In the United States, close to 10% of adults struggle with depression, but because it's a mental illness, it can be a lot harder to understand than, say, high cholesterol.

在美國近 10% 的成人深受憂鬱之擾，但因為這是心理疾病，可能比高膽固醇還更難讓人理解。

One major source of confusion is the difference between having depression and just feeling depressed.

人們常常很容易把有憂鬱症和只是心情低落搞混。

Almost everyone feels down from time to time: getting a bad grade, losing a job, having an argument, even a rainy day can bring on feelings of sadness.

幾乎每個人都有過心情低落的時候，像是成績不理想、被炒魷魚、和人起爭執，甚至只是雨天也可能帶來憂傷。

Sometimes there's no trigger at all, it just pops up out of the blue.

有時根本沒有任何觸發心情低落的原因，它就這麼樣地憑空冒出。

Then circumstances change, and those sad feelings disappear.

但之後情況就會改變，憂傷的情緒消失不見。

Clinical depression is different. It's a medical disorder, and it won't go away just because you want it to.

臨床憂鬱症則完全不同，這是心理健康失調生病，不會說好就好。

It lingers for at least two consecutive weeks, and significantly interferes with one's ability to work, play, or love.

通常會跟著你至少連續兩星期，且會明顯地影響一個人的工作、娛樂，或愛的能力。

Depression can have a lot of different symptoms:

憂鬱可能會有許多不同的症狀：

a low mood, loss of interest in things you'd normally enjoy, changes in appetite, feeling worthless or excessively guilty, sleeping either too much or too little, poor concentration, restlessness or slowness, loss of energy, or recurrent thoughts of suicide.

心情不好、對你平常喜愛的事物沒了興趣、胃口改變、感到毫無價值或極度愧疚、睡太多或失眠、無法集中精神、煩躁或行動緩慢、沒有精神，或是萌生自殺的念頭。

If you have at least five of those symptoms, according to psychiatric guidelines, you qualify for a diagnosis of depression.

如果你有至少五項上述的症狀，根據精神病學方針，你已經罹患憂鬱症。

And it's not just behavioral symptoms.

這不僅只是行為上的症狀。

Depression has physical manifestations inside the brain.

患憂鬱症的人大腦內會有物理性的改變。

First of all, there are changes that could be seen with the naked eye and X-ray vision. These include smaller frontal lobes and hippocampal volumes.

首先有些變化可直接以肉眼和 X 光線看出，包括了額葉和海馬迴體積縮小。

On a more micro-scale, depression is associated with a few things:

微觀下，憂鬱症和幾件事有關：

the abnormal transmission or depletion of certain neurotransmitters, especially serotonin, norepinephrine, and dopamine;

某些神經傳導物質不正常的傳遞或消耗，特別是血清素、正腎上腺素與多巴胺；

blunted circadian rhythms, or specific changes in the REM and slow-wave parts of your sleep cycle;

生理時鐘失調，或是睡眠周期中的快速動眼期與慢波睡眠期明顯改變；

and hormone abnormalities, such as high cortisol and deregulation of thyroid hormones.

荷爾蒙失調，像是過多的皮質醇和異常濃度的甲狀腺素。

But neuroscientists still don't have a complete picture of what causes depression.

但神經學家仍然無法全面掌握憂鬱症的成因。

It seems to have to do with a complex interaction between genes and environment, but we don't have a diagnostic tool that can accurately predict where or when it will show up.

其似乎和複雜的基因與環境交互作用有關，但我們沒有診斷的工具可以準確預測何時、何地會發生憂鬱症。

And because depression symptoms are intangible, it's hard to know who might look fine but is actually struggling.

且因為憂鬱症是無形的，我們很難知道表面看起來很好的人其實內心十分煎熬。

According to the National Institute of Mental Health, it takes the average person suffering with a mental illness over ten years to ask for help.

根據國家精神健康研究院，一般患有憂鬱症的人需要十年以上的時間才會尋求幫助。

But there are very effective treatments—medications and therapy complement each other to boost brain chemicals.

但現在有許多成效不錯的治療，像是結合藥物和療法刺激腦內物質。

In extreme cases, electroconvulsive therapy, which is like a controlled seizure in the patient's brain, is also very helpful.

一些極端的例子，如電痙攣療法經由電擊在病患的腦中誘發痙攣，也是非常有效的方法。

Other promising treatments, like transcranial magnetic stimulation, are being investigated, too.

其他有希望性的治療如頭顱磁刺激療法，也正在被研究觀察中。

So, if you know someone struggling with depression, encourage them, gently, to seek out some of these options.

所以，如果你有認識的人正在對抗憂鬱症，溫柔地鼓勵他們去尋求這些解決方法。

You might even offer to help with specific tasks, like looking up therapists in the area, or making a list of questions to ask a doctor.

你也可以藉由實際行動提供協助，像是尋找附近的治療師，或列出一些問題詢問醫生。

To someone with depression, these first steps can seem insurmountable.

對有憂鬱症的人而言，第一步是最難跨出的。

If they feel guilty or ashamed, point out that depression is a medical condition, just like asthma or diabetes.

如果他們感到內疚或丟臉，告訴他們憂鬱症其實是種疾病，就跟氣喘和糖尿病一樣。

It's not a weakness or a personality trait, and they shouldn't expect themselves to just get over it anymore than they could will themselves to get over a broken arm.

不是軟弱的表現，也不是本身的人格特質，有憂鬱症的人不該指望只靠自己硬撐過去，這和他們從手臂斷掉中恢復過來無法相提並論。

If you haven't experienced depression yourself, avoid comparing it to times you've felt down.

如果你本身沒有過憂鬱症的經驗，千萬別拿它和你心情低落的時候相比。

Comparing what they're experiencing to normal, temporary feelings of sadness can make them feel guilty for struggling.

拿這些人的經歷和正常、短暫的低落情緒做比較會讓他們感到愧疚與煎熬。

Even just talking about depression openly can help, for example, research shows that asking someone about suicidal thoughts actually reduces their suicide risk.

僅僅只是公開討論憂鬱症也能有所助益，例如，研究顯示，詢問某人關於自殺的想法其實可減少其自殺的風險。

Open conversations about mental illness help erode stigma and make it easier for people to ask for help, and the more patients seek treatment, the more scientists will learn about depression, and the better the treatments will get.

把心理疾病攤開來說有助於消除羞恥感，讓他們能更勇於尋求協助，而當越多病患接受治療，便越有利於科學家更深入了解憂鬱症，且得以發展更好的治療方法。