焦慮症成爲美國大學生中最常見心理問題大綱

ORLANDO, Fla. — One morning recently, a dozen college students stepped out of the bright sunshine into a dimly lit room at the counseling center here at the University of Central Florida. They appeared to have little in common: undergraduates in flip-flops and nose rings, graduate students in interview-ready attire.

佛羅里達州奧蘭多——近日的一個早晨，十幾名大學生從明媚的陽光中走入中佛羅里達大學(University of Central Florida, U.C.F.)心理諮詢中心所在的昏暗房間。乍一看，這些學生身上完全沒有共同點：本科生踢拉着人字拖，穿着鼻環；研究生則衣着正式如同正準備參加面試。

But all were drawn to this drop-in workshop: “Anxiety 101.”

但他們都是被該中心開辦的隨到隨加入的研討會——“焦慮症101(Anxiety 101)”吸引而來。

As they sat in a circle, a therapist, Nicole Archer, asked: “When you’re anxious, how does it feel?”

大家圍成一圈坐了下來，治療師妮科爾·阿謝爾(Nicole Archer)問道：“當你焦慮的時候，具體有什麼感覺？”

“I have a faster heart rate,” whispered one young woman. “I feel panicky,” said another. Sweating. Ragged breathing. Insomnia.

“我會心跳加速，”一個年輕女子小聲說。“我感到恐慌，”另一個說。還會冒汗，呼吸急促，失眠。

Causes? Schoolwork, they all replied. Money. Relationships. The more they thought about what they had to do, the students said, the more paralyzed they became.

那麼，焦慮的原因有哪些呢？課業，所有的學生都給出了這一答案；此外還有金錢和人際關係等。越是想着他們必須要做的那些事，他們就越是什麼都幹不成。

Anxiety has now surpassed depression as the most common mental health diagnosis among college students, though depression, too, is on the rise. More than half of students visiting campus clinics cite anxiety as a health concern, according to a recent study of more than 100,000 students nationwide by the Center for Collegiate Mental Health at Penn State.

目前，焦慮症已經超越抑鬱症成爲大學生中最常見的心理健康問題（不過抑鬱症也在增加之中）。賓夕法尼亞州立大學的大學生心理健康中心(Center for Collegiate Mental Health at Penn State)近期的一項研究調查了全美的10萬多名大學生，發現一半以上的學生到校園診所就診時提到了焦慮問題，並視其爲健康隱患。

Nearly one in six college students has been diagnosed with or treated for anxiety within the last 12 months, according to the annual national survey by the American College Health Association.

美國大學健康學會(American College Health Association)的年度全國調查顯示，近六分之一的大學生在過去的12個月內曾被診斷爲焦慮症或因焦慮症接受過治療。

The causes range widely, experts say, from mounting academic pressure at earlier ages to overprotective parents to compulsive engagement with social media. Anxiety has always played a role in the developmental drama of a student’s life, but now more students experience anxiety so intense and overwhelming that they are seeking professional counseling.

專家稱焦慮症的原因多種多樣，從早年積累下來的學業壓力、家長的過度保護到對社交媒體的強迫性依賴等等不一而足。一直以來，焦慮情緒都在從不同程度上影響着學生的成長曆程，但現在，越來越多的學生感到這種情緒已經讓他們不堪重負，以至於需要尋求專業心理輔導的幫助。

As students finish a college year during which these cases continued to spike, the consensus among therapists is that treating anxiety has become an enormous challenge for campus mental health centers.

由於學年結束此類病例的數量持續飆升，所以治療師們達成共識，認爲治療焦慮症已成爲校園心理健康中心面臨的一項巨大挑戰。

Like many college clinics, the Center for Counseling and Psychological Services at the University of Central Florida — one of the country’s largest and fastest-growing universities, with roughly 60,000 students — has seen sharp increases in the number of clients: 15.2 percent over last year alone. The center has grown so rapidly that some supply closets have been converted to therapists’ offices.

