TED演讲｜你到底是正常焦虑，还是焦虑症？这真的很重要！！

What's normal anxiety -- and what's an anxiety disorder?

但我在这告诉你，焦虑症就像糖尿病般真实存在。

与詹·冈特博士聊聊身体里的那些事

Hi again. It's Dr. Jen, and I've noticed something with my patients. They often describe to me some classic symptoms of an anxiety disorder. Constant worry, trouble sleeping, tense muscles and struggle with concentrating. But they aren't getting treatment.

大家好，我是詹博士，我从我的病人身上发现了一个现象。他们经常向我描述一些焦虑症的典型症状。不断担心，难以入睡，肌肉紧张和难以集中注意力，但他们并没有寻求治疗。

There's a lot of issues with mental-health care in this country. Some people don't have insurance that would cover it. Some have been dismissed or minimized in the past, and don't think seeking help will do any good.

这个国家存在着许多心理健康的保健问题。有些人没有这方面的医疗保险，有些人的症治曾被忽略不计，有些则认为治疗也不会有好转。

Some worry about the stigma and whether it could affect future jobs or relationships. But severe anxiety isn't a moral or personal failing. It's a health problem, just like strep throat or diabetes. It needs to be treated with the same kind of seriousness.

有些人担心心理问题将会成为未来的绊脚石，为以后的工作和生活增加麻烦。但重度焦虑并不是一个人的挫折或失败，而是一个健康隐患，就像咽喉炎或糖尿病一样，焦虑症也应该被一视同仁。

Before we can talk about anxiety disorders, let's talk about anxiety itself. Anxiety is the very real and normal emotion we feel in a stressful situation. It's related to fear. But while fear is a response to an immediate threat that quickly subsides, anxiety is a response to more uncertain threats that tends to last much longer.

在讨论焦虑症之前，我们先了解一下焦虑本身。焦虑是一种普遍和正常的情绪，我们在压力下都会感到焦虑。它跟恐惧有所关联。但恐惧是当我们受到短暂的威胁时做出的反应，而焦虑是当我们受到不明确的威胁时做出的长久的反应。

It's all part of the threat detection system, which all animals have to some degree, to help protect us from predators. Anxiety starts in the brain's amygdala, a pair of almond-sized nerve bundles that alert other areas of the brain to be ready for defensive action.

这都是我们身体监测危险系统的一部分，所有动物身上都有这个系统，来保护我们免受掠食者的威胁。焦虑始于大脑的杏仁核，一对杏仁大小的神经提醒大脑的其他区域做好防御行动的准备。

Next, the hypothalamus relays the signal, setting off what we call the stress response in our body. Our muscles tense, our breathing and heart rate increase and our blood pressure rises. Areas in the brain stem kick in and put you in a state of high alertness. This is the fight-or-flight response.

然后，下丘脑传递信号，引发我们所谓的身体压力反应。导致肌肉紧张，呼吸和心跳加速，并且血压升高。脑干区域开始启动，使人处于高度警觉状态。这就是所谓的“战斗或逃跑(fight-or-flight)反应”。

There are ways the fight-or-flight response is kept somewhat in check, with an area of higher-level thinking called the ventromedial prefrontal cortex. It works like this. If a person sees something they think is dangerous, like a tiger, that sends a signal to the amygdala, saying "it's time to run."

有一些方法可以控制战斗或逃跑的反应，利用一个称为前额叶皮层的高级思维区域。举一个例子：假如一个人看见一个危险的东西，比如老虎，那将向大脑杏仁核发送信号，告诉它说“赶快跑”。

The ventromedial prefrontal cortex can say to the amygdala, "Hey, look. The tiger's in a cage. You know what a cage is? They can't escape from a cage. It's OK to calm down." It's a feedback loop that can help keep the response in check. The hippocampus is also involved. It provides context, saying things like, "Hey, we've seen tigers in cages before. We're in a zoo. You are extra safe."

