人為何會憂鬱？全台兩百萬人診斷出憂鬱症？YouTuber是高風險族群？ 書來面對EP24《照亮憂鬱黑洞的一束光》說書【心理學/精神醫學】

Summary

这是关于抑郁症成因的讲座稿子。作者通过采访科学家和病人,探讨社会因素如经济不平等、缺乏归属感、工作环境不健康等如何导致抑郁。他指出抑郁并非单纯大脑机能失调,而是身体对当前社会环境的信号。我们必须减少阶级差距,重建人与自然和他人的联系,让工作更有意义,让人们对未来有安全感。如果社会作为一个整体采取行动,可以制造出更健康的环境,预防抑郁症。

Takeaways

• 😀 台湾近年来抑郁症患者不断增加,许多公众人物也承受着抑郁症的折磨
• 😕 社会阶级差异越大,人们的心理健康状况越差,导致更多抑郁症患者
• 😟 孤独感也是导致抑郁的一个关键因素,缺乏归属感会使大脑认为自己处在危险中
• 🙁 离开自然环境,人类也更容易生病,因为人与自然有着内在的联系
• 😔 工作缺乏控制感和意义感也会引发抑郁,员工需要重获工作的自主性
• 😣 原住民自杀率较高的地区,也往往是他们文化被剥夺的地方
• 😖 缺乏对未来的想象也是抑郁的一个重要症状
• 😫 西方的医疗模式忽视了抑郁背后的更大社会文化背景
• 😩 抑郁患者的症状反映了我们生活的社会有多么不健康
• 😤 我们需要建立一个更公平、人与人、人与自然和谐相处的社会

Q & A

视频中提到了导致抑郁的五大原因,它们分别是什么?

五大原因分别是:社会地位不平等带来的压力;孤独感;离开自然环境;工作缺乏意义和控制感;以及对未来的想象力丧失。

为什么社会地位不平等会导致抑郁?

视频中通过山鸡的社会等级制度做例子,解释了社会地位不平等会带来的压力,使人更容易抑郁。地位高的担心丢失地位,地位低的遭受欺压,都容易导致大脑中的激素变化。

孤独感为什么也会引起抑郁?

视频解释了人类大脑默认设置为群居生活,有归属感。而现代社会关系疏远,缺乏意义共享,容易产生孤独感。孤独会让大脑认为处在危险中,无法入睡,从而抑郁。

为什么离开自然环境也与抑郁有关?

视频引用生物学家的观点,认为人类与生俱来的“生命爱好”本能,渴望与自然环境互动。而现代人群聚城市,脱离自然,无法满足这种需求,因此更易抑郁。

工作环境如何影响抑郁?

视频分析了民营企业与员工合作社的区别。后者员工有自治权和情感表达渠道,工作更有意义,不易抑郁。缺乏控制感和意义的工作更容易导致抑郁。

为什么对未来的想象力丧失也与抑郁相关?

视频指出抑郁的关键症状之一是对未来的想象力丧失。忧虑的工作环境使人难以想象未来,失去稳定感,这本身就容易引起焦虑和抑郁。

视频如何看待抑郁与整个社会环境的关系?

视频认为抑郁的根源不仅仅是个人大脑的问题,而是整个社会结构带来的后果,如经济不平等、人与人及人与自然隔离等都可导致抑郁。必须从根本上解决这些社会结构性问题。

视频中Cambodian的例子说明了什么?

柬埔寨本地人原本没有“抑郁”这一概念。说明抑郁并不是人类必然经历的病症,而是现代社会结构造成的。我们应反思社会对人的基本心理需求是否被忽视了。

视频如何看待抑郁症患者?

视频呼吁社会多理解抑郁症患者,因为他们的症状反映了我们生活的社会有多不健康,也给了我们机会去创造一个更加健康的社会。

你认为影响抑郁的社会因素,在当前的台湾社会中体现得最明显的是什么?

