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).
你觉得有多少人每天表面上看起来很开心，但内心却在与各种抑郁想法抗争？通常抑郁症患者都是被描述为卧床不起或无正常行为能力，但可能会令一些人惊讶的是，根据国家精神健康研究院数据显示，美国约有10%的人口患有抑郁症，是抑郁躁狂型抑郁症患者（1%）和精神分裂患者（1%）人数的十倍。
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.
抑郁症症状并非人人相同。一些人甚至并未认识到他们患有抑郁症，对于那些日常生活正常进行的人来说，尤为如此。一个笑容可鞠、快乐活泼、行为正常的人患有抑郁症，这似乎不大可能。
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.
在我实际工作中，最惊讶于自己竟然患有某种类型抑郁症的患者正是那些“微笑抑郁症”患者。多数人甚至没有听说过这一名词。微笑抑郁症的定义为：在其他人看来，你是开心快乐的，但你内心却正在受到抑郁症状的折磨。微笑抑郁症常常不被察觉。
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 façade 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.”
这类患者通常并不重视自己的感受，并将这些感受置之不理。他们可能并不知道自己患有抑郁症，也或者由于怕被别人认为他们“脆弱”而拒绝承认。
微笑抑郁症的典型特征是“悲伤”。微笑与其他外在表现其实是一种防御机制，这类患者试图以这种方式去隐藏他们的真正感受。
一个人可能正在因为失恋、职业难题、或感觉缺乏真正的人生目的而感到悲伤。这种悲伤还可能表现为一种持续存在的整体感觉：总归觉得哪儿有些不对劲。
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.
微笑抑郁症的其他常见症状还包括：焦虑、恐惧、愤怒、疲劳、易怒、无望、绝望。遭受这类或其他类型抑郁症的患者还可能会有睡眠问题、即使在令人愉快的活动中也感受不到快乐、以及丧失性欲等。每个人的实际经历都不相同。只有上述症状中的一种，或是有很多种，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.
换一种角度看的话，也可以将微笑抑郁症视为“带着面具”。这类抑郁症患者可能在外界看来毫无异样。他们常常有全职工作、有家庭、参加体育活动、并拥有较为活跃的社交生活。
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.
因为他们带着面具，一切都看起来很棒，甚至有时候看起来很完美。但在这面具之下，他们却正在遭受悲伤、恐慌、自卑、失眠、甚至有时是自杀念头的折磨。
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.
对于微笑抑郁症患者而言，自杀尤为可能。通常，患有经典、严重抑郁症的患者可能会有自杀念头，但并没有足够的精力去实施。但微笑抑郁症患者却有足够的精力去规划并执行。这也是为什么微笑抑郁症比传统严重抑郁症要更加危险。
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.
如果你或你认识的人可能患有微笑抑郁症，好消息是，这并非无计可施。这是最易治疗的精神问题之一。无论是通过心理咨询或是心理疗法，都有可能摆脱这种情绪状态，摆脱悲伤。
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.
如果你怀疑你所爱的人或你的好友正遭受微笑抑郁症困扰，他们可能会否认，甚至当你首次提起这个话题时，他们甚至会做出消极回应。这很正常。通常人们并不知道“微笑抑郁症”这个概念，而且“抑郁症”这个词听起来也太极端。需要记住，他们可能会把获取帮助视为“脆弱”的表现，或觉得只有严重抑郁症患者才会需要帮助。
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.
除心理咨询或心理疗法之外，这类患者还可先选择向周围人倾诉。选择一位亲密的家庭成员、朋友或信任的人，与他们谈论你的感受和顾虑，能够有助于缓解症状。重要的一点是，不要担心自己成为别人的负担。
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.
有时候我们会忘记，身边的人是很乐意帮助我们的，就像是如果他们需要，你也会很乐意帮助他们一样。打开心扉，倾诉感受，是应对抑郁念头的关键要素。
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.
只要你继续否认或回避那些让你感到空落落的事情，你的这一病症就几乎难以治愈。当抑郁想法和感受得不到处理，它们通常会累积，然后恶化。最重要的，是主动寻求帮助。
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，心理学博士，临床心理学家，在比佛利山庄有私人诊室。主攻成人微笑抑郁症及其他类型抑郁症、焦虑和情绪障碍症。
