https://mp.weixin.qq.com/s/1lpuKG4rOaEx6KpnIWoVyg

How many people do you imagine look happy but struggle with depressive thoughts on a daily basis? Typically depressed people are depicted as being bed-ridden and incapable of functioning. What may or may not be surprising is, according to the National Institute of Mental Health, approximately 10 percent of the United States population is suffering from depression, which is 10 times more than those suffering from bipolar disorder (1 percent) and schizophrenia (1 percent).

你覺得有多少人每天表面上看起來很開心，但內(nèi)心卻在與各種抑郁想法抗?fàn)?？通常抑郁癥患者都是被描述為臥床不起或無正常行為能力，但可能會令一些人驚訝的是，根據(jù)國家精神健康研究院數(shù)據(jù)顯示，美國約有10%的人口患有抑郁癥，是抑郁躁狂型抑郁癥患者（1%）和精神分裂患者（1%）人數(shù)的十倍。

Not everyone experiences depression in the same way. Some might not even realize that they are depressed, especially if they seem like they're managing their day-to-day life. It doesn’t seem possible that someone can be smiling, chipper, functioning, and at the same time, depressed.

抑郁癥癥狀并非人人相同。一些人甚至并未認(rèn)識到他們患有抑郁癥，對于那些日常生活正常進(jìn)行的人來說，尤為如此。一個笑容可鞠、快樂活潑、行為正常的人患有抑郁癥，這似乎不大可能。

In my practice, those the most surprised to realize they're experiencing some form of depression are those suffering from “smiling depression.” Most people haven’t even heard of the term. The definition of smiling depression is: appearing happy to others, literally smiling, while internally suffering with depressive symptoms. Smiling depression often goes undetected.

在我實(shí)際工作中，最驚訝于自己竟然患有某種類型抑郁癥的患者正是那些“微笑抑郁癥”患者。多數(shù)人甚至沒有聽說過這一名詞。微笑抑郁癥的定義為：在其他人看來，你是開心快樂的，但你內(nèi)心卻正在受到抑郁癥狀的折磨。微笑抑郁癥常常不被察覺。

Those suffering often discount their own feelings and brush them aside. They might not even be aware of their depression, or want to acknowledge their symptoms due to a fear of being considered “weak.”

The hallmark of smiling depression is sadness. The smile and external fa?ade is a defense mechanism, an attempt to hide their true feelings. A person could be experiencing sadness about a failed relationship, career challenges, or lacking what they view as a true purpose in life. The sadness might also manifest as a constant, overall feeling that “something just isn’t right.”

這類患者通常并不重視自己的感受，并將這些感受置之不理。他們可能并不知道自己患有抑郁癥，也或者由于怕被別人認(rèn)為他們“脆弱”而拒絕承認(rèn)。

微笑抑郁癥的典型特征是“悲傷”。微笑與其他外在表現(xiàn)其實(shí)是一種防御機(jī)制，這類患者試圖以這種方式去隱藏他們的真正感受。

一個人可能正在因?yàn)槭?、職業(yè)難題、或感覺缺乏真正的人生目的而感到悲傷。這種悲傷還可能表現(xiàn)為一種持續(xù)存在的整體感覺：總歸覺得哪兒有些不對勁。

Other common symptoms of smiling depression are feelings of anxiety, fear, anger, fatigue, irritability, hopelessness, and despair. Those suffering from this and other forms of depression may also experience problems sleeping, a lack of enjoyment in pleasurable activities, and a loss of libido. Everybody’s experience is different. It’s possible to feel just one or many of these symptoms.

微笑抑郁癥的其他常見癥狀還包括：焦慮、恐懼、憤怒、疲勞、易怒、無望、絕望。遭受這類或其他類型抑郁癥的患者還可能會有睡眠問題、即使在令人愉快的活動中也感受不到快樂、以及喪失性欲等。每個人的實(shí)際經(jīng)歷都不相同。只有上述癥狀中的一種，或是有很多種，都是有可能的。

Another way to think about smiling depression is to see it as wearing a mask. People suffering from smiling depression may offer no hint of their problem to the outside world. They often maintain a full-time job, run a family household, participate in sports, and have a fairly active social life.

