There's a lot of stigma.

還有許多誤解的社會裡

Some people tell you to just suck it up, or get it together, or to stop worrying, or that it's all in your head.

有些人只會叫你撐下去振作起來，不要太擔心 或說只是你在胡思亂想

But I'm here to tell you that anxiety disorders, they're as real as diabetes.

但我想告訴你焦慮症和糖尿病一樣真實（音樂） [與珍醫師了解你身體]

Hi again.

哈囉

It's Dr. Jen, and I've noticed something with my patients.

我是珍醫師我發現我的病患有個共同問題

They often describe to me some classic symptoms of an anxiety disorder.

他們時常向我描述一些典型的焦慮症症狀

Constant worry, trouble sleeping, tense muscles and struggle with concentrating.

持續性擔憂和睡眠障礙肌肉緊繃以及無法專注

But they aren't getting treatment.

但他們卻沒有任何治療

There's a lot of issues with mental-health care in this country.

我們國家的心理保健有許多問題

Some people don't have insurance that would cover it.

有些人因為沒有保險而無法負擔醫藥費

Some have been dismissed or minimized in the past, and don't think seeking help will do any good.

有些人曾被人小看或打發因此不認為尋求幫助是有效的

Some worry about the stigma and whether it could affect future jobs or relationships.

有些人顧慮別人的眼光怕會影響工作和人際關係

But severe anxiety isn't a moral or personal failing.

但嚴重的焦慮不是道德或個人的失敗

It's a health problem, just like strep throat or diabetes.

它是健康問題就像咽喉炎或糖尿病一樣

It needs to be treated with the same kind of seriousness.

它必須被同等嚴肅看待

Before we can talk about anxiety disorders, let's talk about anxiety itself.

在我們談論焦慮症之前我們先談談焦慮本身

Anxiety is the very real and normal emotion we feel in a stressful situation.

當我們處於有壓力的情況時焦慮是很真實和正常的情緒

It's related to fear.

它和恐懼有關

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.

但恐懼是對即刻威脅的反映很快就能平息 而焦慮反映的是更加不明確的威脅 持續的時間更長

It's all part of the threat detection system, which all animals have to some degree, to help protect us from predators.

這是威脅偵測系統的一部分所有動物或多或少都有 它能幫助我們遠離危險

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.

焦慮源自大腦中的杏仁核一對杏仁大小的神經束 它警告大腦中的其他區域做好防禦準備

Next, the hypothalamus relays the signal, setting off what we call the stress response in our body.

接著，下視丘會傳遞這個訊號我們的身體就開始出現壓力反應

Our muscles tense, our breathing and heart rate increase and our blood pressure rises.

肌肉變得緊繃呼吸和心跳加速 血壓升高

Areas in the brain stem kick in and put you in a state of high alertness.

腦幹中部分區域開始作用讓你處於高度警覺狀態

This is the fight-or-flight response.

這就是「戰鬥或逃走」反應

There are ways the fight-or-flight response is kept somewhat in check,

有些方法能使這些反應維持於控制範圍內

with an area of higher-level thinking called the ventromedial prefrontal cortex.

哪就是能提供更高階思考的 腹內側前額葉皮質

It works like this.

它是這樣運作的

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."

如果人類處於危險的情況， 比如看見老虎杏仁核就會收到應該逃跑的訊號

The ventromedial prefrontal cortex can say to the amygdala, "Hey, look. The tiger's in a cage.

腹內側前額葉皮質會通知杏仁核看！老虎被關在籠子裡

You know what a cage is? They can't escape from a cage.

你知道籠子是什麼？ 牠們無法從籠子逃走

It's OK to calm down."

所以你可以冷靜下來了

It's a feedback loop that can help keep the response in check.

這是一個讓反應可控的反饋迴路

The hippocampus is also involved.

海馬體也在此反應中運作

It provides context, saying things like, "Hey, we've seen tigers in cages before.

