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演讲者：Cindy J. Aaronson
演讲题目: What causes panic attacks, and how can you prevent them?
The body becomes its own corset.
身体变成了自己的紧身衣。
Past, present, and future exist as a single force.
过去、现在和未来都是单一的力量。
A swing without gravity soars to a terrifying height.
没有重力的秋千会飞到可怕的高度。
The outlines of people and things dissolve.
人和事物的轮廓消失了。
Countless poets and writers have tried to put words to the experience of a panic attack— a sensation so overwhelming, many people mistake it for a heart attack, stroke, or other life-threatening crisis.
无数的诗人和作家试图用文字来描述恐慌症发作的经历——这种感觉是如此强烈，许多人误认为是心脏病发作、中风或其他危及生命的危机。
Though panic attacks don’t cause long-term physical harm, afterwards, the fear of another attack can limit someone’s daily life— and cause more panic attacks.
虽然恐慌症发作不会造成长期的身体伤害，但之后，对另一次发作的恐惧会限制一个人的日常生活，并导致更多的恐慌症发作。
Studies suggest that almost a third of us will experience at least one panic attack in our lives. And whether it’s your first, your hundredth, or you’re witnessing someone else go through one, no one wants to repeat the experience. Even learning about them can be uncomfortable, but it’s necessary— because the first step to preventing panic attacks is understanding them.
研究表明，几乎三分之一的人一生中至少会经历一次恐慌症发作。不管是你的第一次，第一百次，还是你亲眼目睹别人经历过，没有人愿意重复这种经历。即使了解他们也会感到不舒服，但这是必要的-因为预防恐慌症的第一步就是了解他们。
At its core, a panic attack is an overreaction to the body’s normal physiological response to the perception of danger. This response starts with the amygdala, the brain region involved in processing fear. When the amygdala perceives danger, it stimulates the sympathetic nervous system, which triggers the release of adrenaline. Adrenaline prompts an increase in the heart and breathing rate to get blood and oxygen to the muscles of the arms and legs. This also sends oxygen to the brain, making it more alert and responsive.
从本质上讲，恐慌症发作是对身体正常生理反应的过度反应。这种反应从杏仁核开始，杏仁核是大脑处理恐惧的区域。当杏仁核感觉到危险时，它会刺激交感神经系统，从而触发肾上腺素的释放。肾上腺素促使心脏和呼吸频率增加，从而使血液和氧气输送到手臂和腿部的肌肉。这也会向大脑输送氧气，使其更加警觉和灵敏。
During a panic attack, this response is exaggerated well past what would be useful in a dangerous situation, causing a racing heart, heavy breathing, or hyperventilation. The changes to blood flow cause lightheadedness and numbness in the hands and feet.
在恐慌发作期间，这种反应被夸大了，远远超过了在危险情况下有用的反应，导致心跳加速、呼吸急促或换气过度。血液流动的改变会导致头晕和手脚麻木。
A panic attack usually peaks within 10 minutes. Then, the prefrontal cortex takes over from the amygdala and stimulates the parasympathetic nervous system. This triggers the release of a hormone called acetylcholine that decreases the heart rate and gradually winds down the panic attack.
恐慌发作通常在10分钟内达到高峰。然后，前额叶皮质接管杏仁核，刺激副交感神经系统。这会触发一种叫做乙酰胆碱的激素的释放，这种激素会降低心率，并逐渐减弱恐慌症的发作。
In a panic attack, the body’s perception of danger is enough to trigger the response we would have to a real threat— and then some. We don't know for sure why this happens, but sometimes cues in the environment that remind us of traumatic past experience can trigger a panic attack.
在恐慌症发作时，在恐慌症发作时，身体对危险的感知足以引发一些我们对真正威胁的反应。我们不知道为什么会发生这种情况，但有时环境中的线索会让我们想起过去的创伤经历，这可能会引发恐慌症。
Panic attacks can be part of anxiety disorders like PTSD, social anxiety disorder, OCD, and generalized anxiety disorder. Recurring panic attacks, frequent worry about new attacks, and behavioral changes to avoid panic attacks can lead to a diagnosis of a panic disorder.
恐慌症可能是焦虑症的一部分，如创伤后应激障碍、社交焦虑症、强迫症和广泛性焦虑症。反复发作的恐慌症，经常担心新的发作，以及为避免惊恐发作而改变行为，都会导致恐慌症的诊断。
The two main treatments for panic disorder are antidepressant medication and cognitive behavioral therapy, or CBT. Both have about a 40% response rate— though someone who responds to one may not respond to the other. However, antidepressant medications carry some side effects, and 50% of people relapse when they stop taking them. CBT, meanwhile, is more lasting, with only a 20% relapse rate.
恐慌症的两种主要治疗方法是抗抑郁药物和认知行为疗法。这两种方法的应答率都在40%左右，尽管对其中一种作出反应的人可能不会对另一种作出反应。然而，抗抑郁药物有一些副作用，50%的人停药后会复发。同时，CBT更持久，复发率只有20%。
The goal of CBT treatment for panic disorder is to help people learn and practice concrete tools to exert physical, and in turn mental, control over the sensations and thoughts associated with a panic attack.
CBT治疗惊恐障碍的目的是帮助人们学习和实践具体的工具，从而在身体上，进而在精神上，控制与惊恐发作相关的感觉和思想。
CBT begins with an explanation of the physiological causes of a panic attack, followed by breath and muscle exercises designed to help people consciously control breathing patterns.
CBT首先解释恐慌症发作的生理原因，然后是呼吸和肌肉练习，帮助人们有意识地控制呼吸模式。
Next comes cognitive restructuring, which involves identifying and changing the thoughts that are common during attacks— such as believing you’ll stop breathing, have a heart attack, or die— and replacing them with more accurate thoughts.
下一步是认知重构，它涉及到识别和改变在攻击中常见的想法——比如相信你会停止呼吸、心脏病发作或死亡——并用更准确的想法代替它们。
The next stage of treatment is exposure to the bodily sensations and situations that typically trigger a panic attack. The goal is to change the belief, through experience, that these sensations and situations are dangerous.
治疗的下一个阶段是暴露于身体的感觉和通常会引发恐慌发作的情况。我们的目标是通过经验改变这种信念，即这些感觉和情况是危险的。
Even after CBT, taking these steps isn’t easy in the grip of an attack. But with practice, these tools can both prevent and de-escalate attacks, and ultimately reduce the hold of panic on a person’s life.
即使在CBT之后，采取这些措施也不是一件容易的事。但通过实践，这些工具既可以预防和减轻攻击，最终减少对人的生命的恐慌。
Outside formal therapy, many panickers find relief from the same beliefs CBT aims to instill: that fear can’t hurt you, but holding on to it will escalate panic. Even if you’ve never had a panic attack, understanding them will help you identify one in yourself or someone else— and recognizing them is the first step in preventing them.
在正式的治疗之外，许多恐慌症患者从CBT灌输的相同信念中找到了解脱：恐惧不会伤害你，但坚持下去会使恐慌升级。即使你从未经历过恐慌症，了解他们也会帮助你识别出自己或别人身上的一种——而识别出他们是预防恐慌的第一步。
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