換一種角度看的話，也可以將微笑抑郁癥視為“帶著面具”。這類抑郁癥患者可能在外界看來毫無異樣。他們常常有全職工作、有家庭、參加體育活動、并擁有較為活躍的社交生活。

With their mask on, everything looks great, even at times perfect. However, underneath the mask they are suffering from sadness, panic attacks, low self-esteem, insomnia, and, in some cases, suicidal thoughts.

因?yàn)樗麄儙е婢撸磺卸伎雌饋砗馨?，甚至有時候看起來很完美。但在這面具之下，他們卻正在遭受悲傷、恐慌、自卑、失眠、甚至有時是自殺念頭的折磨。

Suicide can be a particular threat for individuals suffering with smiling depression. Typically, people suffering with classic, severe depression might have suicidal thoughts, but not the energy to act on their feelings. However, those suffering from smiling depression have the energetic ability to plan and follow through. This is why smiling depression can be more dangerous than a classic form of severe depression.

對于微笑抑郁癥患者而言，自殺尤為可能。通常，患有經(jīng)典、嚴(yán)重抑郁癥的患者可能會有自殺念頭，但并沒有足夠的精力去實(shí)施。但微笑抑郁癥患者卻有足夠的精力去規(guī)劃并執(zhí)行。這也是為什么微笑抑郁癥比傳統(tǒng)嚴(yán)重抑郁癥要更加危險(xiǎn)。

If you or anyone you know might be suffering from smiling depression, the good news is help is available. This is one of the most treatable mental health problems. Whether through counseling or psychotherapy, it is possible to successfully navigate out of this state of mind and be freed from the sadness.

如果你或你認(rèn)識的人可能患有微笑抑郁癥，好消息是，這并非無計(jì)可施。這是最易治療的精神問題之一。無論是通過心理咨詢或是心理療法，都有可能擺脫這種情緒狀態(tài)，擺脫悲傷。

Your loved one or close friend whom you suspect is suffering from smiling depression may deny it and might even have a negative reaction when you first broach the subject. This is normal. Often people aren’t aware of smiling depression and the word “depression” might sound too extreme. Keep in mind they may view getting help as a sign of weakness or something only needed by the severely disturbed.

如果你懷疑你所愛的人或你的好友正遭受微笑抑郁癥困擾，他們可能會否認(rèn)，甚至當(dāng)你首次提起這個話題時，他們甚至?xí)龀鱿麡O回應(yīng)。這很正常。通常人們并不知道“微笑抑郁癥”這個概念，而且“抑郁癥”這個詞聽起來也太極端。需要記住，他們可能會把獲取幫助視為“脆弱”的表現(xiàn)，或覺得只有嚴(yán)重抑郁癥患者才會需要幫助。

Aside from counseling or psychotherapy, those suffering can start by opening up to those around them. Choosing one close family member, friend, or confidant, and making it a practice to discuss feelings and concerns can help alleviate symptoms. It's important not to be concerned about being a burden.

除心理咨詢或心理療法之外，這類患者還可先選擇向周圍人傾訴。選擇一位親密的家庭成員、朋友或信任的人，與他們談?wù)撃愕母惺芎皖檻]，能夠有助于緩解癥狀。重要的一點(diǎn)是，不要擔(dān)心自己成為別人的負(fù)擔(dān)。

Sometimes we forget that those around us are happy to support us in the same way we would for them. Opening up and sharing feelings is a key element in coping with depressive thoughts.

有時候我們會忘記，身邊的人是很樂意幫助我們的，就像是如果他們需要，你也會很樂意幫助他們一樣。打開心扉，傾訴感受，是應(yīng)對抑郁念頭的關(guān)鍵要素。

As long as you continue to deny or avoid what makes you feel empty, it will be near impossible to fix the problem. When depressive thoughts and feelings aren’t addressed, they typically build up and become worse. What matters most is to reach out.

只要你繼續(xù)否認(rèn)或回避那些讓你感到空落落的事情，你的這一病癥就幾乎難以治愈。當(dāng)抑郁想法和感受得不到處理，它們通常會累積，然后惡化。最重要的，是主動尋求幫助。

Rita Labeaune, Psy.D., is a clinical psychologist with a private practice in Beverly Hills. She treats adults dealing with smiling depression and other forms of depression, anxiety, and mood disorders.

Rita Labeaune，心理學(xué)博士，臨床心理學(xué)家，在比佛利山莊有私人診室。主攻成人微笑抑郁癥及其他類型抑郁癥、焦慮和情緒障礙癥。