of my GP saying to me:

我的全科醫生對我說。

"You are mentally sick

"你有精神疾病

and you have to accept help to get better."

而你必須接受幫助才能得到改善。"

Hannah was a healthy 20-year-old psychology student

漢娜是一個健康的20歲的心理學學生

living at home with her family

在家與家人生活在一起

when she started experiencing flu-like symptoms.

當她開始出現類似流感的症狀時。

I went to my GP and I was kind of told

我去看了我的全科醫生，我被告知

that viruses will just generally go,

病毒一般都會消失。

you just need to go home and rest, take it easy.

你只需要回家休息，別緊張。

Her GP thought she had glandular fever.

她的全科醫生認為她患有腺熱。

Hannah was feeling very tired, so the symptoms fitted.

漢娜感到非常疲憊，所以症狀符合。

But then she started to develop changes

但後來她開始出現了變化

in her personality.

在她的個性中。

Soon after, Hannah lost her ability to speak.

不久之後，漢娜失去了說話的能力。

I had to ask my mum to come in,

我不得不請我媽媽進來。

sit with me and talk for me to the GP.

和我坐在一起，為我與全科醫生交談。

I would kind of write down to my mum

我想給我媽媽寫封信

what needed to be said.

該說的都說了。

Hannah was sent home with antidepressants

漢娜被送回家，服用抗抑鬱藥

and a referral to a psychologist.

並轉介給心理醫生。

Her symptoms deteriorated, and she was soon admitted

她的症狀惡化了，很快就被送進了醫院。

to a psychiatric hospital,

到一家精神病院。

where she was given antipsychotic medication.

她在那裡接受了抗精神病藥物治療。

She was seen by a psychiatrist,

她被一位精神病醫生看中。

who ordered an MRI scan.

他要求進行核磁共振掃描。

During the scan, doctors found a cyst on her brain

在掃描過程中，醫生髮現她的大腦上有一個囊腫。

and sent her to A&E for investigation.

並將她送到A&E進行調查。

When I got to A&E,

當我到了A&E。

they reviewed the cyst

他們審查了囊腫

and said I was probably born with it,

並說我可能天生就有這種毛病。

it probably had nothing to do with the symptoms.

它可能與這些症狀沒有關係。

But what they did notice was

但他們確實注意到的是

that my blood test showed I was fighting

我的血液測試顯示我正在與其他的人戰鬥

some sort of virus.

某種病毒。

More tests followed,

更多的測試隨之而來。

and after three weeks, the results came back,

並在三週後，結果出來了。

and Hannah finally got her diagnosis:

而漢娜最終得到了她的診斷。

Anti-NMDA receptor encephalitis.

抗NMDA受體腦炎。

It's an autoimmune form of encephalitis,

這是一種自身免疫性的腦炎。

which is the inflammation of the brain.

這是大腦的發炎。

According to Professor Guy Leschziner,

根據蓋伊-萊施齊納教授的說法。

having your physical symptoms mistaken for a mental illness

將你的身體症狀誤認為是精神疾病

is not uncommon.

並非不常見。

We do occasionally see individuals

我們確實偶爾會看到一些人

with very severe psychosis and behavioural change

有非常嚴重的精神病和行為改變

in whom the initial diagnosis

初次診斷的患者

is of a psychotic illness like schizophrenia.

是屬於精神疾病，如精神分裂症。

But actually,

但實際上。

over the course of days or weeks

幾天或幾周的時間裡

whilst they're in hospital,

當他們在醫院的時候。

it begins to be obvious that actually

它開始是明顯的，實際上

what is underlying their condition

他們的病情是什麼原因造成的

is one of these autoimmune conditions.

是這些自身免疫性疾病中的一種。

It's been known for more than a century

一個多世紀以來，人們都知道

that damage to particular parts of the brain

對大腦特定部分的損害

and things like tumours can result in changes

而像腫瘤這樣的東西會導致變化

in personality or behaviour.

在個性或行為上。

But over the last 20 years or so,

但在過去20年左右的時間裡。

we've begun to recognise

我們已經開始認識到

that there are a number of conditions

有一些條件

that have an immune basis,

有免疫基礎的。

whereby the immune system attacks the brain

免疫系統攻擊大腦

and causes changes

並引起變化

to the functioning of that brain.

到該大腦的運作。

In Hannah's case,

在漢娜的情況下。

it took several weeks for doctors to recognise

醫生花了幾個星期才認識到

that this was a serious autoimmune condition

這是一種嚴重的自身免疫性疾病。

that required treatment with very heavy-duty drugs.

需要用非常重的藥物進行治療。

I was moved to neurology ward.

我被轉移到神經科病房。

I was completely mute

我完全是個啞巴

and I had lost the ability to dress myself,

而且我已經失去了自己穿衣服的能力。

wash myself, feed myself.

洗淨自己，餵飽自己。

So I really was trapped in my own body at this stage.

