美国国家公共电台 NPR If You're Often Angry Or Irritable, You May Be Depressed

 

RACHEL MARTIN, HOST:

This month, NPR is exploring anger and what we can learn from it. We're going to focus this morning on anger's role in depression. Most people think of symptoms of depression as fatigue¹, trouble concentrating, maybe even thoughts of death. But some psychiatrists³ say they see a lot of angry outbursts in their depressed⁴ patients. NPR's Nell Greenfieldboyce has more.

NELL GREENFIELDBOYCE, BYLINE⁵: Ebony Monroe is a registered nurse who lives in Texas. She says when she recently went through a period of being unusually quick to anger about every little thing, she didn't realize what it might mean.

EBONY MONROE: If you told me in the beginning that my irritability⁶ was related to depression, I would probably be livid.

GREENFIELDBOYCE: Luckily, a concerned friend brought this up gently, saying, look, I'm not really sure what's going on, but I'm worried about you.

MONROE: The way that she approached me decreased that wall of anger and anxiety. And just listening to her - she was like, hear me out; I want to ask you some things. And that's when I decided⁷ to seek the help.

GREENFIELDBOYCE: Monroe says traumatic events from her childhood had left her depressed and full of unresolved anger. She'd been lashing⁸ out at the people who were closest to her, like her sister and her husband.

MONROE: So they caught the back end of my irritability when, in fact, they had nothing to do with the source of it.

GREENFIELDBOYCE: After about a year of counselling, Monroe says her life has improved a lot. She now works with a group called Families for Depression Awareness⁹. Its list of symptoms that families should watch for includes being angry, irritable¹⁰, critical or mean. But pick up the so-called bible of psychiatry¹¹, the "Diagnostic And Statistical¹² Manual Of Mental Disorders," and the list of core symptoms doesn't include anger.

MAURIZIO FAVA: It's not included at all in the adult classification of depression.

GREENFIELDBOYCE: Maurizio Fava is a psychiatrist² at Massachusetts General Hospital and a professor at Harvard Medical School. He says irritability, a reduced control over one's temper that results in angry outbursts, is listed as a core symptom of depression for children and adolescents. It's never made sense to him that it's not included for adults.

FAVA: Why would someone who happens to be irritable and angry when depressed as an adolescent suddenly stop being angry at age 18?

GREENFIELDBOYCE: You can think of anger as an emotional and physical feeling that makes people want to warn, intimidate¹⁴ or attack anyone who's perceived as threatening. Fava says a depressed adult with lots of anger is often assumed to have bipolar disorder¹³ or a personality disorder.

FAVA: We see in our clinics patients who are labeled as having other diagnoses because people think, well, you shouldn't be so angry if you're depressed.

GREENFIELDBOYCE: The label matters because it affects what kind of treatment people get. Fava says when he was trained, he was taught that in depression, anger is projected inwardly.

FAVA: That people, when depressed, would be angry at themselves and not at others.

GREENFIELDBOYCE: That did not match what he was seeing in a lot of his patients with depression.

FAVA: I would say 1 in 3 patients would report to me that they will lose their temper, they would get angry, they would throw things or yell and scream or slam the door.

GREENFIELDBOYCE: Afterwards, they'd be filled with remorse¹⁵. Fava calls these anger attacks and thinks they're similar to panic attacks. His research shows that this kind of anger subsided¹⁶ in the majority of patients treated with antidepressants. Fava says psychiatry has carefully studied how anxiety and depressed mood are experienced by patients. But anger has been strangely neglected.

FAVA: I don't think that we have really examined all the, you know, variables and all the levels of anger dysregulation that people experience.

GREENFIELDBOYCE: Mark Zimmerman agrees. He's a professor of psychiatry at Brown University.

MARK ZIMMERMAN: The field has not sufficiently¹⁷ attended to problems with anger.

GREENFIELDBOYCE: He says take the way that researchers usually study the effectiveness of antidepressant drugs.

ZIMMERMAN: The most frequently used scales to evaluate whether or not medications work for treating depression don't have any anger-specific items.

GREENFIELDBOYCE: Zimmerman says this is really unfortunate given how much anger clinicians see.

