演讲MP3+双语文稿:治疗抑郁与焦虑的"社会处方" ,不吃药也能轻松告别抑郁症

听力课堂TED音频栏目主要包括TED演讲的音频MP3及中英双语文稿，供各位英语爱好者学习使用。本文主要内容为演讲MP3+双语文稿:治疗抑郁与焦虑的"社会处方" ,不吃药也能轻松告别抑郁症，希望你会喜欢！

【演讲者及介绍】Johann Hari 记者

哈里毕业于剑桥大学，最高学位，双学位，社会科学和政治学。他在伦敦长大，父亲是一位瑞士司机，而苏格兰母亲则在一家家庭暴力受害者收容所工作。今天，他有半年的时间住在伦敦，他每年的另一半时间都在旅行去研究他的书。

【演讲主题】这可能是你抑郁或焦虑的原因

【中英文字幕】

翻译者 psjmz mz 校对者 Jiasi Hao

00:14

For a really long time, I had two mysteries that were hanging over me. I didn't understand them and, to be honest, I was quite afraid to look into them. The first mystery was, I'm 40 years old, and all throughout my lifetime, year after year, serious depression and anxiety have risen, in the United States, in Britain, and across the Western world. And I wanted to understand why. Why is this happening to us? Why is it that with each year that passes, more and more of us are finding it harder to get through the day? And I wanted to understand this because of a more personal mystery.

一直以来 有两个迷团一直困扰着我。我无法理解它们，而且说实话，我害怕深究它们。第一个谜团是，我40岁了，在我一生中，年复一年，严重的抑郁和焦虑症状 在美国，英国等国家 不断浮现出来，横扫整个西方世界。我想要搞清楚为什么。为什么这开始发生在我们身上？ 为什么过去的每一年里，我们越来越多人发现 更难以度过每一天？ 我想要理解这个是因为 一个很私人的谜团。

00:56

When I was a teenager, I remember going to my doctor and explaining that I had this feeling, like pain was leaking out of me. I couldn't control it, I didn't understand why it was happening, I felt quite ashamed of it. And my doctor told me a story that I now realize was well-intentioned, but quite oversimplified. Not totally wrong. My doctor said, "We know why people get like this. Some people just naturally get a chemical imbalance in their heads -- you're clearly one of them. All we need to do is give you some drugs, it will get your chemical balance back to normal."

当我还是10来岁时，我记得有一次去看医生，说我总觉得浑身疼痛。我不能控制它，我不理解为什么它会出现，并且感到非常羞耻。医生告诉我了一个 现在我意识到是出于好意的故事，但太过于简化。并非全错。我医生说，“我们知道 人们为什么会这样。有些人的大脑很自然地 会发生一些化学失衡—— 你显然是其中一个。我们要做的就是给你开一些药，它就会把你的化学平衡 恢复正常。”

01:29

So I started taking a drug called Paxil or Seroxat, it's the same thing with different names in different countries. And I felt much better, I got a real boost. But not very long afterwards, this feeling of pain started to come back. So I was given higher and higher doses until, for 13 years, I was taking the maximum possible dose that you're legally allowed to take. And for a lot of those 13 years, and pretty much all the time by the end, I was still in a lot of pain. And I started asking myself, "What's going on here? Because you're doing everything you're told to do by the story that's dominating the culture -- why do you still feel like this?"

所以我开始服用帕罗西汀 或类似的药物。一个东西在不同国家 有不同的名字。然后我感觉好了很多，也受到了很大的鼓舞。但随后不久，这种疼痛的感觉回来了。所以我使用越来越高的剂量，直到后来的13年，我都在服用法律允许的最高剂量。在这13年的大部分时候，差不多一直到最后，我仍然很痛苦。我开始问自己，“这是怎么回事？” 因为你按照主导文化所说的 做了所有的事情—— 为什么你仍然会有这样的感受？

02:03

So to get to the bottom of these two mysteries, for a book that I've written I ended up going on a big journey all over the world, I traveled over 40,000 miles. I wanted to sit with the leading experts in the world about what causes depression and anxiety and crucially, what solves them, and people who have come through depression and anxiety and out the other side in all sorts of ways. And I learned a huge amount from the amazing people I got to know along the way.

