紙媒轉(zhuǎn)型下的“抑郁癥”困局

At the stage of the CCTV Spring Festival Evening Gala in earlier years， Song Dandan said to Cui Yongyuan， “I heard you are depressed， right？”. Against the camera， Cui’s face with forced smile was engulfed in laughers of audiences. We know that in the context of that short sketch， the word “depression” is no more than a fun and a teasing. However， in recent two months in 2014， 12 media persons have died， among whom people committing suicide due to depression account for nearly one third.

Then， what’s depression on earth？ How far is it away from us？ It’s well said by Andrew Solomon， an American writer and once a heavy depression patient， depression is our common secret.

早年央視春晚的舞臺上，宋丹丹一句“小崔，聽說你抑郁了？”鏡頭下，崔永元一張似笑非笑的臉被觀眾的笑聲所掩蓋。在當(dāng)時的小品語境下，“抑郁”似乎只是一個段子，一種調(diào)侃。然而，在2014年近兩個月時間內(nèi)，有12位媒體人死亡，因抑郁癥選擇自殺的比例幾乎達(dá)到1/3。

那么，抑郁癥究竟是什么？它離我們又有多遠(yuǎn)？曾是一名重度抑郁癥患者的美國作家安德魯·所羅門一語中的——抑郁，是我們共同的秘密。

Revealed in a WHO study， depression patients have totaled up to 340 million worldwide with an annual prevalence rate of about 11%. From the perspective of disease burden， depression has developed as the fourth major disease of humankind in the world currently and is expected possibly to be the second largest one by 2020， closely following coronary heart disease.

據(jù)世界衛(wèi)生組織研究顯示，全世界抑郁癥患者達(dá)到3.4億人，全球抑郁癥的年患病率約為11%。從疾病負(fù)擔(dān)看，目前抑郁癥已經(jīng)成為世界第四大疾病，預(yù)計到2020年可能成為僅次于冠心病的人類第二大疾患。

Origin of depression

“抑郁癥”的由來

In ancient Greece， depression is usually thought to be triggered by imbalance between four humors of the body， namely， blood， phlegm， yellow bile and black bile. Depression occurs when black bile is in a higher proportion in humors. While in early Christ doctrine， depression is attributed to haunt of the devil and the God’s indignation about human’s inability to resist worldly temptation and carnal desire. And in the time of Renaissance， it is taken as an illness which scholars are apt to suffer from.

Presently， continued feeling down is regarded as typical symptom of depression in internationally-accepted depression diagnosis standards. Additionally， it’s considered as depression if four of the following conditions are included， such as lowering or lack of interest in daily life； significant dwindle of experience and sustained sense of fatigue for unknown reasons； stagnation or excess in psychomotor； excess of low self assessment， or a sense of remorse or guilt or even evil delusion； difficulty in thinking， or remarkable decrease in ability to think consciously； repeated thought of death or action of suicide； sleeplessness， or early awakening， or excessive sleep； inappetence or obvious loss of weight； visible shrink of sex. The standard of course is duration of symptom for at least two weeks.

在古希臘，抑郁通常被認(rèn)為由人體內(nèi)的4種體液，即血液、粘液、黃膽汁、黑膽汁的不平衡所導(dǎo)致。當(dāng)黑膽汁在體液中所占比例比較高時，即會產(chǎn)生抑郁狀態(tài)。而在早期的基督教義里，抑郁癥狀被歸結(jié)為魔鬼的作祟和上帝對人類不能抵抗世俗誘惑和肉欲之罪的憤怒。文藝復(fù)興時期，抑郁癥則被認(rèn)為是學(xué)者們易患的疾病。

目前，國際通行的抑郁癥診斷標(biāo)準(zhǔn)中以情緒持續(xù)低落為基本癥狀，此外若含有下列情況中的4項應(yīng)被列為抑郁癥，即對日常生活的興趣下降或缺乏；精力明顯減退，無明顯原因的持續(xù)性疲乏感；精神運(yùn)動型遲滯或激越；自我評價過低，或自責(zé)、或有內(nèi)疚感，甚至出現(xiàn)罪惡妄想；思維困難，或自覺思考能力顯著下降；反復(fù)出現(xiàn)死亡的念頭，或有自殺行為；失眠，或早醒，或睡眠過多；食欲不振，或體重明顯減輕；性欲明顯減退。癥狀至少持續(xù)2周為病程標(biāo)準(zhǔn)。

Estimated by a recent epidemiological survey， patients suffering from depression and anxiety have reached 90 million in China， and shows an increasing trend year on year. “More than 200，000 plus Chinese commit suicide annually owing to severe depression，” expresses by secretary of Psychology Consultation Association of Jilin Province.

“None of people can be utterly immune from depression.” Martin Seligman， a renowned psychologist， calls depression as “a cold” in Psychiatry. Another study indicates that depression has extended to young people these years.

據(jù)最近的一項流行病學(xué)調(diào)查估算，中國抑郁焦慮患者目前已達(dá)9000萬人，并且呈現(xiàn)出逐年上升的趨勢。“中國現(xiàn)在每年有20多萬人因重度抑郁而自殺。”吉林省心理咨詢師協(xié)會秘書長趙會華表示。

“沒有人對抑郁癥有絕對的免疫力。”著名心理學(xué)家馬丁·塞利曼將抑郁癥稱為精神病學(xué)中的“感冒”。另有研究表示，抑郁癥近年來出現(xiàn)年輕化趨勢。

When adolescence conflicts with depression

青春期撞上“抑郁癥”

The reporter noticed many a saying of philosophical meaning on the walls of Chinese Basis for adolescent Psychological Growth， such as “When ideal fails to run on the soil of reality with your legs， it tends to fly high in the sky with wings of illusion. Addiction to the Internet makes some people indulge in imagination and refuse the real world.” It’s learnt that adolescents with Internet addiction are mostly accompanied with depression.

