TEDxMet
Andrew Solomon: Depression, the secret we share
Andrew Solomon: 抑鬱症——我哋都有嘅秘密
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「抑鬱症嘅相反唔係快樂，而係活力。當時活力就好似離開咗我。」呢係一場既流暢又震憾嘅演說， 作家 Andrew Solomon 帶你走入佢對抗抑鬱症嗰幾年內心最黑暗嘅時候。 嗰次經歷令畀佢放眼全世界， 走去訪問其他抑鬱症患者。令佢驚訝嘅係， 佢愈係講得多，啲人愈係想講佢哋自己嘅故事。（喺 TEDxMet 中錄影）
Double-click the English transcript below to play the video.
00:15
"I felt a funeral in my brain,
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「我腦裏面感覺到有一場葬禮，
00:19
and mourners to and fro
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而殮葬嘅人不停行嚟行去，
00:22
kept treading, treading till I felt
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當我嘅感覺返返嚟，佢哋就坐返埋位，
00:24
that sense was breaking through.
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00:27
And when they all were seated,
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葬禮儀式好似鼓一樣敲打著。
00:29
a service, like a drum,
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00:31
kept beating, beating, till I felt
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00:34
my mind was going numb.
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直至我嘅腦完全麻木，
00:37
And then I heard them lift a box
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跟住我聽到佢哋移靈安葬我嘅遺體，
00:39
and creak across my soul
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而我嘅靈魂就好似木一樣敲碎緊，
00:41
with those same boots of lead again,
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仲有佢哋好似之前一樣
鉛一樣沉重嘅腳步，
鉛一樣沉重嘅腳步，
00:45
then space began to toll,
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而成個大嘅空間好似有一個鐘喺度響。
天堂好似一個鐘咁，
00:48
as if the heavens were a bell
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而人就好似耳朵，
00:50
and being were an ear,
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聽到定時響起嘅鐘聲，
00:52
and I, and silence, some strange race
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但我同寂靜屬於同一個異端，
00:55
wrecked, solitary, here.
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都係擱淺喺荒島上，孤零零喺度。
隨著支持我嘅木板斷開，
00:58
Just then, a plank in reason broke,
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01:01
and I fell down and down
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我不斷墜落， 墜落，
01:05
and hit a world at every plunge,
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撞到好多嘢然後跌落一個世界，
01:07
and finished knowing then."
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我唔再認識事物。」
01:12
We know depression through metaphors.
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我哋喺好多喑喻裏邊見到抑鬱症
01:15
Emily Dickinson was able to convey it in language,
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艾米莉 ‧ 狄金森將抑鬱症轉化為文字
01:19
Goya in an image.
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戈雅將抑鬱症轉化成油畫
01:22
Half the purpose of art
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一半嘅藝術創作
01:24
is to describe such iconic states.
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係想表達抑鬱症嘅典形狀態
01:27
As for me, I had always thought myself tough,
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至於我， 我一直認為自己係堅強
01:31
one of the people who could survive
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如果一班人被咗去集中營嘅話
01:33
if I'd been sent to a concentration camp.
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我會係其中一個可以存活落嚟嘅人
01:36
In 1991, I had a series of losses.
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1991 年，我經歷一連串嘅打擊
01:39
My mother died,
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我母親過世、一段感情結束咗
01:41
a relationship I'd been in ended,
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01:43
I moved back to the United States
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同埋我結束咗幾年外國生活
01:45
from some years abroad,
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返返去美國
01:47
and I got through all of those experiences intact.
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而我經歷以上打擊都仍然係好硬淨
01:50
But in 1994, three years later,
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但係喺 1994，三年之後
01:53
I found myself losing interest in almost everything.
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我發覺自己幾乎對所有嘢都冇興趣
01:57
I didn't want to do any of the things
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我唔想做任何之前想做嘅嘢
01:59
I had previously wanted to do,
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我都唔知點解會噉樣
02:01
and I didn't know why.
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02:03
The opposite of depression
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抑鬱嘅反面唔係快樂， 係活力
02:05
is not happiness, but vitality,
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02:08
and it was vitality
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活力就係嗰時我覺得我失去咗嘅嘢
02:10
that seemed to seep away from me in that moment.
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02:14
Everything there was to do
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每日要做嘅嘢實在太多啦
02:16
seemed like too much work.
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我想返屋企
02:18
I would come home
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02:20
and I would see the red light
flashing on my answering machine,
flashing on my answering machine,
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見到電話答錄機上面閃著紅色燈
我冇咁驚
我冇咁驚
02:23
and instead of being thrilled to hear from my friends,
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因為唔使聽到朋友留言
02:25
I would think,
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我就諗︰點解我要覆返咁多人嘅電話？
02:27
"What a lot of people that is to have to call back."
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02:30
Or I would decide I should have lunch,
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或係我應該要食午餐啦
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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但我會諗， 我要將食物攞出嚟
02:35
and put it on a plate
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擺喺個碟度
02:37
and cut it up and chew it and swallow it,
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又要切、又要擺入個口度，又要吞咗去
02:41
and it felt to me like the Stations of the Cross.
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感覺好似耶穌行十架嘅路一樣
02:45
And one of the things that often gets lost
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而有一樣成日喺討論抑鬱症嘅時候
02:47
in discussions of depression
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會忽略嘅嘢係
02:49
is that you know it's ridiculous.
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你知道抑鬱症係非常荒謬嘅一件事
02:51
You know it's ridiculous while you're experiencing it.
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你知道當你經歷抑鬱症嘅時候
佢係有幾咁荒謬
02:54
You know that most people manage
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你知道大部分人
會聽答錄機嘅留言同食晏
會聽答錄機嘅留言同食晏
02:56
to listen to their messages and eat lunch
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02:58
and organize themselves to take a shower
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安排好沖涼、出去屋企
03:00
and go out the front door
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03:02
and that it's not a big deal,
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呢啲都係好簡單
03:03
and yet you are nonetheless in its grip
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但當你仍然係喺抑鬱症嘅控制當中
03:06
and you are unable to figure out any way around it.
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你搵唔到方法解決佢
03:10
And so I began to feel myself doing less
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之後我覺得自己做嘢做得愈嚟愈少
03:15
and thinking less
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又諗得少、感受又愈嚟愈少
03:17
and feeling less.
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03:19
It was a kind of nullity.
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可以話係無能
03:22
And then the anxiety set in.
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跟著焦慮嚟勒
03:24
If you told me that I'd have to be
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如果你話俾我聽之後嗰幾個月
03:26
depressed for the next month,
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我都要處於抑鬱狀態
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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我會話︰只要佢十一月完，我就冇問題
但係如果你同我講
03:31
But if you said to me,
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03:32
"You have to have acute anxiety for the next month,"
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我呢幾個月都要極度焦慮
03:35
I would rather slit my wrist than go through it.
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我寧願割腕自殺，好過極度焦慮幾個月
03:38
It was the feeling all the time
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我嗰陣成日都會有一種感覺
03:40
like that feeling you have if you're walking
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好似你行路突然跣襯或者拤倒
03:42
and you slip or trip
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03:43
and the ground is rushing up at you,
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而地下快速衝埋你度咁嘅感覺
03:45
but instead of lasting half a
second, the way that does,
second, the way that does,
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但係嗰種恐懼感並唔係
剩係跌落地嘅半秒鐘
剩係跌落地嘅半秒鐘
03:48
it lasted for six months.
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而係持續咗半年
03:50
It's a sensation of being afraid all the time
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嗰種感覺令你一直覺得好驚
03:53
but not even knowing what it is that you're afraid of.
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但你又唔會知道你驚嘅係乜嘢
03:57
And it was at that point that I began to think
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就喺嗰個時候我開始諗
03:59
that it was just too painful to be alive,
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活著真係太痛苦
04:03
and that the only reason not to kill oneself
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而唯一唔自殺嘅理由
04:06
was so as not to hurt other people.
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就係因為唔想
因為我自殺會傷害到其他人
因為我自殺會傷害到其他人
04:09
And finally one day, I woke up
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然後有一日，當我瞓醒
突然間覺得我中風
04:12
and I thought perhaps I'd had a stroke,
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04:14
because I lay in bed completely frozen,
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因為我喺床上完全郁唔到
04:16
looking at the telephone, thinking,
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我望住個電話，諗
04:18
"Something is wrong and I should call for help,"
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「有啲唔對路， 我要打去搵人幫手」
04:22
and I couldn't reach out my arm
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但我連手都遞唔到
04:24
and pick up the phone and dial.