这需要我们深入观察和思考。台湾长期经济发展不均、人际关系冷漠、教育高压、就业环境恶化等都可能是影响因素。这需要有数据佐证,也需要我们共同努力,使台湾社会为所有人提供心理健康的环境。

Outlines

00:00

😞 社会阶级差距与孤独是导致抑郁的重要因素

文章分析了社会阶级差距扩大和孤独感增加是导致抑郁的重要社会因素。它提到了霍特人和加拿大原住民的研究,说明社会归属感和文化认同的缺失会增加抑郁。

05:01

😢 离开大自然也会导致抑郁症

第二段提到城市化进程中,人类离开大自然,失去与其他生命的联系,也是抑郁的一个原因。文章分析了动物园黑猩猩和城市人的相似处,说明“生物倾向”不被满足也容易导致心理问题。

10:04

🤔 工作失去意义和控制感也会导致抑郁

文章分析了英国公务员和加拿大土著人士的研究,说明工作环境的民主化和工作的意义是影响心理健康的关键因素。当工作变得没有意义和控制感时,更容易导致抑郁。

15:06

😨 社会不稳定导致难以想象未来 也是抑郁的原因

文章最后分析了“没有未来感”也会导致抑郁。自20世纪80年代以来,就业环境的不稳定性增加,很多人无法想象未来,这种没有集体未来感的社会也容易培养抑郁的土壤。

Keywords

💡抑郁症

抑郁症是一种常见的心理疾病,其特征是持续性的低落、消极和缺乏动力。视频讨论了许多社会文化因素可能导致抑郁症,例如经济不平等、缺乏社会联系、工作没有意义等。例如,“当人们生活在高经济不平等的社会,人们感受到的压力就像巴布亚猴的阶级社会”。

💡社会排斥

社会排斥指个人与社会之间联系的断裂,无法融入社会集体生活。视频认为这会让人产生彷徨、无助的感觉,更容易患上抑郁症。例如独居老年人抑郁症发病率更高,因为他们失去集体归属感。