它能提供一些情境，像是：「嘿，你曾看過老虎在籠子裡

We're in a zoo. You are extra safe."

在動物園裡是非常安全的。」

With anxiety, these threat-detection systems and mechanisms that reduce or inhibit them are functioning incorrectly

當焦慮產生時這些威脅偵測系統與機制會被抑制 並且錯誤地運作

and cause us to worry about the future and our safety in it.

使我們對自身安危感到擔心

But for many people, it goes into overdrive.

但對某部分人來說它運作過度

They experience persistent pervasive anxiety that disrupts work, school and relationships and leads them to avoid situations that may trigger symptoms.

他們的焦慮症狀持續不斷並干擾到工作、課業與人際關係 使他們避開所有會觸發焦慮症狀的情境

Anxiety disorders are not at all uncommon.

焦慮症一點也不少見

Based on data from the World Mental Health Survey, researchers estimate that about 16 percent of individuals

根據世界精神衛生調查的數據顯示約有百分之十六的人

currently have or have had an anxiety disorder.

患有或曾患有焦慮症

These include social anxiety disorder, panic disorder, agoraphobia and phobias.

包含社交恐懼症恐慌症、廣場恐懼症及特殊恐懼症

Studies have shown that people with anxiety disorders don't just have a different way of reacting to stress.

研究顯示患有焦慮症者不只是對於壓力的反應與常人有異

There may be actual differences in how their brain is working.

他們的大腦運作也可能與常人不同

One model describes possible mix-ups in the connections between the amygdala and other parts of the brain.

這個模型說明大腦產生混亂的原因杏仁核與大腦其他部分連結

The pathways that signal anxiety become stronger.

傳送焦慮的路徑會逐漸增強

And the more anxiety you have, the stronger the pathways become, and it becomes a vicious cycle.

且越是焦慮，連結越強然後成為惡性循環

The good news is there's treatment for anxiety, and that you don't have to suffer.

值得慶幸的是焦慮是可以治療的不需要一直受其所苦

Remember, this isn't about weakness.

記住，焦慮並不是你的軟弱

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.

只是你要改變大腦運作模式研究顯示 我們的大腦有能力構成新的連結方式 且一生都有機會轉變

A good first step is to do the basics.

第一步要維持基本的良好生活習慣

Eat a balanced diet, exercise regularly and get plenty of sleep, as your mind is part of your body.

均衡飲食規律運動 保持睡眠充足 畢竟腦部也是身體的一部分

It might also help to try meditation.

冥想可能也會有所幫助

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.

放鬆肌肉並使心跳平穩保持正念和平穩呼吸 我們可以減緩戰鬥或逃走反應 好好感受當下

Cognitive behavioral therapy, a form of talk therapy, can also be fantastic.

「認知行為治療」是其中一種的談話療法效果也很不錯

In it, you learn to identify upsetting thoughts and determine whether they're realistic.

在治療中你學識哪些使你心煩的想法並判斷它們是否切實

Over time, cognitive behavioral therapy can rebuild those neural pathways that tamp down the anxiety response.

認知行為治療可以慢慢重建神經路徑並抑制焦慮反應

Medication can also give relief, in both the short-term and the long-term.

短期或長期服藥也可以使症狀獲得緩解

In the short-term, anti-anxiety drugs can down-regulate the threat-detection mechanisms that are going into overdrive.

短期服用抗焦慮藥物可以抑制威脅偵測機制 避免它過度運作

Studies have shown that both long-term medications and cognitive behavioral therapy can reduce that overreactivity of the amygdala we see an anxiety disorders.

而研究顯示長期用藥以及認知行為治療 可以降低杏仁核的活躍程度 也就是我們所說的焦慮症

High blood pressure and diabetes, they can be treated or managed over time.

就像高血壓與糖尿病可以受控制或被治癒

And the same is true for an anxiety disorder too.

焦慮症也一樣可以