Bipolar disorder has been the focus of attention in recent years, as a
new slew of psychiatric medications have been developed to help treat it. Such
medications drive pharmaceutical marketing and increased educational efforts
surrounding bipolar disorder (for better or worse).
But many myths surround bipolar disorder — what it is, what it means, and how it’s treated. Here’s to busting a few of the most common ones.
1. Bipolar disorder means I’m really “crazy.”
1.双相障碍意味着我真的“疯了”。
While bipolar disorder is a serious mental disorder, it is no more serious than most other mental disorders. Having a mental disorder doesn’t mean you’re “crazy,” it just means you have a concern that is negatively impacting how you live your life. Left unaddressed, this concern can cause a person significant distress and problems in their relationships and life.
双相障碍是一种严重的精神障碍,但是并不比其他大多数精神障碍严重。得精神障碍并不意味你疯了,只是意味着你有个事情,这事情对你的生活会有负面的影响。如果避而不谈,这件事会引起个人的严重压力,生活中跟别人的关系也会出问题。
2. Bipolar disorder is a medical disease, just like diabetes.
2.双相障碍是个医学疾病,就像糖尿病似的。
While some marketing propaganda might simplify bipolar disorder into a medical disease, bipolar disorder is not — according to our knowledge and science at this time — a medical disease. It is a complex disorder (called a mental disorder or mental illness ) that reflects its basis in psychological, social, and biological roots. While it has significant neurobiological and genetic components, it is no more of a pure medical disease than ADHD or any other mental disorder. Treatment of bipolar disorder that focuses solely on its “medical” components often results in failure.
有些市场宣传机构可能会把双相障碍简单化成医学疾病,但就我们现在的知识和科学来说,它不是。它是一种复合型障碍,有心理学、社会和生物基础。它有显著的神经生物学的遗传学成分,跟注意力缺失及多动障碍或其他精神障碍相比,它不仅仅是纯粹的生物医学疾病。单单着眼“医药”成分来治疗双相障碍,通常结果都是失败。
3. Manic depression is different than bipolar disorder.
3.躁郁症和双相障碍不一样。
Manic depression is simply the old name for bipolar disorder. The name was changed to more accurately describe the type of mood disorder it is — someone who experiences swings between two poles of mood (or emotion). Those two poles are mania and depression.
躁郁症是双相障碍的旧名字。
4. I’ll have to be on medications for the rest of my life.
4.我余生都得服药了。
While the default assumption by most mental health professionals is that most people with bipolar disorder will need to be on medications for the rest of your life, nobody can predict how exactly you, as an individual, will react to such medications or what the future holds for your specific needs. So it is a myth to say that all people with bipolar disorder will absolutely be on medications for the rest of their lives. As many people age with this disorder, they find their swings between mania and depression lessen significantly, and the need for medication may decrease, and may even be discontinued without any harmful repercussions.
大多数精神卫生专业人士默认的假设是,大多数得了双相障碍的人需要在余生服药,但是没人能预测你作为一个个体对药物有什么确切反应,或者未来的情况如何。所以说所有得双相障碍的人都需要终身服药是个误传。很多人年纪更大以后,发现自己在躁狂和抑郁之间的摆荡没那么明显了,对药物的需要就下降了,甚至可以停药而没有任何有害反应。
5. I’m feeling better since taking my medications, which means I probably don’t need them any more, right?
5.开始服药之后,我感觉好些了,这意味着我可能不再需要服药了,对吗?
Wrong. Once a person starts feeling better because of the medication, they often discontinue taking the medication, leading to an eventual relapse. This is a common problem in the treatment of bipolar disorder and is something professionals like to call “treatment compliance.” This is just a fancy way of saying that a person needs to continue taking their medication as prescribed, no matter how good they may be feeling. It is perhaps one of the most insidious issues in the treatment of bipolar disorder, and leads many people to greater distress than if they just kept taking their medications.
