our rituals are in some ways very different,
385
939556
1834
我们的宗教仪式有一些不同的地方
15:53
but we do have some rituals that have something
386
941390
2013
但是我们也有一些地方是共通的
15:55
in common with what you're describing."
387
943403
1987
（我们的方法）跟你描述的那种有些相似
15:57
And I said, "Oh." And he said, "Yes," he said,
388
945390
1663
然后我说，“哦”。 他说，“是的”，然后他继续说道
15:59
"but we've had a lot of trouble with
Western mental health workers,
Western mental health workers,
389
947053
2642
但是西方世界跑过来的心理治疗师给我们添了不少麻烦
16:01
especially the ones who came
right after the genocide."
right after the genocide."
390
949695
2757
尤其是那些大屠杀之后跑来的心理医生们
（译注：指1990年代卢旺达大屠杀）
（译注：指1990年代卢旺达大屠杀）
16:04
And I said, "What kind of trouble did you have?"
391
952452
2327
于是我问他，“什么麻烦？”
16:06
And he said, "Well,
392
954779
1546
他说，“是这样的
16:08
they would do this bizarre thing.
393
956325
2664
他们做的事情很古怪
16:10
They didn't take people out in the sunshine
394
958989
1885
他们并不会让人去阳光下活动
16:12
where you begin to feel better.
395
960874
1700
虽然这会让人感觉舒服
16:14
They didn't include drumming or music
to get people's blood going.
to get people's blood going.
396
962574
3094
他们不使用音乐或打鼓的方式激发人们的情绪
16:17
They didn't involve the whole community.
397
965668
1842
他们不会让整个社区参与其中
16:19
They didn't externalize the depression
398
967510
1775
他们也没有将抑郁外显化为一种恶灵
16:21
as an invasive spirit.
399
969285
1433
进行驱逐
16:22
Instead what they did was they took people
400
970718
2631
相反的，他们将那些（抑郁的）人单独地
16:25
one at a time into dingy little rooms
401
973349
2628
带到一个昏暗的小房间
16:27
and had them talk for an hour
402
975977
1343
花一个小时
16:29
about bad things that had happened to them."
403
977320
2230
让他们回忆发生在他们身上的悲惨的事情。”
16:31
(Laughter) (Applause)
404
979550
5460
（笑声）（掌声）
16:37
He said, "We had to ask them to leave the country."
405
985010
2362
他说，“我们只能请他们离开这个国家了。”
16:39
(Laughter)
406
987372
3057
（笑声）
16:42
Now at the other end of alternative treatments,
407
990429
2444
现在，我想分享另外一种替代的疗法
16:44
let me tell you about Frank Russakoff.
408
992873
2035
弗兰克·若萨克夫接受了这种替代疗法
16:46
Frank Russakoff had the worst depression
409
994908
3053
弗兰克的抑郁症可能是我见过的
16:49
perhaps that I've ever seen in a man.
410
997961
2915
最严重的抑郁症之一
16:52
He was constantly depressed.
411
1000876
1993
他一直处于抑郁状态
16:54
He was, when I met him, at a point at which
412
1002869
2141
当我刚见到他的时候
16:57
every month he would have electroshock treatment.
413
1005010
3158
他每个月都要接受电休克治疗
17:00
Then he would feel sort of disoriented for a week.
414
1008168
2575
所以他每个月第一周会被电的迷迷糊糊
17:02
Then he would feel okay for a week.
415
1010743
1803
第二周变得正常起来
17:04
Then he would have a week of going downhill.
416
1012546
1700
第三周开始情绪又开始走下坡路
17:06
And then he would have another
electroshock treatment.
electroshock treatment.
417
1014246
2685
然后他就会寻求下一次电休克治疗
17:08
And he said to me when I met him,
418
1016931
1415
当我开始见到他的时候，他说
17:10
"It's unbearable to go through my weeks this way.
419
1018346
2552
“这种（电休克的）周期对于我而言是无法避免的
17:12
I can't go on this way,
420
1020898
1507
我不能这么下去了
17:14
and I've figured out how I'm going to end it
421
1022405
2264
我知道如果我不能够变好起来
17:16
if I don't get better.
422
1024669
1557
意味着什么
17:18
But," he said to me, "I heard about a protocol
423
1026226
2708
“但是”， 他对我说，
17:20
at Mass General for a procedure called
424
1028934
2223
“我听说麻省总院最近在进行医疗实验，
17:23
a cingulotomy, which is a brain surgery,
425
1031157
2026
实验一种脑手术，叫扣带回切开术
17:25
and I think I'm going to give that a try."
