北师大家庭与儿童发展实验室
我们隶属于北京师范大学发展心理研究院，专注于中国婚姻与家庭研究，致力于将实用有趣的学术成果分享给大家。

本期作者
王 淼
北京师范大学心理学部2019级本科生

在近期上演的都市女性情感剧《今生也是第一次》中，女主陈兰青（唐艺昕饰）一直以为生孩子是一件很简单的事，然而在鬼门关走了一遭才生下女儿后，她发现产后的生活也是一地鸡毛：婆婆和妈妈一切都只为孩子考虑，承诺“你只管生就好”的丈夫也无法理解她的感受，陈兰青的饮食、娱乐乃至工作都在很大程度上受到了限制，还要忍着疼痛坚持给孩子喂奶。

最终痛苦达到巅峰的陈兰青爬上了楼顶，嘀咕着“我不要做妈妈”意欲跳楼，还好被丈夫拦下才没有酿成惨剧。

“女本柔弱，为母则刚”，这是对母亲的赞美，也是对母亲的束缚与苛求。生理上的不适已然会使一位母亲筋疲力竭，家人过多的要求和缺乏理解更是雪上加霜。日剧《产科医鸿鸟》中提到：“产后抑郁属于一种精神疾病，却因为带有‘产后’两个字，而被人们看轻了它的严重性。”妈妈并不是超人，我们需要了解、正视、并更科学地看待产后抑郁。

01
了解产后抑郁

产后抑郁

产后抑郁(postpartum depressive, PPD)一般指女性产后出现的抑郁症状，诊断标准与重性抑郁障碍相似，持续时间较长，且会明显地影响生活生理、人际交往、工作学习等功能，具体表现为烦躁、悲伤、沮丧、焦虑、恐惧等负性情绪，同时伴有头晕乏力、失眠、食欲不振等躯体症状，严重者甚至出现幻觉、自杀以及杀婴行为，需要接受治疗，多达10%-15%的产妇会经历这种严重、持久的情绪障碍(汪大彬 等, 2023)。

产后抑郁，从母亲到家庭

产后阶段，再坚强的女性也可能会无缘无故哭泣，再温柔的女性也可能会对不停哭闹的孩子抓狂，她们和家人并不了解或羞于承认产后抑郁，因而不能及时获得帮助与治疗，这让妈妈们承受更多的压力与负面评价，极有可能加重她们的抑郁症状，且得不到及时治疗的产后抑郁患者日后更易复发抑郁(Seyfried & Marcus, 2003)。

值得注意的是，产后抑郁所影响的并不只是母亲，而是整个家庭。

研究发现，产后抑郁患者会花更少的时间进行母乳喂养(Dias & Figueiredo, 2015)，且高达60%的产后抑郁患者会控制不住地出现攻击婴儿的想法(Patel et al., 2012)。

其次，患有产后抑郁的母亲会更少回应孩子，对孩子的需求和情绪不敏感，也更多表现出消极情绪。这些行为都会新生儿造成不良影响，如使之身体健康状况更差、易患精神疾病、易形成不安全依恋、人际交往困难等(Burke, 2003)。

此外，在与产后抑郁母亲相处的过程中，父亲及其他亲密照料者也难免受到影响。夫妻关系以及母亲与长辈的关系可能出现前所未有的问题，而焦头烂额的父亲也同样容易患上抑郁(Field, 2010; Rao et al., 2020)。

02
是什么让母亲变得脆弱？

看了上述的这些内容，有些人可能产生这样的疑问：产后抑郁真有这么严重？

事实表明，产后抑郁可能和人们想象的不太一样。首先，产后抑郁的发生比人们想象得更普遍，不必为此自责。其次，产后抑郁的发病原因是复杂的，生理、环境和个人特质等因素都会影响到产妇患产后抑郁的风险。

（1）生理因素

激素水平变化的影响。激素水平的变化是无法避免的，其影响是难以凭主观意志控制的。妊娠期女性体内的雌二醇、孕酮等雌激素浓度显著增加，母体逐渐适应远超常值的雌激素水平，而产后雌激素水平迅速下降到孕前水平，某些对雌激素水平波动敏感的女性会因此出现抑郁症状。