中佛羅里達大學擁有約6萬名學生，是全美最大、也是發展最快的大學之一。與許多校園門診一樣，該校的心理諮詢和服務中心(Center for Counseling and Psychological Services)的客戶數量也在急劇增加：僅去年一年就增加了15.2%。由於發展太過迅速，該中心的一部分儲物間都被改造成了治療師的辦公室。

More students are seeking help partly because the stigma around mental health issues is lessening, noted Stephanie Preston, a counselor at U.C.F.

U.C.F.的諮詢師斯蒂芬妮·普雷斯頓(Stephanie Preston)指出，前來求助的學生有所增加，一部分原因是人們已經漸漸不再以心理健康問題爲恥了。

Ms. Preston has seen the uptick in anxiety among her student clients. One gets panic attacks merely at the thought of being called upon in class. And anxiety was among a constellation of diagnoses that became life-threatening for another client, Nicholas Graves.

普雷斯頓發現，在她的學生客戶中，焦慮症正在增加。有一個學生僅僅因爲想到會在課堂上被點名就恐慌發作。對於她的另一個客戶尼古拉斯·格雷夫斯(Nicholas Graves)，焦慮症是危及他生命安全的一系列疾病之一。

Two years ago, Mr. Graves, a stocky cinema studies major in jeans, a T-shirt and Converse sneakers, could scarcely get to class. That involved walking past groups of people and riding a bus — and Mr. Graves felt that everyone was staring at him.

格雷夫斯是電影研究專業的學生，他身材矮胖，喜歡穿牛仔褲、T恤和匡威運動鞋。兩年前，他幾乎無法正常去上課——因爲路上要走過人羣並乘坐公共汽車，而他總覺得每個人都在盯着他看。

He started cutting himself. He was hospitalized twice for psychiatric observation.

他開始割傷自己，也曾兩次住院接受精神科觀察。

After some sessions with Ms. Preston, group therapy and medication, Mr. Graves, 21, who sat in an office at the center recently describing his harrowing journey, said he has made great progress.

格雷夫斯現年21歲。最近某次他坐在該中心辦公室裏描述他在路途上的悲慘經歷時，他表示經過與普雷斯頓談話數次，又接受了小組治療和藥物治療之後，自己已經取得了重大的進步。

“I’m more focused in school, and I’ve made more friends in my film courses — I found my tribe,” he said, smiling. “I’ve been open about my anxiety and depression. I’m not ashamed anymore.”

“現在我在學校更能集中注意力了，還在電影課上交到了更多的朋友——我找到了我的圈子，”他微笑着說。“我沒有避諱我的焦慮症和抑鬱症，我也不再因它們而感到羞愧了。”

Anxiety has become emblematic of the current generation of college students, said Dan Jones, the director of counseling and psychological services at Appalachian State University in Boone, N.C.

阿帕拉契州立大學（Appalachian State University，位於北卡羅來納州布恩市）心理諮詢與服務中心的主任丹·瓊斯(Dan Jones)說，焦慮已成爲當代大學生的典型標誌。

Because of escalating pressures during high school, he and other experts say, students arrive at college preloaded with stress. Accustomed to extreme parental oversight, many seem unable to steer themselves. And with parents so accessible, students have had less incentive to develop life skills.

包括他在內的專家表示，由於高中期間的壓力不斷增大，學生本身就是帶着壓力進的大學。很多學生都習慣於父母無微不至的監督，幾乎沒有自制能力。而且，由於家長總在身邊，學生們普遍缺乏學習獨立生活技能的動力。

“A lot are coming to school who don’t have the resilience of previous generations,” Dr. Jones said. “They can’t tolerate discomfort or having to struggle. A primary symptom is worrying, and they don’t have the ability to soothe themselves.”

