(单词翻译:单击)
For many, just mentioning "Borderline Personality Disorder" conjures up images
对许多人来说，仅提到“边缘人格障碍”就会让人联想到
of an endless cycle of therapy sessions and hospital visits.
一个无休止的治疗周期和去医院就诊的画面。
There's this idea that people who are diagnosed with it have been basically broken by a bad childhood —
有一种观点认为，被诊断出患有此病的人，基本上都是因为拥有一个不幸福的童年，
and there's nothing that can be done to fix them.
而且没有办法能就进行修复。
But that comes from some persistent myths about the condition.
但这来自于一些关于这种疾病流传至今的说法。
The reality of being quote "borderline" is much more nuanced — and hopeful.
“边界性”的说法要微妙得多，而且充满了希望。
People with Borderline Personality Disorder, or BPD, are generally impulsive,
患有边缘型人格障碍（BPD）的人通常冲动，
undergo extreme shifts in mood, and have lots of trouble with interpersonal relationships.
情绪变化剧烈，人际关系也有很多问题。
And when it comes to myths about BPD, we might as well start at the beginning, so to speak.
提到关于边缘型人格障碍的说法时，我们不妨从头说起。
Many people mistakenly believe it's entirely caused by trauma or abuse.
许多人错误地认为，这种疾病完全是由创伤或虐待所致。
But how BPD develops is definitely more complicated than that.
但其发展过程肯定比这更复杂。
It is true that patients with this condition are likely to have histories of trauma,
确实，有这种病症的患者很可能有外伤史，
and are more likely than the general public to have a history of abuse.
而且比普通人更有可能有虐待史。
But, not all people with BPD have such experiences.
但是，并不是所有的患者都有这样的经历。
And doctors may be missing or misdiagnosing a lot of the BPD cases from people who don't have traumatic histories.
医生可能会漏掉或者误诊很多病例，因为患者不存在外伤史。
Plus, it's worth noting that, by far, most people who have been abused don't develop disorders.
另外，值得注意的是，到目前为止，大多数被虐待的人并没有患上精神障碍。
So trauma is neither necessary nor sufficient for the development of BPD.
所以，创伤对其发展既不必要，也不充分。
This may be because both genes and a person's life have important roles to play.
这可能是因为基因和人的生活都扮演着重要的角色。
We do know that BPD is highly heritable, meaning genetics strongly influence the likelihood a person develops the condition.
我们知道边缘型人格障碍具有高度遗传性，这意味着遗传学强烈地影响一个人发展这种疾病的可能性。
But it's proven especially difficult to pin down how or why.
但事实证明，要弄清原因非常困难。
Like, there's no "BPD Gene" or even set of genes, despite lots of people looking for them.
比如，没有“边缘型人格障碍基因”，甚至没有一组这样的基因，尽管有很多人都在寻找它们。
More recently, researchers have come to think that's because those studies were looking for genes related to a BPD diagnosis,
最近，研究人员开始认为这是因为这些研究是在寻找与边缘型人格障碍诊断相关的基因，
when it might make more sense to look for genes that contribute to a vulnerability to the disorder.
而寻找导致边缘型人格障碍易感性的基因可能更有意义。
Basically, the idea is that susceptibility is passed along genetically,
基本上，这个观点认为易感性可遗传，
but there still needs to be some kind of environmental factor for the disorder to develop.
但是这种疾病的发展还需要某种环境因素。
If this idea is right, then trauma may act as a trigger for BPD.
如果这个想法正确，那么创伤可能会成为其触发因素。
Meanwhile, those cases that don't involve trauma might imply that other stresses can be involved.
同时，那些不涉及创伤的病例可能意味着其他压力也可能参与其中。
And figuring out exactly how genes make a person susceptible to this would go a long way
弄清楚基因如何使一个人容易受其影响，
towards identifying those other stressors.
对识别其他压力源有很大帮助。
They might also point doctors towards more effective treatments and better ways of diagnosing the condition in the first place.
他们也可能会让医生先找到更有效的疗法和更好的诊断方法。
As it happens, right now, diagnosing BPD is kind of a tricky thing.
