恩典国际圣经学院

第二课 抑郁症
lesson 2 Depression

Depression 抑郁症
Case Study … 1 案例研究… 1
  • Every morning Bob wakes up tired and struggles to get out of bed. During the day, he can’t find the stamina to get tasks done at work. He has no desire to play with his children after he gets home and doesn’t have the energy for household tasks.

  • 每天早晨,鲍伯醒来时很累,挣扎着起床。白天,他工作时没有精力完成任务。回家后他不想和孩子玩耍,也没有体力做家务。

  • Sarah has a hard time staying focused. She recently flunked out of college and has lost all confidence in herself. She doesn’t want to try to go back to school or interview for a job, so she stays at home and play video games. She feels like she has fallen into a pit.

  • 撒拉很难集中精神。她最近从大学退学,对自己完全失去信心。她既不想回学校也不想面试找工作,因此她呆在家里玩电子游戏。她感到掉进了深渊。

Key Terms … 2 关键词… 2

Depression is a difficult mood disorder to define. It is the symptom of any number of potential problems. For example, individuals who experience stress may show brief symptoms of depression (sadness, frustration, or a lack of interest in pleasurable activities). Although these people are depressed, they don’t likely have depression. This is why a misdiagnosis of depression is common.

抑郁症是一个较难定义的情绪失调症。它是很多潜在问题的症状。比如,感到压力的人会表现短暂的抑郁症状(悲伤,挫败,或对快乐的活动缺乏兴趣)。虽然这些人感到抑郁,他们可能没有抑郁症。这就是为什么误诊抑郁症的情况很普遍。

Depression is not the same as grief. Grief is a reaction to loss in one’s life. Grief or sadness is God’s way of slowing a person down in order to process the trauma of loss that has occurred. There is often a relief found in the grieving process which comes through crying and the support of others.

抑郁和悲痛不是一回事。悲痛是对人生中的损失的一种反应。悲痛或伤心是神的方法,用来使人缓和,从而处理所发生的损失的创伤。在悲痛的过程中常常通过哭泣和别人的支撑得到释放。

Clinical/Major Depression presents symptoms that are severe enough to interfere with a person’s daily life. These symptoms may last from weeks to months.

临床/重症抑郁表现的症状严重到影响一个人的日常生活。这些症状会持续几周到几个月。

Dysthymic Depression is a long-term, mild form of depression.

慢性抑郁症是一种长期的轻型抑郁。

Bipolar Disorder is a mood disorder thought to be caused by chemical imbalances in the brain that can result in severe mood changes—from manic highs to depressive lows.

躁郁症即情绪失调,被认为是因大脑里面化学失衡造成严重情绪改变——从狂躁高峰跌到抑郁低谷。

Seasonal Affective Disorder (SAD) is a severe depression that is related to the change in the seasons. It begins and ends about the same time every year. Symptoms tend to begin in the fall and continue into the winter months, sapping a person’s energy and causing mood changes. Many believe it is caused by a lack of sunlight or a Vitamin D deficiency. (Spark Notes Editors, 2004)

季节性情绪失调(SAD)是一种与季节改变有关的严重抑郁症。每年在同样的时间开始和结束。症状倾向于从秋天开始,入冬后症状持续,损伤人的精力并导致情绪变化。很多人认为是因为缺少太阳光或缺乏维他命D造成。

Causes/Character … 3 原因/特征… 3

Depression can be caused by major changes in a person’s life. These can include everything from the death of a loved one, loss of a job, children moving out, or other changes life brings.

抑郁症可能因为人生的重大变化造成。这些变化包括所爱的人去世,失去工作,儿女从家中搬出去,或其他生活的改变。

Other factors also enable depression: these would include family of origin history, hormone fluctuations, thyroid abnormalities, stress, diabetes, vitamin deficiency, obesity, chemical imbalances, prescription drugs, feelings of guilt or responsibility, divorce, death, or even exposure to certain types of molds.

其他因素也可能导致抑郁症:这些因素包括原生家庭历史问题,荷尔蒙波动,甲状腺异常,压力,糖尿病,维他命缺乏,肥胖,化学失衡,处方药,愧疚感或责任,离婚,死亡,或甚至接触某种毒菌。

Symptoms of depression may include the following:

抑郁症可能包括以下症状:

  • Lack of concentration,

  • 注意力衰退,

  • decreased energy,

  • 力量减弱,

  • feelings of guilt or worthlessness,

  • 负罪感或感觉毫无价值,

  • feelings of helplessness and hopelessness,

  • 感觉无助和绝望,

  • difficulty sleeping,

  • 睡眠困难,

  • dramatic changes in weight,

  • 体重剧烈变化,

  • persistent aches and pains,

  • 持续疼痛,

  • continued sad, anxious or “empty” feelings,

  • 持续悲伤,焦虑或“空虚”感,

  • and, in serious cases, thoughts of suicide (suicidal ideation).