426
1033183
2571
我想我会去尝试一下。”
17:27
And I remember being amazed at that point
427
1035754
1954
我至今都记得当时我听到后的惊喜的心情
17:29
to think that someone
428
1037708
1300
想想这样一个人
17:31
who clearly had so many bad experiences
429
1039008
3221
经历了如此多的悲惨经历
17:34
with so many different treatments
430
1042229
1859
忍受了那么多的治疗方法
17:36
still had buried in him somewhere enough optimism
431
1044088
3122
骨子里依然有一种与生俱来的乐观
17:39
to reach out for one more.
432
1047210
2550
要去尝试新的东西
17:41
And he had the cingulotomy,
433
1049760
2180
后来他做了扣带回切开术
17:43
and it was incredibly successful.
434
1051940
2041
出乎意料地成功
17:45
He's now a friend of mine.
435
1053981
1493
他跟我现在成为了朋友
17:47
He has a lovely wife and two beautiful children.
436
1055474
3492
他有一个可爱的妻子和两个漂亮的小孩
17:50
He wrote me a letter the Christmas after the surgery,
437
1058966
2949
那次手术的圣诞节后，他写了一封信给我
17:53
and he said,
438
1061915
1189
他说
17:55
"My father sent me two presents this year,
439
1063104
2407
“我的父亲今年寄给我两件礼物
17:57
First, a motorized C.D. rack from The Sharper Image
440
1065511
2602
一个是某个品牌的车载CD架
18:00
that I didn't really need,
441
1068113
1421
我不是很需要
18:01
but I knew he was giving it to me to celebrate
442
1069534
2097
但是我知道他是给我这个的目的
18:03
the fact that I'm living on my own
443
1071631
1728
是想要庆祝一下，我可以重新开始
18:05
and have a job I seem to love.
444
1073359
2047
并且有了一份喜欢的工作
18:07
And the other present
445
1075406
1561
另外一件礼物
18:08
was a photo of my grandmother,
446
1076967
1576
是我外婆的一张照片
18:10
who committed suicide.
447
1078543
2252
她自杀了
18:12
As I unwrapped it, I began to cry,
448
1080795
2935
当我拆开包装的时候，我开始哭泣
18:15
and my mother came over and said,
449
1083730
1880
我的妈妈过来问道
18:17
'Are you crying because of the
relatives you never knew?'
relatives you never knew?'
450
1085610
3315
‘你哭是因为你从来没有见过外婆么？’
18:20
And I said, 'She had the same disease I have.'
451
1088925
4088
我说，‘不，是因为她的痛苦，我同样经历过。’
18:25
I'm crying now as I write to you.
452
1093013
2581
写这封信的现在，我又忍不住哭泣
18:27
It's not that I'm so sad, but I get overwhelmed,
453
1095594
3595
不是因为悲伤，而是因为我再也无法承受
18:31
I think, because I could have killed myself,
454
1099189
2221
我想我曾经也可能会自杀
18:33
but my parents kept me going,
455
1101410
1703
但是我的父母给了我勇气
18:35
and so did the doctors,
456
1103113
1749
还有治疗我的医生们
18:36
and I had the surgery.
457
1104862
1854
还有这个手术
18:38
I'm alive and grateful.
458
1106716
2815
我活着，心怀感恩
18:41
We live in the right time,
459
1109531
2260
我们活在美好的时代
18:43
even if it doesn't always feel like it."
460
1111791
3879
虽然有时候看起来很糟。”
18:47
I was struck by the fact that depression
461
1115670
1897
我很不能理解为什么
18:49
is broadly perceived to be
462
1117567
1725
人们普遍的把抑郁症看成是
18:51
a modern, Western, middle-class thing,
463
1119292
3537
现代西方中产阶级特有的一种病
18:54
and I went to look at how it operated
464
1122829
2152
于是我开始寻找抑郁症
18:56
in a variety of other contexts,
465
1124981
2003
与其它社会因素的关联
18:58
and one of the things I was most interested in
466
1126984
2119
在可能相关的社会因素中
19:01
was depression among the indigent.
467
1129103
1790
我对贫困和抑郁的关系特别感兴趣
19:02
And so I went out to try to look at
468
1130893
1781
于是我做了一些研究
19:04
what was being done for
poor people with depression.
poor people with depression.
469
1132674
2580
尝试去了解穷人是如何治疗抑郁的
19:07
And what I discovered is that poor people
470
1135254
2158
我发现大多数情况下
19:09
are mostly not being treated for depression.
