字幕列表 影片播放 列印所有字幕 列印翻譯字幕 列印英文字幕 "I felt a Funeral, in my Brain, 「在我的腦海中，有一場葬禮， And Mourners to and fro 哀悼者來來去去， Kept treading - treading - till it seemed 不停踩踏，踩踏，直到我感覺 That Sense was breaking through - 感官衝破了覺知。 And when they all were seated, 當眾人全都就座， A Service, like a Drum - 儀式開始，像擊鼓般， Kept beating - beating - till I felt 不斷敲擊、敲擊，直到感覺 My mind was going numb - 我的意識就此麻木。 And then I heard them lift a Box 此刻我聽見他們抬起棺木， And creak across my Soul 嘰嘎聲穿透我的魂。 With those same Boots of Lead, again, 鉛靴的踏步聲再度揚起， Then Space - began to toll, 伴隨喪鐘迴盪， As all the Heavens were a Bell, And Being, but an Ear, 彷彿天空是具大鐘，只剩下一只耳朵存在， And I, and Silence, some strange Race, 而我與寂靜間，一場微妙的追逐， Wrecked, solitary, here - 獨自在此破碎。 (Just) then a Plank in Reason, broke, 就在此時，理性忽然斷了弦， And I dropped down, and down - 我不斷墜落， And hit a World, at every plunge, 每次墜落都撞上一個世界， And Finished knowing - then -" 最終豁然開朗。 」 We know depression through metaphors. 我們透過文學隱喻認識了憂鬱。 Emily Dickinson was able to convey it in language, 艾蜜莉．狄更生（十九世紀美國詩人） 用詩歌描寫它， Goya in an image. 哥雅（西班牙畫家）用繪畫詮釋， Half the purpose of art is to describe such iconic states. 半數藝術品的目的是為了描述這象徵性的狀態。 As for me, I had always thought myself tough, 對我而言，我總把自己看做一名鬥士， one of the people who could survive if I'd been sent to a concentration camp. 是那種即使被送往集中營也可以存活下來的人。 In 1991, I had a series of losses. 1991 年，我經歷了一連串的不幸。 My mother died, a relationship I'd been in ended, 我的母親去世，戀情終結， I moved back to the United States from some years abroad, 多年居住外國之後，我返回了美國。 and I got through all of those experiences intact. 我安然無恙地經歷這一切。 But in 1994, three years later, I found myself losing interest in almost everything. 但是到了 1994 年，三年之後，我發現自己對所有的事情都失去了興趣。 I didn't want to do any of the things I had previously wanted to do, and I didn't know why. 任何我曾經喜歡做的事情，我都不願意做，對此我毫無頭緒。 The opposite of depression is not happiness, but vitality. 憂鬱的反面不是快樂，而是活力。 And it was vitality that seemed to seep away from me in that moment. 正是這種活力，在那時似乎從我體內一點一點地消失。 Everything there was to do seemed like too much work. 任何需要做的事情都變得困難無比。 I would come home, 我回到家裡， and I would see the red light flashing on my answering machine, 看到答錄機上閃爍跳躍的紅燈， and instead of being thrilled to hear from my friends, 我非但不會因為有朋友的音訊而感到興奮。 I would think, "What a lot of people that is to have to call back." 我會想著：「怎麼有這麼多人需要我回覆電話！」 Or I would decide I should have lunch, 又比如，我知道自己該吃午餐了。 and then I would think, but I'd have to get the food out 我就會想，我需要把食物取出來， and put it on a plate and cut it up and chew it and swallow it, 放在盤子上，切開它們，嚼碎它們再嚥下去。 and it felt to me like the Stations of the Cross. 這對我就像耶穌受難一樣難熬。 And one of the things that often gets lost in discussions of depression 有關憂鬱的討論中，有一點經常讓人困惑， is that you know it's ridiculous. 那就是你明白這一切都很荒謬。 You know it's ridiculous while you're experiencing it. 當你經歷這一切的時候， 你知道這很荒謬。 You know that most people manage to listen to their messages and eat lunch 你知道大多數人能夠聽他們的電話留言、吃午飯、 and organize themselves to take a shower and go out the front door, 打點好自己、沖個澡，然後走出大門。 and that it's not a big deal, and yet you are nonetheless in its grip, 這些事無關緊要，但你卻依然深陷其中， and you are unable to figure out any way around it. 