  • 严重的情况,产生自杀的念头(自杀意念”)。

(Cunningham et al, 2009)

Counseling Advice… 4 心理辅导建议… 4

One of the most serious symptoms of depression is suicidal ideation (thoughts/talk of suicide). As you counsel an individual, and you discover that the counselee has expressed thoughts of suicide it is imperative to involve family members and mental health professionals immediately.

抑郁症的最严重症状是自杀意念(自杀的想法和谈论)。当你给人进行心理辅导,发现辅导对象已经有自杀的想法时,必须立即要求患者家人和精神健康专业人士参与帮助。

It is also important for the counselee to consult his/her physician about any medications that individual may have been prescribed. Depression feeling and thoughts of suicide are sometimes symptoms of certain medications. It cannot be stressed enough: any talk of suicide is to be taken as a serious threat and handled in such a manner. Don’t overreact or underreact.

辅导对象对于医生所开给他/她的任何药物要进行咨询,这点也很重要。抑郁的感觉和自杀的想法有时是某种药物引起的症状。必须足够重视:任何关于自杀的谈话要视为一个严肃的威胁,并且会这样实施。不要过度反应,也不要反应不足。

Steps to Follow … 5 遵循步骤… 5

1)Change in Physical Activity – Suggest that your counselee take a brisk, 30-minute walk the next time he/she feels depressed. Of course, this would need to be something a physician also approves or recommends. Walking with someone else is also helpful. It not only creates accountability, but provides another person to share thoughts and feelings with. Change in eating habits or diet may also be a help. Again, encourage the individual to consult a physician in this matter.

身体行为改变–建议你的辅导对象下次感到抑郁时,轻松走30分钟。当然这也需要医生批准和建议。和别人一起走路也很有帮助。这不仅建立起责任感,而且可以和另一个人分享思想和感情。改变饮食习惯可能也有帮助。重申一下,辅导对象最好咨询医生是否可以这样做。

2)Get Some Perspective – It is important to lead an individual to see the “bigger picture.” Lead the counselee to understand that while present loss may be painful, our future hope in Christ is secure. Encourage the individual to think of what might be the source of depression. It could be a spiritual matter. To explore that idea, ask similar questions such as these:

正确判断— 引导人看到“更大的画面”是很重要的。引导辅导对象明白虽然目前的损失是痛苦的,但我们在基督里的未来盼望是明确的。鼓励辅导对象去思考抑郁症的根源是什么。这可能是灵性方面的事情。要探讨这个思路,需要问类似的问题如下:

  • Do you have any sins that you have not addressed or confessed to God?

  • 你有没有任何罪还没有向神坦白承认?

  • Do you need to extend forgiveness to someone who has hurt you in the past?

  • 你需要向过去曾伤害你的人表示饶恕吗?

These types of questions will aid the counselor in directed the depressed individual to the cross of Jesus Christ for healing and hope. When people feel frustrated or hopeless, it is important to provide a source of comfort and hope to combat those feelings and to use as a proper motivation for change.

这类问题将帮助心理辅导员引导抑郁症患者到耶稣的十字架前寻求医治和盼望。当人感到挫败或绝望时,重要的是提供一个安慰和希望的源头来对抗那些感觉,并以此作为改变状况的正确动机。

3)Be Mindful – Encourage the counselee to keep a journal that helps him/her to express feelings the moment they are experiencing them. Ask the counselee to prepare a Top 10 List of things the person likes about him/herself or things they are good at or enjoy.

注意事项——鼓励辅导对象记日记,帮助他/她表达自己当时经历的感受。要求辅导对象举出10件人们喜欢他/她的事或他们擅长或喜爱的事情。

(Schuetze & Matzke, 1988)

Light on the Path … 6 路上的光… 6

Read and React. Read the passage and answer the following questions:

阅读并回答。读经文并回答以下问题:

Let’s look at 1 Kings 19:4 – He [Elijah] himself went a day’s journey into the wilderness. He came to a broom bush, sat down under it and prayed that he might die. “I have had enough, Lord,” he said. “Take my life; I am no better than my ancestors.”

参看列王记上19:4 –自 己[Elijah] 在 旷 野 走 了 一 日 的 路 程 , 来 到 一 棵 罗 腾 ( 小 树 名 , 松 类 ; 下 同 ) 树 下 , 就 坐 在 那 里 求 死 , 说 : 耶 和 华 啊 , 罢 了 ! 求 你 取 我 的 性 命 , 因 为 我 不 胜 於 我 的 列 祖 。

1)What are Elijah’s symptoms of depression?

以利亚抑郁的症状是什么?

2)What changes or circumstances did Elijah just experience?

以利亚刚刚经历了什么改变或境遇?

Let’s consider 1 Kings 19:5-6 – Then he lay down under the bush and fell asleep. All at once an angel touched him and said, “Get up and eat.” 6 He looked around, and there by his head was some bread baked over hot coals, and a jar of water. He ate and drank and then lay down again.

