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第十九讲 躁郁症Bipolar Disorder/双极性情感疾患

先说说十多年前我读过严歌苓的一篇短篇小说,说的是一个失眠者,具体内容我记不清了,但记得她描述那个深夜睡不着觉的女人透过夜空看出去,寻找另一扇仍然亮着光的窗口。那个情节给我印象深刻!

我这个人很少失眠,到点就得睡觉,不能熬夜,头挨着枕头很快就睡着。偶尔会在女人生物周期前有一两个晚上精力不寻常得充沛,凌晨三四点会醒过来,那却是我最好的写作时间,创作可以源源不绝,我归之于女人荷尔蒙捣乱期。往往亢奋后的第二天,我就像病猫一只,很早就上床睡觉了,只缺几个钟头的觉我就能这般无精打采的。

想想那些失眠者整夜整夜的不能睡,而且不是一天两天,严歌苓说她曾经有一个月被失眠症折磨着。我难以想象!

我也是听一位海外的男作家讲严歌苓患有两极躁郁症(Bipolar Disorder),后来读到一篇有关她的采访,她也提到她一直不知道自己患有这个毛病,只知道自己有失眠症,受了很多年失眠的折磨。直到来了美国,诊断出有两极躁郁症,吃了药,躁郁症好了,失眠症也随之痊愈了。

不久前还看到一则报道说麦克道格拉斯的美丽妻子卡哒林达琼斯也患有两极躁郁症,夫妻俩深受其苦,闹了一阵子的离婚,不过至今也没离成。以往我都认为麦克道格拉斯,老牛吃嫩草,知道了他试图给患有躁郁症的年轻妻子一个挽救婚姻的机会,不仅对他也有些敬佩之情。

因为与两极躁郁症的人相处,确实需要有一个爱她容忍她的心。正如严歌苓的美国丈夫那么崇拜那么宠爱她一样,却不是没有女人都有这种福气的。

然而,我却想,绝大多数父母都是有能够容忍自己孩子缺陷的爱心的。

让我们先看看什么是躁郁症?

我也摘在维基百科:躁郁症(英语:bipolar disorder,亦称双极性情感疾患,早期称为躁狂抑郁疾病),是一种精神疾病,特征为患者会经历情绪的亢奋和抑郁。情绪亢奋期(躁期)可分为“狂躁”或是“轻躁狂”,两者的区别在于是否影响生活及工作和是否出现精神病症状。于狂躁期,患者感到或表现出异常开心、有活力、易怒,常会做出不计后果的决定,对睡眠的需求也往往会减少。于抑郁期,患者会哭泣、缺乏与他人眼神交流、对生命萌生负面看法,也有自杀的可能。病史长达20年以上的患者,其自杀风险超过6%,自残风险则约30-40%。躁郁症也常伴随焦虑症以及药物滥用等心理问题。

躁郁症发生的原因不明,先天基因与后天环境都有影响。

天才梵高就是两极燥郁症患者,当然后来他出现了幻觉最终自杀身亡,是个极端的例子。

不少艺术家都有不算太严重的躁郁症,在一极躁狂的阶段时,是他们创作极为丰盛的时刻,灵感泉涌,精力用不完,有些工作狂也有躁狂症的因子存在。但一旦“激情”爆发过后,人会陷入如无底的深渊,抵达抑郁之另一极。 这种极喜极悲宛如过山车般的情绪心情大跌宕,谁能长久承受得起?!

再说回到抑郁症,一个人抑郁,原因也可以是先天或者后天或者两者的综合。不可能一件事情导致一个人抑郁,比如,明眼看是离婚导致了那个女人抑郁了,但在离婚前她可能已经积郁很久了,一直没有爆发出来,也有可能她身体里那个缺少的化学元素本来就使得她比一般人容易抑郁,离婚不过是导火线而已。

对一个孩童/青少年来说,也是如此。孩子经历丧母之痛,似乎看上去一下子抑郁了,可很多其他的孩子也经历了失去亲人的痛楚,却能慢慢平复过来,并没有陷入抑郁症的深渊里。还是人与人个体的不同,不能一概而论的。

微信群里,总有些人喜欢把孩子的这些问题归罪到父母,我不是说没有这样的父母,确实有些父母给孩子心灵造成了阴影,但是,追究原因尤其是至今尚未确定的病因,硬要拿孩子的父母做替罪羊,不仅不公平,而且于事无补!孩子得了病,需要父母的帮助,带着去看医生,跟着孩子照料孩子,这才是父母要做的!在这过程中,很多父母都成了半个医生,半个专家!他们反思自己的父母之道,学习各种能帮到孩子的技巧和知识。自从我写这个文集成立了两个教育群以来,多少父母伊妹儿短信给我,告诉我他们和孩子正在挣扎中的痛苦,我原本是写自己育女的感悟,没想到有这么多的共鸣,有这么多的父母跟我一样,在一步一步带着他们出现了行为和心理问题的孩子往前挪!