“很多學生都不具備前幾代人身上的那種堅韌品格，”瓊斯博士說。“他們無法忍受任何不適，也不願意去努力奮鬥。一個主要的症狀就是焦慮，而且他們也缺乏安撫自己情緒的能力。”

Social media is a gnawing, roiling constant. As students see posts about everyone else’s fabulous experiences, the inevitable comparisons erode their self-esteem. The popular term is “FOMO” — fear of missing out.

社交媒體是一個折磨人的、令人不安的存在。當學生看到其他人發佈的講述自己精彩經歷的帖子時，不可避免的攀比心理會削弱他們的自尊。對此，流行的說法叫做“社交控(FOMO, fear of missing out)”。

And so personal setbacks that might once have become “teachable moments” turn into triggers for a mental health diagnosis.

於是，原本應成爲“受到啓迪的契機”的個人挫折變成了心理健康問題的誘發因素。

“Students are seeking treatment, saying, ‘I just got the first C in my life, my whole life just got shattered, I wanted to go to medical school and I can’t cope,’” said Micky M. Sharma, president of the Association for University and College Counseling Center Directors and head of Ohio State University’s counseling center.

美國大學校院心理輔導中心主任協會(Association for University and College Counseling Center Directors)主席，俄亥俄州立大學(Ohio State University)心理諮詢中心的負責人米基·M·夏爾馬(Micky M. Sharma)說：“學生們來尋求治療時說着：‘我剛得了這輩子的第一個C，整個人都不好了，我想進醫學院啊怎麼辦，我受不了了。”

Anxiety is an umbrella term for several disorders, including social anxiety disorder and agoraphobia. It can accompany many other diagnoses, such as depression, and it can be persistent and incapacitating.

焦慮症是幾種疾病的總稱，包括社交焦慮障礙(social anxiety disorder)和廣場恐怖症(agoraphobia)等。它可伴有抑鬱症等許多其它疾病，並可能持續存在並使患者喪失正常的行動能力。

Students who suffer from this acute manifestation can feel their very real struggles are shrugged off, because anxiety has become so ubiquitous, almost a cliché, on campus.

急性焦慮症發作的學生常感到別人對自己的痛苦和困擾不屑一顧，因爲在大學校園中，焦慮症已變得如此普遍，人們已經見怪不怪了。

Alexa, 18, has been treated for an anxiety disorder since middle school, when she was still feeling terrorized by monsters under the bed. She has just finished her freshman year at Queens College in New York.

亞歷克莎(Alexa)在初中時仍會被“牀底下的怪物”嚇壞，從那時起她就開始接受焦慮症治療。如今18歲的她剛剛在紐約的皇后學院(Queens College)唸完大學一年級。

If she had a severe episode during a test, afterward she would try to explain to her professors what had happened but they would dismiss her. “They’d say, ‘Your mind isn’t focused,’ or ‘That’s just an excuse,’ ” said Alexa, who wrote her college application essay about grappling with the disorder. She asked not to be fully identified for privacy reasons.

要是她在考試期間出現嚴重的焦慮症發作，之後她就需要試着向教授們解釋緣由，但他們很可能並不買賬。“他們會說：‘你只是思想不集中，’或者‘你不過是在找藉口，’”亞歷克莎說，她把自己與焦慮症鬥爭的經歷寫在了大學入學申請書裏。爲保護個人隱私，應她的要求隱去了她的部分身份信息。

More often, anxiety is mild, intermittent or temporary, the manifestation of a student in the grip of a normal developmental issue — learning time management, for example, or how to handle rejection from a sorority.

不過，在更多的情況下焦慮症狀都比較輕微，呈間歇性或臨時性，常表現爲學生因正常的個人發展問題而苦惱，例如，學習管理時間，或被女生聯誼會拒絕後應如何進行心理調適。

Mild anxiety is often treatable with early, modest interventions. But to care for rising numbers of severely troubled students, many counseling centers have moved to triage protocols. That means that students with less urgent needs may wait several weeks for first appointments.