💡工作意义

有意义的工作让人有成就感和控制感。视频认为当工作变得没有意义和控制时,更容易导致抑郁。例如文中提到缺乏工作控制感是公务员抑郁的一个重要原因。

💡文化认同

个人对于自己的文化认同,是个人能否想象集体未来的重要因素。视频认为文化认同的丧失会增加忧郁症发病率,例如加拿大土著青年。因为他们无法想象集体的未来。

💡未来感

未来感是个人能否设想自己未来的状态和方向。视频认为未来感的丧失也是抑郁症患者的一个重要特征。可能与就业不稳定,难以想象自己的未来有关。

💡大自然联系

人与大自然的联系,例如经常出门运动或在自然环境中工作,可以帮助治疗抑郁症。视频认为这源自人类渴望与其他生命体联系的本能,所以离开大自然易生病。

💡药物治疗

目前主流的抑郁症治疗通常依赖抗抑郁药物。但视频认为过分依赖药物忽略了社会文化层面的根源,比如经济制度、就业形态是否人性化等。作者通过柬埔寨的例子说明这个观点。

💡社会处方

社会处方指通过增加患者的社会联系和支持来帮助治疗抑郁症。例如英国 NHS 使用社会处方,让抑郁症患者参加团体活动,从中获取支持。

💡资本主义

视频认为资本主义社会追求效率,忽略了人的心理需求,比如稳定感、归属感等,这可能是抑郁症等心理疾病增加的一个重要社会根源。

💡社会改革

视频最后呼吁社会改革,重建人与人、人与自然的联系,让工作更有意义,社会更公平等,因为这些因素都与心理健康息息相关。抑郁症患者的症状其实是这个社会“生病”的信号。

Highlights

抑郁症与社会阶级差距、孤独感、缺乏自然联系、工作缺乏意义与控制感、以及对未来的安全感缺失相关。

分析发现阶级差距越大的国家,精神疾病患病率越高,因为阶级等级制会让人失去生存的意义与目的感。

研究发现人与人之间的联系虽多,但缺乏共享的意义与价值,会让人感到更加孤独和抑郁。

城市里人们被隔离离开自然,这与人类的亲生欲望背道而驰,因此近自然的生活环境可以帮助抗击抑郁症。

工作中缺乏对过程与结果的控制,会让人感到损失工作的意义,这是导致抑郁的重要根源。

保留自己传统文化的少数民族青年,拥有对未来的想象力,自杀率较低;而被同化的少数民族青年,对未来感到迷茫,自杀率较高。

抑郁患者的症状之一就是丧失对未来的想象力和安全感。这种对未来的不确定预期本身就容易使人不安和抑郁。

现今不稳定的就业形态让许多人无法想象自己的未来,这是当前抑郁盛行的重要社会根源。

如果相信抑郁纯粹是个人大脑的问题,只能用药物与心理辅导解决,那是很西方的错误思维方式。

抑郁其实是一种信号,告诉我们这个社会有病,我们必须减少社会不平等、重建人与自然的联系、让工作有意义、对未来有安全感,这是我们所有人共同的责任。

YouTube 的运作机制让创作者面临许多抑郁的社会根源,如地位不保、缺乏群体归属、脱离自然、工作没有意义、对未来没有安全感。

抑郁患者的痛苦让我们知道我们生活的社会有多么不健康,也给了我们机会去创造一个更加健康的社会。

书中归纳了5大抑郁成因:社会阶级差距、孤独感、人与自然断裂、工作缺少意义与控制、对未来的想象力丧失。

抑郁并非单纯个人大脑的问题,而是整个社会结构带来的后果。我们必须集体面对并改变这些社会根源,而不仅仅依赖个人心理调适。

作者通过大量访谈和案例佐证,让我们反思当前社会忽视了人最基本的心理需求,这才是抑郁大流行的重要起因。

Transcripts

2020 Taiwan National Health Agency Survey Estimates

Two million people in Taiwan have symptoms of depression

In recent years, more and more public figures have suffered from depression

Movie star Robin Williams

Linkin Park lead singer Chester

Youtuber Adi

Touch brother

Joeman

Xiaoyu

What changes have taken place in society, and why are more and more people suffering from depression?

The book I will face today "A beam of light illuminating the black hole of melancholy"

We are going to discuss the latest findings in the study of depression in the past 20 years

The author of this book, Johann Hari, is a British journalist who has suffered from depression for many years.

Have been taking antidepressant drugs since the age of 18

But I haven’t gotten better after eating for 13 years

He began to think about the root cause of depression

So the author took three years on his own

Visit scientific experts who study depression around the world

Hundreds of interviews with depression patients from various countries

Finally, the book "A Beam of Light Illuminating the Black Hole of Melancholy" was unified.

Explore the physical, psychological, social and cultural roots of depression

Scientists currently believe that depression is related to changes in several brain chemicals

Like "serotonin", "cortisol", "dopamine"

So what caused the changes in these chemicals?

Robert Sapolsky, a biologist who has personally experienced depression

Go to Kenya to study human relatives, primates, to find clues

There is a strict class system in the baboon society

Which class each baboon is in determines how much resources and mating rights he can enjoy

Sapolsky collects blood samples of baboons locally

Check to see which baboon has the most stress in life

turn out

If the tribe is in a time of "competing for the throne

Baboons at high levels have high concentrations of the stress hormone "cortisol"

Because they most need to worry about whether their status will be lost

If it is in normal times

The lower the ranking baboon, the more stress hormones will be

Because they suffer the most oppression on weekdays

Hormonal changes in the brains of these baboons

Just like the changes that occur in the brains of human depression patients

This makes scientists start to guess

Is human depression also related to social status?

Epidemiologist Richard Wilkinson and Kate Pickett found that

In countries where income is more unequal and class differences are greater

The higher the rate of people suffering from mental illness

When people live in a society with high economic inequality

The pressure that people feel is like the class society of baboons

People at the bottom will feel

Whether I exist or not is not important to this society

What's the meaning of my life?

Middle class people will feel

I finally climbed up, but can I keep this seat?

Will I be replaced by a competitor and will my status be threatened?

This may explain why many famous people

Obviously the material life has been very good

Still get depression?

Not because these people are not satisfied

It’s because these people’s lives are forced to feel insecure

I often worry about my social status being insecure

So physical and psychological depression

In fact, it reflects that we are living in a society where the class gap is getting bigger and bigger

It has caused psychological harm to people invisibly

And the evolutionary mechanism makes humans very sensitive to this kind of thing

Psychologist Paul Gilbert thinks

Human depression is like the submission response of other primates

People with depression often feel that they can’t do anything well

There will be strong self-criticism and feel powerless

It’s like when the baboon doesn’t want to be oppressed anymore

Will assume a posture of obedience in exchange for the highest chance of survival

So depression is not actually a pathology

But the survival mechanism remaining in the evolution process

It releases messages to the same kind, telling them:

Stop bothering me! I have no threat to you!