471
1137412
2557
穷人的抑郁症不会得到治疗
19:11
Depression is the result of a genetic vulnerability,
472
1139969
2919
抑郁属于基因的缺陷
19:14
which is presumably evenly
distributed in the population,
distributed in the population,
473
1142888
3158
这意味着在不同的人群中容易抑郁的人的比例应该是一样的
19:18
and triggering circumstances,
474
1146046
1953
生活环境的不同导致了发病率的不同
19:19
which are likely to be more severe
475
1147999
1903
而当人们处于贫困的生活环境中时
19:21
for people who are impoverished.
476
1149902
1875
抑郁症的发病率更高, 也更严重
19:23
And yet it turns out that if you have
477
1151777
2427
但是, 如果你的生活一帆风顺
19:26
a really lovely life but feel miserable all the time,
478
1154204
2140
然后你觉得自己一直都不开心
19:28
you think, "Why do I feel like this?
479
1156344
2000
你会反思, "我为什么不开心?"
19:30
I must have depression."
480
1158344
1669
"我一定是抑郁了."
19:32
And you set out to find treatment for it.
481
1160013
1923
然后你会去找医生给你治疗
19:33
But if you have a perfectly awful life,
482
1161936
2093
但是如果你的生活本来就很糟糕
19:36
and you feel miserable all the time,
483
1164029
1867
然后你一直都不开心
19:37
the way you feel is commensurate with your life,
484
1165896
2826
你的感觉和你的生活状态是相称的
19:40
and it doesn't occur to you to think,
485
1168722
1724
于是你就不会想到这个是病
19:42
"Maybe this is treatable."
486
1170446
1783
"或许这个可以治疗一下"
19:44
And so we have an epidemic in this country
487
1172229
3136
所以实际上我们这个国家的低收入人群中
19:47
of depression among impoverished people
488
1175365
2913
抑郁症像是传染病一样流行
19:50
that's not being picked up
and that's not being treated
and that's not being treated
489
1178278
2512
但是却一直没有被人注意过, 没有人评估过患病的规模
19:52
and that's not being addressed,
490
1180790
2056
也没有人为这些低收入者提供治疗
19:54
and it's a tragedy of a grand order.
491
1182846
2200
这是非常大的一个悲剧
19:57
And so I found an academic
492
1185046
1488
后来我发现了一位研究人员
19:58
who was doing a research project
493
1186534
1817
她当时正在华盛顿特区周边的贫民窟中
20:00
in slums outside of D.C.,
494
1188351
1741
做与之相关的一项研究
20:02
where she picked up women who had
come in for other health problems
come in for other health problems
495
1190092
2997
当有妇女前来看其它的疾病时, 她会邀请这些妇女
20:05
and diagnosed them with depression,
496
1193089
1779
做一个抑郁症的诊断
20:06
and then provided six months
of the experimental protocol.
of the experimental protocol.
497
1194868
3266
同时提供一份六个月的实验协议
20:10
One of them, Lolly, came in,
498
1198134
2329
其中有一位女士, 名叫洛莉
20:12
and this is what she said the day she came in.
499
1200463
2297
以下是她第一天到诊所来的自述
20:14
She said, and she was a woman, by the way,
500
1202760
3395
她说她是一位母亲
20:18
who had seven children. She said,
501
1206155
2092
7个孩子的母亲, 她说,
20:20
"I used to have a job but I had to give it up because
502
1208247
2651
"我曾经有一份工作, 但是不得不辞掉了"
20:22
I couldn't go out of the house.
503
1210898
2060
"因为我无法离开我的屋子"
20:24
I have nothing to say to my children.
504
1212958
2228
我一句话都不想跟我的孩子们说
20:27
In the morning, I can't wait for them to leave,
505
1215186
2767
早晨, 我迫不及待的让孩子们出门上学
20:29
and then I climb in bed and
pull the covers over my head,
pull the covers over my head,
506
1217953
2990
然后立刻爬上床蒙头大睡
20:32
and three o'clock when they come home,
507
1220943
1646
然后下午三点他们就陆续回家了
20:34
it just comes so fast."
508
1222589
1801
时间过得太快了
20:36
She said, "I've been taking a lot of Tylenol,
509
1224390
2240
她说, "我已经吃了很多的泰诺(一种止痛药)"
20:38
anything I can take so that I can sleep more.
510
1226630
2759
以及其它所有能够让我多睡一会儿的东西
20:41
My husband has been telling me I'm stupid, I'm ugly.
511
1229389
3770
我的丈夫一直说我蠢, 说我令人讨厌
20:45
I wish I could stop the pain."