现在，诊断该病症是一件棘手的事情。
And that's contributed to another persistent myth that BPD is the same thing as bipolar disorder.
这也促成了另一个长期存在的说法，即边缘型人格障碍和双相情感障碍一样。
Now, if you just look at a list of symptoms and also the acronym, it's easy to see how someone might mix them up.
现在，如果你只看一个症状列表和首字母缩略词，就很容易看出有人可能会把它们混淆。
They both involve having volatile emotions that can vary wildly over time, for instance.
例如，这两种病症都涉及情绪会随时间推移而波动较大。
And even doctors confuse them.
甚至连医生都把它们搞混。
Studies have found that patients with BPD are likely to have been previously misdiagnosed as having bipolar disorder.
研究发现，边缘型人格障碍患者很可能之前被误诊为双相情感障碍。
But one of the key differences is that people with BPD suffer from what psychologists call identity disturbance.
但其中一个关键的区别是，边缘型人格障碍患者患有心理学家所称的身份障碍。
Which basically means they don't have a good sense of who they are.
这基本上意味着，他们对自己是谁没有很好的认知。
Most people can tell you some traits about themselves, important things in their life history that shaped their personality,
大多数人能告诉你一些关于他们自己的特质，他们的生活史中塑造其个性的重要事情，
and can share some thoughts about how they're seen socially.
并且可以分享一些别人对他们的看法。
But people with BPD have a harder time piecing those kinds of things together into a coherent whole —
但是边缘型人格障碍患者很难把这些东西拼凑成连贯的整体，
and that can feel kind of disturbing.
这让人感到不安。
People with bipolar disorder can get that too, but it's less common and tends to be only at highs or lows,
患有双相情感障碍的人也有这种情况，但不太常见，往往只出现在高或低水平，
wreas nearly everyone with BPD reports it.
而几乎每个患有边缘型人格障碍患者都会报告存在这种情况。
It's a big reason why one of the most common symptoms of BPD is suicidal thoughts.
这也是双相情感障碍最常见的症状之一是自杀念头，这一点极其重要的一个原因。
The emotional changes that come from BPD also look a bit different than bipolar disorder.
边缘型人格障碍引起的情绪变化，看起来也有点不同于双相情感障碍。
Both disorders tend to come with rapid shifts in mood — that's where the idea of being "bipolar" comes from.
这两种疾病都会伴随着情绪的快速变化，这就是“双相情感”的由来。
But with BPD, a person's mood shifts can be even quicker —
但在边缘型人格障碍中，一个人的情绪变化会更快，
so much so that artificial intelligence can use the speed of mood swings to tell the two disorders apart.
人工智能可以利用情绪波动的速度来区分这两种病症。
Plus, the two look really different neurologically.
另外，两中病症从神经学上来看真的不一样。
Like, people with BPD often have lower activity in regions of their frontal lobe, as well as lower gray matter volume and density there.
例如，边缘型人格障碍患者额叶区域的活动通常较低，那里的灰质体积和密度也较低。
That's the opposite of people with bipolar disorder.
这与双相情感障碍患者的情况正好相反。
All of this leads to very different methods of treatment.
这就导致了截然不同的治疗方法。
There's not a lot of good evidence for treating BPD with medication,
例如，没有很多好的证据表明可以用药物治疗边缘型人格障碍，
for instance, but drugs like mood stabilizers are great for bipolar disorders.
但是像情绪稳定剂这样的药物对双相情感障碍非常有效。
That actually leads really well into our final myth about BPD that it's permanent.
这实际上很好地引出了关于边缘型人格障碍的最后一个说法：它是永久性存在的。
In reality, most people's symptoms improve over time on their own.
事实上，大多数人的症状会随着时间的推移自行改善。
And that improvement can be accelerated with proper treatment.
而这种改善可以通过适当的治疗来加速。
So getting a BPD diagnosis doesn't mean you're doomed to having an emotionally volatile life with unstable relationships.
所以，诊断出边缘型人格障碍，并不意味着你注定会拥有情绪不稳定的生活和紧张的人际关系。
This myth might have arisen from a misunderstanding of the disorder that happened early on.
