The word bipolar means two extremes.

雙極這個字指的是兩個極端。

For the many millions experiencing bipolar disorder around the world,

對於全球數百萬名躁鬱症患者來說，

life is split between two different realities - elation and depression.

生活分裂成兩個不同的現實：興高采烈與意志消沉。

Although there are many variations of bipolar disorder, let's consider a couple.

雖然躁鬱症有許多變型，但就讓我們只考慮一組吧。

Type 1 has extreme highs alongside the lows,

第一型有著極度高漲的情緒，伴隨著低落的情緒，

while Type 2 involves briefer, less extreme periods of elation interspersed with long periods of depression.

而第二型則有較短暫、較輕微的躁期，伴隨著長時間的鬱期。

For someone seesawing between emotional states, it can feel impossible to find the balance necessary to lead a healthy life.

對於在情緒狀態的蹺蹺板上下擺盪的人來說，找到讓自己活得健康的平衡狀態感覺是不可能的。

Type 1's extreme highs are known as manic episodes, and they can make a person range from feeling irritable to invincible.

第一型的極度高漲情緒被稱為躁狂期，這時期可以讓人從感覺易怒，到感覺自己無比強大。

But these euphoric episodes exceed ordinary feelings of joy,

但這些愉悅的時期超出了平常高興的情緒，

causing troubling symptoms like racing thoughts,

造成麻煩的症狀，像是思緒奔騰、

sleeplessness,

失眠、

rapid speech,

語速快、

impuslive actions,

衝動行為，

and risky behaviors.

以及危險行為。

Without treatment, these episodes become more frequent, intense, and take longer to subside.

若不接受治療，這些時期會愈來愈頻繁、更劇烈，花更長時間才能平息。

The depressed phase of bipolar disorder manifests in many ways -

而躁鬱症的鬱期會以不同方式出現：

a low mood,

情緒低落、

dwindling interest in hobbies,

漸漸對自己的嗜好不感興趣、

changes in appetite,

食慾改變、

feeling worthless or excessively guilty,

感到自己一無是處或過於內疚、

sleeping either too much or too little,

睡眠過多或過少、

restlessness or slowness,

坐立不安或行動緩慢，

or persistent thoughts of suicide.

或是不斷有自殺的想法。

Worldwide, about one to three percent of adults experience the broad range of symptoms that indicate bipolar disorder.

全球大約有 1% - 3% 的成年人有非常多的症狀，顯示他們有躁鬱症。

Most of those people are functional, contributing members of society,

這些人大部分都是社會上有作用、有貢獻的一員，

and their lives, choices, and relationships aren't defined by the disorder,

而他們的生活、選擇，以及人際關係都不因躁鬱症而受限，

but still, for many, the consequences are serious.

然而，對於很多人來說，疾病造成的後果還是很嚴重。

The illness can undermine educational and professional performance,

躁鬱症會損害學業、專業表現、

relationships,

人際關係、

financial security,

財務安全，

and personal safety.

以及個人安全。

So what causes bipolar disorder?

那麼，躁鬱症是什麼原因造成的？

Researchers think a key player is the brain's intricate wiring.

研究人員認為，大腦裡錯綜複雜的線路是重要因素。

Healthy brains maintain strong connections between neurons thanks to the brain's continuous efforts to prune itself and remove unused or faulty neural connections.

健康的大腦讓神經元之間保持密切連結，這多虧了大腦不斷地削減自己，移除未使用過或有缺陷的神經連結。

This process is important because our neural pathways serve as a map for everything we do.

這個過程很重要，因為我們的神經路徑作為地圖讓我們做出一切事情。

Using functional magnetic resonance imaging, scientists have discovered that the brain's pruning ability is disrupted in people with bipolar disorder.

科學家使用功能性磁振造影發現，患有躁鬱症的人他們大腦的修整能力會被中斷。

That means their neurons go haywire and create a network that's impossible to navigate.

這意味著他們的神經元不受控制，創造出難以追蹤的網路。

With only confusing signals as a guide, people with bipolar disorder develop abnormal thoughts and behaviors.

因為只有混淆的信號引導，患有躁鬱症的人發展出異常的想法與行為。

Also, psychotic symptoms,

此外，精神病症狀，

like disorganized speech and behavior,

如胡言亂語、行為紊亂、

delusional thoughts,

幻想、

paranoia,

妄想，

and hallucinations can emerge during extreme phases of bipolar disorder.