These studies open new directions for understanding depression

Depression is not that the individual is sick, but that the society in which we live together is sick

This also makes us have to reflect

What we want to build is a fair society that recognizes each other

Or is it a class society that breeds a hotbed of depression?

In addition to class status, loneliness is also a factor that easily leads to depression

Neuroscientist John Cacioppo studied more than 200 elderly Americans for five years

Regularly track their mental health and social status

He found that when a person’s loneliness rises from 50% to 65%

The chance of developing depression symptoms will increase 8 times

Lonely people lose their sense of collective belonging

As if I don’t belong to any group in this world

But why does this feeling cause depression?

Cacioppo thinks this is because millions of years

Human ancestors lived a collective life of hunter-gatherers

Work together to hunt large animals, share food, and take care of each other

Without this kind of cooperation, our ancestors would never face the beasts of the African savannah alone.

So after millions of years of adaptation

The human brain has set "community life" as its original default

Human nature is the desire to connect with the community to strengthen the chance of survival

If you leave the community and sleep alone, you will die if you encounter a beast

So the body will send out various signals to let you know that something is wrong

That's why

Lonely people are more likely to have "micro awakenings" (micro awakenings) when sleeping

I woke up suddenly when I was half asleep

Because your brain knows that you are alone

So deliberately not let you go into full deep sleep and keep on alert at all times

The psychologist found

Hutterites who still maintain a collective life today

They won’t wake up in fragments when they sleep

This explains why the human brain recognizes loneliness as an unhappy state

Because in the most primitive state of nature, human nature is eager for a sense of group belonging

But the society we live in is getting more and more lonely

Sociologists survey found

In 1985, each person in the United States had an average of 2.9 good friends who could share their thoughts

But in 2004, there were only 2.1 people left

And nearly 20% of people report that they don’t have half a close friend

In Taiwan, in 1997, each person had an average of 4.6 friends who could talk about things.

By 2017, there are only 2.9 people left

When people encounter setbacks in life, if you don’t even have a friend to talk to

All emotions can only be swallowed by themselves, and they will become a hotbed of depression

Someone might retort that

My personality is accustomed to being independent and not in contact with others, but to have a happier life

I don't have depression

There is a very important difference here

Loneliness does not mean too little connection with others

But there is no meaning and values ​​that can be shared with others

A person can have many friends, but still feel lonely

Because loneliness is a subjective feeling rather than an objective calculation of how many relatives and friends you have

So even now social media can keep people online all the time

But most people feel more lonely

???

So in recent years

British National Health Service NHS

Began to provide social prescriptions for patients with depression

Let them participate in various pottery, gardening, and sports projects in groups

During the event, people with depression can find people who understand each other

I found that my depression is not a single case. Other people have similar experiences.

It’s like being bullied in the workplace and feels that it’s meaningless to live

Through this "social prescription" depression patients can reconnect with others

Share something meaningful to each other

Animal behaviorist Isabel Behncke was doing research in a British zoo

It is often found that bonobos have various serious mental health problems

Like scratching to bleeding, yelling, and losing the desire to mate

In order to understand what is going on

She decided to go to the Congo rainforest, the original habitat of the bonobo

It turns out that bonobos in their natural habitat

Will not have abnormal symptoms like the orangutans in the zoo

This made her think about the psychological abnormalities of the orangutans in the zoo.

Isn't human beings also a group of orangutans imprisoned in the city?

When I was young, I was locked up in school, but when I grew up I was locked up in factories and offices.

Could the mental illness of human beings also be caused by being separated from the natural environment?

Recently, more and more studies have confirmed

In cities, people have a higher risk of depression

Those who move to green spaces will have a much better depression

But why do people get sick when they leave nature?