輕度的焦慮症常可以通過早期、適度的干預來進行治療。但是，鑑於受到嚴重困擾的學生人數不斷上升，許多諮詢中心都採取了分診措施。這就意味着，情況不太嚴重的學生們可能需要等待數週才能第一次約見諮詢師。

“A month into the semester, a student is having panic attacks about coming to class, but the wait list at the counseling center is two to five weeks out. So something the student could recover from quickly might only get worse,” said Ben Locke, associate director of clinical services at Penn State University and the lead author of the Penn State report.

“開學一個月後，一個學生準備去上課的時候恐慌發作，但心理諮詢中心的候診名單已經排到二到五週之後了。結果該學生本來很快就可以擺脫的一些陰影可能就進一步惡化了，”賓夕法尼亞州立大學(Penn State University)臨牀服務部的副主任，賓州州立大學報告的主要作者本·洛克(Ben Locke)說。

By necessity, most centers can only offer individual therapy on a short-term basis. Ms. Preston estimates that about 80 percent of clients at U.C.F. need only limited therapy.

從必要性來看，大多數心理諮詢中心只提供短期的個性化治療就可以了。普雷斯頓估計，在U.C.F.，大約80%的客戶只需要接受有限的治療。

“Students are busting their butts academically, they’re financially strapped, working three jobs,” she said. “There’s nothing diagnosable, but sometimes they just need a place to express their distress.”

“學生們已經被學業忙得焦頭爛額，他們經濟拮据，說不定要打三份工，”她說。“他們並不需要什麼診斷，有時候，他們只是需要有個地方來發泄一下憂慮的情緒。”

Even with 30 therapists, the center at U.C.F. must find other ways to reach more students — especially the ones who suffer, smoldering, but don’t seek help.

儘管U.C.F.的心理諮詢中心配有30名治療師，但他們仍需找到其他方式來幫助更多的學生，尤其是那些正遭受着痛苦卻悶在心裏，不願意尋求幫助的學生。

Like many college counseling centers, U.C.F. has designed a variety of daily workshops and therapy groups that implicitly and explicitly address anxiety, depression and their triggers. Next fall the center will test a new app for treating anxiety with a seven-module cognitive behavioral program, accessible through a student’s phone and augmented with brief videoconferences with a therapist.

像許多大學的心理諮詢中心一樣，U.C.F.也設置了多種日常研討會和治療小組，以直接或間接的方式解決焦慮、抑鬱問題及其觸發源。明年秋天，該中心將對一種新的擁有七個模塊的認知行爲療法應用程序進行測試，學生可以通過手機獲取該應用，並可與治療師進行簡短的視頻談話。

It also offers semester-long, 90-minute weekly therapy groups, such as “Keeping Calm and in Control,” “Mindfulness for Depression” and “Building Social Confidence” — for students struggling with social anxiety.

它還將提供持續整個學期，每週90分鐘的小組治療，例如爲疲於應付社交焦慮症的學生開設的“保持冷靜和自控”、“抑鬱症的正念冥想治療”和“構建社會信任”療程等。

The therapists have to be prepared to manage students who present a wide array of challenges. “You never know who is going to walk in,” said Karen Hofmann, the center’s director. “Someone going through a divorce. Mourning the death of a parent. Managing a bipolar disorder. Or they’re transgender and need a letter for hormone therapy.”

治療師必須做好準備以應對學生五花八門的問題。“你永遠不知道走進諮詢室將會是怎樣一個人，”該中心的主任卡倫·霍夫曼(Karen Hofmann)說。“有人正在辦離婚，有人沉浸在喪父/喪母的悲痛中，有人正接受躁鬱症(bipolar disorder)治療，又或者，來者是個變性人，需要你開個證明以進行激素治療。”

Indeed, Dr. Locke and his colleagues at Penn State, who have tracked campus counseling centers nationwide for six years, have documented a trend that other studies have noted: Students are arriving with ever more severe mental-health issues.

