焦虑症成为美国大学生中最常见心理问题

　　佛罗里达州奥兰多——近日的一个早晨，十几名大学生从明媚的阳光中走入中佛罗里达大学(University of Central Florida, U.C.F.)心理咨询中心所在的昏暗房间。乍一看，这些学生身上完全没有共同点：本科生踢拉着人字拖，穿着鼻环；研究生则衣着正式如同正准备参加面试。

　　But all were drawn² to this drop-in workshop: “Anxiety 101.”

　　但他们都是被该中心开办的随到随加入的研讨会——“焦虑症101(Anxiety 101)”吸引而来。

　　As they sat in a circle, a therapist, Nicole Archer³, asked: “When you’re anxious, how does it feel?”

　　大家围成一圈坐了下来，治疗师妮科尔·阿谢尔(Nicole Archer)问道：“当你焦虑的时候，具体有什么感觉？”

　　“I have a faster heart rate,” whispered one young woman. “I feel panicky,” said another. Sweating. Ragged⁴ breathing. Insomnia⁵.

　　“我会心跳加速，”一个年轻女子小声说。“我感到恐慌，”另一个说。还会冒汗，呼吸急促，失眠。

　　焦虑症成为美国大学生中最常见心理问题

　　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.

　　那么，焦虑的原因有哪些呢？课业，所有的学生都给出了这一答案；此外还有金钱和人际关系等。越是想着他们必须要做的那些事，他们就越是什么都干不成。

　　Anxiety has now surpassed depression as the most common mental health diagnosis⁶ 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，焦虑症已经超越抑郁症成为大学生中最常见的心理健康问题（不过抑郁症也在增加之中）。宾夕法尼亚州立大学的大学生心理健康中心(Center for Collegiate Mental Health at Penn State)近期的一项研究调查了全美的10万多名大学生，发现一半以上的学生到校园诊所就诊时提到了焦虑问题，并视其为健康隐患。

　　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.

　　美国大学健康学会(American College Health Association)的年度全国调查显示，近六分之一的大学生在过去的12个月内曾被诊断为焦虑症或因焦虑症接受过治疗。

　　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.

　　专家称焦虑症的原因多种多样，从早年积累下来的学业压力、家长的过度保护到对社交媒体的强迫性依赖等等不一而足。一直以来，焦虑情绪都在从不同程度上影响着学生的成长历程，但现在，越来越多的学生感到这种情绪已经让他们不堪重负，以至于需要寻求专业心理辅导的帮助。

　　As students finish a college year during which these cases continued to spike⁷, the consensus⁸ among therapists is that treating anxiety has become an enormous challenge for campus mental health centers.

　　由于学年结束此类病例的数量持续飙升，所以治疗师们达成共识，认为治疗焦虑症已成为校园心理健康中心面临的一项巨大挑战。

　　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.

　　中佛罗里达大学拥有约6万名学生，是全美最大、也是发展最快的大学之一。与许多校园门诊一样，该校的心理咨询和服务中心(Center for Counseling and Psychological Services)的客户数量也在急剧增加：仅去年一年就增加了15.2%。由于发展太过迅速，该中心的一部分储物间都被改造成了治疗师的办公室。

　　More students are seeking help partly because the stigma⁹ around mental health issues is lessening¹⁰, noted¹¹ Stephanie Preston, a counselor¹² at U.C.F.

　　U.C.F.的咨询师斯蒂芬妮·普雷斯顿(Stephanie Preston)指出，前来求助的学生有所增加，一部分原因是人们已经渐渐不再以心理健康问题为耻了。

　　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 constellation¹³ of diagnoses that became life-threatening for another client, Nicholas Graves.

　　普雷斯顿发现，在她的学生客户中，焦虑症正在增加。有一个学生仅仅因为想到会在课堂上被点名就恐慌发作。对于她的另一个客户尼古拉斯·格雷夫斯(Nicholas Graves)，焦虑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 Converse¹⁴ 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.