错。一旦因为药物开始感觉好转,人们通常停药,导致最终复发。这是双相障碍的治疗中常见的问题,是专业人员成为“治疗依从性”的东西。等于说,人们需要遵医嘱继续服药,不管他们感觉可能有多好。这可能是双相障碍治疗中最麻烦的话题,跟保持继续服药相比,很多人会有更大的压力。
6. There’s no need for psychotherapy in bipolar disorder.
6.双相障碍没必要做心理治疗。
This varies from person to person (just as the need for taking medications does), but this is a myth insomuch that many people and professionals believe that psychotherapy doesn’t help much in the treatment of bipolar disorder. Psychotherapy can be very helpful and effective in the treatment of bipolar disorder, since medications alone can’t teach a person new coping skills or how to deal with feelings of an impending manic or depressive episode. Psychotherapy can help a person with bipolar disorder learn to live with the disorder in their lives without as much stress or upset. While many people with bipolar disorder forgo psychotherapy, it is usually a helpful treatment to consider when first diagnosed.
这取决于个人,很多人和专业人员都认为,心理治疗对双相障碍的帮助不大,但这也是个误传。心理治疗对双相的治疗很有帮助也很有效。因为药物不会教人新的应对技巧或者如何处理躁狂或抑郁期间的迫切感觉。心理治疗可以帮助有双相障碍的人学会与障碍相处,而不会有太大的压力或者太难受。虽然很多得了双相障碍的人放弃了心理治疗,但它通常是个有用的治疗方式。
7. Atypical antipsychotics are only for schizophrenia.
7.非典型抗精神病药只用于精神分裂症。
In the U.S. in 1990, a new class of medications was introduced called “atypical antipsychotics.” These newer medications are not used to treat only psychosis (such as that found in schizophrenia), but also a wider range of psychiatric symptoms. One of their approved uses is in the treatment of bipolar disorder in adults. They may also be approved in short time for use in teenagers and children 10 years and older (although they are already sometimes prescribed by doctors for “off label use” in teens and children). So don’t let the name of the class of medications fool you — they treat far more than just psychosis.
它们现在广泛使用,不仅仅用于精神病。
8. Atypical antipsychotics have little to no side effects.
8.非典型抗精神病药不大会无副作用。
Atypical antipsychotics are often the primary drug doctors use to treat bipolar disorder. In the U.S., the Food and Drug Administration has determined that such drugs are both safe and effective for this use. However, like all medications, atypical antipsychotics have their own set of risks and side effects.
非典型抗精神病药通常是医生治疗双相障碍的首选药物。美国FDA认定这些药物安全有效。但是跟所有的药物一样,非典型抗精神病药有自己的风险和副作用。
These medications have a different side effect profile than the medications they replace. While initially marketed as a “better” side effect profile, research since 1990 has shown that the side effects they do produce in many people can be just as worrisome as older medications. Chief among the typical side effects are weight gain and metabolism problems, which can be precursors to type 2 diabetes, increased risk of stroke, and heart problems (including an increase in cardiac arrhythmias which can lead to sudden death).
1990年以来的研究显示,它们给很多人带来的副作用和旧药一样麻烦。典型副作用中主要有体重增加和代谢问题,这是二型糖尿病的先兆,还会提高中风的风险,以及心脏问题(包括增加心律失常,可导致猝死)。
9. I may just have depression.
9.我可能只是得了抑郁。
Many times, bipolar disorder mimics clinical depression, because one of the primary symptoms of bipolar disorder is clinical depression. Up to 25 percent of people who have bipolar disorder are initially misdiagnosed with depression. Why does this occur? Because many people first go to their primary doctor for a diagnosis, and primary doctors do not always ask enough questions to make the proper diagnosis. This can occur with mental health professionals who also fail to probe enough when a person presents with clinical depression in their office.
双相障碍常常与临床抑郁症相似,因为它的主要症状之一就是临床抑郁。双相障碍的人中超过25%最初被误诊为抑郁。因为很多人第一次见医生求诊断的时候,“primary doctor”并不总是问了足够的问题来找到恰当的诊断。当一个人在医生的办公室里呈现出的是临床抑郁时,如果心理卫生专业人士没有仔细探查,就会发生这样的事。
An incorrect initial diagnosis can lead to incorrect treatment, such as the prescription of antidepressant. Generally, antidepressants are not used in the treatment of bipolar disorder, and in fact, can make the disorder worse in the person. So if you’ve ever had an episode of increased energy for no particular reason (not because you just drank a liter of Coke), make sure you share that information with your mental health professional.
不正确的初始诊断会导致不正确的治疗方法,比如开抗抑郁药。抗抑郁药通常不用于治疗双相障碍,实际上还会让情况变得更糟。所以如果你曾经有过一个期间,觉得没有什么特别原因地充满能量(不是因为你喝了一升可乐),要确保你跟你的心理卫生专业人士讲了这个信息。
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