事實上，洛克博士和他在賓夕法尼亞州立大學的同事們追蹤全美的校園心理諮詢中心已有六年之久，他們證實了其他研究早已發現的一個趨勢：前來就診的學生的心理健康問題日益嚴重。

Half of clients at mental health centers in their most recent report had already had some form of counseling before college. One-third have taken psychiatric medication. One quarter have self-injured.

心理健康中心的客戶有一半在其最近的報告中稱他們在上大學之前就已經接受過某種形式的心理輔導。有三分之一曾接受過精神科藥物治療。四分之一存在自傷行爲。

The fundamental goal of campus counseling centers is to help students complete their education. According to federal statistics, just 59 percent of students who matriculated at four year colleges in 2006 graduated within six years.

校園心理諮詢中心的根本目的在於幫助學生完成學業。根據聯邦政府的統計，在2006年被四年制大學錄取的學生中，在六年內畢業的只佔59%。

Studies have repeatedly emphasized the nexus between mental health and academic success. In a survey this year at Ohio State’s center, just over half of the student clients said that counseling was instrumental in helping them remain in school.

衆多研究一再強調心理健康和學業成功之間存在關聯。今年在俄亥俄州立大學心理諮詢中心進行的一項調查中，只有剛剛過半的學生客戶認爲心理輔導有助於他們避免輟學。

Anxiety-ridden students list schoolwork as their chief stressor. U.C.F.’s center and after-hours hotline are busiest when midterm and final exams loom. That’s when the center runs what has become its most popular event: “Paws-a-tively Stress Free.”

深受焦慮症之苦的學生們將課業列爲首要的壓力源。U.C.F.的心理諮詢中心及其非工作時間熱線都是在期中和期末考試迫近時最爲繁忙。在這種時候，該中心就會開展他們最受歡迎的活動：“治療犬減壓法(Paws-a-tively Stress Free)”。

The other afternoon, just before finals week, students, tired and apprehensive, trickled into the center. The majority were not clients.

期末考試周前的一個下午，疲憊而惶惑的學生們陸續走進了心理諮詢中心。其中大多數都不是該中心的客戶。

At a tent outside, their greeter was the center’s mascot and irresistible magnet: a 14-pound Havanese, a certified therapy dog whom many clients ask to hold during individual sessions, stroking his silky white coat to alleviate anxiety.

等在室外帳篷處，帶着不可抗拒的吸引力歡迎他們的是該中心的吉祥物——一條14磅重的哈瓦那犬。這是一條經過認證的治療犬，該中心的很多客戶都要求在他們的個人療程中跟它待在一起，撫摸着它柔滑的白色皮毛以緩解焦慮。

“Bodhi!” they called, as he trotted over, welcoming them to his turf with a friendly sniff.

“菩提！”學生們叫道。它一路小跑過來，友好地嗅嗅他們，歡迎他們來到它的草坪。

For the next two hours, some 75 students visited the center, sitting on floors for a heavy petting session with therapy dogs.

在接下來的兩個小時中，約75名學生參觀了中心，並坐在地板上與治療犬們共同完成了“親密愛撫療程”(heavy petting session)。

They laughed at the dogs’ antics and rubbed their bellies. They remarked on how nice it was to get a study break.

學生們被狗狗的滑稽動作逗得捧腹大笑。他們都說能從學業中得到片刻喘息實在太美好了。

On the way out, the students were handed a smoothie and a “stress kit,” which included a mandala, crayons, markers, stress balls and “Smarties” candy.

在離開的路上，工作人員向學生們遞上了水果冰沙和“壓力工具盒”，裏面放着曼荼羅彩繪(mandala)、彩色蠟筆、記號筆、壓力球和“Smarties”糖什麼的。

Also tucked into the kit was a card with information about how to contact the center, should they ever need something more.

工具盒裏還塞了一張信息卡，告訴學生們如果他們需要更多的幫助，應如何與該中心取得聯繫。