“One year， a boy learning in a key high school came here for an examination. He was diagnosed with depression. He told this to his head-teacher as soon as he went back school， and the teacher’s reaction was ‘The doctor talked non-sense’”. Mentioning such experience， Tao Ran， director from the department of medication habitation of General Hospital of Beijing Military Region and director of Chinese Basis for Adolescent Psychological Growth， said with a wry smile， “In fact， adolescents of mid and later 14-17 years old are prone to depression， but only 5% of them choose to see doctors.”

在中國青少年心理成長基地的墻壁上，記者看到很多充滿哲學(xué)意味的語錄，“當(dāng)理想不能用雙腿在現(xiàn)實的大地上奔跑時，他可能會借助幻想的翅膀在高空中飛翔。網(wǎng)癮讓人活在幻想之中，拒絕真實的世界。”據(jù)介紹，網(wǎng)癮少年大部分伴發(fā)抑郁癥。

“有一年，一個上重點(diǎn)高中的孩子來我這看病，經(jīng)診斷，我跟他說你得了抑郁癥。他回去跟班主任說后，班主任的反應(yīng)是‘那個醫(yī)生胡說八道。’”提起當(dāng)年的經(jīng)歷，北京軍區(qū)總醫(yī)院醫(yī)學(xué)成癮科主任、中國青少年心理成長基地主任陶然苦笑道，“其實，在14-17歲的青春期中后期很容易出現(xiàn)抑郁癥，但只有5%的青少年會去就診。”

He told reports that early behaviors of depression for adolescents is mainly being weary of study， reduction in concentration and memory， lowered sleep and efficiency of learning. As time goes， it will be a combination of significant insufficiency of three energy， say， dynamism， energy and strength. In terms of diet preference， the patients are inclined to prefer meat and sweets to vegetables， yet with poor gastroenteric function. Psychologically， one third adolescents usually feel interior after suffering from depression and the remaining is prone to be self-conceit. On the whole， it’s characterized by stubborn and extreme selfishness.

According to research and analysis， Tao Ran expresses that depression suffered during adolescence is blamed for three core factors. First of all， abuse of antibiotics. This can directly lead to ruin of probiotics of the body， thus reducing the value of 5-hydroxytryptamine which brings human stable mood， abundance of dynamism and is beneficial to sleep. Secondly， statistics shows that 30% of depression patients have allergic history， yet allergy is similarly conducive to growth of probiotics and absorption of nutrients. Finally， occurrence of prestin， that is， huge pressure incurred by perfect education from family and school as well as from concept of control education， after which increased secretion of epinephrine and glucocorticoid will generate intestinal canal stress syndrome which is also harmful to cranial nerve.

The reporter found in subsequent surveys that the majority of adolescents are quite unaware of their own related behaviors when the above occurs. And in the meantime， traditional education concepts from school and family render adolescence depression easily neglected. It’s why latent depression during the adolescence lays siren of time-bomb for the outbreak when the patients come to their adulthood.

他告訴記者，青春期抑郁癥的早期行為主要呈現(xiàn)出厭學(xué)，注意力和記憶力下降、睡眠質(zhì)量下降，學(xué)習(xí)效率低下等，長此以往則會表現(xiàn)出三力不足（動力、精力、體力不足）的明顯特征。而在飲食喜好上，則有不喜蔬菜，好食肉和甜食的傾向，但胃腸道功能表現(xiàn)差。心理特征上，1/3的青少年患抑郁癥后會出現(xiàn)自卑心態(tài)，2/3的青少年則產(chǎn)生自負(fù)心態(tài)。總體表現(xiàn)偏執(zhí)，極度自私的特點(diǎn)。

通過研究分析，陶然表示青春期抑郁癥的出現(xiàn)主要由三大核心因素造成：第一是抗生素的亂用。其直接后果是敗壞了人體內(nèi)的益生菌，由此降低了可使人體情緒穩(wěn)定、充滿動力、有益睡眠的5-羥色胺值；第二，經(jīng)統(tǒng)計，30%的抑郁癥患者都有過敏史。而過敏同樣不利于益生菌的生長和營養(yǎng)物質(zhì)的吸收；第三，壓力素的產(chǎn)生。即來自家庭和學(xué)校的完美教育、控制教育理念帶給青少年以“壓力山大”感，繼而腎上腺素及糖皮質(zhì)激素分泌增多產(chǎn)生腸道應(yīng)激綜合癥，由此也會對腦神經(jīng)帶來傷害。

記者在隨后的調(diào)查過程中發(fā)現(xiàn)，出現(xiàn)上述情況后，大多數(shù)青少年對自己的相應(yīng)行為并沒有清醒的認(rèn)識。而來自學(xué)校和家庭的傳統(tǒng)教育觀念，使得青春期“抑郁癥”極易被忽視。正由此，青春期“抑郁癥”的潛伏也為青壯年時“抑郁癥”的爆發(fā)埋下了定時炸彈。