哈佛健康雜誌介紹說抑鬱症的原因並不是大腦中某一種化學物質過低或者過高，而往往是因爲多種化學物質工作異常。我們大腦中有數以百萬計甚至更多的化學反應，決定了我們的情緒以及我們的`生活感受。
What is depression? 什麼是抑鬱症?
Feeling sad, or what we may call "depressed", happens to all of us. The sensation usually passes after a while. However, people with a depressive disorder - clinical depression - find that their state interferes with daily life.
任何人都會有感覺不快、鬱悶或者悲傷的經歷，但是這些感受都是暫時的。然而，有depressive disorder - clinical depression -抑鬱症的人，卻終身受到抑鬱的折磨。
For people with clinical depression, their normal functioning is undermined to such an extent that both they and those who care about them are affected by it.
Melancholia - clinical depression is a fairly modern term. Hippocrates, known as the father of Western medicine, described a syndrome of "melancholia". He said melancholia was a distinct disease with specific physical and mental symptoms. Hippocrates characterized it as "(all) fears and despondencies, if they last a long time" as being symptomatic of the illness.
抑鬱症怎麼得的?
Depression is an extremely complex disease. It occurs for a variety of reasons. Some people experience depression during a serious medical illness. Others may have depression with life changes such as a move or the death of a loved one. Still others have a family history of depression. Those who do may experience depression and feel overwhelmed with sadness and loneliness for no known reason.
What Are the Main Causes of Depression?
誘發抑鬱症的主要原因
There are a number of factors that may increase the chance of depression, including the following:
Abuse. 虐待 Past physical, sexual, or emotional abuse can cause depression later in life.
Certain medications. 某些藥物 Some drugs, such as Accutane (used to treat acne), the antiviral drug interferon-alpha, and corticosteroids, can increase your risk of depression.
Conflict. 爭吵(人際關係困擾) Depression in someone who has the biological vulnerability to develop depression may result from personal conflicts or disputes with family members or friends.
Death or a loss.喪親 Sadness or grief from the death or loss of a loved one, though natural, may increase the risk of depression.
Genetics.遺傳 A family history of depression may increase the risk. Its thought that depression is a complex trait that may be inherited across generations, although the genetics of psychiatric disorders are not as simple or straightforward as in purely genetic diseases such as Huntingtons chorea or cystic fibrosis.
Major events.重大事件 Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring.
Other personal problems.其他個人困擾 Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can lead to depression.
Serious illnesses.嚴重疾病 Sometimes depression co-exists with a major illness or is a reaction to the illness.
Substance abuse.濫用藥物等 Nearly 30% of people with substance abuse problems also have major or clinical depression.
What causes depression?
Nobody is sure what causes depression. Experts say depression is caused by a combination of factors, such as the persons genes, their biochemical environment, personal experience and psychological factors.
抑鬱症的起因很複雜，很難有確切的定論。
A study published in Archives of Psychiatry found that MRI (magnetic resonance imaging) scans showed patients with clinical depression had less brain volume in several regions, including the frontal lobe, basal ganglia and hippocampus. They also found that after treatment the hippocampus returned to normal size.
The Stanford School of Medicine says that genes do play a role in causing depression. By studying cases of major depression among identical twins (whose genes are 100% identical) and non-identical twins (whose genes are 50% identical) they found that heritability is a major contributory factor in the risk of developing depression.
斯坦福醫學院說基因起了很大作用。通過對同卵雙胞胎和異卵雙胞胎的觀察研究，發現遺傳因素可能是導致抑鬱的主要原因。
An article in Harvard Health Publicaitons explains that depression is not caused simply by the level of one chemical being too low and another too high. Rather, several different chemicals are involved, working both within and outside nerve cells. There are "Millions, even billions, of chemical reactions that make up the dynamic system that is responsible for your mood, perceptions, and how you experience life."
An awful experience can trigger a depressive illness. For example, the loss of a family member, a difficult relationship, physical sexual abuse.
哈佛健康雜誌介紹說抑鬱症的原因並不是大腦中某一種化學物質過低或者過高，而往往是因爲多種化學物質工作異常。大腦中有數以百萬計甚至更多的化學反應，決定了你的情緒以及你的生活體驗。
抑鬱症非常常見，女性患病的機率大大高於男性。很多抑鬱症患者不會或者不願尋求治療。
According to the National Institutes of Health, a significant percentage of people with depressive illness never seek medical help. This is unfortunate, because the vast majority, even those with very severe symptoms, can improve with treatment.