所以为了揭开这两个谜团的谜底，为了我写的一本书，我进行了一场环球旅行，旅途超过4万英里。我想跟世界一流的专家坐在一起 讨论是什么引发了抑郁和焦虑，并且最重要的是： 有什么治愈方法，以及那些经历过抑郁和焦虑的人 是如何以各种方式走出来的。我一路走来，从我认识的那些，了不起的人身上学到了很多。

02:26

But I think at the heart of what I learned is, so far, we have scientific evidence for nine different causes of depression and anxiety. Two of them are indeed in our biology. Your genes can make you more sensitive to these problems, though they don't write your destiny. And there are real brain changes that can happen when you become depressed that can make it harder to get out. But most of the factors that have been proven to cause depression and anxiety are not in our biology. They are factors in the way we live. And once you understand them, it opens up a very different set of solutions that should be offered to people alongside the option of chemical antidepressants.

但我认为 我所学到的最核心的是，目前为止，科学依据能够证明 有9种不同的 引发抑郁和焦虑的原因。其中两个确实是由于生理因素。你的基因会让你 对这些问题更敏感，虽然它们不能决定你的命运。当你变得抑郁时，你的大脑会发生实质的变化，让你更难摆脱出来。但绝大部分被证实 引发抑郁和焦虑的因素 跟我们的生理因素无关，而主要取决于我们的生活方式。一旦你理解了它们，就能开启一套 非常不同的解决方案，应该和化学抗抑郁药 一起提供给人们。

03:08

For example, if you're lonely, you're more likely to become depressed. If, when you go to work, you don't have any control over your job, you've just got to do what you're told, you're more likely to become depressed. If you very rarely get out into the natural world, you're more likely to become depressed.

比如，如果你很孤独，你很可能会变得抑郁。如果，当你工作时，你对 自己的工作没有控制权，你得按照吩咐去做，你就更可能变得抑郁。如果你很少接触自然世界，你更可能变得抑郁。

03:24

And one thing unites a lot of the causes of depression and anxiety that I learned about. Not all of them, but a lot of them. Everyone here knows you've all got natural physical needs, right? Obviously. You need food, you need water, you need shelter, you need clean air. If I took those things away from you, you'd all be in real trouble, real fast. But at the same time, every human being has natural psychological needs. You need to feel you belong. You need to feel your life has meaning and purpose. You need to feel that people see you and value you. You need to feel you've got a future that makes sense. And this culture we built is good at lots of things. And many things are better than in the past -- I'm glad to be alive today. But we've been getting less and less good at meeting these deep, underlying psychological needs. And it's not the only thing that's going on, but I think it's the key reason why this crisis keeps rising and rising. And I found this really hard to absorb. I really wrestled with the idea of shifting from thinking of my depression as just a problem in my brain, to one with many causes, including many in the way we're living.

有一件事情把所有 我所知道的抑郁和焦虑 联系在一起。不是所有，但很多。这里每个人都知道，你们都有自然的生理需求，对吧？ 显然。你需要食物，你需要水，你需要住所，你需要干净的空气。如果我拿走那些东西，你们都会很快就陷入巨大的困境。但同时，每个人都有自然的心理需求，你需要有归属感。你需要感到 你的生活有意义和目的。你需要感到人们关注你并重视你。你需要感觉 你有一个有意义的未来。我们建立的这种文化 擅长很多事情。很多事情比过去好多了—— 我很高兴生活在今天。但我们对满足这些 深层次的心理需求 越来越不擅长了。这并不是唯一的原因，但我认为是这场危机 不断升级的关键原因。我发现这很难理解。我真的很纠结于这个想法： 把我的抑郁症 从一个仅仅是我大脑中的问题，转变成一个有很多 成因的问题，包括我们的生活方式。