（2）环境因素

缺乏社会支持会大大增加产妇患上产后抑郁症的风险。通俗来说，社会支持是指亲人、朋友等人向受助者提供的物质或精神上的帮助与支持。缺乏社会支持，特别是缺乏来自丈夫的支持，会让女性的育儿与家务负担加重、需求无法及时得到满足、体会到更多的挫败感，从而增加了其患病的风险(Cho et al., 2022; Terada et al., 2021)。

（3）个人特质

研究表明，神经质水平较高的个体情绪较不稳定。高神经质的女性在面临压力时会产生强烈的负面情绪，怀孕和分娩会为其带来压力，并导致她们陷入担忧、沉思和情感回避中，这使得她们更容易出现产后抑郁症状。类似地，脆弱人格（包含焦虑、担忧、敏感、缺乏自信、善变以及轻微的强迫等特质）会通过影响母亲自我效能感而诱发产后抑郁(Han et al., 2022; Puyané et al., 2022)。

除上述因素外，产妇年龄较小、失业、意外怀孕、早产、吸烟、滥用药物等因素也会导致其患产后抑郁风险增加。

03
预防产后抑郁，
我们可以做些什么？

了解了致病风险因素后，我们就有了预防产后抑郁的方向，下文将提出一些建议，希望能够给有小宝贝的家庭提供一些帮助。

（1）留心自身情况，及时进行筛查诊断

女性产后体内激素含量变化较大，情绪和精力容易受到影响，特别是平时对激素变化就比较敏感的人群（如经期及经期前后身体和情绪状态明显比平时差的女性）。妈妈们要关注自己的状态，如果出现产后抑郁相关症状要及时就医进行筛查，确诊则需要按医嘱进行治疗。

（2）适当运动、保持饮食健康，提升孕期身心抵抗力

身体健康是心理健康的基础。研究表明，孕期在专业指导下坚持运动(Lewis et al., 2021)，多吃水果、少吃氧化剂含量较高的红肉及其副产品等可以降低患产后抑郁的风险(Flor-Alemany et al., 2022)。健康的饮食、定期的锻炼、良好的睡眠都是抵御产后抑郁与压力的有效力量。

（3）学习育儿知识

妈妈们和家人可以在生产前通过阅读、网络、讲座、宣传栏等多了解科学的育儿知识，必要时可以进行线下或线上的医疗保健咨询，了解如何应对照顾孩子的过程中可能出现的挑战，这样可以增强妈妈抚养孩子的信心，缓解焦虑，也可以使准妈妈们面对这些问题时更加从容。

（4）家人和朋友的支持

分娩意味着离开工作或学校，要应付孩子的需要和问题，忍受身体上的疼痛，没有时间参加社交活动等。因此社会支持，特别是来自家庭成员的支持，对妈妈们来说是一种强有力的帮助。家人和朋友可以多向妈妈们表达关心、理解与爱，一同了解育儿和产后恢复的知识，在产后与其一同分担工作、家务和照顾孩子的责任，多鼓励和安慰她们。

04
已经患上产后抑郁，
怎样帮助母亲好起来？

产后抑郁和非产后抑郁类似，建议通过药物和心理治疗来缓解和治愈，越早接受治疗症状就能够越早得到控制，恢复所需的时间也越短。

（1）药物以及仪器治疗

确诊产后抑郁的妈妈们应遵医嘱坚持服用药物，按时复诊。如有必要，可以考虑接受经颅磁等仪器治疗以及在精神科医院住院治疗。

（2）心理治疗

具有以下特点的心理治疗在应对产后抑郁方面有着显著的效果：
a. 针对母亲自我效能感的治疗(Law et al., 2019)
b. 认知行为疗法、以正念为基础的认知训练、元认知训练等与认知相关的疗法(Bohne et al., 2022)
c. 婚姻/家庭/人际治疗：