思考列王记上19:5-6— 他 就 躺 在 罗 腾 树 下 , 睡 着 了 。 有 一 个 天 使 拍 他 , 说 : 起 来 吃 罢 ! 6他 观 看 , 见 头 旁 有 一 瓶 水 与 炭 火 烧 的 饼 , 他 就 吃 了 喝 了 , 仍 然 躺 下 。

1)In what ways did God provide for Elijah in his moment of depression?

神在以利亚抑郁的时候采用了什么方法?

2)What are some practical ways we can provide for others who suffer from depression?

我们能向身患抑郁症的其他人能提供哪些实际的方法?

We now take a moment to read Isaiah 41:10 – So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand.

现在我们花点时间读以赛亚书41:10–你 不 要 害 怕 , 因 为 我 与 你 同 在 ; 不 要 惊 惶 , 因 为 我 是 你 的   神 。 我 必 坚 固 你 , 我 必 帮 助 你 ; 我 必 用 我 公 义 的 右 手 扶 持 你 。

1)It has been said that a depressed heart is a fearful heart. What does God specifically promise to help combat fear and depression?

据说抑郁的心是一颗充满恐惧的心。神怎样特别应许帮助战胜恐惧和抑郁?

2)The Bible recognizes the burden of depression. How can that message serve as a source of comfort to one who is suffering?

圣经承认抑郁症的负担。这节经文怎样成为痛苦的抑郁症患者安慰的泉源?

Some Mindful Questions … 7 思考题… 7
  1. How long have you been feeling depressed?

    你感到抑郁有多长时间了?

  2. Have you been depressed before?

    你以前抑郁过吗?

  3. Is there a family history of depression?

    有家族抑郁史吗?

  4. Have you lost interests in hobbies or other activities?

    你对自己的爱好或其他活动失去兴趣吗?

  5. Have you recently thought about harming yourself?

    最近你想过要伤害自己吗?

  6. Do you have trouble sleeping?

    你有睡眠问题吗?

  7. Have your eating habits changed?

    你改变了饮食习惯吗?

Now, it’s Your Turn … 8 现在,实战练习… 8

Choose one of the case studies provided. Apply the concepts we’ve learned in this lesson to the vignette:

请选择一个提供的案例研究。在案例中应用我们所学的理念。

  • Every morning Bob wakes up tired and struggles to get out of bed. During the day, he can’t find the stamina to get tasks done at work. He has no desire to play with his children after he gets home and doesn’t have the energy for household tasks.

  • 每天早晨,鲍伯醒来时很累,挣扎着起床。白天,他无法工作时没有精力完成任务。回家后他不想和孩子玩耍,也没有体力做家务。

  • Sarah has a hard time staying focused. She recently flunked out of college and has lost all confidence in herself. She doesn’t want to try to go back to school or interview for a job, so she stays at home and play video games. She feels like she has fallen into a pit.

  • 撒拉很难精神集中。她最近从大学退学,对自己完全失去信心。她既不想回学校也不想找个工作,因此她待在家里玩电子游戏。她感到掉进深渊。

1) Distinguish the kind of depression that is being presented. Defend your decision.

辨别上述的瘾症类型。阐明你的判断。

2) What other questions might you need to ask to help you with your decision?

你需要问什么其他问题来帮助你做判断?

3) How could you encourage this person with God’s Word?

你怎样用神的话来鼓励这个人?

4)Why would it be a bad idea to tell this individual to “just snap out of it”?

为什么告诉辅导对象“只要重新振作起来”不是好办法?

References:

Collin, Gary R. (2007) Christian Counseling 3rd Ed.: A Comprehensive Guide. Nashville, TN: Thomas Nelson.

Cunningham, Patricia D.; Connor Pamela D.; Stegbauer; Cheryl Cummings; Mynatt, Sarah L. Measures of

Affective Temperament, Mental Health Risk Factors, and Functional Health in a Retrospective,“”

Descriptive Study of 35 Patients. The Primary Care Companion to the Journal of Clinical Psychiatry 11(2):68-73 · February, 2009

Meier, Minirth, Wichern, Ratcliff. (1992) Introduction to Psychology and Counseling: Christian Perspectives and Applications. Grand Rapids, MI: Baker Book House.

Schuetze, A., Matzke, F. (1988) The Counseling Shepherd. Milwaukee, WI: Northwestern Publishing House.

Spark Notes Editors. (2004) Spark Charts: Abnormal Psychology. Barnes and Noble Publications.

Christian-Counseling-Part 1
基督徒心理辅导 大纲
Christian Counseling Catalog
第一课 上瘾
lesson 1 Addictions
第二课 抑郁症
lesson 2 Depression
第三课 焦虑
lesson 3 Anxiety
第四课 妒忌和羡慕
lesson 4 Jealousy and Envy
第五课 生气的解决方案
lesson 5 Anger Resolution
第六课 愧疚和羞耻
lesson 6 Guilt and Shame
第七课 悲痛和损失
lesson 7 Grief and Loss
第八课 自尊
lesson 8 Self Esteem
第二课 抑郁症
lesson 2 Depression