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There's a common misconception that if you like to meticulously organize your things, keep your hands clean, or plan out your weekend to the last detail, you might have OCD.
人們常有這樣的誤解:如果你喜歡一絲不苟地把東西擺好、保持雙手乾淨,或者鉅細靡遺地計畫好週末,你可能患有強迫症。
In fact, OCD, which stands for obsessive-compulsive disorder, is a serious psychiatric condition that is frequently misunderstood by society and mental health professionals alike.
事實上,OCD 是 obsessive-compulsive disorder(強迫性精神官能症,簡稱強迫症)的縮略詞,是一種常被社會和心理專家誤解的極端精神官能症。
So, let's start by debunking some myths.
那讓我們先從破除幾項迷思作為開頭。
Myth one: Repetitive or ritualistic behaviors are synonymous with OCD.
迷思一:進行重複或例行公事般的行為就是强迫症。
As its name suggests, obsessive-compulsive disorder has two aspects.
如同其名,強迫症有兩個面向。
The intrusive thoughts, images, or impulses known as obsessions and the behavioral compulsions people engage in to relieve the anxiety the obsessions cause.
被稱為「執著」的侵入性思維、影像,和強烈衝動;以及為了緩解執著而產生的「行為強迫」。
The kinds of actions that people often associate with OCD, like excessive hand-washing or checking things repeatedly,
人們時常把一些行為聯想到强迫症,像是太常洗手或是反覆檢查東西 ,
may be examples of obsessive or compulsive tendencies that many of us exhibit from time to time.
又或是我們多數人不時表現出來的有執著或是強烈衝動傾向的例子。
But the actual disorder is far more rare and can be quite debilitating.
但是真正的病症極為罕見,而且相當折騰人。
People affected have little or no control over their obsessive thoughts and compulsive behaviors,
病患不太能或根本無法控制執著的念頭和衝動的行為 ,
which tend to be time-consuming and interfere with work, school, or social life to the point of causing significant distress.
那會耗費許多時間並且干擾工作、學業與社交生活,甚至會引發嚴重的憂鬱 。
This set of diagnostic criteria is what separates people suffering from OCD from those who may just be a bit more meticulous or hygiene-obsessed than usual.
這套診斷標準區分出真正受强迫症所苦的人群,和只是比一般人更加一絲不茍或是更愛乾淨的人群。
Myth two: The main symptom of OCD is excessive hand-washing.
迷思二:强迫症的主要症狀是過度頻繁地洗手
Although hand-washing is the most common image of OCD in popular culture, obsessions and compulsions can take many different forms.
雖然洗手是一般對於強迫症最常有的印象,不過執著與衝動卻能在不同形式上體現。
Obsessions can manifest as fears of contamination and illness, worries about harming others, or preoccupations with numbers, patterns, morality, or sexual identity.
執著可以是對於感染與疾病的恐懼、擔心傷害到其他人、或是滿腦子只想著數字、圖案、道德觀、性別認定等
And compulsions can range from excessive cleaning or double-checking to the fastidious arrangement of objects or walking in predetermined patterns.
而衝動的行為則可以從過度清潔或反覆檢查,到過分嚴謹的擺設物品,或是必須按照既定的方式走路。
Myth three: Individuals with OCD don't understand that they are acting irrationally.
迷思三:患有強迫症的人在當下並不曉得他們行為不正常
Many individuals with OCD actually understand the relationship between their obsessions and compulsions quite well.
很多强迫症患者事實上相當了解他們執著與強烈衝動之間的關聯。
Being unable to avoid these thoughts and actions despite being aware of their irrationality is part of the reason why OCD is so distressing.
儘管意識到這些行為與想法的不合理,但是還是不可避免地去想跟做就是強迫症使人致鬱的原因。
OCD sufferers report feeling crazy for experiencing anxiety based on irrational thoughts and finding it difficult to control their responses.
強迫症患者們反應,因為控制不住那些失去理性的想法而產生的焦慮令其覺得自己像發瘋了一樣。
So, what exactly causes OCD?
那麼,到底是什麽引起强迫症呢?
The frustrating answer is: We don't really know.
答案令人沮喪:我們並不清楚。
However, we have some important clues.
然而,我們有一些重要的線索。
OCD is considered a neurobiological disorder.
强迫症被認爲是神經系統障礙。
In other words, research suggests that OCD sufferers' brains are actually hardwired to behave in a certain fashion.
換言之,研究顯示强迫症患者的大腦事實上早被一套模式給制約住了。
Research has implicated three regions of the brain variously involved in social behavior and complex cognitive planning, voluntary movement, and emotional and motivational responses.
研究表明,大腦有三個區塊在不同方面和社交行為、複雜的認知規劃、 自主性動作以及情緒與動機反應有關。
The other piece of the puzzle is that OCD is associated with low levels of serotonin,
其他費解的地方是強迫症與低血清素有關,
a neurotransmitter that communicates between brain structures and helps regulate vital processes
血清素是一種在大腦組織之間傳遞資訊的神經遞質,幫助管理像
such as mood, aggression, impulse control, sleep, appetite, body temperature, and pain.
心情、敵對情緒、脈搏控制、 睡眠、食慾、體溫和疼痛等的重要運作。
But are serotonin and activity in these brain regions the sources of OCD or symptoms of an unknown underlying cause of the disorder?
但血清素和這些大腦區塊的活動就是强迫症的根源嗎?或是他們是這個疾病病症的潛在原因?
We probably won't know until we have a much more intimate understanding of the brain.
在我們對大腦有更多了解前可能不會知道答案。
The good news is there are effective treatments for OCD, including medications which increase serotonin in the brain by limiting its reabsorption by brain cells,
好消息是是能夠有效治療強迫症的,包括增加腦內血清素的藥物,這種藥物能阻止血清素被大腦細胞再吸收回去,
behavioral therapy that gradually desensitizes patients to their anxieties,
以及使病人對焦慮逐漸感到麻木的行為療法,
and in some cases, electroconvulsive therapy, or surgery, when OCD doesn't respond to other forms of treatment.
而當強迫症病患對其他療法沒反應時,部分案例會使用電療或是做手術。
Knowing that your own brain is lying to you while not being able to resist its commands can be agonizing.
知道自己的大腦正在説謊卻無法抗拒它的指令是非常痛苦的。
But with knowledge and understanding comes the power to seek help.
但有了知識與理解,就有了力量能找到幫助。
And future research into the brain may finally provide the answers we're looking for.
而未來對大腦內的研究也許最終會給予我們找尋已久的答案。