What is bipolar disorder? The word bipolar means two extremes.
什么是双向情感障碍？“bipolar”这个单词意思是两个极端。
For the many millions experiencing bipolar disorder around the world,
对于世界上数百万躁郁症患者来说，
life is split between two different realities -- elation and depression.
生活被分裂成两个截然不同的部分，愉快期和抑郁期。
Although there are many variations of bipolar disorder, let's consider a couple.
躁郁症有多种类型，我们来看其中两种。
Type 1 has extreme highs alongside the lows,
第一种包含极端的情绪高潮，伴随情绪低谷，
while Type 2 involves briefer, less extreme periods of elation interspersed with long periods of depression.
第二种包含更温和的情绪高潮，穿插在长期的抑郁期中。
For someone seesawing between emotional states, it can feel impossible to find the balance necessary to lead a healthy life.
情感起伏很大的人会觉得找到健康生活的平衡点是不可能的。
Type 1's extreme highs are known as manic episodes,
第一种类型中的精神愉快期，被称为躁狂发作，
and they can make a person range from feeling irritable to invincible.
患者可能感到狂躁易怒，或是觉得自己无所不能。
But these euphoric episodes exceed ordinary feelings of joy,
但这种精神愉快超过一般的喜悦感，
causing troubling symptoms like racing thoughts, sleeplessness, rapid speech, impuslive actions, and risky behaviors.
会引发其他症状，比如思绪翻腾，失眠，言语急促，做出冲动行为以及危险行为。
Without treatment, these episodes become more frequent, intense, and take longer to subside.
若未接受治疗，异常的精神愉快期会更频繁出现，程度加重，同时需要花更久的时间平息。
The depressed phase of bipolar disorder manifests in many ways
躁郁症的精神沮丧期有以下表现形式：
a low mood, dwindling interest in hobbies, changes in appetite,
情绪低落，兴趣减弱，食欲不振，
feeling worthless or excessively guilty, sleeping either too much or too little,
感到自己没有价值或者极端内疚，睡太多或者太少，
restlessness or slowness, or persistent thoughts of suicide.
精力充沛或者行动缓慢，或者常有自杀的想法。
Worldwide, about one to three percent of adults experience the broad range of symptoms that indicate bipolar disorder.
全世界大约1-3%的成年人表现出躁郁症的不同症状。
Most of those people are functional, contributing members of society,
其中大多数是对社会有贡献的人，
and their lives, choices, and relationships aren't defined by the disorder,
他们的生活，选择以及人际关系并不受躁郁症限制，
but still, for many, the consequences are serious.
即便如此，对于很多人来说，躁郁症带来了严重的后果。
The illness can undermine educational and professional performance, relationships, financial security, and personal safety.
躁郁症会影响人们在学习和工作上的表现，人际关系，财务稳定以及个人安全。
So what causes bipolar disorder?
那么，是什么原因引起了躁郁症？
Researchers think a key player is the brain's intricate wiring.
研究人员认为，复杂的大脑回路是主因。
Healthy brains maintain strong connections between neurons
健康的大脑中神经元之间强有力地连接在一起，
thanks to the brain's continuous efforts to prune itself and remove unused or faulty neural connections.
多亏了大脑不断修剪清除无用的或错误的神经连接。
This process is important because our neural pathways serve as a map for everything we do.
这一过程之所以很重要是因为神经通路的作用就像是地图一样指引我们。

Using functional magnetic resonance imaging,
通过机能性磁共振成像，
scientists have discovered that the brain's pruning ability is disrupted in people with bipolar disorder.
科学家发现，大脑的修剪清理过程，在躁郁症患者身上受到了干扰。
That means their neurons go haywire and create a network that's impossible to navigate.
这意味着神经元连接失控，形成了一个无法正确导航的网络。
With only confusing signals as a guide, people with bipolar disorder develop abnormal thoughts and behaviors.