512
1233159
3505
我真希望能够结束这痛苦
20:48
Well, she was brought into
this experimental protocol,
this experimental protocol,
513
1236664
2640
然后她接受了实验协议开始进行治疗
20:51
and when I interviewed her six months later,
514
1239304
2308
六个月之后当我去采访她的时候
20:53
she had taken a job working in childcare
515
1241612
4407
她有了一份新工作, 在美国海军(的幼儿园)
20:58
for the U.S. Navy, she had left the abusive husband,
516
1246019
3805
照看孩子, 她离开了以前那个虐待她的丈夫
21:01
and she said to me,
517
1249824
2082
她对我说
21:03
"My kids are so much happier now."
518
1251906
2369
我的孩子们现在比以前开心多了
21:06
She said, "There's one room in my new place
519
1254275
1977
她说, 现在我的新家有两个孩子的卧室
21:08
for the boys and one room for the girls,
520
1256252
2608
男孩子们一间, 女孩子们一间
21:10
but at night, they're just all up on my bed,
521
1258860
2539
到了晚上的时候, 他们都会来到我的房间
21:13
and we're doing homework
all together and everything.
all together and everything.
522
1261399
2612
我们一直做家庭作业, 做其它的事情
21:16
One of them wants to be a preacher,
523
1264011
1673
一个儿子立志做一名牧师
21:17
one of them wants to be a firefighter,
524
1265684
1700
另一个想要做消防队员
21:19
and one of the girls says she's going to be a lawyer.
525
1267384
2966
我的一个女儿想要做一名律师
21:22
They don't cry like they used to,
526
1270350
2005
他们不像以前那样哭得那么频繁
21:24
and they don't fight like they did.
527
1272355
2558
也不再像以前那样相互打来打去了
21:26
That's all I need now is my kids.
528
1274913
3780
看着这些孩子, 我现在觉得很满足
21:30
Things keep on changing,
529
1278693
1912
一切都在不断的变好
21:32
the way I dress, the way I feel, the way I act.
530
1280605
5193
我的穿着, 我的情绪, 我的言行
21:37
I can go outside not being afraid anymore,
531
1285798
3687
我不会再像以前那样害怕出门
21:41
and I don't think those bad feelings are coming back,
532
1289485
3409
也不会再担心糟糕的心情会卷土重来
21:44
and if it weren't for Dr. Miranda and that,
533
1292894
3035
如果没有米兰达医生(那位研究人员)的帮助
21:47
I would still be at home with
the covers pulled over my head,
the covers pulled over my head,
534
1295929
3617
我现在可能还我在家里, 用被子蒙住头呼呼大睡
21:51
if I were still alive at all.
535
1299546
2349
或许我已经死了
21:53
I asked the Lord to send me an angel,
536
1301895
3732
我曾祈祷上帝为我下凡一位天使
21:57
and he heard my prayers."
537
1305627
4330
而上帝听到了我的声音." (译注: 指米兰达博士)
22:01
I was really moved by these experiences,
538
1309959
3353
我被这些真实的故事深深打动了
22:05
and I decided that I wanted to write about them
539
1313312
2539
我之前计划只是写一本书来记录
22:07
not only in a book I was working on,
540
1315851
1379
但是现在我觉得远远不够
22:09
but also in an article,
541
1317230
1311
我还要写一篇文章(让更多的人知道)
22:10
and so I got a commission from
The New York Times Magazine
The New York Times Magazine
542
1318541
2321
所以我跟纽约时报杂志说好
22:12
to write about depression among the indigent.
543
1320862
2016
写一篇有关低收入群里中抑郁症的报告
22:14
And I turned in my story,
544
1322878
1616
当我写好之后
22:16
and my editor called me and said,
545
1324494
1596
我的编辑打电话给我说
22:18
"We really can't publish this."
546
1326090
1710
我们真的没办法发表这个
22:19
And I said, "Why not?"
547
1327800
1750
然后我问, "为什么?"
22:21
And she said, "It just is too far-fetched.
548
1329550
2305
她说, "故事太牵强了"
22:23
These people who are sort of at
the very bottom rung of society
the very bottom rung of society
549
1331855
3778
这些人生活在接近社会底层的地方
22:27
and then they get a few months of treatment
550
1335633
1704
然后他们经过了六个月的治疗
22:29
and they're virtually ready to run Morgan Stanley?
551
1337337
2632
然后他们就可以去管理摩根史坦利了?
(译注: 一家知名投资机构)
(译注: 一家知名投资机构)
22:31
It's just too implausible."