　　格雷夫斯是电影研究专业的学生，他身材矮胖，喜欢穿牛仔裤、T恤和匡威运动鞋。两年前，他几乎无法正常去上课——因为路上要走过人群并乘坐公共汽车，而他总觉得每个人都在盯着他看。

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

　　他开始割伤自己，也曾两次住院接受精神科观察。

　　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.

　　格雷夫斯现年21岁。最近某次他坐在该中心办公室里描述他在路途上的悲惨经历时，他表示经过与普雷斯顿谈话数次，又接受了小组治疗和药物治疗之后，自己已经取得了重大的进步。

　　“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.”

　　“现在我在学校更能集中注意力了，还在电影课上交到了更多的朋友——我找到了我的圈子，”他微笑着说。“我没有避讳我的焦虑症和抑郁症，我也不再因它们而感到羞愧了。”

　　Anxiety has become emblematic¹⁵ 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.

　　阿帕拉契州立大学（Appalachian State University，位于北卡罗来纳州布恩市）心理咨询与服务中心的主任丹·琼斯(Dan Jones)说，焦虑已成为当代大学生的典型标志。

　　Because of escalating¹⁶ pressures during high school, he and other experts say, students arrive at college preloaded with stress. Accustomed to extreme parental¹⁷ oversight¹⁸, many seem unable to steer¹⁹ themselves. And with parents so accessible, students have had less incentive²⁰ to develop life skills.

　　包括他在内的专家表示，由于高中期间的压力不断增大，学生本身就是带着压力进的大学。很多学生都习惯于父母无微不至的监督，几乎没有自制能力。而且，由于家长总在身边，学生们普遍缺乏学习独立生活技能的动力。

　　“A lot are coming to school who don’t have the resilience of previous generations,” Dr. Jones said. “They can’t tolerate discomfort²¹ or having to struggle. A primary symptom is worrying, and they don’t have the ability to soothe²² themselves.”

　　“很多学生都不具备前几代人身上的那种坚韧品格，”琼斯博士说。“他们无法忍受任何不适，也不愿意去努力奋斗。一个主要的症状就是焦虑，而且他们也缺乏安抚自己情绪的能力。”

　　Social media is a gnawing²³, roiling²⁴ constant. As students see posts about everyone else’s fabulous²⁵ experiences, the inevitable²⁶ comparisons erode²⁷ their self-esteem. The popular term is “FOMO” — fear of missing out.

　　社交媒体是一个折磨人的、令人不安的存在。当学生看到其他人发布的讲述自己精彩经历的帖子时，不可避免的攀比心理会削弱他们的自尊。对此，流行的说法叫做“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.

　　于是，原本应成为“受到启迪的契机”的个人挫折变成了心理健康问题的诱发因素。

　　“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.

　　美国大学校院心理辅导中心主任协会(Association for University and College Counseling Center Directors)主席，俄亥俄州立大学(Ohio State University)心理咨询中心的负责人米基·M·夏尔马(Micky M. Sharma)说：“学生们来寻求治疗时说着：‘我刚得了这辈子的第一个C，整个人都不好了，我想进医学院啊怎么办，我受不了了。”

　　Anxiety is an umbrella term for several disorders²⁹, including social anxiety disorder²⁸ and agoraphobia. It can accompany many other diagnoses, such as depression, and it can be persistent³⁰ and incapacitating.

　　焦虑症是几种疾病的总称，包括社交焦虑障碍(social anxiety disorder)和广场恐怖症(agoraphobia)等。它可伴有抑郁症等许多其它疾病，并可能持续存在并使患者丧失正常的行动能力。

　　Students who suffer from this acute manifestation³¹ can feel their very real struggles are shrugged³² off, because anxiety has become so ubiquitous, almost a cliché, on campus.

　　急性焦虑症发作的学生常感到别人对自己的痛苦和困扰不屑一顾，因为在大学校园中，焦虑症已变得如此普遍，人们已经见怪不怪了。

　　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 freshman³³ year at Queens College in New York.

