智慧人生篇章 第36期:何以解憂?

Each year the serious depression affects 6% of UKadults and 121 million people worldwide. At sometime in our lives, one in six of us will experience anepisode and the World Health Organisation predictsby 2020 depression will be the largest single healthissue in developed countries. As well as being apersonal hell for its sufferers, tackling depression isbig business. This week GlaxoSmithKline accepted a$3 billion penalty from US authorities after pleadingguilty to wrongly marketing two leading anti-depression drugs and a range of othermisdemeanours. But even this huge penalty may be offset by the $17 billion sales of the samedrugs in the years covered by the settlement alone. The case raises ethical and regulatoryissues, but the wider context is commercialisation of mental healthcare. Drug companies havea natural interest in finding pharmacological solutions to medical problems and use theirconsiderable resources to promote them to both doctors and patients. Medication cancertainly help, and sometimes there's no alternative.

英國每年有6%的成年人抱受嚴(yán)重抑郁癥的困擾，全世界則有1億2千1百萬人。每六個(gè)人中就有一人在某段時(shí)期有抑郁的經(jīng)歷。世界衛(wèi)生組織預(yù)計(jì)，到2020年，抑郁癥將成為發(fā)達(dá)國家中最大的健康問題。抑郁癥讓患者痛苦萬分，應(yīng)對(duì)工作也同樣十分棘手。這周，由于違規(guī)營銷兩大主要抗抑郁藥物以及一系列其它罪行，葛蘭素史克公司向美國當(dāng)局支付了30億美元的罰金。盡管受到嚴(yán)懲，但該公司僅在違規(guī)營銷這幾年就憑同種藥物達(dá)成了170億美元的銷售額，足以抵消掉罰款金額。這一案子揭露了道德和管理方面的問題，但從更廣的層面來看，體現(xiàn)的是精神治療商業(yè)化的問題。藥品公司的天性就是通過在醫(yī)療問題中尋找藥理學(xué)的解決方法來謀求利益，并且運(yùn)用它們相當(dāng)豐富的資源向醫(yī)生和患者推銷藥物。藥物治療當(dāng)然有用，而且這有時(shí)是唯一的解決辦法。

But I think many of us reach first for a prescription when problems arise. And perhaps we findthat congenial. We often seem to treat our minds and bodies like a car that goes wrong. Wewant to get them fixed, so we can get on with our lives But another body of thought holds thataddressing the underlying causes of depression, not just tackling its symptoms, meanschanging how we live and even how we think. A substantial movement along these lines isunderway in mainstream healthcare and clinical psychology, and rather surprisingly, it drawson Buddhist meditation and mindfulness practice.

但我認(rèn)為有許多人遇到問題一開始就想著去開藥方。也許我們覺得生病吃藥是天經(jīng)地義的。人們總像對(duì)待出故障的汽車那樣對(duì)待自己的身心。我們想修好它們，繼續(xù)自己的生活。但另外一種看法是我們不僅僅要解決癥狀，還要解決導(dǎo)致抑郁癥的根本原因，這意味著改變我們的生活和思考方式。主流的醫(yī)療保健和臨床心理學(xué)正在沿著此方針開展實(shí)際的進(jìn)展。令人吃驚的是，它運(yùn)用了佛教中的冥想和正念的做法。

Mindfulness Based Cognitive Therapy aims at avoiding depression relapse. Using meditation,it asks people to accept the troubling thoughts and feelings that can grow into depression,seeing them as part of their experience, at least for now. That mirrors the Buddhistunderstanding that we suffer because what we want is at odds with the way life is. Youralternative is turning towards reality with awareness and finding a more creative response.I see in my own work as a mindfulness trainer that when people stop fighting what they findchallenging and stop judging themselves harshly they are able to access a kinder responseand a sense of peace. This assumes that people have the resources within themselves to copemore effectively. That doesn't mean there's no place for drugs in alleviating the effects ofdepression, but you can also help yourself. And that's an important insight whether you'redepressed or not.

正念認(rèn)知療法旨在避免抑郁癥復(fù)發(fā)。它要求人們運(yùn)用冥想來接受可能會(huì)演變成抑郁的一些不安的想法和感受，把它們看作是自身體驗(yàn)的一部分，至少在當(dāng)前如此。這反映出佛教的思想：人之所以受苦是因?yàn)槠溆c生活相悖。你要做出取舍，有意識(shí)地轉(zhuǎn)向現(xiàn)實(shí)，做出更有創(chuàng)造力的回應(yīng)。作為一位正念教練，我在工作中注意到，當(dāng)人們不再與他們所認(rèn)為的挑戰(zhàn)作斗爭(zhēng)，不再嚴(yán)厲地自我評(píng)定時(shí)，他們會(huì)更加善待生活，獲得心靈上的平靜。由此可以假設(shè)出人們體內(nèi)有能使自己更有效運(yùn)作的源泉。這并不是說藥品在緩解抑郁方面沒有一席之地，而是說人可以自救。能否自救是洞悉自己是否抑郁的十分重要的一點(diǎn)。