所以在這個階段，我真的被困在自己的身體裡了。

Hannah underwent immunotherapy treatment

漢娜接受了免疫療法治療

and had 13 plasma exchanges –

並進行了13次血漿交換 -

a process of filtering blood

一個過濾血液的過程

before pumping it back into her body.

在把它抽回她的身體之前。

Although the treatment didn't work initially,

儘管最初的治療並不奏效。

and her parents were told by doctors

而她的父母被醫生告知

she probably didn't have long to live,

她可能已經活不長了。

after two weeks, Hannah woke up.

兩週後，漢娜醒了。

Hannah, say "Dad".

漢娜，說 "爸爸"。

Dad.

爸爸。

Over subsequent weeks,

在隨後的幾周內。

she learnt to speak again and walk again.

她又學會了說話，又學會了走路。

She says it was like learning how to live again.

她說這就像重新學習如何生活。

I look back at the person

我回頭看了看那個人

before I got encephalitis,

在我得腦炎之前。

and I don't really know her.

而我並不真正瞭解她。

I just can't connect with that person.

我只是無法與那個人聯繫。

Five years on, Hannah has mostly recovered,

五年過去了，漢娜已經基本康復了。

though she is still on immunotherapy treatment,

儘管她仍在接受免疫療法治療。

and that makes her more vulnerable to infections

而這使她更容易受到感染

and could impact her fertility.

並可能影響她的生育能力。

I wish GPs would know more about encephalitis,

我希望全科醫生能對腦炎有更多的瞭解。

because they're the first point of contact

因為他們是第一個接觸點

for a lot of patients.

對於很多病人來說。

I wish my GP knew more about it,

我希望我的全科醫生對它有更多瞭解。

so she could direct me to the right pathway.

所以她可以把我引向正確的途徑。

If I was to think about all the people who had encephalitis

如果讓我想想所有患有腦炎的人

and died in psychiatric hospitals

並死於精神病院

or care homes,

或護理院。

I wouldn't be able to sleep at night.

我晚上就會睡不著覺。

In Hannah's case,

在漢娜的情況下。

a physical illness, encephalitis, was mistaken

一種身體疾病，即腦炎，被誤認為是

for mental illness.

為精神疾病。

But sometimes it's the other way around.

但有時情況恰恰相反。

We know that the connection

我們知道，連接

between body and mind goes both ways.

身體和心靈之間的關係是雙向的。

Physical problems can result in psychiatric symptoms,

身體問題會導致精神症狀。

but also psychological issues

但也有心理問題

can contribute to physical disease.

可以促成身體疾病。

Professor Leschziner says he sees patients

Leschziner教授說他看到的病人

who have symptoms like seizures, paralysis

有癲癇發作、癱瘓等症狀的人

and numbness with no obvious physical cause.

和麻木，沒有明顯的身體原因。

Some are eventually diagnosed

有些人最終被診斷出

as having functional neurological disorder,

為有功能性神經障礙。

or FND,

或FND。

which is a problem with how the brain receives

這是一個關於大腦如何接收

and sends information to the rest of the body.

並向身體的其他部分發送信息。

We don't fully understand

我們並不完全瞭解

what causes these conditions.

是什麼導致了這些情況。

It seems that anybody can be vulnerable to changes

似乎任何人都會受到變化的影響

within the software that defines

的軟件內，定義了

how our nervous systems work.

我們的神經系統如何工作。

We know that there are some risk factors.

我們知道，有一些風險因素。

So stress, anxiety, depression,

是以，壓力、焦慮、抑鬱。

previous psychological trauma in particular.

尤其是以前的心理創傷。

But ultimately,

但最終。

anybody can develop

任何人都可以發展

these functional neurological disorders.

這些功能性神經疾病。

Globally, hundreds of thousands of people

在全球範圍內，有數十萬人

develop FND every year.

每年發展FND。

Conditions like FND

像FND這樣的情況

and the experiences of people like Hannah

以及像漢娜這樣的人的經歷

have led some doctors to believe that we need

導致一些醫生認為，我們需要

to stop thinking of mental and physical health

停止思考身心健康的問題

as separate.

作為單獨的。

I think we need to move away

我認為我們需要移開

from defining diseases or disorders

來自確定的疾病或失調

as of the body and of the mind.

如同身體和心靈的。

We know that actually, in almost all cases,

我們知道，實際上，在幾乎所有的情況下。

there are contributions from both.

兩者都有貢獻。

Even in conditions that are thought to have

即使在被認為是有

a pure physical basis,

一個純粹的物理基礎。

we know that how people interpret their symptoms

我們知道，人們如何解釋他們的症狀

is important in terms of defining their quality of life

在定義他們的生活品質方面是很重要的。

and how severe they perceive their symptoms to be.

以及他們認為自己的症狀有多嚴重。

So actually understanding that,

是以，實際上理解這一點。

making sure that everybody has access

確保每個人都有機會

to both physical and psychological treatments

對身體和心理的治療

is really of utmost importance

是最重要的

for pretty much every condition that is seen

幾乎所有看到的條件都是如此

by our healthcare systems,

由我們的醫療系統。

and is important for everyone.

而且對每個人都很重要。