552
1339969
1854
太没有说服力了
22:33
She said, I've never even heard of anything like it."
553
1341823
2205
她说, "我从来没有听过这样的事情"
22:36
And I said, "The fact that you've never heard of it
554
1344028
2534
然后我说, "你从没有听说过"
22:38
is an indication that it is news."
555
1346562
3000
恰恰说明这个是一个'新闻'
22:41
(Laughter) (Applause)
556
1349562
6134
(笑声)(掌声)
22:49
"And you are a news magazine."
557
1357317
2494
而且你们是一家新闻媒体啊
22:51
So after a certain amount of negotiation,
558
1359811
1982
来回协商了几次之后
22:53
they agreed to it.
559
1361793
1241
他们同意发表了
22:55
But I think a lot of what they said
560
1363034
1615
但是他们说的话让我想了很多
22:56
was connected in some strange way
561
1364649
2295
他们这种态度跟另外一个观点多少有点关系
22:58
to this distaste that people still have
562
1366944
2142
即很多人还是反感
23:01
for the idea of treatment,
563
1369086
1463
抑郁症需要治疗这个观点
23:02
the notion that somehow if we went out
564
1370549
1882
好像这就意味着我们会开始
23:04
and treated a lot of people in indigent communities,
565
1372431
2696
大规模的开始治疗低收入者
23:07
that would be an exploitative thing to do,
566
1375127
1898
这将是一件带有剥削性质的事情
23:09
because we would be changing them.
567
1377025
1642
因为我们是在改造他们
23:10
There is this false moral imperative
568
1378667
2033
看起来我们所有的人
23:12
that seems to be all around us
569
1380700
1789
都受到一种教条的影响
23:14
that treatment of depression,
570
1382489
2354
即治疗抑郁的疗法也好,
23:16
the medications and so on, are an artifice,
571
1384843
2299
药物也好, 都是人造的产物
23:19
and that it's not natural.
572
1387142
2172
并不是自然的结果
23:21
And I think that's very misguided.
573
1389314
2849
我觉得这完全是使入歧途了
23:24
It would be natural for people's teeth to fall out,
574
1392163
3532
虽然人老了掉牙是很自然的时候
23:27
but there is nobody militating against toothpaste,
575
1395695
3330
但是这并不影响任何人使用牙膏
23:31
at least not in my circles.
576
1399025
2128
至少我的周围没有
23:33
And people then say, "Well, but isn't depression
577
1401153
2502
人们可能会接着问, "那么, 抑郁本身
23:35
part of what people are supposed to experience?
578
1403655
2185
不应该是我们注定需要经历的一个过程么
23:37
Didn't we evolve to have depression?
579
1405840
1741
难道抑郁不是我们的演化的结果么
23:39
Isn't it part of your personality?"
580
1407581
1907
难道这不是你个性的一部分么
23:41
To which I would say, mood is adaptive.
581
1409488
2746
对此我的看法是, 情绪是有适应性的
23:44
Being able to have sadness and fear
582
1412234
3329
对于我们而言
23:47
and joy and pleasure
583
1415563
1842
能够感受喜怒哀乐
23:49
and all of the other moods that we have,
584
1417405
1803
以及其它丰富的情感
23:51
that's incredibly valuable.
585
1419208
2064
意义重大
23:53
And major depression is something that happens
586
1421272
3047
而当一个人总是抑郁的时候, 那一定是
23:56
when that system gets broken.
587
1424319
2012
他的情绪系统出问题了
23:58
It's maladaptive.
588
1426331
1717
不再能够适应环境了
24:00
People will come to me and say,
589
1428048
1572
有些人会跟我这样说,
24:01
"I think, though, if I just stick it out for another year,
590
1429620
2768
"即便如此, 我想如果我自己再多熬一年"
24:04
I think I can just get through this."
591
1432388
2076
我就可以走出抑郁了
24:06
And I always say to them, "You may get through it,
592
1434464
2303
对此我总是这样回答, "或许你能够自己走出来,
24:08
but you'll never be 37 again.
593
1436767
2709
但是失去的青春你再也找不回了
24:11
Life is short, and that's a whole year
594
1439476
2550
人生苦短, 你现在却在跟我说
24:14
you're talking about giving up.
595
1442026
1956
要浪费一年的时间(自己挺过抑郁)
24:15
Think it through."