04:35

And it only really began to fall into place for me when one day, I went to interview a South African psychiatrist named Dr. Derek Summerfield. He's a great guy. And Dr. Summerfield happened to be in Cambodia in 2001, when they first introduced chemical antidepressants for people in that country. And the local doctors, the Cambodians, had never heard of these drugs, so they were like, what are they? And he explained. And they said to him, "We don't need them, we've already got antidepressants." And he was like, "What do you mean?" He thought they were going to talk about some kind of herbal remedy, like St. John's Wort, ginkgo biloba, something like that. Instead, they told him a story.

直到有一天，我前去采访一位 名叫德里克·萨莫菲尔德的 南非精神病医生，我才真正明白了这一点。他是个很棒的人。2001年，萨莫菲尔德在柬埔寨，当时他们首次在那个国家 为人们引入化学抗抑郁药。当地的柬埔寨医生 从没听过这些药物，所以，他们问“这些是什么？” 于是他解释了。然后他们告诉他，“我们不需要它们，我们已经有抗抑郁药了。” 他问，“你指的是什么？” 他以为他们会谈及某种草药，比如圣约翰草，银杏叶之类的。反之，他们告诉他一个故事。

05:15

There was a farmer in their community who worked in the rice fields. And one day, he stood on a land mine left over from the war with the United States, and he got his leg blown off. So they him an artificial leg, and after a while, he went back to work in the rice fields. But apparently, it's super painful to work under water when you've got an artificial limb, and I'm guessing it was pretty traumatic to go back and work in the field where he got blown up. The guy started to cry all day, he refused to get out of bed, he developed all the symptoms of classic depression. The Cambodian doctor said, "This is when we gave him an antidepressant." And Dr. Summerfield said, "What was it?" They explained that they went and sat with him. They listened to him. They realized that his pain made sense -- it was hard for him to see it in the throes of his depression, but actually, it had perfectly understandable causes in his life. One of the doctors, talking to the people in the community, figured, "You know, if we bought this guy a cow, he could become a dairy farmer, he wouldn't be in this position that was screwing him up so much, he wouldn't have to go and work in the rice fields." So they bought him a cow. Within a couple of weeks, his crying stopped, within a month, his depression was gone. They said to doctor Summerfield, "So you see, doctor, that cow, that was an antidepressant, that's what you mean, right?"

他们社区有个农民在稻田里干活。有天，他踩到了 抗美战争时留下的地雷，他的腿被炸掉了。所以他们给他装了一只假腿，不久之后他就回到稻田干活。但显然，你带着假腿 在水下干活非常痛疼，而且我猜他 回到腿被炸掉的地方干活 一定很痛苦。这个人开始整天哭泣，他拒绝下床，他出现了所有 典型的抑郁症症状。柬埔寨医生说，“就在这时 我们给他开了抗抑郁药。” 萨莫菲尔德医生问，“是什么药？” 他们解释说，他们过去跟他坐在一起。他们倾听他。他们认识到他的痛苦合情合理—— 身处沮丧的阵痛中，他本人很难看出这一点，但确实，这是他生活中 完全可以理解的原因。其中一个医生 和社区里的人交谈，想到，“如果我们给这人买一头奶牛，他就可以变成一个奶农了，他就不会处在这种境地，把自己搞得如此狼狈了，他也不用去稻田里干活了。” 于是他们给他买了一头奶牛。没几周，他停止了哭泣，不到1个月，他的抑郁症消失了。他们跟萨莫菲尔德医生说，“所以你看，医生，那头奶牛，就是抗抑郁药，那是你说的药吧？”

06:30

(Laughter)

（笑声）

06:32

(Applause)

（掌声）

06:35

If you'd been raised to think about depression the way I was, and most of the people here were, that sounds like a bad joke, right? "I went to my doctor for an antidepressant, she gave me a cow." But what those Cambodian doctors knew intuitively, based on this individual, unscientific anecdote, is what the leading medical body in the world, the World Health Organization, has been trying to tell us for years, based on the best scientific evidence.