Biologist Edward O. Wilson believes

This is because humans are born with a kind of "biophilia"

A desire to come into contact with other life forms

People are not only eager to be company with others, but also to be company with other life in nature

When we are in a natural environment, we have an indescribable sense of comfort

But if we look around ourselves, we can find

Urban people are surrounded by man-made things, not natural landscapes

So from this point of view, people with depression are more sensitive people

They found out that there was a problem with our living environment early

Already far away from the pro-life nature of human instinct

Human beings who left nature and locked in the city

It's like a frog that doesn't go back to the water after climbing on the land

Can still live, but not healthy

And depression is a signal to this unhealthy environment

This is why many studies have found that being close to nature and exercising outdoors can fight depression

Because our animal nature wants to continue to interact with nature

Depression often makes people feel closed and negative thoughts lingering

But when people come into contact with nature, they will have a sense of tolerance and awe

I feel that the self is actually just a small corner of the natural network

This will allow people to open up their originally closed selves

Contact with nature is a good antidepressant

In the 1980s

The British government launches a 10-year large-scale project "Whitehall Study" (Whitehall Study)

Invited epidemiologist Michael Marmot to study 10,000 British civil servants

Each person conducts one-hour individual interviews

Investigate which people in public institutions are in better health

Everyone thought that the supervisor had the most responsibility

Should be the most stressed and the worst in health

But the results of the study found

Low-ranking civil servants are 4 times more likely to get heart disease than high-ranking civil servants

The lower the position, the more prone to depression and heart disease

The health of employees in the entire workplace is like a ladder showing a ``social gradient''

Why is this so?

The results of the interview found

People with higher positions usually have more contacts

Often go out to socialize with friends after get off work, the pressure is easier to release

But the lower the position, because many things can’t be in charge of themselves

It is generally believed that work is meaningless, just passively accepting instructions

After a day’s work, the whole person is dead and feels disintegrated.

The source of depression is a sense of powerlessness due to lack of control over work

So civil servants in the same rank and office

People who have control over their work experience fewer symptoms of depression

In the past 10 years, the UK Revenue and Customs Administration often reported that tax inspectors committed suicide

The British government asked Michael Marmot to study

He found that there was always a pile of unfinished documents on the receipt box of the tax inspector

After they finish their work every day, they feel that their progress is always behind.

And no matter how hard you try, you won’t be appreciated

It seems that this job is to say to employees: No one cares about you, you don’t matter at all

So Michael Marmot concluded: It’s not the job itself that makes people sick

It’s the loss of the meaning and control of the job that makes people sick and melancholy

The author mentioned in the book Mitchell, a bicycle shop assistant who has been suffering from depression and anxiety for many years.

She and her colleagues decided to strike for better working conditions

But in the end it was crushed by the boss’s lawyer team

One day these employees had a whim

Since everyone knows how to run a bicycle shop

Why don't we go out and open a bicycle shop without an owner?

A democratized cooperative enterprise

So Mitchell and his colleagues set up Baltimore bicycle works

After entering the new work environment, Mitchell's depression and anxiety symptoms gradually eased

Obviously she did the same work in the old company and the cooperative she started her own

I help others repair their bicycles

Why did the depression and anxiety alleviate after leaving the old company?

Because although the work content is the same, the organizational system structure is different

In the cooperative, every employee has the freedom and autonomy to participate in discussion and decision-making

Unlike the employees of capital enterprises

I feel that work is meaningless, I am just a social animal to make money

And in the cooperative, employees can express their emotions freely

It’s not like you have to suppress your emotions when you are employed by the boss

So in a good working environment

People can feel that the work is meaningful and in control

The true inner needs of the heart can also be met

It’s less likely to produce depression and anxiety

In 2016, 11 aboriginals committed suicide in Ontario, Canada

This incident shocked the entire Canadian society

Michael Chandler, a psychologist who has long studied the health of Canadian aborigines, found

The suicide rate of Canadian aboriginal youth is five times that of the average Canadian

Moreover, the distribution of suicides among Canadian aboriginals is regional

Suicide is more likely to occur in certain areas

So Chandler analyzed 196 tribal groups in Canada

It turns out that the higher the degree of autonomy of the indigenous communities, the lower the suicide rate

This association is strong enough to know the degree of autonomy of an aboriginal community

Can successfully predict their subsequent suicide rate

Why is this so?

Because the Canadian government has used various methods to forcibly assimilate the indigenous peoples

Deprive them of their traditional fields

Forcing aboriginal children to leave their parents

Forbid them to speak their mother tongue

Aboriginal young people in these areas have lost their traditional culture

Without culture, there is no collective future

Without a future, human life has no meaning

Since life is meaningless, why people still have to live becomes a problem

So these aboriginal teenagers ended up in depression, drug abuse, and even suicide in the end.

