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  • The body becomes its own corset.

    身體變成了自身的束縛。

  • Past, present, and future exist as a single force.

    過去、現在、未來 全都匯合成為單一股力量。

  • A swing without gravity soars to a terrifying height.

    沒有重力的鞦韆 擺盪到嚇人的高度。

  • The outlines of people and things dissolve.

    人與物的輪廓在溶解。

  • Countless poets and writers have tried to put words

    無數的詩人和作家都嘗試過

  • to the experience of a panic attack

    用文字來形容恐慌發作的經歷——

  • a sensation so overwhelming, many people mistake it for a heart attack, stroke,

    這種讓人無法招架的感覺 讓許多人會誤以為是心臟病發作、中風,

  • or other life-threatening crisis.

    或其他會致命的疾病。

  • Though panic attacks don't cause long-term physical harm,

    雖然恐慌發作並不會 造成長期的身體傷害,

  • afterwards, the fear of another attack can limit someone's daily life

    但之後,對下次發作的恐懼可能 讓病人的日常生活受到限制——

  • and cause more panic attacks.

    反而更常造成恐慌發作。

  • Studies suggest that almost a third of us

    研究指出,幾乎有三分之一的人

  • will experience at least one panic attack in our lives.

    在一生中至少會經歷一次恐慌發作。

  • And whether it's your first, your hundredth,

    不論是你的第一次或第一百次發作,

  • or you're witnessing someone else go through one,

    或者你看到其他人恐慌發作,

  • no one wants to repeat the experience.

    都不會想要再經歷一次。

  • Even learning about them can be uncomfortable, but it's necessary

    就連去了解恐慌發作都會讓人 不舒服,但去了解是必要的——

  • because the first step to preventing panic attacks is understanding them.

    因為預防恐慌發作的第一步 就是去了解它。

  • At its core, a panic attack is an overreaction to the body's

    恐慌發作的核心,是身體在感受到

  • normal physiological response to the perception of danger.

    危險時的正常生理因應措施 發生了過度反應。

  • This response starts with the amygdala,

    這種反應始於杏仁核,

  • the brain region involved in processing fear.

    負責處理恐懼的大腦區域。

  • When the amygdala perceives danger,

    當杏仁核感受到危險時,

  • it stimulates the sympathetic nervous system,

    它就會刺激交感神經系統,

  • which triggers the release of adrenaline.

    觸發腎上腺素釋放。

  • Adrenaline prompts an increase in the heart and breathing rate

    腎上腺素會使心率提升和呼吸加速,

  • to get blood and oxygen to the muscles of the arms and legs.

    讓血液和氧氣能被送到 手臂及腿部的肌肉。

  • This also sends oxygen to the brain, making it more alert and responsive.

    同時也會把氧氣送到腦部,讓腦部能更有警覺性且更敏感。

  • During a panic attack,

    在恐慌發作時,

  • this response is exaggerated well past what would be useful

    這種反應會被擴大到已經遠遠超過

  • in a dangerous situation,

    對於處理危險情況有幫助的程度,

  • causing a racing heart, heavy breathing, or hyperventilation.

    造成心率飆升、 大聲呼吸、過度換氣。

  • The changes to blood flow cause lightheadedness

    血流的改變則造成頭昏眼花

  • and numbness in the hands and feet.

    以及手腳麻木。

  • A panic attack usually peaks within 10 minutes.

    恐慌發作通常會在 十分鐘內達到高峰。

  • Then, the prefrontal cortex takes over from the amygdala

    接著,前額葉皮質 接手杏仁核的工作,

  • and stimulates the parasympathetic nervous system.

    刺激副交感神經系統。

  • This triggers the release of a hormone called acetylcholine

    這會觸發一種稱為 乙醯膽素的荷爾蒙釋放,

  • that decreases the heart rate and gradually winds down the panic attack.

    讓心率降低,並漸漸緩解恐慌發作。

  • In a panic attack, the body's perception of danger

    在恐慌發作時,身體對危險的感受

  • is enough to trigger the response we would have to a real threatand then some.

    足以觸發我們面對 真實威脅時的反應——且還更多。

  • We don't know for sure why this happens,

    我們還無法肯定 為什麼會發生這種狀況,

  • but sometimes cues in the environment that remind us

    但有時環境中有某些暗示,

  • of traumatic past experience can trigger a panic attack.