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噉點拎起電話打呢？
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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經過四個鐘頭我依煞瞓喺張床
郁都郁唔到
04:30
the phone rang,
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電話響，我用盡力咁攞起個電話
04:32
and somehow I managed to pick it up,
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04:34
and it was my father,
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嗰個係我老豆打嚟
04:36
and I said, "I'm in serious trouble.
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我話「 我遇到好大嘅麻煩，
04:39
We need to do something."
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我哋必須諗辦法解決佢。」
04:41
The next day I started with the medications
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第二日我就開始治療同食藥
04:44
and the therapy.
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04:47
And I also started reckoning
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而我同時諗到一個好弊嘅問題
04:49
with this terrible question:
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04:51
If I'm not the tough person
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如果我唔係一個堅強嘅人
04:53
who could have made it
through a concentration camp,
through a concentration camp,
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可以喺集中營裏面生存嘅人
04:56
then who am I?
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噉我係乜？
04:57
And if I have to take medication,
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如果我要靠藥物
04:59
is that medication making me more fully myself,
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噉藥物係咪令我做返真正嘅自己？
05:03
or is it making me someone else?
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定係將我變成第二個人？
如果藥物令我變成第二個人
05:05
And how do I feel about it
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05:07
if it's making me someone else?
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噉我應該有咩感受？
05:09
I had two advantages as I went in to the fight.
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我對抗抑鬱會有兩個好處
05:13
The first is that I knew that, objectively speaking,
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第一就係客觀嚟講，我會有好嘅生活
05:16
I had a nice life,
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05:17
and that if I could only get well,
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如果當我好返
05:19
there was something at the other end
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噉之後就會有更美好嘅嘢等住我
05:21
that was worth living for.
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05:23
And the other was that I had
access to good treatment.
access to good treatment.
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第二樣就係我會得到好好嘅治療
05:26
But I nonetheless emerged and relapsed,
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但我好轉又復發，好轉又復發
05:29
and emerged and relapsed,
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05:32
and emerged and relapsed,
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05:35
and finally understood
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最後我終於明白
05:37
I would have to be on medication
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我以後都要靠食藥同治潦生活
05:39
and in therapy forever.
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05:41
And I thought, "But is it a chemical problem
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我就諗 ，抑鬱症到底
係化學問題定精神問題呢？
係化學問題定精神問題呢？
05:44
or a psychological problem?
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05:45
And does it need a chemical cure
or a philosophical cure?"
or a philosophical cure?"
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需要化學治療定係心理治療？
05:49
And I couldn't figure out which it was.
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我搞唔清楚
05:51
And then I understood that actually,
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跟住我明白到
我哋無論呢兩個領域嘅知識
都未夠深入去解釋事物
都未夠深入去解釋事物
05:54
we aren't advanced enough in either area
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05:56
for it to explain things fully.
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05:58
The chemical cure and the psychological cure
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化學治療同心理治療都有佢哋嘅作用
06:01
both have a role to play,
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06:03
and I also figured out that depression was something
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我同時發覺抑鬱症係一種
06:06
that was braided so deep into us
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同我哋內心深深糾纏著嘅嘢嚟
06:09
that there was no separating it
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即係話我哋冇辦法將
佢由我哋人格同個性當中分離
佢由我哋人格同個性當中分離
06:10
from our character and personality.
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06:13
I want to say that the treatments we have
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我想講我哋對抑鬱症嘅治療方法
其實係唔係好好
其實係唔係好好
06:15
for depression are appalling.
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06:17
They're not very effective.
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嗰啲治療都唔係好有效
06:19
They're extremely costly.
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而且仲非常昂貴
06:21
They come with innumerable side effects.
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有好多數唔曬嘅副作用
06:24
They're a disaster.
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呢啲治療嘅禍害好大
06:25
But I am so grateful that I live now
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但慶幸嘅係我生活喺呢個年代
06:28
and not 50 years ago,
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而唔係五十年前
06:30
when there would have been almost nothing
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五十年前面對抑鬱症係束手無策
06:32
to be done.
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06:33
I hope that 50 years hence,
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我希望五十年之後
06:36
people will hear about my treatments
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當人聽到我呢一刻接受過嘅治療
06:37
and be appalled that anyone endured
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會覺訝異點解會有人接受咁原始嘅科學
06:40
such primitive science.
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06:42
Depression is the flaw in love.
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抑鬱症喺感情上係一個裂口
06:47
If you were married to someone and thought,
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如果你今日同某人結婚，然後諗
06:50
"Well, if my wife dies, I'll find another one,"
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「如果我老婆過生， 我會搵另一個」
06:54
it wouldn't be love as we know it.
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噉樣就唔係我哋所認知嘅愛情
06:57
There's no such thing as love
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如果冇預料過會失去，噉就唔叫做愛情
06:59
without the anticipation of loss,
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07:01
and that specter of despair
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預見過絕望係人變得親密嘅原動力
07:04
can be the engine of intimacy.
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07:08
There are three things people tend to confuse:
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人成日會撈亂三樣嘢︰
07:11
depression, grief and sadness.
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抑鬱、哀痛同悲傷
07:14
Grief is explicitly reactive.
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哀痛係好有反應
07:18
If you have a loss and you feel incredibly unhappy,
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如果你因為失去某樣嘢而非常唔開心
07:21
and then, six months later,
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半年之後你仲係覺得好難過
07:22
you are still deeply sad, but
you're functioning a little better,
you're functioning a little better,
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但比起半年前好咗啲
07:25
it's probably grief,
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嗰種應該哀痛
07:27
and it will probably ultimately resolve itself
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佢自己最後會慢慢消失
07:29
in some measure.
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07:31
If you experience a catastrophic loss,
171
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2751
如果你經歷過一場浩劫，感覺好慘
07:34
and you feel terrible,
172
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1214
07:35
and six months later you can barely function at all,
173
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2997
六個月後你只能夠僅僅噉捱落去
07:38
then it's probably a depression that was triggered
174
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2585
好可能就係浩劫發生嗰陣
同時引起你嘅抑鬱
07:40
by the catastrophic circumstances.
175
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2474
07:43
The trajectory tells us a great deal.
176
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3632
噉樣嘅軌跡畀我哋了解到
抑鬱症係一件好嚴重嘅事
07:47
People think of depression as being just sadness.
177
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3358
人哋覺得抑鬱症就同等於悲傷
07:50
It's much, much too much sadness,
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但係抑鬱症卻係帶著太多太多嘅悲傷
07:52
much too much grief
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1664
同埋太多太多嘅哀痛
07:54
at far too slight a cause.
180
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2929
而一切都係由小事引起
07:57
As I set out to understand depression,
181
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2747
當我開始去了解抑鬱症
08:00
and to interview people who had experienced it,
182
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2835
開始同一啲曾經患過嘅人傾嘅時候
08:02
I found that there were people who seemed
183
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3031
我發現嗰啲人表現上睇起嚟
有輕微嘅抑鬱
有輕微嘅抑鬱
08:05
on the surface to have what sounded like
184
473981
1705
08:07
relatively mild depression
185
475686
2062
08:09
who were nonetheless utterly disabled by it.
186
477748
3447
但實際上抑鬱症令佢哋失去咗生活能力
08:13
And there were other people who had what sounded
187
481195
1858
另一邊有批人聽起上嚟
有好嚴重嘅抑鬱
有好嚴重嘅抑鬱
08:15
as they described it
188
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1312
08:16
like terribly severe depression
189
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2251
08:18
who nonetheless had good lives in the interstices
190
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2815
但佢哋卻係兩次病發之間生活得好好
08:21
between their depressive episodes.
191
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2155
08:23
And I set out to find out what it is
192
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2685
跟著我開始搵出
係乜原因畀令某啲人比另一啲更堅強
08:26
that causes some people
193
494271
1603
08:27
to be more resilient than other people.
194
495874
2253
08:30
What are the mechanisms
195
498127
1559
係乜嘢機制
08:31
that allow people to survive?
196
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1844
令人就算有抑鬱都可以生存落嚟？
08:33
And I went out and I interviewed person after person
197
501530
3169
跟著我一個又一個咁同曾經抑鬱嘅人傾
08:36
who was suffering with depression.
198
504699
2175
08:38
One of the first people I interviewed
199
506874
1951
其中一個人形容抑鬱症
08:40
described depression
200
508825
1881
係一個慢慢死亡嘅過程
08:42
as a slower way of being dead,
201
510706
3261
08:45
and that was a good thing for me to hear early on
202
513967
2124
一開頭聽到呢種講法係好事嚟
08:48
because it reminded me
203
516091
1366
因為佢提醒咗我
08:49
that that slow way of being dead
204
517457
1999
慢慢步入死亡真係可以死亡
08:51
can lead to actual deadness,
205
519456
2035
08:53
that this is a serious business.