如果你打小就和我一样 思考抑郁症，像座大多数人这样，那听起来像个冷笑话，对吧？ “我找医生开抗抑郁药，她给了我一头奶牛。” 但那些柬埔寨人凭直觉就知道的、 基于这个个体的，不科学的轶事，是世界领先的医疗机构，世界卫生组织，多年来，基于最好的科学证据，一直试图告诉我们的。

07:01

If you're depressed, if you're anxious, you're not weak, you're not crazy, you're not, in the main, a machine with broken parts. You're a human being with unmet needs. And it's just as important to think here about what those Cambodian doctors and the World Health Organization are not saying. They did not say to this farmer, "Hey, buddy, you need to pull yourself together. It's your job to figure out and fix this problem on your own." On the contrary, what they said is, "We're here as a group to pull together with you, so together, we can figure out and fix this problem." This is what every depressed person needs, and it's what every depressed person deserves.

如果你抑郁，如果你很焦虑，你不是脆弱，你没有疯，总的来说，你不是一个 零部件坏了的机器，你是个需求未被满足的人。在这里，思考柬埔寨医生说的 和世界卫生组织没说的同样重要。他们没跟这个农民说，“嘿，伙计，你需要振作起来，你得自己解决和修复这个问题。” 相反，他们说的是，“我们作为一个团队 来和你一起努力，所以一起，我们可以解决 和修复这个问题。” 这是每一个抑郁的人需要的，并且也是 每一个抑郁的人应得的。

07:48

This is why one of the leading doctors at the United Nations, in their official statement for World Health Day, couple of years back in 2017, said we need to talk less about chemical imbalances and more about the imbalances in the way we live. Drugs give real relief to some people -- they gave relief to me for a while -- but precisely because this problem goes deeper than their biology, the solutions need to go much deeper, too.

这是为什么 有位联合国的顶尖医生，在2017年世界卫生日的 官方宣言中写到，我们要少谈化学失衡，多谈谈我们生活方式的失衡。药物对有些人 有真正的缓解作用—— 它们对我有阵子也很有效—— 但因为这个问题 比他们的生物构造更深入，解决方案也需要更为深入。

08:13

But when I first learned that, I remember thinking, "OK, I could see all the scientific evidence, I read a huge number of studies, I interviewed a huge number of the experts who were explaining this," but I kept thinking, "How can we possibly do that?" The things that are making us depressed are in most cases more complex than what was going on with this Cambodian farmer. Where do we even begin with that insight?

但当我第一次知道的时候，我记得我在想，“我能看到所有的科学证据，我阅读了大量的研究，我采访了很多专家来 解释这一问题，” 但我一直在想，“我们怎么可能做到？” 让我们抑郁的事情 在很多情况下比那个柬埔寨农民 远复杂得多。基于那个观点，我们该从哪里下手呢？

08:35

But then, in the long journey for my book, all over the world, I kept meeting people who were doing exactly that, from Sydney, to San Francisco, to São Paulo. I kept meeting people who were understanding the deeper causes of depression and anxiety and, as groups, fixing them. Obviously, I can't tell you about all the amazing people I got to know and wrote about, or all of the nine causes of depression and anxiety that I learned about, because they won't let me give a 10-hour TED Talk -- you can complain about that to them.