    讓我們想到帶有創傷的經歷,就可能會造成恐慌發作。

  • Panic attacks can be part of anxiety disorders

    恐慌發作有可能是焦慮症的一部分,

  • like PTSD, social anxiety disorder, OCD, and generalized anxiety disorder.

    如創傷後壓力症候群、社交恐懼症、強迫症,以及廣泛性焦慮症。

  • Recurring panic attacks, frequent worry about new attacks,

    重覆恐慌發作、經常擔心會再發作,

  • and behavioral changes to avoid panic attacks

    以及為了避免恐慌發作而改變行為,

  • can lead to a diagnosis of a panic disorder.

    這些是診斷恐慌症的指標。

  • The two main treatments for panic disorder

    恐慌症的治療方式主要有兩種,

  • are antidepressant medication and cognitive behavioral therapy, or CBT.

    抗憂鬱藥物及認知行為治療,或稱 CBT。

  • Both have about a 40% response rate

    對這兩種治療方式 有反應的病人大概都佔 40%——

  • though someone who responds to one may not respond to the other.

    不過對於一種治療有反應, 不見得會對另一種治療有反應。

  • However, antidepressant medications carry some side effects,

    然而,抗憂鬱藥物會有一些副作用,

  • and 50% of people relapse when they stop taking them.

    且 50% 的病人在停止服用 這類藥物之後又會復發。

  • CBT, meanwhile, is more lasting, with only a 20% relapse rate.

    而 CBT 的效果比較持久,復發率只有 20%。

  • The goal of CBT treatment for panic disorder is to help people learn

    恐慌症 CBT 治療的目的

  • and practice concrete tools to exert physical, and in turn mental,

    是協助病人學習和運用具體的工具,

  • control over the sensations and thoughts associated with a panic attack.

    先後控制身體和心理對造成恐慌發作的感覺和想法。

  • CBT begins with an explanation of the physiological causes of a panic attack,

    CBT 一開始會先解釋 恐慌發作的生理原因,

  • followed by breath and muscle exercises designed to help people

    接著進行設計來協助病人有意識地

  • consciously control breathing patterns.

    控制呼吸模式的呼吸和肌肉練習。

  • Next comes cognitive restructuring,

    接下來是認知重建,

  • which involves identifying and changing the thoughts

    要做的是辨識出在發作時 有哪些常見想法,

  • that are common during attacks

    並改變這些想法——

  • such as believing you'll stop breathing, have a heart attack, or die

    比如相信你會停止呼吸、 會心臟病發,或會死亡——

  • and replacing them with more accurate thoughts.

    再用更正確的想法來取代這些想法。

  • The next stage of treatment is exposure to the bodily sensations and situations

    治療的下一個階段,是讓病人接觸

  • that typically trigger a panic attack.

    通常會觸發恐慌發作的 身體感覺和情境。

  • The goal is to change the belief, through experience,

    目標是要透過經歷這些感覺和情境,

  • that these sensations and situations are dangerous.

    來改變認定它們很危險的信念。

  • Even after CBT, taking these steps isn't easy in the grip of an attack.

    即使在 CBT 之後,被恐慌攻擊時,採行這些步驟並不容易。

  • But with practice, these tools can both prevent and de-escalate attacks,

    但是經由練習,這些工具可以同時預防並緩和攻擊,

  • and ultimately reduce the hold of panic on a person's life.

    並根本地減少生活上被恐慌佔據的情況。

  • Outside formal therapy,

    外在的正規治療,

  • many panickers find relief from the same beliefs CBT aims to instill:

    很多恐慌者發現這些CBT主要逐漸灌輸的相同信念,讓他們症狀減輕:

  • that fear can't hurt you, but holding on to it will escalate panic.

    像恐懼並不會傷害你,但是懷抱恐懼會讓恐慌更嚴重。

  • Even if you've never had a panic attack,

    即使你不曾過發生恐慌症,

  • understanding them will help you identify one in yourself or someone else

    了解他們會幫助你辨識你自己或其他人的情況-

  • and recognizing them is the first step in preventing them.

    而認知是預防恐慌的第一個步驟。

The body becomes its own corset.

身體變成了自身的束縛。

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