而大脑前额叶片层则说：“你看，这老虎被关在一个笼子里。你知道笼子是什么吧？它是逃不出来的。可以放松了。”这是一个循环的反馈，可以帮助控制我们的反应，脑部的海马体也参与其中。它们可以判断情况，比如：“我们之前也见过老虎被关在笼子里，我们现在在动物园，你非常安全。”

With anxiety, these threat-detection systems and mechanisms that reduce or inhibit them are functioning incorrectly and cause us to worry about the future and our safety in it. But for many people, it goes into overdrive. They experience persistent pervasive anxiety that disrupts work, school and relationships and leads them to avoid situations that may trigger symptoms. Anxiety disorders are not at all uncommon.

由于焦虑，这些减少或抑制威胁的检测系统无法正常运行，导致我们担心未来和我们的安全。但是对于很多人来说，他们将经历疲劳过度。他们经历持续的焦虑，扰乱他们的工作、学校和人际关系，并导致他们刻意避免可能引发焦虑的场合。焦虑症并不罕见。

Based on data from the World Mental Health Survey, researchers estimate that about 16 percent of individuals currently have or have had an anxiety disorder. These include social anxiety disorder, panic disorder, agoraphobia and phobias. Studies have shown that people with anxiety disorders don't just have a different way of reacting to stress. There may be actual differences in how their brain is working.

根据世界心理健康调查的数据，研究人员估计大约16%的人目前患有或曾经患有焦虑症。这包括社交焦虑症，恐慌症，空间恐惧症和其他的恐惧症。研究表明那些患有焦虑症的人不仅面对压力会有不同的反应。他们大脑运转的方式可能存在差异。

One model describes possible mix-ups in the connections between the amygdala and other parts of the brain. The pathways that signal anxiety become stronger. And the more anxiety you have, the stronger the pathways become, and it becomes a vicious cycle.

这种模型描述了杏仁核和大脑其他部分之间连接中可能出现的混淆。发出焦虑信号的路径变得更强，他越焦虑，路径就越强，最终变成一个恶性循环。

The good news is there's treatment for anxiety, and that you don't have to suffer. Remember, this isn't about weakness. It's about changing brain patterns, and research shows that our brains have the ability to reorganize and form new connections all throughout our lives.

好消息是有治疗焦虑症的方法，确保你不必经历苦难。请记住，这与弱点无关。这是关于改变大脑模式，研究表明，我们的大脑具有能力重组并在我们的一生中建立新的联系。

A good first step is to do the basics. Eat a balanced diet, exercise regularly and get plenty of sleep, as your mind is part of your body. It might also help to try meditation. Instead of our heart rate rising and our body tensing, with mindfulness and breathing, we can slow down the fight-or-flight response and improve how we feel in the moment.

一个好的开始是做好基础工作。饮食均衡，经常锻炼，并且保持睡眠充足，因为大脑也是身体的一部分。尝试冥想也可能有所帮助。与其心率上升和身体紧张，不如通过呼吸来减缓“战斗或逃跑反应”，并改善我们当下的感受。

Cognitive behavioral therapy, a form of talk therapy, can also be fantastic. In it, you learn to identify upsetting thoughts and determine whether they're realistic. Over time, cognitive behavioral therapy can rebuild those neural pathways that tamp down the anxiety response. Medication can also give relief, in both the short-term and the long-term.

认知行为疗法是一种谈话疗法，也是很有帮助的一种。在其中，你将学会如何识别令人不安的想法并确认他们是否符合现实。随着时间的推移，认知行为疗法可以重建这些抑制焦虑反应的神经通路。药剂也能缓解焦虑，无论是短期还是长期。

In the short-term, anti-anxiety drugs can down-regulate the threat-detection mechanisms that are going into overdrive. Studies have shown that both long-term medications and cognitive behavioral therapy can reduce that overreactivity of the amygdala we see an anxiety disorders.

在短期内，当体内威胁检测系统超速运转时，抗焦虑药物可以帮助缓解。研究表明，长期药物治疗和认知行为治疗都可以减少我们在焦虑症中看到的脑部杏仁核的过度反应。

High blood pressure and diabetes, they can be treated or managed over time. And the same is true for an anxiety disorder too.

高血压和糖尿病都可以循序渐进慢慢治疗或控制，那么焦虑症也是如此。