　　亚历克莎(Alexa)在初中时仍会被“床底下的怪物”吓坏，从那时起她就开始接受焦虑症治疗。如今18岁的她刚刚在纽约的皇后学院(Queens College)念完大学一年级。

　　If she had a severe episode during a test, afterward³⁴ 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 fully³⁵ identified for privacy reasons.

　　要是她在考试期间出现严重的焦虑症发作，之后她就需要试着向教授们解释缘由，但他们很可能并不买账。“他们会说：‘你只是思想不集中，’或者‘你不过是在找借口，’”亚历克莎说，她把自己与焦虑症斗争的经历写在了大学入学申请书里。为保护个人隐私，应她的要求隐去了她的部分身份信息。

　　More often, anxiety is mild, intermittent³⁶ or temporary, the manifestation of a student in the grip of a normal developmental issue — learning time management, for example, or how to handle rejection³⁷ from a sorority.

　　不过，在更多的情况下焦虑症状都比较轻微，呈间歇性或临时性，常表现为学生因正常的个人发展问题而苦恼，例如，学习管理时间，或被女生联谊会拒绝后应如何进行心理调适。

　　Mild anxiety is often treatable with early, modest interventions³⁸. But to care for rising numbers of severely³⁹ troubled students, many counseling centers have moved to triage protocols⁴⁰. That means that students with less urgent needs may wait several weeks for first appointments.

　　轻度的焦虑症常可以通过早期、适度的干预来进行治疗。但是，鉴于受到严重困扰的学生人数不断上升，许多咨询中心都采取了分诊措施。这就意味着，情况不太严重的学生们可能需要等待数周才能第一次约见咨询师。

　　“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.

　　“开学一个月后，一个学生准备去上课的时候恐慌发作，但心理咨询中心的候诊名单已经排到二到五周之后了。结果该学生本来很快就可以摆脱的一些阴影可能就进一步恶化了，”宾夕法尼亚州立大学(Penn State University)临床服务部的副主任，宾州州立大学报告的主要作者本·洛克(Ben Locke)说。

　　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.

　　从必要性来看，大多数心理咨询中心只提供短期的个性化治疗就可以了。普雷斯顿估计，在U.C.F.，大约80%的客户只需要接受有限的治疗。

　　“Students are busting⁴¹ their butts⁴² academically, they’re financially strapped⁴³, working three jobs,” she said. “There’s nothing diagnosable, but sometimes they just need a place to express their distress⁴⁴.”

　　“学生们已经被学业忙得焦头烂额，他们经济拮据，说不定要打三份工，”她说。“他们并不需要什么诊断，有时候，他们只是需要有个地方来发泄一下忧虑的情绪。”

　　Even with 30 therapists, the center at U.C.F. must find other ways to reach more students — especially the ones who suffer, smoldering⁴⁵, but don’t seek help.

　　尽管U.C.F.的心理咨询中心配有30名治疗师，但他们仍需找到其他方式来帮助更多的学生，尤其是那些正遭受着痛苦却闷在心里，不愿意寻求帮助的学生。

　　Like many college counseling centers, U.C.F. has designed a variety of daily workshops and therapy groups that implicitly⁴⁶ and explicitly⁴⁷ address anxiety, depression and their triggers. Next fall the center will test a new app for treating anxiety with a seven-module cognitive⁴⁸ behavioral program, accessible through a student’s phone and augmented⁴⁹ with brief videoconferences with a therapist.

　　像许多大学的心理咨询中心一样，U.C.F.也设置了多种日常研讨会和治疗小组，以直接或间接的方式解决焦虑、抑郁问题及其触发源。明年秋天，该中心将对一种新的拥有七个模块的认知行为疗法应用程序进行测试，学生可以通过手机获取该应用，并可与治疗师进行简短的视频谈话。

　　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.

　　它还将提供持续整个学期，每周90分钟的小组治疗，例如为疲于应付社交焦虑症的学生开设的“保持冷静和自控”、“抑郁症的正念冥想治疗”和“构建社会信任”疗程等。

　　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 hormone⁵⁰ therapy.”