ZIMMERMAN: Irritability is not that much less frequent than sadness and anxiety in patients who are presenting for psychiatric treatment.

GREENFIELDBOYCE: He and some colleagues recently surveyed nearly 4,000 of those patients. All were asked about the level of anger they had felt or experienced in the preceding week.

ZIMMERMAN: Two-thirds of individuals reported notable irritability and anger, and approximately half reported it at a moderate or severe level.

GREENFIELDBOYCE: This increased anger was prevalent across a bunch of diagnoses, and one of the strongest associations was with depression. Still, people with depression can have a hard time recognizing this in their own lives. When I called up the Depression and Bipolar Support Alliance asking about anger, I reached its communications person Kevin Einbinder. He says when I first called, he thought to himself...

KEVIN EINBINDER: I'm sure somebody else, you know, certainly deals with anger, but I don't have anger issues associated with depression.

GREENFIELDBOYCE: Then he started reflecting on his life with depression over the last three decades.

EINBINDER: I thought of all the people in my life who've interacted with me, so my family, the counselors¹⁹, psychiatrists, even employers, significant others. And I realized that anger was an underlying²⁰ factor in all those relationships.

GREENFIELDBOYCE: For example, he used to use caustic²¹, sarcastic²² humor to put people down.

EINBINDER: And this really drove people away.

GREENFIELDBOYCE: He also used to send angry emails late at night after lying awake and ruminating²³ about things that had happened during the day. A counselor¹⁸ helped him see why this wasn't such a good idea. But he says, overall, he and his therapist never focused on anger.

EINBINDER: In hindsight, I really wished we did because I think that would've provided a tremendous amount of context for what's adding to my depression and helping²⁴ me early on in my life with more effective coping mechanisms²⁵.

GREENFIELDBOYCE: He says with medication and therapy, he's doing much better now. And he hopes that talking about this might help others see that depression can sometimes look like anger. Nell Greenfieldboyce, NPR News.

1 fatigue   

n.疲劳，劳累

参考例句：

• The old lady can't bear the fatigue of a long journey.这位老妇人不能忍受长途旅行的疲劳。
• I have got over my weakness and fatigue.我已从虚弱和疲劳中恢复过来了。

2 psychiatrist   

n.精神病专家；精神病医师

参考例句：

• He went to a psychiatrist about his compulsive gambling.他去看精神科医生治疗不能自拔的赌瘾。
• The psychiatrist corrected him gently.精神病医师彬彬有礼地纠正他。

3 psychiatrists   

n.精神病专家，精神病医生( psychiatrist的名词复数 )

参考例句：

• They are psychiatrists in good standing. 他们是合格的精神病医生。 来自辞典例句
• Some psychiatrists have patients who grow almost alarmed at how congenial they suddenly feel. 有些精神分析学家发现，他们的某些病人在突然感到惬意的时候几乎会兴奋起来。 来自名作英译部分

4 depressed   

adj.沮丧的，抑郁的，不景气的，萧条的

参考例句：

• When he was depressed,he felt utterly divorced from reality.他心情沮丧时就感到完全脱离了现实。
• His mother was depressed by the sad news.这个坏消息使他的母亲意志消沉。

5 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

6 irritability   

n.易怒

参考例句：

• It was the almost furtive restlessness and irritability that had possessed him. 那是一种一直纠缠着他的隐秘的不安和烦恼。
• All organisms have irritability while alive. 所有生物体活着时都有应激性。

7 decided   

adj.决定了的，坚决的；明显的，明确的

参考例句：

• This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
• There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。

8 lashing   

n.鞭打；痛斥；大量；许多v.鞭打( lash的现在分词 )；煽动；紧系；怒斥

参考例句：

• The speaker was lashing the crowd. 演讲人正在煽动人群。 来自《简明英汉词典》
• The rain was lashing the windows. 雨急打着窗子。 来自《简明英汉词典》

9 awareness   

n.意识，觉悟，懂事，明智

参考例句：

• There is a general awareness that smoking is harmful.人们普遍认识到吸烟有害健康。
• Environmental awareness has increased over the years.这些年来人们的环境意识增强了。

