Depression is flourishing. Less, of course, like a bank of daffodils and more like an irruption of dry rot: hidden, silent, pervasive, and a vast drain on national and universal wellbeing. According to The Depression Report produced by the London School of Economics' Centre for Economic Performance in June 2006, depression and chronic anxiety cost the UK £12bn a year in total loss of output. In Britain, nearly 9 per cent of adults suffer from some form of depression in any given week.
抑郁癥在泛濫。 當(dāng)然,不那么像一堆水仙花,而更像是干腐病的爆發(fā):隱秘、沉默、大面積肆虐,對國家和全世界福祉帶來巨大消耗。據(jù)2006年6月倫敦政經(jīng)學(xué)院(London School of Economics)經(jīng)濟(jì)效益中心(Centre for Economic Performance)制作的《抑郁癥報(bào)告》(The Depression Report)稱,抑郁癥和長期焦慮導(dǎo)致英國每年產(chǎn)出總量減少120億英鎊。在英國,每周都有近9%的成年人遭受某種形式的抑郁癥困擾。
Why is it on the rise? Human misery has always caused depression, and there are now many more humans alive to endure misery than in the past. For those whose lives are not materially miserable, depression can be, paradoxically, a consequence of better education and the global communications revolution combined with a sympathetic imagination. Family breakdown and the hyper-mobility which cuts social roots are further factors
抑郁癥為何會(huì)增多呢?人類的苦難總是會(huì)導(dǎo)致抑郁癥,而如今活著忍受苦難的人要比過去更多。對那些并非物質(zhì)生活困苦的人而言,矛盾之處在于導(dǎo)致抑郁癥的可能是更好的教育、全球通信革命再加上富有同情心的想象。家庭的瓦解和割斷社會(huì)根基的高度流動(dòng)性則是更深層次的因素。
According to statistics assembled by the Samaritans, only 20 per cent of sufferers from depression ever seek medical help. The rest, if they do anything at all other than make the lives of intimates dank, will self-medicate. The self-medication of overwhelming choice is alcohol: the favourite drug of the non-Muslim developed world. The sensation of short-term wellbeing provided by alcohol is inexpensive, widely available and culturally acceptable. Yet alcohol and depression are closely linked, with 40 per cent of heavy drinkers showing depressive symptoms. Given that 38 per cent of men and 16 per cent of women in the UK drink above recommended limits, the size of the problem is unsurprising.
據(jù)撒馬利坦會(huì)(Samaritan)整理的統(tǒng)計(jì)數(shù)字顯示,僅有20%的抑郁癥患者曾經(jīng)尋求醫(yī)療救助。其他人,要是自己真的會(huì)想想辦法,而不只是讓親密愛人日子難過的話,則會(huì)自己用藥。絕大多數(shù)人給自己開的藥方選了酒精——非穆斯林發(fā)達(dá)國家的首選藥物。酒精帶來的短期良好感覺不貴,到處都可以買到,在文化上也能接受。然而,酒精和抑郁癥有著緊密的聯(lián)系,40%的酗酒者都有抑郁癥狀。鑒于英國38%的男性和16%的女性飲酒量都超過推薦標(biāo)準(zhǔn),因此抑郁癥的規(guī)模也就不足為奇了。
Alcohol itself, following the initial rosy flush, is a depressant, and can cause depression in those who would otherwise not be depressed. The advice from the Royal College of Psychiatrists to those prone to depression is unambiguous: “Beware alcohol!”
酒精本身,在讓你的臉色開始變紅之后,就成了鎮(zhèn)靜劑,可能會(huì)導(dǎo)致本來不抑郁的人患上抑郁癥;始揖窨漆t(yī)學(xué)院(Royal College of Psychiatrists)給那些有抑郁傾向的人提出來十分明確的建議:“小心飲酒!”
I am an alcohol worker, in that around two-thirds of my professional life involves tasting, drinking, talking or writing about alcohol, and my experience corroborates the findings of experts in this field.
我是一名酒工作者,因?yàn)槲衣殬I(yè)生涯的約三分之二都在品酒、飲酒、談酒或?qū)懢,我的?jīng)驗(yàn)證實(shí)了該領(lǐng)域?qū)<业陌l(fā)現(xiàn)。
The social context in which alcohol is consumed can be benficial when depressed but downing half a bottle or more may dramtically darken the hours which follow.