你無法找到逃離的方式。 And so I began to feel myself doing less and thinking less and feeling less. 於是我發現自己做的事越來越少，思考愈來愈少，感覺越來越少。 It was a kind of nullity, and then the anxiety set in. 處在一種虛無狀態中。這時焦慮出現了。 If you told me that I'd have to be depressed for the next month, 如果你告訴我，我會在下個月一直憂鬱， I would say, "As long I know it'll be over in November, I can do it." 我會說：「只要我知道， 憂鬱會在 11 月消失，我就能挺過去。」 But if you said to me, "You have to have acute anxiety for the next month," 然而如果你這樣說：「你會在下個月嚴重焦慮。」 I would rather slit my wrist than go through it. 我寧願割腕也不願意承受。 It was the feeling all the time, like that feeling you have if you're walking, 這是一種持續的感受，就好像你走在路上， and you slip or trip, and the ground is rushing up at you, 你跌倒了或者絆倒了，地面猛然衝向你。 but instead of lasting half a second, the way that does, it lasted for six months. 但是這感覺不是只有半秒，這感覺要持續六個月。 It's a sensation of being afraid all the time, but not even knowing what it is that you're afraid of. 這是一種無時無刻感到害怕，卻不知道你在害怕什麼的感覺。 And it was at that point that I began to think that it was just too painful to be alive, 那一刻我開始想，活著太痛苦了。人不會自殺的唯一理由， and that the only reason not to kill oneself was so as not to hurt other people. 就是不想傷害旁人。 And finally one day, I woke up, and I thought perhaps I'd had a stroke, 終於有一天，我醒來，我想我可能中風了。 because I lay in bed completely frozen, looking at the telephone, thinking, 因為我躺在床上，渾身僵硬。我看著電話，心想： "Something is wrong and I should call for help," 「出事了，我應該打電話求救。」 and I couldn't reach out my arm and pick up the phone and dial. 我卻無法伸出胳膊，無法拿起電話撥號， And finally, after four full hours of my lying and staring at it, 終於，在我躺著盯著電話 整整四個小時之後， the phone rang, and somehow I managed to pick it up, 電話響了，不知怎麼我拿起了聽筒， and it was my father, and I said, 是我父親來電，我說： "I'm in serious trouble. We need to do something." 「我麻煩大了，我們必須做點什麼。 」 The next day I started with the medications and the therapy. 第二天我開始接受藥物治療和心理治療。 And I also started reckoning with this terrible question: 並且我開始思索這個可怕的問題： If I'm not the tough person who could have made it through a concentration camp, then who am I? 如果我不是個堅強的人，不是那種可以在集中營裡存活的人，那麼我是誰？ And if I have to take medication, is that medication making me more fully myself, 如果我必須服用藥物，那麼藥物是讓我變得更像我自己， or is it making me someone else? 還是讓我變成了別人？ And how do I feel about it if it's making me someone else? 如果藥物讓我變成了別人我有有什麼感覺呢？ I had two advantages as I went into the fight. 在這場戰鬥中我有兩個優勢： The first is that I knew that, objectively speaking, I had a nice life, 第一，我很清楚，客觀地說，我有很好的生活。 and that if I could only get well, 一旦我好起來， there was something at the other end that was worth living for. 還會有一些東西值得我去追求。 And the other was that I had access to good treatment. 另外一點是我能接受很好的治療。 But I nonetheless emerged and relapsed, and emerged and relapsed, 然而我卻反覆發作，好轉又發作，又一次好轉， and emerged and relapsed, and finally understood 再發作，終於我明白， I would have to be on medication and in therapy forever. 自己必須一輩子服藥和治療。 And I thought, "But is it a chemical problem or a psychological problem? 於是我想：「但是這到底是化學問題還是心理問題？ And does it need a chemical cure or a philosophical cure?" 是需要化學療法還是哲學療法？」 And I couldn't figure out which it was. 我想不出是哪一種。 