大部分父母都不大声张,谁都害怕成为众矢之敌,孩子是花朵,不可能有错,错都在父母!这是很多人不论发生什么都会轻而易举做的事情:责怪父母!我想是上帝给我的启示,先让我有个能说服很多人的乖孩子,让我成为众人眼里的好母亲,然后再让我尝一尝有问题孩子的滋味,从而我不会去论断有相似孩子的父母,我终于理解他们无声的心痛!

再把话题拉回到主题上来,来说说孩童/青少年躁郁症。

孩童/青少年躁郁症的症状:

狂躁时会有:

·         很高兴,表现出不同寻常的甚至是有些愚蠢的举动。

·         脾气暴躁

·         讲话快速,不停地讲

·         失眠或者睡不好,却不觉得疲倦

·         不能集中思想

·         冲动想发生性行为

·         冒险

抑郁时会有:

·         情绪低落伤感

·         身体痛疼,说头疼或者肚子疼

·         睡得少或者睡得多

·         感觉没有意思

·         吃得很少或者吃得很多

·         不感兴趣做任何事情

·         想自杀和死亡

青少年躁郁症患者很多还会发展出其它的问题,比如:

·         酗酒和吸毒或者乱用药物

·         思想不能集中,发展成精神涣散症

·         焦虑症

·         抑郁症

青少年有这种躁郁症的有的会乱开车,驾飞车,这点家长特别要注意,不要让这样的孩子随便开车。一旦孩子提到或者留下任何自杀迹象的语言语句,都要认真对待,立即送医决不耽搁!

如何治疗?正如治疗抑郁症一样,两种方法:药物和讲话,药物当然是医生对症下药,讲话就是心理咨询师与孩子的对话。

父母能做些什么?

第一,  耐心,别急躁!

第二,  鼓励你的孩子说出来,你要学会做个好的倾听者。

第三,  理解孩子情绪的波动和孩子可能上演的“情绪连续剧”。

第四,  帮助孩子寻找能使他开心的事情。

第五,  鼓励孩子接受治疗。

第六,  最后,在照顾孩子的同时,别忘了照顾好自己! 

 

待续

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评论

雨林的头像
 #

写这个系列,海云做了许多案头工作,让我十分钦佩。

你提到严歌苓的失眠, 让我想起这里的一个朋友曾经提到的,孩子的bipolor没有被及时诊断的往事。孩子在八年级时,毫无缘故整晚失眠,去看了儿科医生, 只作为失眠症处理, 建议用melatonin (国内翻译成脑白金)而已。可见即使在美国, 也容易被忽视。

你也提到梵高,让我想起一首写给他的歌, 用的是他的画作的名字《Starry Starry night》: https://www.youtube.com/watch?v=nkvLq0TYiwI

天下每一个父母,都愿望自己有现世游戏规则里面“正常”的孩子。 可是, 那些现在看上去不合常规的孩子,让懂得他们的父母和人们,对世界有更多深刻的理解从而更加慈祥宽容和谦卑,从这个角度看,他们, 其实是人间更美好的天使啊。

(btw, 第六段的最后一句可能有一个typo)

 
海云的头像
 #

雨林你的最后一段正是我想说的,所以,让我们感恩!拥抱!

 
天地一弘的头像
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感动雨林最后一段话,许多孩子,可能都存在不同程度的行为、心理和精神症状,只是表现形式不同而已。每一个父母都希望孩子健康快乐成长,只是在个案孩子的成长过程中,失去了真正的爱心和耐心,有时以一种极端的形式表现出来,于是出现了父母孩子沟通上的困难。所以,平静对待个案孩子真的非常不容易。

 
百草园的头像
 #

的确,要写这个系列是要有许多医学常识,和教育心理学。谢谢海运的耕耘。

 
海云的头像
 #

我自己也在学习中,写的过程,让我思索,尤其是那些不能将心比心的父母的责难,更让我觉得这本书值得写!一定要写!传统老旧的观念一定要更新,否则,还不知道有多少孩子深受其害多少父母痛苦难耐而不自知根源所在!