喝酒的社會(huì)環(huán)境,在感到抑郁時(shí)可能是有益的,但喝下半瓶或更多酒可能會(huì)讓接下來的幾小時(shí)變得昏天黑地。
I greatly enjoy entire days spent tasting wine when judging wine competitions for their sensual challenges and rewards. But thanks to the alcohol ingested during the process and the loss of vital fluids consequent on repeated acts of spitting, I usually feel drained and depressed afterwards. The best therapy is glass after glass of green tea. True drunkenness and its aftermath are unredeemed horror, both physical and mental.
在給酒類競賽做評委,評判他們的感官刺激和獎(jiǎng)項(xiàng)時(shí),我非常享受花整天時(shí)間品酒。但在品酒過程中喝下的酒,以及其后反復(fù)吐口水所損失的生命液,通常都讓我在事后筋疲力盡而且抑郁。解酒的最好辦法是一杯又一杯地喝綠茶。真的醉酒及其后果都可怕得無法挽回,在生理上和心理上都是。
Yet there are nuances which sensible blanket advice necessarily overlooks. The balance of evidence is that small quantities of alcohol are physically beneficial, and physical health promotes mental wellbeing.
不過,明智的普遍性建議必然有忽略的細(xì)節(jié)?陀^地說,少量飲酒對身體有益,而身體健康會(huì)促進(jìn)精神健康。
More important, though, is the understanding that not all alcohol is alike. For me, red wine – and particularly dense, dark, extractive and tannic red wine – will raise spirits, if taken in small quantities, in a no less satisfactory way to that of the neurotransmitter-lubricating SSRIs (selective serotonin reuptake inhibitors), such as Prozac, or Citalopram, which are the usual prescription. A small quantity of vodka and Red Bull, or gin and tonic, does not achieve the same effect.
但更重要的是要明白,并非所有的酒都是一樣的。對我而言,紅酒——特別是濃郁、深色、萃取且含有丹寧的紅酒——可以提神,假如少量飲用,其效果可媲美潤滑神經(jīng)傳遞素的選擇性5-羥色胺再攝取抑制劑(SSRI),例如百憂解(PROZAC)或者西酞普蘭(Citalopram),這些都是常見的處方。少量的伏特加和紅牛(Red Bull),或者杜松子酒和湯力水都達(dá)不到相同的效果。
The area is under-researched, yet it seems at least possible that this is an additional benefit of red wine's phenolic compounds – those same compounds which are already thought to be behind the other benefits of moderate red-wine consumption in preventing heart disease and strokes, keeping the neurotoxins associated with Alzheimer's at bay, retarding or inhibiting certain cancers and decreasing the likelihood of thrombosis. Phenolic compounds are derived from grape skins – and, when not drinking, I try to eat dark-skinned table grapes (though the quality of the bloated waterballs sold as table grapes by British supermarkets is execrable).
這一領(lǐng)域的相關(guān)研究還不夠充分,但似乎至少有一點(diǎn)是可能的:這是紅酒酚化合物的額外益處——人們認(rèn)為,適度飲用紅酒的其他一些好處,也是這些相同的化合物在起作用,像預(yù)防心臟病和中風(fēng),阻止與阿爾茨海默氏病(Alzheimer)相關(guān)的神經(jīng)毒素,延遲或抑制某些癌癥,降低患血栓癥的可能性。酚化合物來源于葡萄皮——在不喝酒的時(shí)候,我會(huì)去吃深色皮的鮮食葡萄(雖然英國各超市拿來做鮮食葡萄賣的“發(fā)脹水球”質(zhì)量糟透了)。
There is something more fundamental and more impalpable at work, too. All of our nourishment comes from earth and sky, and in no other food or drink substance can one get quite the same sense of tasting soil and stones and light as from dark red wine. SSRIs are no doubt a dandy invention but the drug feels alien in the blood, with a strange lurching sensation which rarely goes, whereas a glass of good Madiran or Bandol not only feels wholly tonic but brings, for an hour or two and without unpleasant regress later, a sense of universal connectedness, wholeness and compassion which briefly fills the void.
起作用的還有些更為基本,更為無形的東西。我們的營養(yǎng)都來自于地下和天上,在其他的食物或飲料當(dāng)中,人們都無法獲得喝深色紅酒時(shí)品嘗到的土壤、石頭和光的感覺。選擇性5-羥色胺再攝取抑制劑,無疑是一流的發(fā)明,但藥物在血液里的感覺是陌生的,還有一種揮之不去的奇怪挫折感,而一杯上好的Madiran或者Bandol不僅感覺讓人完全精神振奮,而且會(huì)帶來一兩個(gè)鐘頭的普遍聯(lián)系感、圓滿感以及暫時(shí)填補(bǔ)空虛的悲天憫人感,事后也不會(huì)令人不爽地抑郁再現(xiàn)。