　　治疗师必须做好准备以应对学生五花八门的问题。“你永远不知道走进咨询室将会是怎样一个人，”该中心的主任卡伦·霍夫曼(Karen Hofmann)说。“有人正在办离婚，有人沉浸在丧父/丧母的悲痛中，有人正接受躁郁症(bipolar disorder)治疗，又或者，来者是个变性人，需要你开个证明以进行激素治疗。”

　　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.

　　事实上，洛克博士和他在宾夕法尼亚州立大学的同事们追踪全美的校园心理咨询中心已有六年之久，他们证实了其他研究早已发现的一个趋势：前来就诊的学生的心理健康问题日益严重。

　　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.

　　心理健康中心的客户有一半在其最近的报告中称他们在上大学之前就已经接受过某种形式的心理辅导。有三分之一曾接受过精神科药物治疗。四分之一存在自伤行为。

　　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.

　　校园心理咨询中心的根本目的在于帮助学生完成学业。根据联邦政府的统计，在2006年被四年制大学录取的学生中，在六年内毕业的只占59%。

　　Studies have repeatedly emphasized the nexus⁵¹ 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 helping⁵² them remain in school.

　　众多研究一再强调心理健康和学业成功之间存在关联。今年在俄亥俄州立大学心理咨询中心进行的一项调查中，只有刚刚过半的学生客户认为心理辅导有助于他们避免辍学。

　　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 loom⁵³. That’s when the center runs what has become its most popular event: “Paws-a-tively Stress Free.”

　　深受焦虑症之苦的学生们将课业列为首要的压力源。U.C.F.的心理咨询中心及其非工作时间热线都是在期中和期末考试迫近时最为繁忙。在这种时候，该中心就会开展他们最受欢迎的活动：“治疗犬减压法(Paws-a-tively Stress Free)”。

　　The other afternoon, just before finals week, students, tired and apprehensive⁵⁴, trickled⁵⁵ into the center. The majority were not clients.

　　期末考试周前的一个下午，疲惫而惶惑的学生们陆续走进了心理咨询中心。其中大多数都不是该中心的客户。

　　At a tent outside, their greeter was the center’s mascot⁵⁶ and irresistible⁵⁷ magnet: a 14-pound Havanese, a certified⁵⁸ therapy dog whom many clients ask to hold during individual sessions, stroking his silky white coat to alleviate⁵⁹ anxiety.

　　等在室外帐篷处，带着不可抗拒的吸引力欢迎他们的是该中心的吉祥物——一条14磅重的哈瓦那犬。这是一条经过认证的治疗犬，该中心的很多客户都要求在他们的个人疗程中跟它待在一起，抚摸着它柔滑的白色皮毛以缓解焦虑。

　　“Bodhi!” they called, as he trotted⁶⁰ over, welcoming them to his turf with a friendly sniff⁶¹.

　　“菩提！”学生们叫道。它一路小跑过来，友好地嗅嗅他们，欢迎他们来到它的草坪。

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

　　在接下来的两个小时中，约75名学生参观了中心，并坐在地板上与治疗犬们共同完成了“亲密爱抚疗程”(heavy petting session)。

　　They laughed at the dogs’ antics and rubbed their bellies⁶². They remarked on how nice it was to get a study break.

　　学生们被狗狗的滑稽动作逗得捧腹大笑。他们都说能从学业中得到片刻喘息实在太美好了。

　　On the way out, the students were handed a smoothie and a “stress kit⁶³,” which included a mandala, crayons, markers, stress balls and “Smarties” candy.

　　在离开的路上，工作人员向学生们递上了水果冰沙和“压力工具盒”，里面放着曼荼罗彩绘(mandala)、彩色蜡笔、记号笔、压力球和“Smarties”糖什么的。

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

　　工具盒里还塞了一张信息卡，告诉学生们如果他们需要更多的帮助，应如何与该中心取得联系。

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