然而后来，在我写书的漫长旅途中，在全球旅行中，我不断遇到正在那样做的人，从悉尼，到旧金山，到圣保罗。我一直遇见理解引发 抑郁和焦虑深层原因的人，并且，作为群体，修复它们。显然，我不能告诉你们 我认识和写下的 所有这些让人惊叹的人，或者所有我所习得的引发 抑郁和焦虑的9个原因，因为他们不会让我做一个 10小时的TED演讲—— 你们可以向他们抱怨。

09:05

But I want to focus on two of the causes and two of the solutions that emerge from them, if that's alright. Here's the first. We are the loneliest society in human history. There was a recent study that asked Americans, "Do you feel like you're no longer close to anyone?" And 39 percent of people said that described them. "No longer close to anyone." In the international measurements of loneliness, Britain and the rest of Europe are just behind the US, in case anyone here is feeling smug.

但如果可以的话，我想聚焦在两个原因，以及对应的两个解决方案。这是第一个。我们处于人类历史上 最孤独的社会。最近研究有一项研究，询问美国人 “你感觉不再跟任何人亲近了吗？” 39%的人说这描述符合他们。“不再跟任何人亲近。” 在国际孤独测量评估中，英国和其他欧洲国家仅次于美国。以防这里有人沾沾自喜。

09:34

(Laughter)

（鼓掌）

09:35

I spent a lot of time discussing this with the leading expert in the world on loneliness, an incredible man named professor John Cacioppo, who was at Chicago, and I thought a lot about one question his work poses to us. Professor Cacioppo asked, "Why do we exist? Why are we here, why are we alive?" One key reason is that our ancestors on the savannas of Africa were really good at one thing. They weren't bigger than the animals they took down a lot of the time, they weren't faster than the animals they took down a lot of the time, but they were much better at banding together into groups and cooperating. This was our superpower as a species -- we band together, just like bees evolved to live in a hive, humans evolved to live in a tribe. And we are the first humans ever to disband our tribes. And it is making us feel awful. But it doesn't have to be this way.

我花了很多时间就孤独问题 和世界一流的专家交流。一个非常优秀的人，约翰·卡奇奥波教授，他在芝加哥，他的工作给我们提出了 一个问题，我想了很久。卡奇奥波教授问到，“我们为什么存在？ 我们为什么在这儿，我们为什么活着？” 一个关键的原因在于 我们非洲大草原上的祖先 真的非常擅长一件事情。他们不比很多时候 他们放倒的动物高大，他们不比很多时候 他们放倒的动物跑得更快，但他们更擅长抱团 与协作。这是我们作为一个物种的超能力。我们聚集在一起，就像蜜蜂进化到住在蜂巢中一样，人类进化到部落聚居。而我们是第一批 解散部落的人类。这让我们感到糟糕。但事情不一定非得这样。

10:29

One of the heroes in my book, and in fact, in my life, is a doctor named Sam Everington. He's a general practitioner in a poor part of East London, where I lived for many years. And Sam was really uncomfortable, because he had loads of patients coming to him with terrible depression and anxiety. And like me, he's not opposed to chemical antidepressants, he thinks they give some relief to some people. But he could see two things. Firstly, his patients were depressed and anxious a lot of the time for totally understandable reasons, like loneliness. And secondly, although the drugs were giving some relief to some people, for many people, they didn't solve the problem. The underlying problem. One day, Sam decided to pioneer a different approach. A woman came to his center, his medical center, called Lisa Cunningham. I got to know Lisa later. And Lisa had been shut away in her home with crippling depression and anxiety for seven years. And when she came to Sam's center, she was told, "Don't worry, we'll carry on giving you these drugs, but we're also going to prescribe something else. We're going to prescribe for you to come here to this center twice a week to meet with a group of other depressed and anxious people, not to talk about how miserable you are, but to figure out something meaningful you can all do together so you won't be lonely and you won't feel like life is pointless."