幻覺等等會出現在躁鬱症的極端期。

This is attributed to the overabundance of a neurotransmitter called dopamine.

這是因為一個稱為多巴胺的神經傳導物質過剩導致。

But despite these insights, we can't pin bipolar disorder down to a single cause.

但儘管了解了以上知識，我們還是不能確定躁鬱症只有一種原因造成。

In reality, it's a complex problem.

實際上，躁鬱症是個複雜的問題。

For example, the brain's amygdala is involved in thinking,

舉例來說，大腦中的杏仁核涉及思考、

long-term memory,

長期記憶，

and emotional processing.

以及情緒處理。

In this brain region, factors as varied as genetics and social trauma may create abnormalities and trigger the symptoms of bipolar disorder.

在此大腦區塊，如遺傳學、社會創傷等諸多因素都有可能造成異常，或引發躁鬱症症狀。

The condition tends to run in families, so we do know that genetics have a lot to do with it.

這種狀況好發於家人間，因此，我們確實知道，遺傳學有很大的關聯。

But that doesn't mean there's a single bipolar gene.

但這不表示只有單一個躁鬱症基因。

In fact, the likelihood of developing bipolar disorder is driven by the interactions between many genes in a complicated recipe we're still trying to understand.

實際上，發展成躁鬱症的可能性是由許多基因間的互動驅使，而人正試圖了解這些複雜的互動方法。

The causes are complex, and consequently, diagnosing and living with bipolar disorder is a challenge.

躁鬱症形成原因很複雜，也因此，診斷躁鬱症、帶著躁鬱症生活都是種挑戰。

Despite this, the disorder is controllable.

儘管如此，躁鬱症還是可以控制的。

Certain medications like lithium can help manage risky thoughts and behaviors by stabilizing moods.

像是鋰等藥物治療能穩定情緒，有助於控制危險的想法與行為。

These mood stabilizing medications work by decreasing abnormal activity in the brain, thereby strengthening the viable neural connections.

這些能穩定心情的藥物，藉著減少大腦中異常活動而起作用，因此加強可活化的神經連結。

Other frequently used medications include antipsychotics, which alter the effects of dopamine,

其他常用的藥物包括抗精神病劑，這種藥物可以改變多巴胺的效果，

and electroconvulsive therapy, which works like a carefully controlled seizure in the brain, is sometimes used as an emergency treatment.

此外還有電痙攣療法，這種療法的作法是在腦中小心地控制引發痙攣，有時會用作緊急治療 。

Some bipolar patients reject treatment because they're afraid it will dim their emotions and destroy their creativity.

不過有些躁鬱症患者會拒絕治療，因為他們害怕治療會讓他們的情緒低落，以及破壞他們的創造力。

But modern psychiatry is actively trying to avoid that.

但是現今的精神病學很努力地避免這種情況。

Today, doctors work with patients on a case-by-case basis to administer a combination of treatments and therapies that allows them to live to their fullest possible potential.

如今，醫生會視個案中病人的情況不同，提供不同組合的治療與療法，讓療法能夠達到最大的成效。

And beyond treatment, people with bipolar disorder can benefit from even simpler changes.

除了治療之外，患有躁鬱症的人也可因更簡單的改變而受益。

Those include regular exercise,

這些改變包括規律運動、

good sleep habits,

良好的睡眠習慣、

and sobriety from drugs and alcohol,

對藥物、酒精節制，

not to mention the acceptance and empathy of family and friends.

更重要的是家人與朋友能接納與同情。

Remember, bipolar disorder is a medical condition, not a person's fault, or their whole identity,

請記得，躁鬱症是一種疾病，並不是患者的錯，也不能代表患者的全部個性，

and it's something that can be controlled through a combination of medical treatments doing their work internally,

而躁鬱症也是可以受控制的，透過一連串的藥物治療等內在因素，

friends and family fostering acceptance and understanding on the outside,

還有朋友與家人學會接納與諒解等外在因素，

and people with bipolar disorder empowering themselves to find balance in their lives.

患有躁鬱症的人就能自力更生找到生活中的平衡點。