206
521491
2004
呢樣嘢係好嚴肅
08:55
It's the leading disability worldwide,
207
523495
2659
抑鬱症係全世界第一大
引致失去活動能力嘅疾病
引致失去活動能力嘅疾病
08:58
and people die of it every day.
208
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3030
每日都有人因為抑鬱症而離開世界
09:01
One of the people I talked to
209
529184
1769
其中一個喺我了解抑鬱症嘅時候傾嘅人
09:02
when I was trying to understand this
210
530953
1974
09:04
was a beloved friend
211
532927
1668
係我一個認識多年嘅好友
09:06
who I had known for many years,
212
534595
2018
09:08
and who had had a psychotic episode
213
536613
2542
佢喺大學第一年有精神問題
09:11
in her freshman year of college,
214
539155
1904
09:13
and then plummeted into a horrific depression.
215
541059
3056
之後惡化成幾多人驚嘅抑鬱症
09:16
She had bipolar illness,
216
544115
1426
佢精神好兩極化
09:17
or manic depression, as it was then known.
217
545541
2643
即係之後嘅躁狂抑鬱症
09:20
And then she did very well
218
548184
2044
經過多年鋰鹽治療
09:22
for many years on lithium,
219
550228
1708
佢復完得相當唔錯
09:23
and then eventually,
220
551936
1375
到最後醫生停咗開鋰鹽俾佢
09:25
she was taken off her lithium
221
553311
1960
09:27
to see how she would do without it,
222
555271
1835
睇下佢可唔可以唔使藥物都得
09:29
and she had another psychosis,
223
557106
1975
跟著佢又再度精神失常
09:31
and then plunged into the worst depression
224
559081
2338
仲惡化成我見過最嚴重嘅抑鬱症
09:33
that I had ever seen
225
561419
1872
09:35
in which she sat in her parents' apartment,
226
563291
3015
佢坐喺佢父母間屋裏面
09:38
more or less catatonic, essentially without moving,
227
566306
3077
手腳好硬，坐喺度唔郁
09:41
day after day after day.
228
569383
2482
日日都係咁
09:43
And when I interviewed her about
that experience some years later --
that experience some years later --
229
571865
3217
幾年之後我問佢呢段經歷時
09:47
she's a poet and psychotherapist
named Maggie Robbins —
named Maggie Robbins —
230
575082
3331
佢已經係詩人同心理治療師
Maggie Robins
Maggie Robins
09:50
when I interviewed her, she said,
231
578413
3233
佢話︰「我一直重複唱著
09:53
"I was singing 'Where Have All The Flowers Gone'
232
581646
3384
Where Have All The Flowers Gone，
09:57
over and over to occupy my mind.
233
585030
3210
令我個腦剩係得呢首歌。
10:00
I was singing to blot out the
things my mind was saying,
things my mind was saying,
234
588240
3135
我唱著呢首歌去掩蓋心入邊把聲，
10:03
which were, 'You are nothing. You are nobody.
235
591375
4490
嗰把聲就係
『你係冇用嘅，
你對世界嚟講可有可無。
你對世界嚟講可有可無。
10:07
You don't even deserve to live.'
236
595865
2826
你根本唔配活喺呢個世界上。』
10:10
And that was when I really started thinking
237
598691
2178
呢個時候我開始諗住自殺。」
10:12
about killing myself."
238
600869
2213
10:15
You don't think in depression
239
603082
1908
你有抑鬱嘅時候唔會諗
10:16
that you've put on a gray veil
240
604990
2137
你戴咗一塊灰色面紗
10:19
and are seeing the world through the haze
241
607127
1980
唔會覺得自己係透過負面情緒去睇嘢
10:21
of a bad mood.
242
609107
1894
10:23
You think that the veil has been taken away,
243
611001
2720
你只會認為一塊
代表快樂嘅面紗被人攞走咗
代表快樂嘅面紗被人攞走咗
10:25
the veil of happiness,
244
613721
1922
10:27
and that now you're seeing truly.
245
615643
2424
你覺得宜家先係睇到真實嘅世界
10:30
It's easier to help schizophrenics who perceive
246
618067
2964
同樣係人格分裂嘅病人
10:33
that there's something foreign inside of them
247
621031
1811
內心覺得有嘢需要驅趕嘅一類病人
10:34
that needs to be exorcised,
248
622842
2187
比較容易治療
10:37
but it's difficult with depressives,
249
625029
2164
但抑鬱類型嘅病人就難啲
10:39
because we believe we are seeing the truth.
250
627193
3847
因為病人相信佢哋睇到真實世界
但真實世界卻係講緊大話
10:43
But the truth lies.
251
631040
2947
10:45
I became obsessed with that sentence:
252
633987
1998
我成日聽到呢句說話
10:47
"But the truth lies."
253
635985
2375
「但真實世界卻係講緊大話」
10:50
And I discovered, as I talked to depressive people,
254
638360
2453
當我同抑鬱嘅人傾計嘅時候
10:52
that they have many delusional perceptions.
255
640813
2682
我發現佢哋有好多幻覺
10:55
People will say, "No one loves me."
256
643495
1667
佢哋會話「冇人愛我」
10:57
And you say, "I love you,
257
645162
1651
然後你同佢講
「我愛你，你老婆愛你，
你媽咪愛你。」
你媽咪愛你。」
10:58
your wife loves you, your mother loves you."
258
646813
2522
11:01
You can answer that one pretty readily,
259
649335
1923
你可以好快咁應返佢哋大部分人
11:03
at least for most people.
260
651258
1665
11:04
But people who are depressed will also say,
261
652923
2267
但係抑鬱症嘅人會話
11:07
"No matter what we do,
262
655190
1705
「無論我哋點樣努力，
我哋最後都會死。」
我哋最後都會死。」
11:08
we're all just going to die in the end."
263
656895
2273
11:11
Or they'll say, "There can be no true communion
264
659168
2203
或者佢哋會話
「兩個人之間唔會有真正嘅溝通。
11:13
between two human beings.
265
661371
1653
11:15
Each of us is trapped in his own body."
266
663024
2576
每個人只會畀自己嘅身體困住。」
11:17
To which you have to say,
267
665600
1849
你只可以回答
「冇錯，但我覺得我哋宜家應該諗，
11:19
"That's true,
268
667449
1321
11:20
but I think we should focus right now
269
668770
1818
11:22
on what to have for breakfast."
270
670588
1896
我哋早餐食啲乜。」
11:24
(Laughter)
271
672484
2185
（笑聲）
好多時佢哋表逹嘅並唔係一種病，
11:26
A lot of the time,
272
674669
1669
11:28
what they are expressing is not illness, but insight,
273
676338
2896
而係佢哋睇嘢嘅角度
11:31
and one comes to think what's really extraordinary
274
679234
2657
而佢哋會覺得好特別嘅嘢會係
11:33
is that most of us know about
those existential questions
those existential questions
275
681891
2934
我哋大部分人都一早知道嘅問題
11:36
and they don't distract us very much.
276
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2290
呢啲問題唔會好令我哋分心
11:39
There was a study I particularly liked
277
687115
2159
我幾鐘意一個調查
11:41
in which a group of depressed
278
689274
1680
一班抑鬱症病人同一班冇抑鬱嘅人
11:42
and a group of non-depressed people
279
690954
1901
11:44
were asked to play a video game for an hour,
280
692855
2623
需要分別玩電子遊戲一粒鐘
11:47
and at the end of the hour,
281
695478
1813
當佢哋玩完
11:49
they were asked how many little monsters
282
697291
1651
佢哋要回答佢哋覺得喺遊戲裏面
11:50
they thought they had killed.
283
698942
1864
殺咗幾多隻怪獸
11:52
The depressive group was usually accurate
284
700806
2212
抑鬱症嗰班人通常講到
10% 之內誤差嘅數字
10% 之內誤差嘅數字
11:55
to within about 10 percent,
285
703018
2058
11:57
and the non-depressed people
286
705076
1471
至於冇抑鬱症嘅人
11:58
guessed between 15 and 20 times as many
287
706547
3545
佢哋估嘅數字
係佢哋真正殺咗數目嘅 15-20 倍
12:02
little monsters — (Laughter) —
288
710092
1742
12:03
as they had actually killed.
289
711834
4111
（笑聲）
12:07
A lot of people said, when I chose
to write about my depression,
to write about my depression,
290
715945
3066
好多人會話，當我決定寫我嘅抑鬱症
12:11
that it must be very difficult
291
719011
1769
係一個非常困難嘅決定
12:12
to be out of that closet, to have people know.