And then I understood that actually, 接著我懂了， we aren't advanced enough in either area for it to explain things fully. 事實上，我們對這兩個領域的了解都不足以完全解釋真相。 The chemical cure and the psychological cure both have a role to play, 化學療法和心理療法都有各自的作用， and I also figured out that depression was something that was braided so deep into us 同時我明白了憂鬱是一種深深根植於我們體內的東西， that there was no separating it from our character and personality. 我們無法從性格和個性中將憂鬱剝離開來。 I want to say that the treatments we have for depression are appalling. 我想說我們對憂鬱的治療方法太過恐怖。 They're not very effective. They're extremely costly. 這些方法不太有效，而且代價高昂， They come with innumerable side effects. They're a disaster. 還帶來無數副作用，簡直就是場災難。 But I am so grateful that I live now and not 50 years ago, 不過我很慶幸自己活在現代，而不是 50 年前， when there would have been almost nothing to be done. 那時候幾乎沒有任何治療的辦法。 I hope that 50 years hence, people will hear about my treatments 我想 50 年以後，人們聽說我的治療方法， and be appalled that anyone endured such primitive science. 會驚訝於居然有人能忍受如此原始粗糙的科學。 Depression is the flaw in love. 憂鬱是愛的缺陷。 If you were married to someone and thought, "Well, if my wife dies, I'll find another one," 如果你將要和另一半結婚，然後想：「好吧，如果我妻子死了，我會再找一個。」 it wouldn't be love as we know it. 這不是我們熟知的愛情。 There's no such thing as love without the anticipation of loss, 沒有這樣一種愛情，只有獲取幸福卻不用體驗失去， and that specter of despair can be the engine of intimacy. 這種絕望的幽靈，會是親密關係的動力。 There are three things people tend to confuse: depression, grief and sadness. 人們容易混淆三件事：憂鬱，悲傷和難過。 Grief is explicitly reactive. 悲傷是明確的反應。 If you have a loss and you feel incredibly unhappy, and then, six months later, 如果你因為損失而感到非常不開心，那麼六個月之後， you are still deeply sad, but you're functioning a little better, it's probably grief, 你仍然很難過，但日常作息好轉了一些，這大概就是悲傷。 and it will probably ultimately resolve itself in some measure. 它可能最終在一定程度上能自行修復。 If you experience a catastrophic loss, and you feel terrible, 如果你經歷了一次災難性的打擊，你感覺非常糟糕， and six months later you can barely function at all, 六個月之後依然無法正常生活， then it's probably a depression that was triggered 那麼可能就是一種憂鬱被 by the catastrophic circumstances. 災難性的情形所觸發了。 The trajectory tells us a great deal. 這個分析軌跡告訴我們很多訊息。 People think of depression as being just sadness. 人們認為憂鬱只是難過。 It's much, much too much sadness, 只是太多太多的難過， much too much grief at far too slight a cause. 太多太多的悲傷，因為微不足道的事情而起。 As I set out to understand depression, and to interview people who had experienced it, 當我開始了解憂鬱，採訪了經歷過憂鬱的人們， I found that there were people who seemed, on the surface, 我發現有些人表面上看起來 to have what sounded like relatively mild depression 似乎有輕微的憂鬱， who were nonetheless utterly disabled by it. 他們卻因此完全喪失了行為能力。 And there were other people who had what sounded 另外一些人， as they described it like terribly severe depression, who nonetheless had good lives a根據他們的描述，有非常嚴重的憂鬱， in the interstices between their depressive episodes. 卻能在憂鬱的間隙過著不錯的生活。 And I set out to find out what it is that causes some people to be more resilient than other people. 我開始著手研究，為什麼有些人比另一些人有更好的復元能力。 What are the mechanisms that allow people to survive? 是什麼機制讓人得以倖存？ And I went out and I interviewed person after person who was suffering with depression. 我出去採訪了一個又一個因憂鬱而受苦的人。 