596
1443982
1538
你再想想
24:17
It's a strange poverty of the English language,
597
1445520
2846
关于抑郁这种情感, 英语中用来形容的词出奇地少
24:20
and indeed of many other languages,
598
1448366
2108
当然别的语言也多不到哪里去
24:22
that we use this same word, depression,
599
1450474
2218
我们用'depression'这一个单词
(译注: 中文可以翻译成'沮丧'或'抑郁')
(译注: 中文可以翻译成'沮丧'或'抑郁')
24:24
to describe how a kid feels
600
1452692
1805
即用来描述一个小孩子
24:26
when it rains on his birthday,
601
1454497
1712
生日那天下大雨的心情
24:28
and to describe how somebody feels
602
1456209
2528
也用来描述一个自杀者
24:30
the minute before they commit suicide.
603
1458737
2454
自杀前一分钟的感觉
24:33
People say to me, "Well, is it
continuous with normal sadness?"
continuous with normal sadness?"
604
1461191
3105
人们会问, "这是不是就是长时间的悲伤?"
24:36
And I say, in a way it's continuous
with normal sadness.
with normal sadness.
605
1464296
3144
某种意义上可以这么理解
24:39
There is a certain amount of continuity,
606
1467440
2200
悲伤和抑郁之间有一定的连续性
24:41
but it's the same way there's continuity
607
1469640
1957
但是他们之间的连续性就像是
24:43
between having an iron fence outside your house
608
1471597
1987
悲伤可以看成是你房子周围的铁栅栏
24:45
that gets a little rust spot
609
1473584
1677
有一点生锈了
24:47
that you have to sand off and do a little repainting,
610
1475261
2746
你需要用沙纸打磨一下重新喷漆
24:50
and what happens if you leave
the house for 100 years
the house for 100 years
611
1478007
2647
但是如果你的房子100年没有人住了
24:52
and it rusts through until it's only a pile
612
1480654
2898
那么铁栅栏会锈蚀到只剩下
24:55
of orange dust.
613
1483552
1234
一堆黄锈
24:56
And it's that orange dust spot,
614
1484786
2173
悲伤和抑郁的差别
24:58
that orange dust problem,
615
1486959
1789
就好比生了一点锈和锈蚀到什么都没有了
25:00
that's the one we're setting out to address.
616
1488748
2989
后者是我们要解决的问题
25:03
So now people say,
617
1491737
2240
现在人们会问
25:05
"You take these happy pills, and do you feel happy?"
618
1493977
2731
你吃了这些快乐丸(指抗抑郁药), 你快乐么
25:08
And I don't.
619
1496708
1886
不
25:10
But I don't feel sad about having to eat lunch,
620
1498594
2822
但是我不会因为要吃饭而不开心
25:13
and I don't feel sad about my answering machine,
621
1501416
2836
不会因为要回电话而不开心
25:16
and I don't feel sad about taking a shower.
622
1504252
2845
不会因为要洗澡而感到不开心
25:19
I feel more, in fact, I think,
623
1507097
2854
事实上我觉得自己的感受比以前更多
25:21
because I can feel sadness without nullity.
624
1509951
2430
因为我现在能够体会到悲伤, 但是不会感到虚无
25:24
I feel sad about professional disappointments,
625
1512381
4347
我会因为工作上的不如意而悲伤
25:28
about damaged relationships,
626
1516728
2347
会因为破碎的爱情悲伤
25:31
about global warming.
627
1519075
2039
会因为全球变暖而悲伤
25:33
Those are the things that I feel sad about now.
628
1521114
2725
这些是我当下能够体会到的悲伤
25:35
And I said to myself, well, what is the conclusion?
629
1523839
2734
最后我问自己, "结论是什么呢?"
25:38
How did those people who have better lives
630
1526573
2561
为什么有些人的生活条件更好
25:41
even with bigger depression manage to get through?
631
1529134
2554
却需要去战胜更严重的抑郁?
25:43
What is the mechanism of resilience?
632
1531688
2797
又为什么我们能够康复?
25:46
And what I came up with over time
633
1534485
2084
我总是一次次地遇见
25:48
was that the people who deny their experience,
634
1536569
2916
抑郁之后的康复者不愿意接受这段经历
25:51
the ones who say, "I was depressed a long time ago
635
1539485
2032
他们会说, "我很久之前抑郁过,
25:53
and I never want to think about it again
636
1541517
1737
我再也不想回忆那段时光了
25:55
and I'm not going to look at it
637
1543254
1242
我也不会再去分析它
25:56
and I'm just going to get on with my life,"
638
1544496
1890
我只希望继续自己当下的生活
25:58
ironically, those are the people
639
1546386
1959
讽刺的是, 恰恰是这些人
26:00
who are most enslaved by what they have.
640
1548345
2698
最容易被他们过往经历的纠缠不放
26:03
Shutting out the depression strengthens it.