292
720780
3124
12:15
They said, "Do people talk to you differently?"
293
723904
2200
佢哋問︰
「人哋同你傾計嘅時候會唔會唔同？」
12:18
And I said, "Yes, people talk to me differently.
294
726104
2072
我話︰「係，
人哋同我傾計會有唔同。」
人哋同我傾計會有唔同。」
12:20
They talk to me differently insofar
295
728176
1914
佢哋會同我講佢哋抑鬱症嘅經驗
12:22
as they start telling me about their experience,
296
730090
2790
12:24
or their sister's experience,
297
732880
1835
可能係佢哋家姐、細妹
12:26
or their friend's experience.
298
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1774
可能係佢哋嘅朋友
12:28
Things are different because now I know
299
736489
2292
宜家唔同啦因為我知道
12:30
that depression is the family secret
300
738781
2681
抑鬱症每個家庭都曾經有過
12:33
that everyone has.
301
741462
2077
12:35
I went a few years ago to a conference,
302
743539
3628
前幾年我去咗個研討會
喺嗰個為期三日嘅研討會入面
12:39
and on Friday of the three-day conference,
303
747167
2653
其中一日，係星期五嚟
12:41
one of the participants took me aside, and she said,
304
749820
2891
其中一個參加者將我拉到一旁
然後佢同我講︰
然後佢同我講︰
12:44
"I suffer from depression and
305
752711
3405
「我有抑鬱症，呢個病令我覺得尷尬，
12:48
I'm a little embarrassed about it,
306
756116
2769
12:50
but I've been taking this medication,
307
758885
2103
但係我一路有食藥。
12:52
and I just wanted to ask you what you think?"
308
760988
2948
我剩係想問下你你點樣睇？」
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
所以我就盡我所能答佢
12:58
And then she said, "You know,
310
766770
1720
佢跟住話︰ 「你知嗎？
13:00
my husband would never understand this.
311
768490
2791
我老公永遠唔會明白架。
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
呢樣嘢對佢完全冇意義。
13:05
so I just, you know, it's just between us."
313
773854
2867
所以， 呢個係我哋嘅秘密。」
13:08
And I said, "Yes, that's fine."
314
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1786
我答 ︰「冇問題。」
13:10
On Sunday of the same conference,
315
778507
2109
跟著喺研討會嘅最後一日
13:12
her husband took me aside,
316
780616
3044
佢丈夫又拉埋我一邊
（笑聲）
13:15
and he said, "My wife wouldn't think
317
783660
1694
佢話 ︰「我老婆
如果知道我有抑鬱症嘅話，
如果知道我有抑鬱症嘅話，
13:17
that I was really much of a guy if she knew this,
318
785354
2435
絕對唔會覺得我係一個男人。
13:19
but I've been dealing with this depression
319
787789
2466
我有療程，有食藥。
我想知道你點諗？」
我想知道你點諗？」
13:22
and I'm taking some medication,
320
790255
1354
13:23
and I wondered what you think?"
321
791609
2505
13:26
They were hiding
322
794114
1423
佢哋兩夫妻將佢哋同一款藥
13:27
the same medication in two different places
323
795537
2215
收埋喺同一間睡房嘅唔同地方
13:29
in the same bedroom.
324
797752
2645
（笑聲）
13:32
And I said that I thought
325
800397
2021
我諗佢哋溝通唔係好好
13:34
communication within the marriage
326
802418
1684
13:36
might be triggering some of their problems.
327
804102
2014
導致一啲問題出現
13:38
(Laughter)
328
806116
4191
（笑聲）
13:42
But I was also struck
329
810307
1655
同時我都因為佢哋互相提防而覺得辛苦
13:43
by the burdensome nature
330
811962
1806
13:45
of such mutual secrecy.
331
813768
2373
13:48
Depression is so exhausting.
332
816141
1885
抑鬱症令人好攰
13:50
It takes up so much of your time and energy,
333
818026
2768
佢用咗你好多時間同精力
13:52
and silence about it,
334
820794
1504
唔理抑鬱症只會令抑鬱症惡化
13:54
it really does make the depression worse.
335
822298
2731
13:57
And then I began thinking about all the ways
336
825029
1733
然後我開始諗抑鬱症患者康復嘅方法
13:58
people make themselves better.
337
826762
1966
14:00
I'd started off as a medical conservative.
338
828728
2439
我會由傳統治療開始
14:03
I thought there were a few
kinds of therapy that worked,
kinds of therapy that worked,
339
831167
2372
我知道只有少數治療
至可以對患者有幫助
至可以對患者有幫助
14:05
it was clear what they were --
340
833539
1809
好明顯係某幾種方法
14:07
there was medication,
341
835348
1644
有藥物治療
14:08
there were certain psychotherapies,
342
836992
1476
有一啲心理治療
14:10
there was possibly electroconvulsive treatment,
343
838468
2445
仲可能有電痙攣療法
14:12
and that everything else was nonsense.
344
840913
2675
但其他方法都係冇用
14:15
But then I discovered something.
345
843588
1832
我發現咗一樣嘢
14:17
If you have brain cancer,
346
845420
1752
如果你有腦癌
14:19
and you say that standing on your head
347
847172
1472
而每朝倒立廿分鐘會令你感覺好啲
14:20
for 20 minutes every morning makes you feel better,
348
848644
2995
14:23
it may make you feel better,
349
851639
1514
可能真係會畀你感覺好啲啦
14:25
but you still have brain cancer,
350
853153
1588
但係你嘅腦癌從來都冇消失過
14:26
and you'll still probably die from it.
351
854741
2289
你最終都有可能死於腦癌
14:29
But if you say that you have depression,
352
857030
2512
但如果你有抑鬱症
14:31
and standing on your head for 20 minutes every day
353
859542
2105
每日倒立廿分鐘
14:33
makes you feel better, then it's worked,
354
861647
2484
會畀你感覺好一啲， 噉就真係有效啦
14:36
because depression is an illness of how you feel,
355
864131
2360
因為抑鬱症係你認知上出現咗問題
14:38
and if you feel better,
356
866491
1609
你感覺好啲就代表咗你唔再係抑鬱
14:40
then you are effectively not depressed anymore.
357
868100
2830
14:42
So I became much more tolerant
358
870930
2033
所以我開始接受其他唔同嘅治療
14:44
of the vast world of alternative treatments.
359
872963
2925
14:47
And I get letters, I get hundreds of letters
360
875888
2384
然後我收到好多患者寄嚟嘅信
14:50
from people writing to tell me
about what's worked for them.
about what's worked for them.
361
878272
2516
講有咩方法對佢哋奏效
14:52
Someone was asking me backstage today
362
880788
2201
就好似今日噉就有人喺後台
問我藥物方面嘅嘢
問我藥物方面嘅嘢
14:54
about meditation.
363
882989
1463
14:56
My favorite of the letters that I got
364
884452
2465
一個女士曾經寫過一封我係最鐘意嘅
14:58
was the one that came from a woman
365
886917
1474
15:00
who wrote and said that she had tried therapy,
366
888391
2207
佢話佢曾經嘗試過治療、藥物
15:02
she had tried medication,
she had tried pretty much everything,
she had tried pretty much everything,
367
890598
2387
所有嘅嘢都試過曬
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
最後佢搵到一種方法，想我同大家分享
15:07
and that was making little things from yarn.
369
895822
3812
就係用毛冷整唔同嘅小飾物
15:11
(Laughter)
370
899634
2999
（笑聲）
15:14
She sent me some of them. (Laughter)
371
902633
3524
佢仲送咗啲佢整嘅作品
（笑聲）
15:18
And I'm not wearing them right now.
372
906157
3688
不過我宜家冇帶著佢哋
15:21
I suggested to her that she also should look up
373
909845
2515
我叫佢睇一睇
心理醫學診斷同統計手冊裡面
15:24
obsessive compulsive disorder in the DSM.
374
912360
4048
有關強迫症嘅部分
15:28
And yet, when I went to look
at alternative treatments,
at alternative treatments,
375
916408
3128
當我搵其他治療嘅時候
15:31
I also gained perspective on other treatments.