A similar situation also occurs in Taiwan

Researchers found that Dawu people have a higher percentage of schizophrenia

The Dawu people were forced to come to Taiwan to break away from their cultural roots in order to find a job

Strive to adapt to a modern capitalist society that is inconsistent with their traditional culture

Attending the Golden Bell Awards ceremony to show your own culture will be laughed at by Taiwanese

They have to endure more mental pain than the average Taiwanese

It’s also harder to imagine the collective future because of cultural inadequacy.

In contrast, a small number of Canadian aborigines have gained control over traditional fields

You can revive your own language

Rebuild your own culture cut off by white people

Imagine a possible future

These social factors make them mentally healthier

So we all think we need to find the cause of depression in the past

But a very important key is actually in the future, not the past

The symptoms of patients with severe depression are the disappearance of the future

They can't imagine what they will look like in the future

So if you comfort the depression patient and say: you will get better in the future

Not necessarily effective

Because in a melancholy state without a sense of the future, there is no way to imagine the "later"

The author further points out that this lack of future sense is becoming more and more common in society

May be one of the reasons why depression is becoming more and more prevalent

Since the 1980s, labor market regulations in countries around the world have been loosened

Many people have changed from fixed-hour work to "atypical work"

Such as accepting cases, outsourcing, short-term contracts

"Gig economy" has become the mainstream of the work system

This kind of short-term employment prevents workers from knowing if there are any jobs available next year.

This kind of job instability will further cause psychological instability

More and more people cannot imagine their own future without a sense of stability

This thing itself is easy to make people melancholy and anxious

If the root of the problem comes from the entire social structure

Then the whole community should work together to change this

Instead of throwing the blame on someone with depression

Tell them to take medicine and do psychological counseling by themselves

The author gave a very interesting example

When psychiatrist Derek Summerfield was doing fieldwork in Cambodia

Found that the locals could not understand Western psychiatry

Because they don’t have the words "depression" or "antidepressant" at all.

So this psychiatrist tried to explain "what is melancholy" to Cambodians

They finally understood when they heard that they said that one of them did have symptoms of depression

Because Cambodians live by growing rice

But a local farmer had his leg broken by a landmine left over from the Vietnam War and had to wear a prosthesis.

As a result, he was unable to work on the terraces

The farmer who feels he can't work feels that his future has been lost

Begins to experience severe symptoms of depression

The locals collectively came up with a method

Since he can't grow rice, let him switch to dairy farming.

So the people in the village decided to give him a cow

So that the farmer can change his work and lifestyle

The collective support of society is the antidepressant for Cambodians

This makes the author begin to reflect

Think that depression is just a problem with the brain, and you can solve it by taking medicine

It’s actually a very western way of thinking

Could Westerners actually look for answers in the wrong place?

Ignore the larger social and cultural context behind depression

In this episode, we introduced five causes of depression

We can find that Youtuber hits almost every item

I have to worry about the number of views and subscriptions every day, and I feel that my status is not guaranteed

Often faced with a bunch of acid people’s comments and insults, losing social links

I have to shut down at home every day and night to cut the film, losing the natural connection

Work has no control at all, life and death are controlled by YouTube’s algorithm

Loss of meaningful work

There is no way to have a sense of time in the future, I can only keep thinking about the next movie to be released

I don’t even know if I will be eliminated in a few months and lose a meaningful future.

YouTube is simply a melancholy producer

So why are so many YouTubers suffering from depression

It’s not because they have low stress resistance

It’s that society is increasingly ignoring people’s basic psychological needs

Depression is not just a malfunction of the human brain

But the signal from the body

Tell us this is a sick society

We must transform a class society that makes people feel uneasy

Recover the connection between man and nature

Get back a meaningful job

Find a safe future

These are not the responsibility of the depression patient

It’s a problem that the whole society must face together

If you want to learn more about depression

I highly recommend you to read this "A Beam of Light Illuminating the Black Hole of Melancholy"

I also hope that everyone can listen to people with depression

Because their symptoms let us know how unhealthy we are in a society

It also gives us the opportunity to know how to create a healthier society

It also gives us the opportunity to know how to create a healthier society