641
1551043
2564
回避抑郁, 只会让它更凶猛
26:05
While you hide from it, it grows.
642
1553607
3280
你越躲, 它越强
26:08
And the people who do better
643
1556887
2860
而另外一些人
26:11
are the ones who are able to tolerate the fact
644
1559747
2599
他们承认并接纳自己有抑郁这个事实
26:14
that they have this condition.
645
1562346
1622
他们表现得更好一些
26:15
Those who can tolerate their depression
646
1563968
2470
能够接纳自己抑郁的人
26:18
are the ones who achieve resilience.
647
1566438
1782
最终会康复起来
26:20
So Frank Russakoff said to me,
648
1568220
1783
弗兰克对我说
26:22
"If I had it again to do over,
649
1570003
1516
如果一切重新来过
26:23
I suppose I wouldn't do it this way,
650
1571519
2137
那么我可能会换种处理方式
26:25
but in a strange way, I'm grateful
651
1573656
1964
但是很奇怪地, 我很感激
26:27
for what I've experienced.
652
1575620
1503
感激我经历过的一切
26:29
I'm glad to have been in the hospital 40 times.
653
1577123
3817
我很高兴住了40次医院
26:32
It taught me so much about love,
654
1580940
2603
这段经历让我深刻的理解了什么是爱
26:35
and my relationship with my parents and my doctors
655
1583543
2840
我的爱人, 我的父母, 以及我的医生
26:38
has been so precious to me, and will be always."
656
1586383
4389
这对我而言都是巨大的恩赐, 过去是, 将来也是.
26:42
And Maggie Robbins said,
657
1590772
1926
玛吉·罗宾斯说
26:44
"I used to volunteer in an AIDS clinic,
658
1592698
2989
我在艾滋诊所做过志愿者
26:47
and I would just talk and talk and talk,
659
1595687
3014
我跟自己负责的病人
26:50
and the people I was dealing with
660
1598701
1813
不断的说话, 但是
26:52
weren't very responsive, and I thought,
661
1600514
2067
他们的反应并不积极, 然后我想
26:54
'That's not very friendly or helpful of them.'
662
1602581
3961
'是不是对他们来说这样不太友好, 或不管用.'
26:58
And then I realized,
663
1606542
1642
后来我意识到
27:00
I realized that they weren't going to do more
664
1608184
2127
我意识到在第一次见面的简短聊天中
27:02
than make those first few minutes of small talk.
665
1610311
2387
他们只要能够坐在那里就好
27:04
It was simply going to be an occasion
666
1612698
2057
第一次的聊天实际上是一个机会
27:06
where I didn't have AIDS and I wasn't dying,
667
1614755
2878
让他们认识到虽然我没有艾滋病, 我没有等待死亡,
27:09
but could tolerate the fact that they did
668
1617633
2973
但是我能够接受他们有艾滋病
27:12
and they were.
669
1620606
1787
并不断恶化的事实
27:14
Our needs are our greatest assets.
670
1622393
3603
我们的需求是我们最宝贵的财富
27:17
It turns out I've learned to give
671
1625996
2139
后来我学会了
27:20
all the things I need."
672
1628135
4025
如何尽我所能(去帮助他人)
27:24
Valuing one's depression
673
1632160
1691
正视抑郁的价值
27:25
does not prevent a relapse,
674
1633851
2194
并不能保证不再复发
27:28
but it may make the prospect of relapse
675
1636045
2661
但是却能改变看待抑郁复发的态度
27:30
and even relapse itself easier to tolerate.
676
1638706
4218
甚至会减弱抑郁复发的程度
27:34
The question is not so much
677
1642924
2045
我们要解决的问题
27:36
of finding great meaning and deciding
678
1644969
2175
并不是要去找到伟大的意义和决策
27:39
your depression has been very meaningful.
679
1647144
2027
让你的抑郁看起来意义非凡
27:41
It's of seeking that meaning
680
1649171
2171
而是要去寻找这样的意义
27:43
and thinking, when it comes again,
681
1651342
1804
能够让你思考, 当抑郁卷土重来
27:45
"This will be hellish,
682
1653146
1640
"这会向下地狱般痛苦,
27:46
but I will learn something from it."
683
1654786
2701
但是我会受益良多
27:49
I have learned in my own depression
684
1657487
2264
我从自己的抑郁中看到
27:51
how big an emotion can be,
685
1659751
2013
情绪的作用能够如此之大
27:53
how it can be more real than facts,
686
1661764
3097
甚至能够盖过客观存在
27:56
and I have found that that experience
687
1664861
2949
而且我发现我的这段经历
27:59
has allowed me to experience positive emotion
688
1667810
2892
让我能够更加强烈和专注的
28:02
in a more intense and more focused way.