家庭新成员的到来会使夫妻对彼此的关心减少，此时妻子的身体与心理都处于较为脆弱的状态，而丈夫需要努力工作来补偿妻子产假期间家庭收入的减少，二者很难为彼此提供支持，且更容易发生冲突，使婚姻满意度降低。此外，妈妈们与婆婆的关系对其心理健康乃至夫妻关系都有重要的影响。

（3）侧重婴儿护理的干预

改善婴儿睡眠质量等针对婴儿及其身体健康的干预能够缓解妈妈们的焦虑，并改善其身体健康状况，从而缓解其抑郁症状(Skodova et al., 2022)。

（4）进行体育锻炼

坚持运动不仅能够预防产后抑郁，还能够减轻已经患病女性的症状(He et al., 2023)，但需要在医生等专业人士的指导下进行体育运动。

05
写在最后

妈妈不必是超人，请多给自己一些宽容与关怀，幸福快乐的妈妈能够给宝宝更好的爱。产后抑郁不是洪水猛兽，科学预防，积极就医，全家共同努力，焦虑与悲伤终会云开雾散。感谢每一位伟大的母亲以及默默支持她们的家人。

“我希望你被爱着，我希望你要快乐。”

END

参考文献

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策划 | 蔺秀云
撰稿 | 王 淼
编辑 | 丁欣怡
排版 | 丁欣怡
图源网络 | 侵删

北师大家庭与儿童发展实验室
我们隶属于北京师范大学发展心理研究院，专注于中国婚姻与家庭研究，致力于将实用有趣的学术成果分享给大家。

本期作者
姜赛
一个喜欢雨和音乐的普通人

画家文森特·威廉·梵高，在37岁的时候开枪自杀，据悉其生前疑似患有双相情感障碍，曾经出现过多次情绪剧烈波动的情况，也曾在精神病医院接受治疗。自2015年起，世界双相障碍协会和国际双相情感障碍基金会将3月30日（也是梵高的生日）设立为“世界双相情感障碍日”。

双相情感障碍更广为人知的名字是“躁郁症”，是一组患病率高、复发率高、自杀率高的精神障碍。严格按照诊断标准来看，双相障碍在人群中的患病率约为1%，将标准放宽到有类似症状后，患病率约为5%。统计数据显示，双相障碍个体的自杀风险至少是普通人群的15倍，有6%~7% 的双相障碍患者死于自杀(Schaffer et al., 2015)。

01
什么是双相情感障碍

定义和表现

双相障碍（Bipolar disorders，BD），也称双相情感障碍，是指既有躁狂或轻躁狂发作，又有抑郁发作的一类心境障碍。它之所以被称为“双相”，是因为患者的心境会在高峰和低谷两极之间来回波动。

在躁狂或轻躁狂的“高峰”期，至少一周（轻躁狂为4天）内每天的大部分时间里，患者在各个方面都表现出“活动增高”的特点。

在心理上，有明显异常的、持续的心情高涨，或变得极为敏感和容易激怒。

在行为上，个体从事的活动明显增加，说话增多，还可能做出一些不计后果的冲动行为（如使用成瘾性药物、参与危险活动、无节制地消费等）。

在思维上，个体可能变得盲目自大或自负，甚至产生幻觉，思考的内容也可能会变得非常跳跃，容易随着情境改变；在生理上，个体的精力变得格外旺盛，对睡眠的需求明显减少。

在抑郁的“低谷”中，患者持续两周以上，在每天的大部分时间里，有明显且持续的情绪低落、兴趣丧失、思维迟缓症状。

个体可能会认为自己没有价值，或是贬低、责怪自己，体验到强烈的无力、无望、无价值感。

个体的食欲、体重、睡眠状况等可能发生明显变化，或出现一些身体上的疼痛。

患者可能产生想要自杀的念头、形成自杀的具体计划甚至实施自杀行为。

双相障碍的类型

双相障碍有不同的类型，主要的类型是双相Ⅰ型和双相Ⅱ型。图片中显示了患者的心境随着时间变化的常见模式。

双相Ⅰ型障碍的患者会有至少一次的躁狂发作；双相Ⅱ型障碍的患者会出现严重的抑郁发作和至少一次的轻躁狂发作。轻躁狂的症状与躁狂相似，但持续的时间更短，也不会严重到损害个体的日常生活，因此也很容易被忽视或是看作某种正常状态，导致误诊，影响治疗。

