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We all have an inner dialogue inside our mind - reminding yourself to pay your cellphone
在我們腦海中都有著一段段的內在對話─像是提醒自己記得支付手機帳單、
bill, or even rehearsing a tough conversation with a friend. But what if that voice becomes
或者演練著要怎麼和朋友進行一場艱難的對話。但如果那個聲音逐漸
voices that are out of your control?
脫離你的掌控呢?
Psychologist Julian Jaynes proposed a theory that, not so long ago all humans heard voices
心理學家Julian Jaynes提出了一項理論,內容講述:在不久之前所有人類都聽得到某種聲音─
- created internally from the right hemisphere of the brain, but perceived as external from
它是由我們右腦所內部創造出來的,但卻被左腦知覺是外部產生的
the left hemisphere (bicameralism). As a result these voices were perceived as communication
因此這些聲音便被解讀成神與我們的對話 (譯註:這就是Jaynes所提出的二分心智理論)
from the gods. But around 1000 BC, with the rise of modern consciousness, these voices
但大約在西元前1000年,隨著現代意識的興起,這些聲音
became recognized as our own. Some psychiatrists believe that the brains of schizophrenic people
被認為是屬於我們自己的。有些精神科醫師相信患有思覺失調症的病人大腦
may revert to this state, and not recognize some of their thoughts as their own.
可能會回復成之前的狀態,且並不認為他們的某些想法是源自於自己
Schizophrenia is a disease of the nervous system, affecting approximately 1% of the
思覺失調症是一種神經系統的疾病,影響了大約1%的人口
population. To be clear, schizophrenia is not the same as having ‘multiple personality
講得明確點,思覺失調症和「多重人格障礙」並不相同
disorder’. Symptoms often include hallucinations: from seeing things that aren’t there, to
它的症狀通常包含幻覺,例如看見不存在的事物、
delusions such as a higher belief in conspiracy, higher rates of depression, and most notably
產生像是「堅信事物有陰謀」的妄想、擁有高比例的憂鬱傾向,還有最明顯地是會聽到某些聲音
hearing voices. Auditory hallucinations occur in many disorders - from simple sounds to
幻聽發生在很多疾病─從簡單的聲音到單詞、或者聽到有人呼喚名字─
words or names being called - but the voices heard in schizophrenics are quite different.
但思覺失調症的患者所聽到的聲音相當不同
They are often associated with their current mental state, and can be quite hostile, accusing,
它們經常關連到他們當下的精神狀況,且十分地具有敵對性、指責性、
threatening or persecuting (58); ultimately embodying many of their fears.
威脅性或者迫害性,並最終體現了他們的恐懼
A 2006 study of over 3000 schizophrenic patients found that genes related to immune function
在2006年,一個針對3000多名思覺失調症患者所做的研究中發現,免疫功能基因
may play a role - specifically the complement component 4 or C4 genes. C4 is a gene involved
可能扮演了某種角色─特別是C4基因(complement component 4),C4是一個
in trimming the synapses in the brain; for example, teenage brains undergo a process
與修剪腦中突觸有關的基因,舉例來說,青少年的大腦會經歷一段
known as ‘synaptic pruning’ in which unused connections are cut away to aid in our brains
被稱作是「突觸修剪」的時期,這段時期裡會修剪無用的連結、以增進我們大腦的效率
efficiency. But in individuals with schizophrenia, this C4 gene may be overactive and cut down
只是在思覺失調症患者身上,C4基因會過度活躍,
areas that are involved in planning, cognition and thinking. Links have also made between
並修剪了與規劃、認知、思考有關的區域。思覺失調與腸道中的微生物也有所關連─
microbes in the gut - after all, the microbes that live within us have also been shown to
畢竟存在於我們體內的微生物也被證明
modulate immune response and impact brain development. One study found that lactic acid
可以調節免疫反應,並影響大腦發展。其中一項研究發現乳酸菌在
bacteria were significantly more abundant in people with schizophrenia, while another
思覺失調症病人身上特別地多,同時另一項研究也發現
found that the prevalence of lipid and glucose abnormalities is much higher in patients with schizophrenia.
脂質與葡萄糖異常的發生率,在思覺失調症患者身上也是較高的
And while diagnosing schizophrenia is primarily based on behavior and reported experiences,
而儘管診斷思覺失調症主要是依據病人行為和其自述經歷,
research has found the cause to be a combination of these genetic factors along with some environmental
研究已發現疾病原因是來自於遺傳因子與環境壓力源的配合,
stressors like growing up in an urbanized area, minority group position, and even cannabis
而環境壓力源包含─生長在都市地區、少數群體的自我定位、甚至還有使用大麻中的四氫大麻酚
use as THC can exaggerate psychotic response in some individuals with genetic risk or developmental trauma.
會擴大某些人精神方面的反應,並伴隨著遺傳上的風險或發展上的創傷
Currently, medication for schizophrenia mostly focuses on combating hallucinations and delusions
目前對思覺失調症的藥物治療,大多專注在抑制幻覺與妄想
but, unfortunately, 49.5% of schizophrenia patients don’t end up taking their medicine.
但不幸地是,有49.5%的思覺失調症患者最終並沒有選擇服藥
This is why genetic research is so important to combatting this disease. Of course, some
這也是為何遺傳學研究對抑制此疾病如此重要。當然地,
people can and do recover through a combination of medication, counselling and support which
有些人可以經由藥物治療、個別輔導與他人支持的搭配下逐漸康復
can greatly reduce the symptoms.
而這些對減輕症狀有極大的幫助
On AsapTHOUGHT we talk about how mental health stigma is a serious issue in our culture and
在AsapTHOUGHT,我們談論了精神健康的烙印 如何在我們的文化與媒體中成為嚴重的問題
the media. Many of us negatively contribute to the stereotyping of mental illness without
我們大多數對精神疾病抱有負面的刻板印象─即使我們並不了解它─
even realizing it - so we break down 5 ways we can all reduce mental health stigma right
所以我們找出5個可以減少汙名化精神健康的方法
now. Check it out with the link below.
點開並查看下面的連結
And special thanks to audible for supporting this episode to give you a free 30 day trial
還有特別感謝audible支持本集,並給予你們在audible.com/asap 上的30天免費試用
at audible.com/asap. This week we wanted to recommend the book “Schizophrenia: Understanding
這週我們想要推薦一本書─《Schizophrenia: Understanding Symptoms Diagnosis & Treatment》,
Symptoms Diagnosis & Treatment” which tackles much of the stigma tied to schizophrenia and
這本書處理了很多與思覺失調症有關的汙名化問題,
how it affects those with the condition. You can get a free 30 day trial at audible.com/asap
還有談論了它如何影響這種情況。你可以取得在audible.com/asap 上的30天免費試用,
and choose from a massive selection! We love them as they are great when you’re on the go.
並從大量選擇中挑選你想要的!我們喜歡使用它是因為在你想邊走邊聽時,它十分地方便
And subscribe for more weekly science videos!
訂閱我們以獲得更多的每週科學影片