 
海伦的头像
 #

生活中,有时会误解这些人:以为他们是性格古怪,其实是心理的问题,需要治疗。

 
海云的头像
 #

更确切地说是头脑问题,抑郁症就是头脑中缺少一种化学成分,运动和药物都能促进这种化学成份的增加。当然,心理因素也存在。

 
Joanna的头像
 #

海云,

 

Hope the following information can help you with your book.  Best, Joanna.

 

According to psychology, when people are in pain, they automatically try to defend themselves. Typical defensive behaviors are:

 

1) blame/criticize others 

 

2) attempt to fix/correct others because they think that it is the OTHERS who cause the pain/problem.

 

3) victimize themselves: they think the situation is not fair. From a victim’s perspective, they judge what is right or wrong. They believe that they have the right to fight back or to rebel.

 

These kinds of behaviors are very common and we can easily find them in ourselves and the people around us.

 

Children often don't have sufficient experience and knowledge to understand their behaviors. When they are in deep trouble, they cannot focus on overcoming their own problems. Rather, they blame school for its boring classes, teachers for their unfairness, and parents for their cluelessness and injustice. Their balmes do have certain degree of truth. Most often, teachers’ and parents' help simply do not work.

 

Because they are under numerous pressures, they want to escape by using drugs, by dropping classes and etc.

 

Victimizing themselves, they believe that they have a RIGHT to rebel against parents, school and society. Some of them end up in prison. 

 

On the other hand, parents DO NOT realize that they have done anything wrong. Some of them think that they are victims and they believe that it is their parental responsibility to FIX their children. 

 

A lot of parents do not realize the underlying problems of their children amd simply believe that their children are lazy.

 

Although they love their children deeply, most parents DO NOT FIX their children appropriately. Especially when children act in a terrible way such as screaming and smashing things, parents's rages are provoked instantly and they end up fixing children in a way which they did not intend.

 

Parents do not realize that they must FIX their OWN parental skill in order to solve the probelms. 

 

Because mentally disordered children challenge parents in such a painful way, if parents are no aware of the root cause of the problems, they not only cannot FIX their children but also develop mental disorder illnesses themselves such as depression.

 

Many years ago, I heard that a beloved aunt, my father's coworker, committed suicide after many years of struggling with her son and her husband. I didn't understand at that time because she was very beautiful, intelligent and always kind to people around her. If children have mental disorders, their parents and their grand-parents may have very very minor mental disorders as well.

 

Relatives and close friends DON'T truly understand the special situation because they have NO knowledge on how to help children with metal disorders. 

 

They try to FIX those parents by giving advice based on their own parental experience. However, not only do those parents not value their friends’ advice, but they also feel offended because their friends or relatives are trying to FIX /BLAME them rather than understand their pain.

 

To help those children, everyone including children, parents, teachers, relatives and friends should make an effort to LEARN. 

 

 

BTW, for those people who verbally abuse their spouse and children, they use the same excuse - they have their responsibility to fix others. Or they are the victims...

 
海云的头像
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"To help those children, everyone including children, parents, teachers, relatives and friends should make an effort to LEARN. "  Thank you, Joanna! Yes, lets all learn from this expereince. 

 
Joanna的头像
 #

海云,

You are very welcome! Thank you for sharing your experience!

The reason that I am looking into general Psychology is because humans have a lot of common reactions/behaviours in the face of predicaments. I find it helps to solve the problems in a profound way once we understand why we, our children or others think/act in a certain way.  

Most people, especially parents, focus on fixing/complaining/criticizing their children or others rather than improving themselves. Their arrogrance, over-confidence or extreme stress prevent them from taking extra time to learn.

Once, I talked to the father of an ODD child about those books. He looked at me desperately and said that he does not need books but an Immediate Solution to change his child. Watching his family suffer for years, I understood his longing for a fast FIX. 

From your writing, I can see that your tremendous effort to translate the book enables you to digest the information more throughly than most readers. A lot of parents probably just scan your writings for a solution. A lot of parents just want to gain some understanding and support from friends and society rather than to change/improve themselves. 

I understand that it is very hard for parents to calm down and learn carefully when they are over stressed. But the ultimate solution truly lays in how deep parents digest your infomation and how they reflect when they practice those solutions.

Years ago, I heard from a friend that almost every American parent in Palo Alto sent their kids to see therapists. We were laughing about it because we believe our chinese culture, wisdom and traditions will undoubtly enable us to raise a responsible child. Recently, I read a book published by a psychologist and she said that she, a psychologist, had been seeing a psychologist when she could not clear her mind. I was surprised. Most of us only see psychologists in movies or books. Hope you can discuss more about the role of psychologists in helping your daughter.

Best,

Joanna

 
海云的头像
 #

I will try to write more on the therapist/psychologist experiences on next chapter.

 
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