虽然我们每个人都会短暂地经历悲伤或快乐的阶段，但是对于心境障碍的患者来说，这种心境持续的时间很长，而且会对他们的正常生活产生严重的负面影响，使他们无法维持正常的学习、工作、社交等活动。

02
个体患双相障碍的可能原因

生理因素

基因研究发现，双相障碍的遗传率很高，在20%~45%的范围内(Kerig & Ludlow, 2014)。基因影响着人的生理系统，如大脑额叶和边缘系统的结构，调节情绪的激素的释放等(Fleck et al., 2012)。当遇到一些会带来痛苦的事件时，这些生理系统无法正常发挥作用，使个体表现出各种心理或身体上的症状。

心理社会因素

童年期的创伤性经历会增加孩子患双相障碍的风险。研究发现，患者心理功能受损的程度和住院的次数与遭受情感忽视和虐待的程度有关，在童年期遭受过躯体虐待、情绪忽视的患者在长大后更容易出现情绪问题(Larsson et al., 2013)。

03
应对双相情感障碍，我们可以做什么

从这些线索发现可能存在的问题

在儿童中，双相障碍的预兆常常是一些情绪症状，例如，在一天中出现多次的情绪摇摆循环，极快地从情绪的高峰转向情绪的低谷(Kerig & Ludlow, 2014)。当孩子在一段时间内常常因为一些极小的刺激变得非常愤怒（甚至无法控制地攻击他人），或是情绪极为低落，对所有事情失去兴趣时，需要对孩子的心理状态多加注意。

如何寻求帮助和控制疾病

当出现疑似的严重症状或感觉到生活受到明显影响时，需要及时寻求帮助和治疗。精神专科医院或综合医院的精神科可以做出较为可靠的诊断，并提供对应的治疗方案。药物治疗是双相障碍治疗的必要手段，心理治疗可以作为对药物治疗的补充，帮助解决病症和药物治疗带来的问题。

可以为身边的他们做些什么

双相障碍是一种慢性的、容易复发的疾病，需要长期的护理和关注。与双相障碍的斗争，需要病人和家人朋友的共同努力。那么，作为家人或朋友，可以为他们做些什么呢？

首先，了解双相障碍的知识，减少对患者的误解。双相障碍是一种病理性的障碍，患者在疾病发作期间的“失控”的行为不是因为任性或无理取闹，而是因为疾病，这需要通过治疗来恢复。

其次，为患者提供安全的环境和稳定的支持。例如，关心他们的想法和需求，坚定地陪伴他们，表达对他们的支持和爱。

另外，在关心患者的同时，也不要忽视对自己的照顾。当察觉到压力过大时，可以寻求家人朋友的支持或心理咨询师的帮助，或是参与一些其他的活动来缓解压力。

04
写在最后

凯·雷德菲尔德·杰米森教授在自传《躁郁之心：我与躁郁症共处的30年》中记录了自己的感受：“它什么时候会再次复发？哪些感觉是真实的？哪个我才是真正的我？是那个狂野、冲动、喧闹、充满能量、疯狂诡异的我，还是那个羞涩、退缩、绝望、企图自杀、走向毁灭、疲惫不堪的我？也许两者兼而有之，但我真希望两者都不存在。”

与这样复杂多变的心境共存绝非易事，多试着了解他们一些，多给他们一些时间和支持，双相障碍是可以通过科学的治疗应对和控制的，他们的发展也不会因此受限。就像《Next to Normal》的结尾，女儿对妈妈唱的那样：“正常的生活离我太遥远，只要近于正常就好，那是我愿意尝试的。”

参考文献

董湘萍, 尚倩倩, 张芸, 胥云霞, 陈立芳. (2019). 双相情感障碍患者自我效能感的相关因素研究. 四川医学, 40(01), 47–51.