How common is clinical depression? - Nobody is sure exactly how many people are affected by depression. Health authorities from country to country and even within the same nation publish different figures:
The National Institute of Mental Health estimates that 6.7% of American adults have had depressive illness during the last 12 months, and 30.4% of these cases (2% of the whole adult population) have severe symptoms.
While the National Institute of Mental Health says women are 70% more likely to develop depressive symptoms during their lifetime, an article published in JAMA Psychiatry (August 2013 issue) showed thatdepression affects 30.6% of men and 33.3% of women, not a statistically significant difference.
The National Institute for Clinical Excellence (NICE) estimates that in the United Kingdom 21 in every 1,000 16-to-65 year olds live with major depression (17/1000 males and 25/1000 females). If "mixed depression and anxiety", a less specific and broader category is included, the prevalence rises to 98 per 1,000.
In Australia only 1 in every five people with clinical depression is accurately diagnosed, according to theState Government of Victoria, "because depression can mask itself as a physical illness like chronic pain, sleeplessness or fatigue."
抑鬱症的種類Types of depression
There are several forms of depression (depressive disorders). Major depressive disorder and dysthymic disorder are the most common.
Major depressive disorder (major depression)
Major depressive disorder is also known as major depression. The patients suffer from a combination of symptoms that undermine their ability to sleep, study, work, eat, and enjoy activities they used to find pleasurable.
Experts say that major depressive disorder can be very disabling, preventing the patient from functioning normally. Some people experience only one episode, while others have recurrences.
Dysthymic disorder (dysthymia)
Dysthymic disorder is also known as dysthymia, or mild chronic depression. The patient will suffer symptoms for a long time, perhaps as long as a couple of years, and often longer. The symptoms are not as severe as in major depression - they do not disable the patient. However, people affected with dysthymic disorder may find it hard to function normally and feel well.
Some people experience only one episode during their lifetime, while others may have recurrences.
A person with dysthymia might also experience major depression, once, twice, or more often during their lifetime. Dysthymia can sometimes come with other symptoms. When they do, it is possible that other forms of depression are diagnosed.
For a patient to be diagnosed with dysthymia he or she must have experienced a combination of depressive symptoms for at least two years.
Psychotic depression
When severe depressive illness includes hallucinations, delusions, and/or withdrawing from reality, the patient may be diagnosed with psychotic depression. Psychotic depression is also referred to as delusional depression.
Postpartum depression (postnatal depression)
Postpartum depression is also known as postnatal depression or PND. This is not to be confused with baby blues which a mother may feel for a very short period after giving birth.
If a mother develops a major depressive episode within a few weeks of giving birth it is most likely she has developed postpartum depression. Experts believe that about 10% to 15% of all women experience this type of depression after giving birth. Sadly, many of them go undiagnosed and suffer for long periods without treatment and support.
Postpartum depression can start any time within a year of giving birth, according to the National Library of Medicine.
SAD (seasonal affective disorder)
SAD is much more common the further from the equator you go, where the end of summer means the beginning of less sunlight and more dark hours. A person who develops a depressive illness during the winter months might have SAD.
SAD symptoms go away during spring and/or summer. In Scandinavia, where winter can be very dark for many months, patients commonly undergo light therapy - they sit in front of a special light. Light therapy works for about half of all SAD patients. In addition to light therapy, some people may needantidepressants, psychotherapy, or both. Light therapy is becoming more popular in other northern countries, such as Canada and the United Kingdom.
The National Health Service9, UK, suggest that sunlight may stimulate the hypothalamus, a part of the brain that controls sleep, appetite and mood.
Bipolar disorder (manic-depressive illness)
Bipolar disorder is also known as manic-depressive illness. It used to be known as manic depression. It is not as common as major depression or dysthymia. A patient with bipolar disorder experiences moments of extreme highs and extreme lows. These extremes are known as manias.
抑鬱症的跡象和症狀
Signs and symptoms
epression is not uniform. Signs and symptoms may be experienced by some sufferers and not by others. How severe the symptoms are, and how long they last depends on the individual person and his illness. Below is a list of the most common symptoms:
A constant feeling of sadness, anxiety, and emptiness
A general feeling of pessimism sets in (the glass is always half empty)
The person feels hopeless
Individuals can feel restless
The sufferer may experience irritability
Patients may lose interest in activities or hobbies they once enjoyed
He/she may lose interest in sex
Levels of energy feel lower, fatigue sets in
Many people with a depressive illness find it hard to concentrate, remember details, and make decisions
Sleep patterns are disturbed - the person may sleep too little or too much
Eating habits may change - he/she may either eat too much or have no appetite
Suicidal thoughts may occur - some may act on those thoughts
The sufferer may complain more of aches and pains, headaches, cramps, or digestive problems. These problems do not get better with treatment.
