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We live in a culture that doesn't take mental health issues seriously.
我们生活在一个不把心理健康问题当回事儿的文化当中。
There's a lot of stigma. 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.
心理健康涉及到很多尊严问题。有些人会让你忍着，让你振作起来，或者让你别想了，也或者这些想法全在你的脑子里。
But I'm here to tell you that anxiety disorders, they're as real as diabetes.
但我在这里要告诉大家的是，焦虑症，就像糖尿病一样是真实存在的。
Hi again. It's Dr. Jen, and I've noticed something with my patients.
嗨，咱们又见面了。我是珍医生，我在我的病人身上发现了一些问题。
They often describe to me some classic symptoms of an anxiety disorder. Constant worry, trouble sleeping, tense muscles and struggle with concentrating.
他们经常向我描述一些焦虑症的典型症状：总是忧虑、失眠、肌肉紧张、难以集中注意力。
But they aren't getting treatment.
然而他们并没有得到治疗。
There's a lot of issues with mental-health care in this country.
咱们国家在心理健康护理方面有很多问题。
Some people don't have insurance that would cover it.
有些人的医保里没有“心理健康治疗”这一块儿；
Some have been dismissed or minimized in the past, and don't think seeking help will do any good.
有些人过去根本不在乎什么“心理健康治疗”或者不予重视，他们觉得就算寻求帮助也不会有什么用。
Some worry about the stigma and whether it could affect future jobs or relationships.
还有一些人担心尊严问题，他们觉得有心理问题会影响未来的工作和人际关系。
But severe anxiety isn't a moral or personal failing. It's a health problem, just like strep throat or diabetes.
不过严重的焦虑并不是道德或个人的失败，而是一种健康问题，就像链球菌性喉炎或糖尿病一样。
It needs to be treated with the same kind of seriousness.
我们需要以同样的严肃态度来对待心理问题。
Before we can talk about anxiety disorders, let's talk about anxiety itself.
在我们讨论焦虑症之前，我们先来谈谈焦虑症本身。
Anxiety is the very real and normal emotion we feel in a stressful situation.
“焦虑”是我们在有压力的情况下所感受到的真实的、正常的情绪。
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.
它和恐惧有点关系，不过恐惧是对可以迅速消退的直接威胁的反应，而焦虑则是对持续时间更长、更不确定的威胁的反应。
It's all part of the threat detection system, which all animals have to some degree, to help protect us from predators.
它俩都是威胁探测系统的一部分，某种程度上所有动物都有这个系统来保护自己免受捕食者的伤害。
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.
焦虑始于大脑的杏仁核，杏仁核是一对杏仁大小的神经束，负责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.
接下来，下丘脑会传递这一信号，在我们体内触发所谓的“压力反应”。
Our muscles tense, our breathing and heart rate increase and our blood pressure rises.
之后我们会肌肉紧张，呼吸和心率加快，血压升高。
Areas in the brain stem kick in and put you in a state of high alertness. This is the fight-or-flight response.
脑干的一些区域开始发挥作用，使你处于一种高度警觉的状态，这就是“战或逃”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.
有一种方法可以通过一个叫做“腹内侧前额叶皮层”的高级思维区域在一定程度上控制“战或逃”反应。
It works like this.
它是这样工作的。
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."
如果某人看到了他们认为危险的东西，比如一只老虎，杏仁核就会收到“是时候逃跑了”的信号。
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."
这时“腹内侧前额叶皮层”会对杏仁核说，“嘿，看，老虎在笼子里呢，你知道笼子是什么吧？老虎是逃不出来的，冷静，别担心。”
It's a feedback loop that can help keep the response in check.
这是一个反馈循环，有助于控制反馈。
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."
此时“海马体”也会参与其中，它会提供语境，比如，“嘿，我们以前见过笼子里的老虎，我们是在动物园里，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.
不过在焦虑的情况下，这些减少或抑制焦虑的威胁探测系统和机制会功能失常，从而导致我们对自身未来的安全产生担忧。
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.
但对很多人来说，焦虑会超速运行。他们会持续经历各种焦虑，这些焦虑会扰乱他们的工作、学习和人际关系，使他们避免可能引发症状的情况。
Anxiety disorders are not at all uncommon. Based on data from the World Mental Health Survey, researchers estimate that about 16% of individuals currently have or have had an anxiety disorder.
焦虑症并不罕见。根据世界心理健康调查的数据，研究人员估计目前约有16%的人患有或曾经患有焦虑症。
These include social anxiety disorder, panic disorder, agoraphobia and phobias.
症状包括社交焦虑障碍、恐慌障碍、广场恐怖症和恐惧症。
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.
研究表明，焦虑症患者不仅对压力会有不同的反应方式，他们大脑的工作方式可能也确实有所不同。
One model describes possible mix-ups in the connections between the amygdala and other parts of the brain.
有一个模型描述了杏仁核和大脑其他部分之间可能存在的联系混乱。
The pathways that signal anxiety become stronger. And the more anxiety you have, the stronger the pathways become, and it becomes a vicious cycle.
信号性焦虑的神经通路变得更强。焦虑越多，神经通路就越强，这样便形成了恶性循环。
The good news is there's treatment for anxiety, and that you don't have to suffer.
好消息是，现在有治疗焦虑的方法，而且你不必忍受痛苦。
Remember, this isn't about weakness. It's about changing brain patterns,
记住，这和软弱无关，而是有关改变大脑模式
and research shows that our brains have the ability to reorganize and form new connections all throughout our lives.
研究表明我们的大脑有能力在我们的一生中重新组织并形成新的联系。
A good first step is to do the basics.
好的第一步是做好基础小事。
Eat a balanced diet, exercise regularly and get plenty of sleep, as your mind is part of your body.
饮食要均衡，要经常锻炼，保证充足的睡眠，因为思想是身体的一部分。
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.
尝试冥想也会有帮助。通过正念和呼吸，而非心跳加速和身体紧张，可以减缓“战或逃”反应，改善我们当下的感觉。
Cognitive behavioral therapy, a form of talk therapy, can also be fantastic.
认知行为疗法，一种谈话疗法，也会有很棒的效果。
In it, you learn to identify upsetting thoughts and determine whether they're realistic.
在认知行为疗法中，你会学会辨别令人不安的想法，并确定它们是否现实。
Over time, cognitive behavioral therapy can rebuild those neural pathways that tamp down the anxiety response.
随着时间的推移，认知行为疗法可以重建那些抑制焦虑反应的神经通路。
Medication can also give relief, in both the short-term and the long-term.
药物也可以短期或长期缓解疼痛。
In the short-term, anti-anxiety drugs can down-regulate the threat-detection mechanisms that are going into overdrive.
在短期内，抗焦虑药物可以下调正在超速运转的威胁检测机制。
Studies have shown that both long-term medications and cognitive behavioral therapy can reduce that overreactivity of the amygdala we see an anxiety disorders.
研究表明，长期药物治疗和认知行为疗法都可以减少杏仁核的过度反应，也就是焦虑症。
High blood pressure and diabetes, they can be treated or managed over time. And the same is true for an anxiety disorder too.
高血压和糖尿病可以慢慢得到治疗或控制，焦虑症也是如此。
