Depression is the leading cause of disability in the world.
抑郁症在世界上是造成失能的主要原因。
In the United States, close to 10% of adults struggle with depression.
在美国，近10%的成人为抑郁所苦。
But because it's a mental illness, it can be a lot harder to understand than, say, high cholesterol.
但由于它是心理上的疾病，所以它比像高胆固醇之类的疾病还要让人难以理解。
One major source of confusion is the difference between having depression and just feeling depressed.
一个主要令人困惑的是“抑郁症”和“只是感觉沮丧”的差别。
Almost everyone feels down from time to time.
每个人都有失落的时候。
Getting a bad grade, losing a job, having an argument, even a rainy day can bring on feelings of sadness.
成绩考差了、被炒魷鱼、发生争执，甚至是下雨天都可能使人忧伤。
Sometimes there's no trigger at all. It just pops up out of the blue.
有时根本没有什么诱因。沮丧就会凭空出现。
Then circumstances change, and those sad feelings disappear. Clinical depression is different.
接着情境改变，而沮丧的心情也随之消散。临床上的抑郁症是不同的。
It's a medical disorder, and it won't go away just because you want it to.
它是一种疾病，而它不会因为你想让它滚蛋就滚蛋。
It lingers for at least two consecutive weeks, and significantly interferes with one's ability to work, play, or love.
它至少会持续两个星期，并严重地干扰一个人的工作能力、游玩意愿或情感生活。
Depression can have a lot of different symptoms.
抑郁症可以有很多不同的症狀。
a low mood, loss of interest in things you'd normally enjoy, changes in appetite,
心情低落、对平常喜爱的事物兴趣缺缺、胃口改变、
feeling worthless or excessively guilty, sleeping either too much or too little,
觉得无用或过度的罪恶感、睡太多或太少、
poor concentration, restlessness or slowness, loss of energy, or recurrent thoughts of suicide.
难以专注、躁动或迟钝、没有活力、或反覆兴起自杀念头。
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5项症状，根据精神科的准则你会被诊断为抑郁症。
And it's not just behavioral symptoms.
它不只是行为上的症状而已。
Depression has physical manifestations inside the brain.
抑郁症在脑部还会有实质的表征。

First of all, there are changes that could be seen with the naked eye and X-ray vision.
首先有些改变可透过肉眼或 X 光观察发现。
These include smaller frontal lobes and hippocampal volumes.
包括额叶和海马体的容量变小。
On a more microscale, depression is associated with a few things:
从更细微的来说，抑郁症和有些事物有所关连：
the abnormal transmission or depletion of certain neurotransmitters,
某些神经传导物质不正常地传递或耗损，
especially serotonin, norepinephrine, and dopamine, blunted circadian rhythms,
特别是血清素、去甲肾上腺素和多巴胺使得生理节奏失调，
or specific changes in the REM and slow-wave parts of your sleep cycle,
或睡眠周期中的快速动眼期及慢波睡眠的特定改变，
and hormone abnormalities, such as high cortisol and deregulation of thyroid hormones.
以及荷尔蒙异常，例如皮质醇过高和甲状腺荷尔蒙失常。
But neuroscientists still don't have a complete picture of what causes depression.
但神经学家还尚未全面了解掌握造成抑郁症的原因。
It seems to have to do with a complex interaction between genes and environment,
似乎与基因和环境间复杂的交互作用有关，
but we don't have a diagnostic tool that can accurately predict where or when it will show up.
但目前没有诊断的工具可以精确地预测在何地或何时会发病。
And because depression symptoms are intangible, it's hard to know who might look fine but is actually struggling.
也因为抑郁症的症状是变化莫测的，我们很难知道看起来好端端的人其实正处于挣扎中。
According to the National Institute of Mental Health,
根据美国国家心理健康研究院所说，
it takes the average person suffering with a mental illness over ten years to ask for help.
通常罹患心理疾病的病患都拖了超过10年才寻求协助。
But there are very effective treatments.
但现在有非常有效的治疗方法。
Medications and therapy complement each other to boost brain chemicals.
药物和治疗相辅相成来强化大脑化学物质。
In extreme cases, electroconvulsive therapy, which is like a controlled seizure in the patient's brain, is also very helpful.
在一些极端的个案，“电痉挛疗法”它是一种在患者脑部以可控制的电击来诱发痉挛的疗法也非常有帮助。
Other promising treatments, like transcranial magnetic stimulation, are being investigated, too.
其他有前景的疗法像是“经颅磁刺激法”也都在研究中。
So, if you know someone struggling with depression, encourage them, gently, to seek out some of these options.
所以，如果你认识为抑郁症所苦的人温和地鼓励他，去寻求其中几项的帮助。
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.
你甚至也可提供特别的协助，像帮他找附近的治疗师或是列出一张要问医师问题的清单。
To someone with depression, these first steps can seem insurmountable.
对抑郁症患者来说踏出寻求治疗的最初几步都可谓举步难难。
If they feel guilty or ashamed, point out that depression is a medical condition, just like asthma or diabetes.
如果他们会觉得罪恶或羞耻的话，要点醒他们：抑郁是一种疾病，就像气喘或糖尿病。
It's not a weakness or a personality trait,
它不是弱点或人格特质，
and they shouldn't expect themselves to just get over it anymore than they could will themselves to get over a broken arm.
也不应该认为自己有办法熬过去，这正如不能光靠自己的意志力就治好手骨折一样。
If you haven't experienced depression yourself, avoid comparing it to times you've felt down.
如果你没有得过抑郁症，要避免拿它来和自己失意时比较。
Comparing what they're experiencing to normal, temporary feelings of sadness can make them feel guilty for struggling.
将他们的抑郁症和自己平常短暂的沮丧相比会让他们对挣扎有罪恶感。
Even just talking about depression openly can help.
就算只是公开谈论抑郁症也会有帮助。
For example, research shows that asking someone about suicidal thoughts actually reduces their suicide risk.
举例来说，研究显示问某人对自杀的看法真的可降低他们的自杀风险。
Open conversations about mental illness help erode stigma and make it easier for people to ask for help.
公开谈论心理疾病可以削弱它的坏名声，让人们能更无拘束地去寻求协助。
And the more patients seek treatment, the more scientists will learn about depression, and the better the treatments will get.
而就诊的病患越多，科学家对抑郁症的了解就越多，治疗方式就会越来越好。