689
1670702
3520
去感受和体会积极向上的情绪
28:06
The opposite of depression is not happiness,
690
1674222
3487
抑郁的反面不是快乐
28:09
but vitality,
691
1677709
1454
而是活力
28:11
and these days, my life is vital,
692
1679163
2741
现在这段时间, 我的生活充满活力
28:13
even on the days when I'm sad.
693
1681904
2745
即便我有时会悲伤, 也是如此
28:16
I felt that funeral in my brain,
694
1684649
3313
我看到自己的脑海中也进行着一场葬礼
28:19
and I sat next to the colossus
695
1687962
2024
我坐在世界的边缘
28:21
at the edge of the world,
696
1689986
2247
挨着一个巨人
28:24
and I have discovered
697
1692233
2089
我发现
28:26
something inside of myself
698
1694322
1851
身体里的一些东西
28:28
that I would have to call a soul
699
1696173
2133
称为灵魂的东西
28:30
that I had never formulated
until that day 20 years ago
until that day 20 years ago
700
1698306
3756
在20年前尚未真正的成型
28:34
when hell came to pay me a surprise visit.
701
1702062
4518
直到地狱的使者突然出现
28:38
I think that while I hated being depressed
702
1706580
4098
我想, 虽然我很厌恶抑郁时候的状态
28:42
and would hate to be depressed again,
703
1710678
2334
也很厌恶抑郁旧病复发
28:45
I've found a way to love my depression.
704
1713012
2744
我还是会寻到一种方法接受并爱抑郁的自己
28:47
I love it because it has forced me
705
1715756
2025
我爱它, 因为他迫使我去寻找快乐
28:49
to find and cling to joy.
706
1717781
2769
并牢牢抓住
28:52
I love it because each day I decide,
707
1720550
3488
我爱它, 因为它让我在生活中
28:56
sometimes gamely,
708
1724038
1540
牢牢抓住
28:57
and sometimes against the moment's reason,
709
1725578
2698
让我活下去的理由, 虽然有时候也会不那么理性
29:00
to cleave to the reasons for living.
710
1728276
2578
虽然偶尔也会游戏人生
29:02
And that, I think, is a highly privileged rapture.
711
1730854
4123
而这, 我想, 是非常值得高兴和赞赏的事情.
29:06
Thank you.
712
1734977
3983
谢谢大家
29:10
(Applause)
713
1738960
3136
（掌声）
ABOUT THE SPEAKER
Andrew Solomon - WriterAndrew Solomon writes about politics, culture and psychology.
Why you should listen
Andrew Solomon is a writer, lecturer and Professor of Clinical Psychology at Columbia University. He is president of PEN American Center. He writes regularly for The New Yorker and the New York Times.
Solomon's newest book, Far and Away: Reporting from the Brink of Change, Seven Continents, Twenty-Five Years was published in April, 2016. His previous book, Far From the Tree: Parents, Children, and the Search for Identity won the National Book Critics Circle award for nonfiction, the Wellcome Prize and 22 other national awards. It tells the stories of parents who not only learn to deal with their exceptional children but also find profound meaning in doing so. It was a New York Times bestseller in both hardcover and paperback editions. Solomon's previous book, The Noonday Demon: An Atlas of Depression, won the 2001 National Book Award for Nonfiction, was a finalist for the 2002 Pulitzer Prize and was included in The Times of London's list of one hundred best books of the decade. It has been published in twenty-four languages. Solomon is also the author of the novel A Stone Boat and of The Irony Tower: Soviet Artists in a Time of Glasnost.
Solomon is an activist in LGBT rights, mental health, education and the arts. He is a member of the boards of directors of the National LGBTQ Force and Trans Youth Family Allies. He is a member of the Board of Visitors of Columbia University Medical Center, serves on the National Advisory Board of the Depression Center at the University of Michigan, is a director of Columbia Psychiatry and is a member of the Advisory Board of the Depression and Bipolar Support Alliance. Solomon also serves on the boards of the Metropolitan Museum of Art, Yaddo and The Alex Fund, which supports the education of Romani children. He is also a fellow of Berkeley College at Yale University and a member of the New York Institute for the Humanities and the Council on Foreign Relations.
Solomon lives with his husband and son in New York and London and is a dual national. He also has a daughter with a college friend; mother and daughter live in Texas but visit often.
Andrew Solomon | Speaker | TED.com