376
919536
2908
我對佢哋了解深咗
15:34
I went through a tribal exorcism in Senegal
377
922444
2903
我曾經去過塞內加爾
一個部落嘅驅邪儀式
一個部落嘅驅邪儀式
15:37
that involved a great deal of ram's blood
378
925347
2013
儀式入面有好多公羊嘅血
15:39
and that I'm not going to detail right now,
379
927360
2062
我唔喺度描述啦
15:41
but a few years afterwards I was in Rwanda
380
929422
2000
但幾年後我喺盧旺達參與另一項計畫
15:43
working on a different project,
381
931422
1758
15:45
and I happened to describe
my experience to someone,
my experience to someone,
382
933180
2796
我要同人講我喺塞內加爾嘅經歷
15:47
and he said, "Well, you know,
383
935976
1760
佢話︰「嗰度係西非，你知嗎？
15:49
that's West Africa, and we're in East Africa,
384
937736
1820
我哋係喺東非，
15:51
and our rituals are in some ways very different,
385
939556
1834
我哋嘅儀式同佢哋嘅
喺幾方面都有好大分別，
喺幾方面都有好大分別，
15:53
but we do have some rituals that have something
386
941390
2013
但同時都有一啲相同嘅地方。
15:55
in common with what you're describing."
387
943403
1987
15:57
And I said, "Oh." And he said, "Yes," he said,
388
945390
1663
我話係呀
佢話佢哋同西方心理健康人員
有唔少麻煩
有唔少麻煩
15:59
"but we've had a lot of trouble with
Western mental health workers,
Western mental health workers,
389
947053
2642
16:01
especially the ones who came
right after the genocide."
right after the genocide."
390
949695
2757
尤其係嗰啲喺種族屠殺之後嚟嘅人
16:04
And I said, "What kind of trouble did you have?"
391
952452
2327
我問︰「佢哋帶俾你咩麻煩？」
16:06
And he said, "Well,
392
954779
1546
佢話︰「佢哋做啲嘢真係好好，
16:08
they would do this bizarre thing.
393
956325
2664
16:10
They didn't take people out in the sunshine
394
958989
1885
佢哋不但止冇帶病人曬太陽，
16:12
where you begin to feel better.
395
960874
1700
令病人感覺好啲，
16:14
They didn't include drumming or music
to get people's blood going.
to get people's blood going.
396
962574
3094
佢哋仲冇打鼓或者播音樂，
令病人嘅血活起上嚟。
16:17
They didn't involve the whole community.
397
965668
1842
佢哋冇帶動成個社群，
16:19
They didn't externalize the depression
398
967510
1775
佢哋冇將抑鬱症
16:21
as an invasive spirit.
399
969285
1433
講成係一種入侵性嘅惡靈。
16:22
Instead what they did was they took people
400
970718
2631
佢哋反而將病人逐個帶入黑房，
16:25
one at a time into dingy little rooms
401
973349
2628
16:27
and had them talk for an hour
402
975977
1343
由佢哋自己講返
16:29
about bad things that had happened to them."
403
977320
2230
佢哋經歷過痛苦嘅嘢。」
16:31
(Laughter) (Applause)
404
979550
5460
（笑聲）
（掌聲）
（掌聲）
16:37
He said, "We had to ask them to leave the country."
405
985010
2362
佢話 ︰「 我哋只好請佢哋離開國家。」
16:39
(Laughter)
406
987372
3057
（笑聲）
16:42
Now at the other end of alternative treatments,
407
990429
2444
宜家講下其他另類療法
16:44
let me tell you about Frank Russakoff.
408
992873
2035
介紹一下 Frank Russakoff
16:46
Frank Russakoff had the worst depression
409
994908
3053
Frank Russakoff 有好嚴重嘅抑鬱症
16:49
perhaps that I've ever seen in a man.
410
997961
2915
應該話我係從來未喺
任何一個男人身上見過嘅
任何一個男人身上見過嘅
佢成日抑鬱
16:52
He was constantly depressed.
411
1000876
1993
16:54
He was, when I met him, at a point at which
412
1002869
2141
當我見佢嘅時候
16:57
every month he would have electroshock treatment.
413
1005010
3158
佢每個月都要接受電擊治療
17:00
Then he would feel sort of disoriented for a week.
414
1008168
2575
治療完之後嘅一個禮拜佢會覺得迷茫
17:02
Then he would feel okay for a week.
415
1010743
1803
之後第二個禮拜又會好返
17:04
Then he would have a week of going downhill.
416
1012546
1700
跟著又會抑鬱
17:06
And then he would have another
electroshock treatment.
electroshock treatment.
417
1014246
2685
噉樣嘅話佢又要去接受電擊治療
17:08
And he said to me when I met him,
418
1016931
1415
當我見到佢，佢同我講
17:10
"It's unbearable to go through my weeks this way.
419
1018346
2552
「我已經忍受唔到噉樣過日子，
17:12
I can't go on this way,
420
1020898
1507
我唔可以再繼續噉樣落去。
17:14
and I've figured out how I'm going to end it
421
1022405
2264
假如情況冇好轉，我知道點樣解決佢。」
17:16
if I don't get better.
422
1024669
1557
17:18
But," he said to me, "I heard about a protocol
423
1026226
2708
佢又同我講︰「但係，
我聽過麻省總醫院有個療法叫做
17:20
at Mass General for a procedure called
424
1028934
2223
扣帶回切開術， 係一種腦科手術，
17:23
a cingulotomy, which is a brain surgery,
425
1031157
2026
17:25
and I think I'm going to give that a try."
426
1033183
2571
我諗我可以試試。」
17:27
And I remember being amazed at that point
427
1035754
1954
我記得當時我好開心
17:29
to think that someone
428
1037708
1300
因為一個人已經經歷過咁多
17:31
who clearly had so many bad experiences
429
1039008
3221
慘痛經歷、咁多唔同嘅治療
17:34
with so many different treatments
430
1042229
1859
17:36
still had buried in him somewhere enough optimism
431
1044088
3122
但佢內心仲抱著一絲嘅樂觀
17:39
to reach out for one more.
432
1047210
2550
佢願意再試多次
17:41
And he had the cingulotomy,
433
1049760
2180
佢做咗個好成功嘅手術
17:43
and it was incredibly successful.
434
1051940
2041
17:45
He's now a friend of mine.
435
1053981
1493
宜家仲係我朋友
17:47
He has a lovely wife and two beautiful children.
436
1055474
3492
佢有一個好老婆同兩個可愛嘅細路
17:50
He wrote me a letter the Christmas after the surgery,
437
1058966
2949
佢手術之後嘅聖誕節寫咗封信俾我
17:53
and he said,
438
1061915
1189
佢話︰
17:55
"My father sent me two presents this year,
439
1063104
2407
「我老豆今年寄咗我兩份禮物，
17:57
First, a motorized C.D. rack from The Sharper Image
440
1065511
2602
第一份係 The Sharper Image 牌嘅
可捲動式 CD 架，
可捲動式 CD 架，
18:00
that I didn't really need,
441
1068113
1421
但我唔需要佢。
18:01
but I knew he was giving it to me to celebrate
442
1069534
2097
不過我知道佢送嚟係想
18:03
the fact that I'm living on my own
443
1071631
1728
慶祝我可以獨立生活、
18:05
and have a job I seem to love.
444
1073359
2047
有自己鐘意嘅工。
18:07
And the other present
445
1075406
1561
另一份禮物係我婆婆嘅相，
18:08
was a photo of my grandmother,
446
1076967
1576
18:10
who committed suicide.
447
1078543
2252
我婆婆死於自殺。
18:12
As I unwrapped it, I began to cry,
448
1080795
2935
當我拆禮物，我就喊咗出嚟，
18:15
and my mother came over and said,
449
1083730
1880
然後我媽咪過嚟同我講︰
18:17
'Are you crying because of the
relatives you never knew?'
relatives you never knew?'
450
1085610
3315
『你係咪未見過婆婆而喊？』
18:20
And I said, 'She had the same disease I have.'
451
1088925
4088
我答︰『婆婆同我都有同樣嘅病。』
18:25
I'm crying now as I write to you.
452
1093013
2581
我喊係因為我寫俾你。
18:27
It's not that I'm so sad, but I get overwhelmed,
453
1095594
3595
我唔係傷心， 而係我個腦太多嘢啦。
18:31
I think, because I could have killed myself,
454
1099189
2221
我覺得自己會自殺，
18:33
but my parents kept me going,
455
1101410
1703
但父母同醫生支持我。
18:35
and so did the doctors,
456
1103113
1749
18:36
and I had the surgery.
457
1104862
1854
我做咗手術，我仲生存，我好感激。
18:38
I'm alive and grateful.
458
1106716
2815
18:41
We live in the right time,
459
1109531
2260
雖然有時感覺唔係活喺一個啱嘅年代，
18:43
even if it doesn't always feel like it."