One of the first people I interviewed described depression as a slower way of being dead, 我最早採訪的某個人將憂鬱描述為一種緩慢的死亡方式。 and that was a good thing for me to hear early on 最初就聽到這說法對我來說是好事， because it reminded me that that slow way of being dead 因為它提醒了我緩慢的死亡 can lead to actual deadness, that this is a serious business. 可以通往真正的死亡，這可是正經話。 It's the leading disability worldwide, and people die of it every day. 憂鬱是世界上名列前茅的身心障礙，每天都有人因此喪生。 One of the people I talked to when I was trying to understand this, 當我試著了解這些的時候，我的一位採訪對象， was a beloved friend who I had known for many years, 也是我的摯友，我與她相識多年。 and who had had a psychotic episode in her freshman year of college, 在她大一的時候，有過一次精神病發作， and then plummeted into a horrific depression. 之後她陷入了可怕的憂鬱。 She had bipolar illness, or manic depression, as it was then known. 她患有雙相障礙，當時也稱為躁鬱症。 And then she did very well for many years on lithium, 經過多年的鋰治療，她恢復得不錯， and then eventually, she was taken off her lithium 於是到最後，她停止了化學治療， to see how she would do without it, and she had another psychosis, 看看自己不治療能撐多久。然而她的精神病復發， and then plunged into the worst depression that I had ever seen, a接著陷入了我所見過最嚴重的憂鬱。 in which she sat in her parents' apartment, a她坐在父母的公寓裡， more or less catatonic, essentially without moving, day after day after day. 基本上就像植物人一樣， And when I interviewed her about that experience some years later, 幾乎一動也不動，就這樣過了一天又一天。 she's a poet and psychotherapist named Maggie Robbins, when I interviewed her, she said, 多年後我採訪她，談起了這段經歷──她叫瑪姬．羅賓 (Maggie Robbins) ， 是一位詩人和精神治療師──當我採訪她時，她說： "I was singing 'Where Have All The Flowers Gone,' over and over, to occupy my mind. 「 當時我一遍一遍地唱著 《花兒都去哪兒了》，滿腦子都是這首歌。 I was singing to blot out the things my mind was saying, 我唱著歌來清除腦子裡的那個聲音， which were, 'You are nothing. You are nobody. You don't even deserve to live.' 那個聲音說：『你什麼都不是，你一文不名。你不配活著。』 And that was when I really started thinking about killing myself." 從那一刻起，我真的開始想要殺死我自己。 」 You don't think in depression that you've put on a gray veil 你憂鬱的時候，並不像是你戴上了一個灰色面紗， and are seeing the world through the haze of a bad mood. 透過沮喪情緒的霧霾來看待這個世界。 You think that the veil has been taken away, the veil of happiness, and that now you're seeing truly. 而是你認為那層快樂的面紗已經被拿走，所以現在你面對的是赤裸裸的現實。 It's easier to help schizophrenics who perceive 幫助精神分裂症患者相對容易一些， that there's something foreign inside of them that needs to be exorcised, 他們知道身體裡有異物，需要把它們弄出去， but it's difficult with depressives, because we believe we are seeing the truth. 而對於憂鬱症患者就困難多了，因為我們相信自己看到的是現實。 But the truth lies. I became obsessed with that sentence: "But the truth lies." 但是事實會說謊。我為這句話著迷：「事實會說謊。」 And I discovered, as I talked to depressive people, that they have many delusional perceptions. 據我觀察，當我和憂鬱症患者交談時，他們有許多妄想的念頭。 People will say, "No one loves me." 他們會說：「沒人愛我。」 And you say, "I love you, your wife loves you, your mother loves you." 你會說：「我愛你，你的妻子愛你，你的媽媽愛你。」 You can answer that one pretty readily, at least for most people. 你可以馬上說出這個答案，至少大多數人是這樣。 But people who are depressed will also say, "No matter what we do, we're all just going to die in the end." 但是憂鬱症患者還會說：「不管我們做什麼，最終，我們都會死去。」 Or they'll say, "There can be no true communion between two human beings. 