在混乱的信号指导下，躁郁症患者产生异常的想法和行为。
Also, psychotic symptoms, like disorganized speech and behavior,
同时，精神病症状，比如言语混乱、行为失控、
delusional thoughts, paranoia, and hallucinations can emerge during extreme phases of bipolar disorder.
妄想、偏执以及幻觉，会在躁郁症的极端阶段出现。
This is attributed to the overabundance of a neurotransmitter called dopamine.
这是由于存在过多的神经递质多巴胺导致的。
But despite these insights, we can't pin bipolar disorder down to a single cause.
即便如此，我们不能把躁郁症的成因归结成一个。
In reality, it's a complex problem.
实际上，这是个很复杂的问题。
For example, the brain's amygdala is involved in thinking, long-term memory, and emotional processing.
比方说，大脑的杏仁核与思考、长期记忆和情绪处理有关。
In this brain region, factors as varied as genetics and social trauma
在大脑的这块区域，遗传因素和社会创伤等因素，
may create abnormalities and trigger the symptoms of bipolar disorder.
可能形成异常并引发躁郁症。
The condition tends to run in families, so we do know that genetics have a lot to do with it.
这种情况往往在家族中发生，我们知道这与遗传基因有很大关系。
But that doesn't mean there's a single bipolar gene.
但是这并不意味着有一个躁郁症的基因存在。
In fact, the likelihood of developing bipolar disorder
实际上，躁郁症的形成
is driven by the interactions between many genes in a complicated recipe we're still trying to understand.
是许多基因共同作用的结果，我们仍然在试图找到答案。
The causes are complex, and consequently, diagnosing and living with bipolar disorder is a challenge.
由于躁郁症成因复杂，要症断出躁郁症并与之共处是很有挑战的。
Despite this, the disorder is controllable.
尽管如此，躁郁症是能够被控制的。
Certain medications like lithium can help manage risky thoughts and behaviors by stabilizing moods.
一些药物，比如锂盐，能够控制危险的想法和行为以平稳情绪。
These mood stabilizing medications work by decreasing abnormal activity in the brain, thereby strengthening the viable neural connections.
这些稳定情绪的药物通过减少大脑中异常活动来加强有效的神经连接。
Other frequently used medications include antipsychotics,
其他常用的药物，包括抗精神病药，
which alter the effects of dopamine, and electroconvulsive therapy,
通过改变多巴胺的作用以及采用电休克疗法
which works like a carefully controlled seizure in the brain, is sometimes used as an emergency treatment.
来人为控制大脑的癫痫，这种疗法有时也被称为紧急治疗。
Some bipolar patients reject treatment because they're afraid it will dim their emotions and destroy their creativity.
一些躁郁症患者拒绝治疗，因为他们担心治疗会让他们情绪低落并扼杀创造力。
But modern psychiatry is actively trying to avoid that.
但是现代精神治疗法正在努力避免这种情况。
Today, doctors work with patients on a case-by-case basis to administer a combination of treatments and therapies
如今，医生会根据每个病人的情况制定出混合的治疗方法，
that allows them to live to their fullest possible potential.
让病人的生命发挥充分的潜力。
And beyond treatment, people with bipolar disorder can benefit from even simpler changes.
除了治疗以外，躁郁症患者可以从很简单的改变中受益。
Those include regular exercise, good sleep habits, and sobriety from drugs and alcohol,
这包括定期运动，形成良好的睡眠习惯，节制毒品以及酒精饮料，
not to mention the acceptance and empathy of family and friends.
当然还包括来自家人和朋友的接纳和认同。
Remember, bipolar disorder is a medical condition, not a person's fault, or their whole identity,
请注意，躁郁症是一种身体状况，这不是患者个人的错，也不是他整个人身份的问题，
and it's something that can be controlled through a combination of medical treatments doing their work internally,
这是一个能被控制的症状，可以通过药物治疗在脑内发挥功效，
friends and family fostering acceptance and understanding on the outside,
加上外部来自家人和朋友的接纳和理解，
and people with bipolar disorder empowering themselves to find balance in their lives.
同时患者自身努力去寻找生活的平衡。