460
1111791
3879
我哋確實活喺一個啱嘅年代。」
18:47
I was struck by the fact that depression
461
1115670
1897
我驚訝抑鬱症竟然
18:49
is broadly perceived to be
462
1117567
1725
被認為係一種現代、西方、中產嘅嘢
18:51
a modern, Western, middle-class thing,
463
1119292
3537
18:54
and I went to look at how it operated
464
1122829
2152
於是我就睇下抑鬱症
18:56
in a variety of other contexts,
465
1124981
2003
喺其他唔同地方係點發生
18:58
and one of the things I was most interested in
466
1126984
2119
我最感到興趣嘅係低下階層嘅抑鬱情況
19:01
was depression among the indigent.
467
1129103
1790
19:02
And so I went out to try to look at
468
1130893
1781
所以我搵出針對窮人嘅抑鬱有乜係做咗
19:04
what was being done for
poor people with depression.
poor people with depression.
469
1132674
2580
19:07
And what I discovered is that poor people
470
1135254
2158
我發現大多數有抑鬱症嘅窮人
都冇接受過治療
都冇接受過治療
19:09
are mostly not being treated for depression.
471
1137412
2557
19:11
Depression is the result of a genetic vulnerability,
472
1139969
2919
抑鬱症係基因易受損嘅結果
19:14
which is presumably evenly
distributed in the population,
distributed in the population,
473
1142888
3158
呢種基因按理會喺
成個人口裡面平均分布
成個人口裡面平均分布
19:18
and triggering circumstances,
474
1146046
1953
而發病情況，尤其窮人會相對嚴重
19:19
which are likely to be more severe
475
1147999
1903
19:21
for people who are impoverished.
476
1149902
1875
19:23
And yet it turns out that if you have
477
1151777
2427
但實情係如果你有一個美好嘅生活
19:26
a really lovely life but feel miserable all the time,
478
1154204
2140
但一直覺得自己好淒慘
19:28
you think, "Why do I feel like this?
479
1156344
2000
同埋問︰「點解我會有咁嘅感覺？
我應該有抑鬱啦。」
19:30
I must have depression."
480
1158344
1669
然後你去搵治療
19:32
And you set out to find treatment for it.
481
1160013
1923
19:33
But if you have a perfectly awful life,
482
1161936
2093
但係如果你有一個好慘嘅人生
19:36
and you feel miserable all the time,
483
1164029
1867
而你一直都覺得好慘
19:37
the way you feel is commensurate with your life,
484
1165896
2826
你慘嘅感覺同你慘嘅生活呼應
19:40
and it doesn't occur to you to think,
485
1168722
1724
你唔會諗呢個病可以醫得好
19:42
"Maybe this is treatable."
486
1170446
1783
19:44
And so we have an epidemic in this country
487
1172229
3136
換句話講，我哋抑鬱國家
入面嘅貧窮人口
入面嘅貧窮人口
19:47
of depression among impoverished people
488
1175365
2913
爆發咗一種流行病叫做抑鬱症
19:50
that's not being picked up
and that's not being treated
and that's not being treated
489
1178278
2512
但冇人提過佢、冇人會醫過佢
19:52
and that's not being addressed,
490
1180790
2056
冇人重視過佢
19:54
and it's a tragedy of a grand order.
491
1182846
2200
可以話係社會悲劇
19:57
And so I found an academic
492
1185046
1488
所以我搵咗一個學者
19:58
who was doing a research project
493
1186534
1817
佢進行梗一個
關於華盛頓外圍貧民區嘅研究
關於華盛頓外圍貧民區嘅研究
20:00
in slums outside of D.C.,
494
1188351
1741
20:02
where she picked up women who had
come in for other health problems
come in for other health problems
495
1190092
2997
佢揀咗求診嘅女性做對象
20:05
and diagnosed them with depression,
496
1193089
1779
呢啲女性係因為其他病至求診
但後來都發現到有抑鬱
20:06
and then provided six months
of the experimental protocol.
of the experimental protocol.
497
1194868
3266
於是班人得到六星期嘅試驗性治療
20:10
One of them, Lolly, came in,
498
1198134
2329
Lolly 係其中一個參加嘅人
20:12
and this is what she said the day she came in.
499
1200463
2297
佢第一日入嚟就話佢係七個細路嘅母親
20:14
She said, and she was a woman, by the way,
500
1202760
3395
20:18
who had seven children. She said,
501
1206155
2092
佢以前有做嘢，但佢宜家要放棄份工
20:20
"I used to have a job but I had to give it up because
502
1208247
2651
「因為我出唔到間屋。
20:22
I couldn't go out of the house.
503
1210898
2060
20:24
I have nothing to say to my children.
504
1212958
2228
我同細路冇嘢講。
20:27
In the morning, I can't wait for them to leave,
505
1215186
2767
朝早， 我唔可以等住佢哋走，
20:29
and then I climb in bed and
pull the covers over my head,
pull the covers over my head,
506
1217953
2990
我只好返上床用被遮住個頭。
20:32
and three o'clock when they come home,
507
1220943
1646
三點鐘當小朋友返到屋企，
20:34
it just comes so fast."
508
1222589
1801
我覺得時間過得好快。
20:36
She said, "I've been taking a lot of Tylenol,
509
1224390
2240
佢仲話︰ 「我一直有食開 Tylenol，
20:38
anything I can take so that I can sleep more.
510
1226630
2759
任何可以畀我瞓耐啲嘅藥物。
20:41
My husband has been telling me I'm stupid, I'm ugly.
511
1229389
3770
我丈夫一直話我又蠢又醜，
20:45
I wish I could stop the pain."
512
1233159
3505
我希望痛楚可以停止。」
20:48
Well, she was brought into
this experimental protocol,
this experimental protocol,
513
1236664
2640
佢就係噉帶咗入嚟呢個試驗性嘅治療
20:51
and when I interviewed her six months later,
514
1239304
2308
六個月後我再同佢傾
20:53
she had taken a job working in childcare
515
1241612
4407
佢已經喺一間美國海軍嘅托兒所度做
20:58
for the U.S. Navy, she had left the abusive husband,
516
1246019
3805
佢離開有暴力傾向嘅丈夫
21:01
and she said to me,
517
1249824
2082
佢話畀我知
佢啲細路比以前仲開心咗添
21:03
"My kids are so much happier now."
518
1251906
2369
21:06
She said, "There's one room in my new place
519
1254275
1977
佢間新屋入面整咗一間房專門俾男仔
21:08
for the boys and one room for the girls,
520
1256252
2608
仲有一間房專門俾女仔
21:10
but at night, they're just all up on my bed,
521
1258860
2539
「但係夜晚細路都去晒我張床，
21:13
and we're doing homework
all together and everything.
all together and everything.
522
1261399
2612
我哋一齊做功課同埋其他嘢。
21:16
One of them wants to be a preacher,
523
1264011
1673
其中一個小朋友話想做牧師，
21:17
one of them wants to be a firefighter,
524
1265684
1700
另一個想做消防員。
21:19
and one of the girls says she's going to be a lawyer.
525
1267384
2966
有個女話想做律師。
21:22
They don't cry like they used to,
526
1270350
2005
佢哋唔似以前噉喊，同埋冇再打交。
21:24
and they don't fight like they did.
527
1272355
2558
21:26
That's all I need now is my kids.
528
1274913
3780
我宜家需要嘅就只係我小朋友。
21:30
Things keep on changing,
529
1278693
1912
事情一直喺度改變梗，
21:32
the way I dress, the way I feel, the way I act.
530
1280605
5193
我著衫、我對事物嘅感覺，
仲有我平時嘅態度都有唔同。
21:37
I can go outside not being afraid anymore,
531
1285798
3687
我可以行出門口而唔覺得驚。
21:41
and I don't think those bad feelings are coming back,
532
1289485
3409
我唔覺得以前唔好嘅感覺會返返嚟。
21:44
and if it weren't for Dr. Miranda and that,
533
1292894
3035
如果唔係 Miranda 醫生，
21:47
I would still be at home with
the covers pulled over my head,
the covers pulled over my head,
534
1295929
3617
我可能仲要匿喺屋企用被襟著個頭。
21:51
if I were still alive at all.
535
1299546
2349
如果我仲活著嘅話，
21:53
I asked the Lord to send me an angel,
536
1301895
3732
我會問上帝派一隻天使嚟，
21:57
and he heard my prayers."
537
1305627
4330
令佢可以聽到我嘅禱告。」
22:01
I was really moved by these experiences,
538
1309959
3353
佢嘅經驗令我非常感動
22:05
and I decided that I wanted to write about them
539
1313312
2539
我決定將佢嘅經歷寫落嚟
22:07
not only in a book I was working on,
540
1315851
1379
唔只寫入我喺寫梗嘅一本書
22:09
but also in an article,
541
1317230
1311
仲會寫喺專欄裡面
22:10
and so I got a commission from
The New York Times Magazine
The New York Times Magazine
542
1318541
2321
同埋紐約時代雜誌邀請我
寫關於窮人嘅抑鬱症
寫關於窮人嘅抑鬱症
22:12
to write about depression among the indigent.