我书中，也是我生活中的一个英雄，是一个叫山姆·艾佛林顿的医生。他是东伦敦贫民区的 一名全科医生，我在那生活过好多年。山姆真的很不容易，因为很多病人 都带着严重的抑郁和焦虑来找他。和我一样，他不反对使用抗抑郁药，他认为药物对一些人有缓解作用。但他可以看到两件事情。第一，他的病人很多时候 因为完全可以理解的理由 而抑郁和焦虑，比如说孤独。第二，尽管药物能给 部分人带来一些缓解。对多数人而言，它们无法解决问题，根本性的问题。一天，山姆决定 开创一种不同的方法。一位女性来到他的医疗中心，她叫丽莎·坎宁安。我后来才认识的。丽莎因为严重的抑郁和焦虑 被隔离家中，长达7年。当她来到山姆的中心时，她被告知，“不要担心，我们会继续给你这些药，但我们也会开一些其他东西。你需要每周来这个中心两次，去见其他抑郁和焦虑的人们，不是来说你有多么不幸，而是找出一些你们可以 一起做的有意义的事情，这样你就不会感到孤独，或是生活没有意义。

11:45

The first time this group met, Lisa literally started vomiting with anxiety, it was so overwhelming for her. But people rubbed her back, the group started talking, they were like, "What could we do?" These are inner-city, East London people like me, they didn't know anything about gardening. They were like, "Why don't we learn gardening?" There was an area behind the doctors' offices that was just scrubland. "Why don't we make this into a garden?" They started to take books out of the library, started to watch YouTube clips. They started to get their fingers in the soil. They started to learn the rhythms of the seasons. There's a lot of evidence that exposure to the natural world is a really powerful antidepressant. But they started to do something even more important. They started to form a tribe. They started to form a group. They started to care about each other. If one of them didn't show up, the others would go looking for them -- "Are you OK?" Help them figure out what was troubling them that day. The way Lisa put it to me, "As the garden began to bloom, we began to bloom."

这些人第一次见面时，丽莎焦虑到开始呕吐，因为这对她而言压力非常大。不过人们开始给她按摩，这群人开始聊天，“我们能做什么？” 这些都是和我一样 住在伦敦东部贫民区的人，他们不懂园艺。“为什么我们不学习园艺呢？” 医生办公室后面有块区域 是个灌木丛。“我们为什么不把它 改造成花园呢？” 于是他们开始从图书馆借书，开始看YouTube视频。他们开始把手伸进土里。他们开始学习四季的旋律。有大量的研究表明 接触自然世界 是一种非常有效的抗抑郁药。但他们开始做一些更重要的事情。他们开始形成部落。他们开始形成团队。他们开始关心彼此。如果其中有个人没出现，其他人会去寻找—— “你还好吗？” 帮助他们解决 他们那天遇到的麻烦。就像丽莎向我说的，“随着园中花朵的绽放，我们也开始绽放。”

12:45

This approach is called social prescribing, it's spreading all over Europe. And there's a small, but growing body of evidence suggesting it can produce real and meaningful falls in depression and anxiety.

这个方法被称为社会处方，它正在整个欧洲蔓延。有一个小的，但不断增长的证据 表明它可以真正且有意义地 缓解抑郁和焦虑。

12:56

And one day, I remember standing in the garden that Lisa and her once-depressed friends had built -- it's a really beautiful garden -- and having this thought, it's very much inspired by a guy called professor Hugh Mackay in Australia. I was thinking, so often when people feel down in this culture, what we say to them -- I'm sure everyone here said it, I have -- we say, "You just need to be you, be yourself." And I've realized, actually, what we should say to people is, "Don't be you. Don't be yourself. Be us, be we. Be part of a group."

有天，我记得站在这个 丽莎和她那些一度抑郁的 朋友建造的花园中—— 这真是个美丽的花园—— 我产生了这个想法，很大程度上受到 澳大利亚的休·麦凯教授的启发。我在想，当人们 在这种文化中感到沮丧时，我们是怎么跟他们说的—— 我确信这里每个人这么说过，我也说过—— “你只要做自己，做你自己。” 我已经意识到，其实，我们应该跟人们说的是，“别自己一个人，不要做自己。做我们，我们一起。成为团队的一员。”

13:30

(Applause)

（鼓掌）

13:34

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