10 irritable   

adj.急躁的；过敏的；易怒的

参考例句：

• He gets irritable when he's got toothache.他牙一疼就很容易发脾气。
• Our teacher is an irritable old lady.She gets angry easily.我们的老师是位脾气急躁的老太太。她很容易生气。

11 psychiatry   

n.精神病学，精神病疗法

参考例句：

• The study appeared in the Amercian science Journal of Psychiatry.这个研究发表在美国精神病学的杂志上。
• A physician is someone who specializes in psychiatry.精神病专家是专门从事精神病治疗的人。

12 statistical   

adj.统计的，统计学的

参考例句：

• He showed the price fluctuations in a statistical table.他用统计表显示价格的波动。
• They're making detailed statistical analysis.他们正在做具体的统计分析。

13 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

14 intimidate   

vt.恐吓，威胁

参考例句：

• You think you can intimidate people into doing what you want?你以为你可以威胁别人做任何事？
• The first strike capacity is intended mainly to intimidate adversary.第一次攻击的武力主要是用来吓阻敌方的。

15 remorse   

n.痛恨，悔恨，自责

参考例句：

• She had no remorse about what she had said.她对所说的话不后悔。
• He has shown no remorse for his actions.他对自己的行为没有任何悔恨之意。

16 subsided   

v.（土地）下陷（因在地下采矿）( subside的过去式和过去分词 )；减弱；下降至较低或正常水平；一下子坐在椅子等上

参考例句：

• After the heavy rains part of the road subsided. 大雨过后，部分公路塌陷了。 来自《简明英汉词典》
• By evening the storm had subsided and all was quiet again. 傍晚， 暴风雨已经过去，四周开始沉寂下来。 来自《现代汉英综合大词典》

17 sufficiently   

adv.足够地，充分地

参考例句：

• It turned out he had not insured the house sufficiently.原来他没有给房屋投足保险。
• The new policy was sufficiently elastic to accommodate both views.新政策充分灵活地适用两种观点。

18 counselor   

n.顾问，法律顾问

参考例句：

• The counselor gave us some disinterested advice.顾问给了我们一些无私的忠告。
• Chinese commercial counselor's office in foreign countries.中国驻国外商务参赞处。

19 counselors   

n.顾问( counselor的名词复数 )；律师；（使馆等的）参赞；（协助学生解决问题的）指导老师

参考例句：

• Counselors began an inquiry into industrial needs. 顾问们开始调查工业方面的需要。 来自《现代英汉综合大词典》
• We have experienced counselors available day and night. ) 这里有经验的法律顾问全天候值班。） 来自超越目标英语 第4册

20 underlying   

adj.在下面的，含蓄的，潜在的

参考例句：

• The underlying theme of the novel is very serious.小说隐含的主题是十分严肃的。
• This word has its underlying meaning.这个单词有它潜在的含义。

21 caustic   

adj.刻薄的，腐蚀性的

参考例句：

• He opened his mouth to make a caustic retort.他张嘴开始进行刻薄的反击。
• He enjoys making caustic remarks about other people.他喜欢挖苦别人。

22 sarcastic   

adj.讥讽的，讽刺的，嘲弄的

参考例句：

• I squashed him with a sarcastic remark.我说了一句讽刺的话把他给镇住了。
• She poked fun at people's shortcomings with sarcastic remarks.她冷嘲热讽地拿别人的缺点开玩笑。

23 ruminating   

v.沉思( ruminate的现在分词 )；反复考虑；反刍；倒嚼

参考例句：

• He sat there ruminating and picking at the tablecloth. 他坐在那儿沉思，轻轻地抚弄着桌布。 来自《简明英汉词典》
• He is ruminating on what had happened the day before. 他在沉思前一天发生的事情。 来自《简明英汉词典》

24 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

25 mechanisms   

n.机械( mechanism的名词复数 )；机械装置；[生物学] 机制；机械作用

参考例句：

• The research will provide direct insight into molecular mechanisms. 这项研究将使人能够直接地了解分子的机理。 来自《简明英汉词典》
• He explained how the two mechanisms worked. 他解释这两台机械装置是如何工作的。 来自《简明英汉词典》