543
1320862
2016
22:14
And I turned in my story,
544
1322878
1616
我就寫咗我遇過真實嘅故事
22:16
and my editor called me and said,
545
1324494
1596
但編輯打嚟話︰
22:18
"We really can't publish this."
546
1326090
1710
「我哋登唔到噉樣嘅文章。」
22:19
And I said, "Why not?"
547
1327800
1750
我話點解唔得？
22:21
And she said, "It just is too far-fetched.
548
1329550
2305
佢話個故事太牽強啦
22:23
These people who are sort of at
the very bottom rung of society
the very bottom rung of society
549
1331855
3778
「呢啲人係社會嘅最底層，
22:27
and then they get a few months of treatment
550
1335633
1704
佢哋接受咗幾個月治療之後，
22:29
and they're virtually ready to run Morgan Stanley?
551
1337337
2632
就可以去摩根史坦利返工？
22:31
It's just too implausible."
552
1339969
1854
簡直難以置信。」
22:33
She said, I've never even heard of anything like it."
553
1341823
2205
佢話︰「我從來未聽過噉樣嘅嘢。」
22:36
And I said, "The fact that you've never heard of it
554
1344028
2534
我話你冇聽過就代表咗
22:38
is an indication that it is news."
555
1346562
3000
呢單係一單「新」聞
（笑聲）
（掌聲）
（掌聲）
22:41
(Laughter) (Applause)
556
1349562
6134
22:49
"And you are a news magazine."
557
1357317
2494
我仲話呢個係一間新聞雜誌社嚟架
22:51
So after a certain amount of negotiation,
558
1359811
1982
噉傾咗一輪之後
佢哋同意刊登我嘅文章
22:53
they agreed to it.
559
1361793
1241
22:55
But I think a lot of what they said
560
1363034
1615
但我諗好多佢哋講嘅嘢都係好怪
22:56
was connected in some strange way
561
1364649
2295
22:58
to this distaste that people still have
562
1366944
2142
同埋有偏見
佢哋覺得如果我哋去醫班窮人
23:01
for the idea of treatment,
563
1369086
1463
23:02
the notion that somehow if we went out
564
1370549
1882
23:04
and treated a lot of people in indigent communities,
565
1372431
2696
就係剝削梗佢哋
23:07
that would be an exploitative thing to do,
566
1375127
1898
23:09
because we would be changing them.
567
1377025
1642
原因係我哋會改變佢哋
23:10
There is this false moral imperative
568
1378667
2033
呢啲虛偽嘅道德情操似乎無處不在
23:12
that seems to be all around us
569
1380700
1789
23:14
that treatment of depression,
570
1382489
2354
佢哋覺得抑鬱症嘅治療
藥物以至其他嘢
藥物以至其他嘢
23:16
the medications and so on, are an artifice,
571
1384843
2299
都係人工合成嘅、唔係自然嘅
23:19
and that it's not natural.
572
1387142
2172
23:21
And I think that's very misguided.
573
1389314
2849
而我覺得佢哋係非常之誤導
23:24
It would be natural for people's teeth to fall out,
574
1392163
3532
人隻牙脫落係正常不過嘅事
23:27
but there is nobody militating against toothpaste,
575
1395695
3330
但唔會因為噉有人反對用牙膏
23:31
at least not in my circles.
576
1399025
2128
至少我圈子裏面嘅人冇
然後有人會話
23:33
And people then say, "Well, but isn't depression
577
1401153
2502
抑鬱症唔係每個人都一定會經歷嘅嘢？
23:35
part of what people are supposed to experience?
578
1403655
2185
23:37
Didn't we evolve to have depression?
579
1405840
1741
我哋唔係進化到有抑鬱症架咩？
23:39
Isn't it part of your personality?"
580
1407581
1907
抑鬱症唔通唔係我哋性格嘅一部分？
23:41
To which I would say, mood is adaptive.
581
1409488
2746
噉我就會話，情緒係可以改嘅
23:44
Being able to have sadness and fear
582
1412234
3329
能夠有傷痛、恐懼、快樂、舒適
23:47
and joy and pleasure
583
1415563
1842
23:49
and all of the other moods that we have,
584
1417405
1803
以及其他唔同嘅情緒
23:51
that's incredibly valuable.
585
1419208
2064
其實係非常珍貴嘅
23:53
And major depression is something that happens
586
1421272
3047
抑鬱症係由於情緒系統崩潰
23:56
when that system gets broken.
587
1424319
2012
23:58
It's maladaptive.
588
1426331
1717
係壞嘅轉變
24:00
People will come to me and say,
589
1428048
1572
有啲人走嚟同我講︰
24:01
"I think, though, if I just stick it out for another year,
590
1429620
2768
「如果我再撐多年，
我應該會走出抑鬱症。」
我應該會走出抑鬱症。」
24:04
I think I can just get through this."
591
1432388
2076
24:06
And I always say to them, "You may get through it,
592
1434464
2303
我一直同佢哋講︰
「你可以走得返出嚟，
「你可以走得返出嚟，
24:08
but you'll never be 37 again.
593
1436767
2709
但你永遠唔會再係年輕。
24:11
Life is short, and that's a whole year
594
1439476
2550
人生短暫，
但你成年都喺度講想放棄。
但你成年都喺度講想放棄。
24:14
you're talking about giving up.
595
1442026
1956
24:15
Think it through."
596
1443982
1538
諗下啦。」
24:17
It's a strange poverty of the English language,
597
1445520
2846
英文入面關於抑鬱嘅字真係好少
24:20
and indeed of many other languages,
598
1448366
2108
其他語言都係噉
24:22
that we use this same word, depression,
599
1450474
2218
我哋用同一個字︰depression
24:24
to describe how a kid feels
600
1452692
1805
去形容一個細路
24:26
when it rains on his birthday,
601
1454497
1712
喺佢生日嗰日遇到落雨時嘅感覺
24:28
and to describe how somebody feels
602
1456209
2528
同一個字會形容一個人自殺前嘅心情
24:30
the minute before they commit suicide.
603
1458737
2454
24:33
People say to me, "Well, is it
continuous with normal sadness?"
continuous with normal sadness?"
604
1461191
3105
有啲人同我講︰
「抑鬱係唔係平時傷心嘅延續？」
24:36
And I say, in a way it's continuous
with normal sadness.
with normal sadness.
605
1464296
3144
我話︰「可以係延續嘅，
抑鬱係有傷心嘅延續。」
抑鬱係有傷心嘅延續。」
24:39
There is a certain amount of continuity,
606
1467440
2200
24:41
but it's the same way there's continuity
607
1469640
1957
打個比喻
24:43
between having an iron fence outside your house
608
1471597
1987
你間屋出面道圍欄有一個好細嘅鏽跡
24:45
that gets a little rust spot
609
1473584
1677
24:47
that you have to sand off and do a little repainting,
610
1475261
2746
你可以磨佢然後再上漆
24:50
and what happens if you leave
the house for 100 years
the house for 100 years
611
1478007
2647
但如果你唔理間屋一百年
24:52
and it rusts through until it's only a pile
612
1480654
2898
成個欄就會生鏽到剩返一堆橙色嘅鏽屑
24:55
of orange dust.
613
1483552
1234
24:56
And it's that orange dust spot,
614
1484786
2173
就係開頭小小嘅生鏽我哋要去解決
24:58
that orange dust problem,
615
1486959
1789
25:00
that's the one we're setting out to address.
616
1488748
2989
25:03
So now people say,
617
1491737
2240
所以宜家啲人話
25:05
"You take these happy pills, and do you feel happy?"
618
1493977
2731
「你食咗開心丸， 你會開心嗎？」
25:08
And I don't.
619
1496708
1886
對於我嚟講冇
25:10
But I don't feel sad about having to eat lunch,
620
1498594
2822
我唔會因為食晏而覺得傷心
25:13
and I don't feel sad about my answering machine,
621
1501416
2836
我唔會因為我嗰電話答錄機而傷心
25:16
and I don't feel sad about taking a shower.
622
1504252
2845
我唔會因為沖涼而傷心
25:19
I feel more, in fact, I think,
623
1507097
2854
我諗我感受到更多
25:21
because I can feel sadness without nullity.