这个说法可能是由于早期对这种病症的误解产生的。
See, the whole idea of someone being "borderline" came from an old model of mental illness.
你看，一个人被“边缘化”的想法来自古老的精神疾病模型。
It meant they were on the border between a neurosis, which was considered treatable thing,
这意味着它们处于神经症和精神病之间的边缘，人们认为神经症可以治疗，
and a psychosis, which was not.
而精神病则不行。
Nowadays, we know that classification system isn't great, and that treatment can help.
现在，我们知道这种分类系统不太好，而治疗是有帮助的。
That can include drugs — sometime — like antidepressants for certain mood symptoms.
治疗包括药物，抗抑郁药有时可以治疗某些情绪症状。
But, as I mentioned earlier, the evidence for treating BPD with meds is somewhat mixed.
但是，正如我前面提到的，用药物治疗边缘型人格障碍的证据说法不一。
What does generally work well is a form of talk therapy that was designed for BPD called dialectic behavioral therapy.
通常有效的是一种方法是为边缘型人格障碍设计的谈话疗法，叫做辩证行为疗法。
It's goal is to teach specific skills that help the person manage their emotions when something distressing happens.
其目标是教授一些特殊的技能，帮助患者在烦躁时控制自己的情绪。
Like, how to observe thoughts or emotions as they are without trying to change them.
比如，如何观察思想或情绪，而不是试图改变它们。
Or, learning how to be assertive in relationships — like, telling people "no" or asking for help when you need it.
或是学习如何在人际关系中保持自信。比如，向别人说“不”，或者在需要帮助的时候寻求帮助。
One 2014 study found that after a year of treatment,
2014年的一项研究发现，在接受一年的治疗后，
77% of those who completed this therapy no longer met diagnostic criteria for BPD.
77%的患者不再符合边缘型人格障碍的诊断标准。
And a randomized control study in 2006 found that people with BPD who got dialectic behavioral therapy were half as likely
2006年的一项随机对照研究发现，接受辩证行为疗法的患者，
to attempt suicide than those who received regular talk therapy.
自杀的可能性是接受常规谈话治疗患者的一半。
So people with BPD who get the right treatment can have happy, healthy lives.
因此，边缘型人格障碍患者只要得到正确的治疗，就能过上幸福、健康的生活。
Part of getting there is getting the right diagnosis, of course — which thankfully, is also improving,
当然，获得正确的诊断是取得成功的一部分，值得庆幸的是诊断也在提升，
now that everyone has a better understanding of what separates BPD from bipolar disorders.
因为大家对边缘型人格障碍和双相情感障碍的区别有了更好的理解。
And researchers are continuing to discuss out exactly how BPD develops, and what roles genes and experiences play in that.
研究人员正在继续研究边缘型人格障碍的发展方式，以及基因和生活经验在其中发挥的作用。
All of which means it's time to stop seeing BPD as this life-dooming diagnosis.
所有这些都意味着，该停止把边缘型人格障碍看作是一种危及生命的诊断了。
Thanks for watching this episode of SciShow Psych!
感谢收看本期《心理科学秀》！
And thanks to today's sponsor, Babbel.
感谢今天的赞助商，巴贝尔。
Babbel is a language learning app designed to get you speaking a new language fast.
巴贝尔是一个语言学习应用，旨在让你快速地学会说一种新语言。
There are more than a dozen languages you can choose from, each of which was designed by experts.
你可以从十几种语言中进行选择，每一种都由专家设计。
And the goal is that after just five hours, you'll be able to place an order in a foreign restaurant,
我们的目标是仅在五小时后，你就能在外国餐馆点菜，
or ask where the bathroom is.
或者询问洗手间在哪儿。
So if you've always wanted to aprendez some español, or polish your for real life situations,
如果你一直想学新语言或想在现实生活中实践一下，
you might want to check out the Babbel app.
可以看看巴贝尔应用。
And as a SciShow viewer, you can get 50% off a month subscription by using the link in the description.
作为《科学秀》的观众，你可以使用描述中的链接，每月订阅获得五折折扣。