或者他們會說：「人與人之間不可能有真正的交流。 Each of us is trapped in his own body." To which you have to say, "That's true, 我們每個人都被困在自己的身體裡。」關於這點你會反駁說：「這沒錯， but I think we should focus right now on what to have for breakfast." 但是我認為，我們當下應該考慮的是早飯吃什麼。」 A lot of the time, what they are expressing is not illness, but insight, 大多數時候，他們所表現出來的不是病症，而是思想偏執， and one comes to think what's really extraordinary 他們對這些問題特別在意， is that most of us know about those existential questions, and they don't distract us very much. 而大多數人都知道這些存在主義問題，但是我們不會太困擾。 There was a study I particularly liked, 我特別喜歡這個研究： in which a group of depressed and a group of non-depressed people 一群憂鬱症患者 和一群非憂鬱症患者 were asked to play a video game for an hour, and at the end of the hour, 被要求玩一個小時的電玩，一小時後問他們， they were asked how many little monsters they thought they had killed. 他們認為自己殺死了多少只小怪獸。 The depressive group was usually accurate to within about 10 percent, 憂鬱症組的回答通常是準確的，誤差在 10％ 以內， and the non-depressed people guessed between 15 and 20 times as many little monsters, as they had actually killed. 而非憂鬱症組的人，回答打死小怪獸的數量比實際數目多了15到20倍 。 A lot of people said, when I chose to write about my depression, 當我選擇寫下我自己的憂鬱經歷，很多人說要揭開這個秘密， that it must be very difficult to be out of that closet, to have people know. 讓別人知道，一定非常困難。 They said, "Do people talk to you differently?" I said, "Yes, people talk to me differently." 他們說：「人們會用不同的口吻和你說話嗎？」我回答：「是的，人們用不一樣的語氣和我說話。」 They talk to me differently insofar as they start telling me about their experience, 這種不一樣表現在他們會開始和我談自己的經歷， or their sister's experience, or their friend's experience. 或者他們姐妹的經歷，或者他們朋友的經歷。 Things are different because now I know that depression is the family secret that everyone has. 事情和以前有所不同，因為現在我知道憂鬱是每個家庭裡的秘密。 I went a few years ago to a conference, and on Friday of the three-day conference, 幾年前我參加一個會議，會議有三天，週五的時候， one of the participants took me aside, and she said, 一名與會者把我拉到一旁，對我說： "I suffer from depression, and I'm a little embarrassed about it, 「我有憂鬱症，我覺得有點不好意思， but I've been taking this medication, and I just wanted to ask you what you think?" 但是我一直在服這種藥，我只想問問你的意見？」 And so I did my best to give her such advice as I could. 於是我盡我所能給了她一些建議。 And then she said, "You know, my husband would never understand this. 然後她說：「你知道，我丈夫永遠不會理解這些。 He's really the kind of guy to whom this wouldn't make any sense, 他就是那種認為這些都是胡說八道的人， so, you know, it's just between us." And I said, "Yes, that's fine." 所以我想，嗯，希望我們的談話能保密。」我回答：「當然沒問題。」 On Sunday of the same conference, her husband took me aside, 週日在同一個會議上，她的丈夫把我拉到一邊， and he said, "My wife wouldn't think that I was really much of a guy if she knew this, 他說：「我妻子如果知道這事，她就不會覺得我是個男子漢， but I've been dealing with this depression and I'm taking some medication, and I wondered what you think?" 但是我一直在對抗憂鬱，而且在服用藥物，我想能否聽聽你的建議？」 They were hiding the same medication in two different places in the same bedroom. 他們兩個把同樣的藥物藏在臥室不同的地方。 And I said that I thought communication within the marriage might be triggering some of their problems. 於是我對他說，我認為婚姻中的溝通可能引起他們的某些問題。 But I was also struck by the burdensome nature of such mutual secrecy. 