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我们应该有不同的治疗自杀?

来源:杭州博尔英语作者:博尔英语 吴老师 18705812701免费在线预约课程试听,

我们应该有不同的治疗自杀?

   


Should we be treating suicide differently?

我们应该有不同的治疗自杀?

It is so easy to read meaning into the smallest things after a tragedy. In a 2006 interview, Robin Williams talked openly about his mood swings. “Do I perform sometimes in a manic style? Yes. Am I manic all the time? No. Do I get sad? Oh yeah. Does it hit me hard? Oh yeah.” He didn’t say that he’d been clinically diagnosed with a specific disorder, but his publicist has confirmed that Williams had been battling depression in the months leading up to his suicide.

它是如此易于阅读的意义为最小的事情后,一个悲剧。在一个2006的采访中,罗宾威廉姆斯公开谈论自己的情绪波动。“我在一个疯狂的方式有时会表演?可以.我疯狂吗?不行,我就伤心?哦,是的。它用力打我?哦,是的。”他没有说他被临床诊断为一个特定的疾病,但他的发言人证实,威廉姆斯已经在导致他的自杀的月的萧条。

Among the hundreds of tributes to Williams’ warmth and comic genius, many have pointed out that his death highlights, yet again, the many misconceptions and stigmas surrounding mental health problems. NBC News has a thoughtful piece about the “deadly stigma” surrounding this “silent epidemic” – suicide is rarely discussed, despite the fact that it is a growing issue; more people in the United States now die of suicide than in automobile accidents. Then there are people who still consider suicide a “selfish act” that can be cured with willpower. It is sad we are even having these discussions. Tony Blair’s former spin doctor, Alistair Campbell, who has himself suffered from mental health problems, best described the misunderstandings in an article for the Guardian: “If he’d had a heart attack, lost a fight with cancer or been knocked over by a car, would there be a need for a debate about what this says about the state of heart disease, or cancer care or road safety?”

在成千上百的悼念威廉姆斯的温暖和喜剧天才,许多人指出,他的死集锦,然而,许多的误解和柱头的心理健康问题。NBC新闻的“致命的耻辱”围绕这一“沉默的流行病”–自杀是很少讨论了富有创见的,尽管事实上它是一个日益严重的问题;在美国有更多的人死于自杀的国家现在比在汽车事故中。还有人认为自杀是一种“自私的行为”,是可以治愈的毅力。可悲的是我们有这些讨论。托尼布莱尔的前私人医生,Alistair坎贝尔,谁拥有自己遭受精神健康问题,最好的描述中存在的误区,对卫报的一篇文章:“如果他心脏病发作了,失去了与癌症或被一辆汽车撞倒一个战斗,会有一个关于这说的心脏病的国家辩论的需要,或癌症护理或者道路安全吗?“

Fans of Robin Williams have paid tribute to the comedian, who was honest about his struggles with mental health problems (Getty Images)

罗宾威廉姆斯的球迷致敬的喜剧演员,他对他的心理健康问题的斗争,诚实(Getty Images)

Yet even once the taboos have been broken, we still have a long way to go if we are to treat suicidal feelings with the same precision as other diseases. Anti-depressant drugs and cognitive behavioural therapy seem to reduce suicidal thoughts for many people with depression – but they are not a perfect cure for every patient. Why some respond, while others don’t, has been the matter of much soul searching, but recent research is helping to shed a little light on this dark state of mind.

然而即使禁忌已经被打破了,如果我们把自杀情绪具有相同的精度,为其他疾病,我们仍有很长的路要走。抗抑郁药物和认知行为疗法似乎减少许多患有抑郁症的人–自杀的想法,但不是每个病人一个完美的治疗。为什么一些回应,而别人没有,一直是很多寻找灵魂的事,但最近的研究有助于在这黑暗的心态棚一点光。

Self-awareness

自我意识

For instance, there is a growing recognition that the disease we call “depression” could be an umbrella-term covering many distinct problems, each with a different biological origin. In particular, a suicide attempt may be foreshadowed by a string of neurological changes that are not found in people with other kinds of depression. Of the most noticeable differences, patients who have tried to kill themselves seem to have less of the white-matter connections that transmit information in the dorsomedial prefrontal cortex – the part of the brain right behind your forehead’s hairline. That’s significant, since this region helps us process our self-awareness.