624
1509951
2430
因為我唔會冇嘢走去傷心
25:24
I feel sad about professional disappointments,
625
1512381
4347
我可以因為工作上嘅失望而傷心
25:28
about damaged relationships,
626
1516728
2347
或者因為轉壞嘅關係，又或者全球暖化
25:31
about global warming.
627
1519075
2039
25:33
Those are the things that I feel sad about now.
628
1521114
2725
呢啲嘢都係我宜家傷心嘅
25:35
And I said to myself, well, what is the conclusion?
629
1523839
2734
然後我同自己講，噉又點？
25:38
How did those people who have better lives
630
1526573
2561
有更好生活嘅人，甚至有更嚴重抑鬱
25:41
even with bigger depression manage to get through?
631
1529134
2554
係點樣走出嚟架呢？
25:43
What is the mechanism of resilience?
632
1531688
2797
對抗逆境個心理機制又係點架呢？
25:46
And what I came up with over time
633
1534485
2084
我慢慢總結出否定過往有抑鬱嘅人
25:48
was that the people who deny their experience,
634
1536569
2916
25:51
the ones who say, "I was depressed a long time ago
635
1539485
2032
話自己好耐以前曾經抑鬱
25:53
and I never want to think about it again
636
1541517
1737
但唔想諗返轉頭，唔再面對佢
25:55
and I'm not going to look at it
637
1543254
1242
25:56
and I'm just going to get on with my life,"
638
1544496
1890
只係想過好嘅生活
25:58
ironically, those are the people
639
1546386
1959
非常諷刺地
呢啲人卻係畀佢哋擁有嘅嘢控制咗
26:00
who are most enslaved by what they have.
640
1548345
2698
26:03
Shutting out the depression strengthens it.
641
1551043
2564
唔正視抑鬱症只會令得情況更加嚴重
26:05
While you hide from it, it grows.
642
1553607
3280
當你避佢，佢反而惡化
26:08
And the people who do better
643
1556887
2860
表現比較好嘅人反而會
接受佢哋有抑鬱症
接受佢哋有抑鬱症
26:11
are the ones who are able to tolerate the fact
644
1559747
2599
26:14
that they have this condition.
645
1562346
1622
26:15
Those who can tolerate their depression
646
1563968
2470
肯面對抑鬱嘅人就會更堅強
26:18
are the ones who achieve resilience.
647
1566438
1782
26:20
So Frank Russakoff said to me,
648
1568220
1783
所以 Frank Russakoff 同我講︰
26:22
"If I had it again to do over,
649
1570003
1516
「如果我可以再嚟一次，
26:23
I suppose I wouldn't do it this way,
650
1571519
2137
我唔會揀呢條路，
我反而會揀一個唔尋常嘅方式。
26:25
but in a strange way, I'm grateful
651
1573656
1964
我好感激我經歷過嘅嘢。
26:27
for what I've experienced.
652
1575620
1503
26:29
I'm glad to have been in the hospital 40 times.
653
1577123
3817
我好開心我留過院四十次。
26:32
It taught me so much about love,
654
1580940
2603
我留院學識咗乜係愛。
26:35
and my relationship with my parents and my doctors
655
1583543
2840
我同父母、醫生嘅關係
係以後都係最珍惜嘅。」
係以後都係最珍惜嘅。」
26:38
has been so precious to me, and will be always."
656
1586383
4389
26:42
And Maggie Robbins said,
657
1590772
1926
而 Maggie Robbins 話︰
26:44
"I used to volunteer in an AIDS clinic,
658
1592698
2989
「我以前喺一個愛滋病嘅診所做義工。
26:47
and I would just talk and talk and talk,
659
1595687
3014
我工作嘅時候，我會唔停咁講嘢。
26:50
and the people I was dealing with
660
1598701
1813
我對著嘅人冇乜反應，
26:52
weren't very responsive, and I thought,
661
1600514
2067
所以我就覺得佢哋唔係好友善。」
26:54
'That's not very friendly or helpful of them.'
662
1602581
3961
（笑聲）
26:58
And then I realized,
663
1606542
1642
「但我之後發覺，
27:00
I realized that they weren't going to do more
664
1608184
2127
佢哋除咗頭五分鐘嘅傾計之外，
27:02
than make those first few minutes of small talk.
665
1610311
2387
就唔想做其他嘢。
27:04
It was simply going to be an occasion
666
1612698
2057
27:06
where I didn't have AIDS and I wasn't dying,
667
1614755
2878
好似我冇愛滋病、唔使死，
27:09
but could tolerate the fact that they did
668
1617633
2973
但又可以接受到嗰啲人一樣，
27:12
and they were.
669
1620606
1787
27:14
Our needs are our greatest assets.
670
1622393
3603
我哋嘅需求正正係我哋最大嘅本錢。
27:17
It turns out I've learned to give
671
1625996
2139
我學識點樣放開我想要嘅嘢。」
27:20
all the things I need."
672
1628135
4025
重視抑鬱症唔擔保抑鬱症唔會復發
27:24
Valuing one's depression
673
1632160
1691
27:25
does not prevent a relapse,
674
1633851
2194
27:28
but it may make the prospect of relapse
675
1636045
2661
但會令復發嘅心理準備
同復發本身都更容易去接受
同復發本身都更容易去接受
27:30
and even relapse itself easier to tolerate.
676
1638706
4218
27:34
The question is not so much
677
1642924
2045
個意義唔係在於去搵抑鬱症嘅意義
27:36
of finding great meaning and deciding
678
1644969
2175
或者覺得自己嘅抑鬱症好有意義
27:39
your depression has been very meaningful.
679
1647144
2027
27:41
It's of seeking that meaning
680
1649171
2171
而係當抑鬱症再嚟嘅時候
27:43
and thinking, when it comes again,
681
1651342
1804
雖然好似好弊
27:45
"This will be hellish,
682
1653146
1640
但我會從中學到嘢
27:46
but I will learn something from it."
683
1654786
2701
27:49
I have learned in my own depression
684
1657487
2264
由以前嘅抑鬱學到情緒可以有幾大
27:51
how big an emotion can be,
685
1659751
2013
27:53
how it can be more real than facts,
686
1661764
3097
而又點樣可以比事實更加真實
27:56
and I have found that that experience
687
1664861
2949
經歷過之後，令我情緒正面嘅時候
27:59
has allowed me to experience positive emotion
688
1667810
2892
28:02
in a more intense and more focused way.
689
1670702
3520
我識得更加集中同投入咁感受正面情緒
28:06
The opposite of depression is not happiness,
690
1674222
3487
抑鬱症嘅相反唔係快樂，係活力
28:09
but vitality,
691
1677709
1454
而這些日子我的生命充滿活力,
28:11
and these days, my life is vital,
692
1679163
2741
28:13
even on the days when I'm sad.
693
1681904
2745
就算傷心嘅時候都係
28:16
I felt that funeral in my brain,
694
1684649
3313
我腦入面感受到嗰場葬禮
28:19
and I sat next to the colossus
695
1687962
2024
我同一個巨人坐喺世界嘅邊緣
28:21
at the edge of the world,
696
1689986
2247
我發現自己內心嘅一啲嘢
28:24
and I have discovered
697
1692233
2089
28:26
something inside of myself
698
1694322
1851
28:28
that I would have to call a soul
699
1696173
2133
以前我要呼喚內心
28:30
that I had never formulated
until that day 20 years ago
until that day 20 years ago
700
1698306
3756
但直到廿年前嘅一日
地獄好似派咗使者嚟
之後我明白到所有嘢
28:34
when hell came to pay me a surprise visit.
701
1702062
4518
我唔使再呼喚自己
28:38
I think that while I hated being depressed
702
1706580
4098
當我唔鐘意抑鬱、唔想再抑鬱嘅時候
28:42
and would hate to be depressed again,
703
1710678
2334
28:45
I've found a way to love my depression.
704
1713012
2744
我搵到一個愛上抑鬱症嘅方法
28:47
I love it because it has forced me
705
1715756
2025
我愛佢係因為佢令我去尋同埋堅持快樂
28:49
to find and cling to joy.
706
1717781
2769
28:52
I love it because each day I decide,
707
1720550
3488
我愛佢因為我決定每日…
28:56
sometimes gamely,
708
1724038
1540
有時因為玩
28:57
and sometimes against the moment's reason,
709
1725578
2698
有時因為喺嗰刻特登唱反調
29:00
to cleave to the reasons for living.
710
1728276
2578
去擁抱生存嘅理由
29:02
And that, I think, is a highly privileged rapture.
711
1730854
4123
呢樣嘢可喜可賀，亦係一份榮譽
29:06
Thank you.
712
1734977
3983
多謝
（掌聲）
29:10
(Applause)
713
1738960
3136
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