不過我也震驚於這種相互隱瞞的惱人天性。 Depression is so exhausting. 憂鬱令人精疲力盡，它消耗了你那麼多的時間和精力。 It takes up so much of your time and energy, and silence about it, 對此緘口不提， it really does make the depression worse. 真的只會讓憂鬱更糟糕。 And then I began thinking about all the ways people make themselves better. 我開始考慮各種方法可以讓人們感覺更好。 I'd started off as a medical conservative. 一開始我對醫學治療較保守。 I thought there were a few kinds of therapy that worked. 我認為一些療法是有效的。 It was clear what they were. There was medication. 它們確實有效，包括藥物治療， There were certain psychotherapies. There was possibly electroconvulsive treatment, 還有一些特定的心理治療，電痙攣療法也可能有效。 and that everything else was nonsense. 除此以外的都沒用。 But then I discovered something. 但是後來我發現， If you have brain cancer, and you say that standing on your head for 20 minutes every morning 如果你得了腦癌，而且你認為每天早上倒立 20 分鐘 makes you feel better. It may make you feel better, but you still have brain cancer, 能讓你感覺好些。這可能讓你感覺好一些，但是你仍然會有腦癌。 and you'll still probably die from it. 你還是有可能因此死去。 But if you say that you have depression, 不過如果你說你得了憂鬱症， and standing on your head for 20 minutes every day makes you feel better, 然後每天倒立 20 分鐘讓你感覺好些， then it's worked, because depression is an illness of how you feel, 那麼這是有效的。因為憂鬱是一種關於感受的疾病。 and if you feel better, then you are effectively not depressed anymore. 如果你感覺好一點了，那麼你就不會那麼憂鬱了。 So I became much more tolerant of the vast world of alternative treatments. 所以我開始對無數的替代療法抱有更加寬容的看法。 And I get letters, I get hundreds of letters from people writing to tell me about what's worked for them. 我收到來信，多達幾百封的來信，人們來信告訴我，什麼樣的療法對他們有效。 Someone was asking me backstage today about meditation. 今天有人在後臺問我關於藥物治療的事情。 My favorite of the letters that I got was the one that came from a woman 我最喜歡的一封來信是來自一位女士， who wrote and said that she had tried therapy, medication. 她說她嘗試過心理治療，也嘗試過藥物治療， She had tried pretty much everything, and she had found a solution and hoped I would tell the world, 嘗試了幾乎所有的治療方式。她找到一個治療方法希望我能告訴全世界， and that was making little things from yarn. 那就是用紗線做些小東西。 She sent me some of them, and I'm not wearing them right now. 她還寄給我一些她的作品，我今天並沒有把它們戴在身上。 I suggested to her that she also should look up obsessive compulsive disorder in the DSM. 我建議她還應該去醫院，檢查一下是否得了強迫症。 And yet, when I went to look at alternative treatments, I also gained perspective on other treatments. 然而，當我去了解各種療法的時候，我也對其它療法有了新看法。 I went through a tribal exorcism in Senegal that involved a great deal of ram's blood 我在塞內加爾參加了一次部落驅魔，裡面還有很多公羊的血， and that I'm not going to detail right now, but a few years afterwards I was in Rwanda, 這裡我就不描述細節了。但是多年之後，我在盧旺達 working on a different project, and I happened to describe my experience to someone, 做另一個計畫，我湊巧把自己的經歷告訴某個人， and he said, "Well, that's West Africa, and we're in East Africa, 他說：「嗯，你知道，那裡是西非，我們這兒是東非， and our rituals are in some ways very different, 我們的儀式在一些方面很不同， but we do have some rituals that have something in common with what you're describing." 不過我們確實有一些儀式內容和你描述的相同。」 And he said, "But we've had a lot of trouble with Western mental health workers, 他又說：「不過西方的心理工作者 讓我們很苦惱， especially the ones who came right after the genocide." 尤其是大屠殺之後來的那些心理醫生。」 I said, "