例如,人们日益认识到,我们称之为“萧条”可能是一个总称,涵盖了许多不同的疾病问题,每一个不同的生物起源。特别是,自杀可能预示着一连串的神经系统的变化,不与其他类型的抑郁症的人发现。最明显的差异,患者曾试图自杀似乎有较少的白质连接的传输信息的背内侧前额叶皮层–脑的一部分,就在你的额头的发际线。这很重要,因为这有助于我们处理我们的自我意识的区域。

People who try to kill themselves seem to get stuck in ruminative, negative styles of thinking full of self-criticism – so the study’s authors wonder if the neurological changes could lie behind those destructive trains of thought, blinding people to the hope and promise of the future, and even of their sense of their own self-worth.

有人试图自杀,似乎陷入了沉思,消极的思维方式充满了自我批评–所以研究者想知道神经系统的变化可能背后那些破坏性的思路,盲目的人们对未来的希望和承诺,甚至他们自己的自我价值感。

People feeling suicidal thoughts also seem to have reduced connectivity in the frontal areas of the brain associated with emotional control and inhibition. Again, the consequences of this are hypothetical, but suicide is considered to be an impulsive action, so it could be that the abnormal wiring in these regions makes it harder for someone to cope with the urge for self-destruction. On top of these specific changes, the brain cells themselves seem to be wasting away across diverse regions of the brain, potentially impairing problem solving and decision making – cognitive problems that are commonly seen in people who have attempted suicide.

人们感觉自杀的想法似乎也在情绪控制和抑制相关的大脑额叶区域减少连接。再次,这样的结果是假设的,但自杀是冲动的行动,所以它可能是在这些地区的异常接线使人应对自我毁灭的冲动更难。在这些具体的变化,脑细胞本身似乎是浪费的距离在不同的大脑区域,有可能损害的问题解决和决策–认知问题,都是在试图自杀的人常见的。

At the moment, it’s not clear what triggers these anatomical changes and whether they are the primary cause of the suicidal urges – it could be that they are just a side-effect of the depressed, desperate feelings that the patient is already experiencing. Most likely, the psychological symptoms and the altered brain wiring are both the result of a complex interplay between your genes and your circumstances.

目前,还不清楚是什么引发了这些解剖学上的变化,以及他们是否是主要的原因,想自杀的冲动–可能他们只是一个副作用的沮丧,绝望的感觉,病人已经经历。最有可能的是,心理症状和改变大脑线路都是你的基因和环境之间复杂的相互作用的结果。

Brain fibres, as seen in this MRI scan, could leave physical clues of depression (Science Photo Library)

脑纤维,就像在这MRI扫描,可以把抑郁的物理线索(科学图片库)

Once we have picked apart the specific mechanism, this new understanding could eventually change the way we treat people with depression. Firstly, it could help identify who is most at risk for suicidal tendencies. Many suicidal patients are unlikely to tell anyone, even their doctors, about their darkest feelings – but a brain scan might reveal those characteristic anatomical changes, giving doctors an insight that they couldn’t have gained from an interview. Since neural degeneration – such as the death of neurons – has certain chemical signatures, some have suggested that blood tests could one day reveal the early signs that could precede a suicide attempt. Preliminary explorations of the technique have been positive, but much larger trials will be needed before any form of this test could be used in the clinic.

一旦我们除了挑选特定的机制,这种新的理解可能最终会改变我们对待别人的方式与抑郁。首先,它可以帮助确定谁在自杀倾向风险最。许多自杀患者不会告诉任何人,甚至他们的医生,他们的黑暗的感觉–但脑部扫描可能揭示这些特征的解剖学上的变化,给医生一个深入了解,他们不可能从面试了。由于神经变性–如神经元–死亡有一定的化学签名,有些人认为,血液测试可以揭示一天可能先于企图自杀的早期迹象。该技术的初步探索是积极的,但更大的试验将在任何形式的测试用于临床需要。

Once the patients’ particular needs have been identified, the work could then tailor treatments that best suit the particular type of depression they have. Doses of lithium, for instance, seem to replenish the grey matter in damaged areas of the suicidal brain; and studies have found that the drugs do indeed reduce the risk of a second suicide attempt, when applied to people with bipolar disorder who have already attempted to take their life once. Other drugs could have a similar function.

一旦病人的特殊需求已经确定,工作可以调整治疗最适合他们的特定类型的抑郁症。例如锂,剂量,似乎补充灰质中的自杀性脑损伤区;有研究发现,该药确实减少了第二次自杀企图的风险,当应用于双相情感障碍的人已经试图把他们的生命的人一旦。其他药物可能有类似的功能。

 

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