Alloy, L. B., Abramson, L. Y., Walshaw, P. D., Cogswell, A., Smith, J. F., Neeren, A. M., Hughes, M. E., Iacoviello, B. M., Gerstein, R. K., Keyser, J., Urosevic, S., & Nusslock, R. (2006). Behavioral Approach System (BAS) Sensitivity and Bipolar Spectrum Disorders: A Retrospective and Concurrent Behavioral High-Risk Design. Motivation and Emotion, 30, 143–155.

Çuhadar, D., Savaş, H.A., Ünal, A., & Gökpınar, F. (2015). Family Functionality and Coping Attitudes of Patients with Bipolar Disorder. Journal of Religion and Health, 54, 1731–1746.

Fleck, D. E., Eliassen, J. C., Durling, M., Lamy, M., Adler, C. M., DelBello, M. P., Shear, P. K., Cerullo, M. A., Lee, J. H., & Strakowski, S. M. (2012). Functional MRI of sustained attention in bipolar mania. Molecular psychiatry, 17(3), 325–336.

González, I. A., Echeburúa, E., & Limiñana, J. (2014). Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: A 5-year controlled clinical trial. European Psychiatry, 29(3), 134–141.

Kerig, P. K. & Ludlow, A. (2014). Developmental psychopathology with DSM-5 update. Columbus, Mcgraw-hill publishing company.

Larsson, S., Aas, M., Klungsøyr, O., Agartz, I., Mork, E., Steen, N. E., Barrett, E. A, Lagerberg, T. V., Røssberg, J. I., Melle, I., Andreassen, O. A., & Lorentzen, S. (2013). Patterns of childhood adverse events are associated with clinical characteristics of bipolar disorder. BMC Psychiatry, 13, 97.

Schaffer, A., Isometsä, E. T., Tondo, L., Moreno, D. H., Sinyor, M., Kessing L. V., Turecki, G., Weizman, A., Azorin, J. M., Ha, K., Reis, C., Cassidy, F., Goldstein, T., Rihmer, Z., Beautrais, A., Chou Y, H., Diazgranados, N., Levitt, A. J., Zarate, C. A. Jr, & Yatham, L. (2015). Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: Part I of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder. Australian & New Zealand Journal of Psychiatry, 49(9), 785–802.

Sierra, P., Livianos, L., Arques, S., Castelló, J., & Rojo, L. (2007). Prodromal symptoms to relapse in bipolar disorder. Australian & New Zealand Journal of Psychiatry, 41(5), 385–391.

Sullivan, A. E., & Miklowitz, D. J. (2010). Family Functioning among Adolescents with Bipolar Disorder. Journal of Family Psychology, 24, 60–67.

策划丨蔺秀云
撰稿丨姜 赛
编辑丨张昱凌
排版丨张昱凌
图源网络丨侵删

People with this syndrome exhibit social behaviors and traits considered immature

患有这一综合症的人会表现出被视为不成熟的社交行为和特征。

We can all probably agree that adulting is just hard sometimes. Between paying the bills on time, taking care of the kids and carving out space for social interactions, it all piles up really fast, leaving some of us wishing we could skirt our responsibilities for good.

我们可能都认同成年有时很艰辛。账单、孩子、社交，各种压力纷至沓来，让我们不禁希望能够永远逃避这些责任。

But for some, growing up seems near impossible — so much so, that their immaturity can ruin relationships, hinder employment and have a lasting impact on their mental and physical health.

但对一些人而言，长大似乎是几近不可能的，以至于，他们的这种不成熟会摧毁他们的感情关系、阻碍他们的职业，对他们的精神和生理健康造成持久的影响。

Growing up is particularly difficult for people who have what’s popularly known as Peter Pan syndrome, but what can they do to break the cycle of immaturity and when is it a real problem?

对患有广为人知的“彼得潘综合症”的人而言，成长尤其困难。但他们如何才可以打破这种不成熟的循环，什么时候这才能被视为存在问题呢？

What is Peter Pan syndrome?
什么是彼得潘综合症？

Peter Pan syndrome (PPS), while not a recognized diagnosis, is a popular psychology term used to describe an adult who has difficulty growing up. The term is derived from the fictional character of Peter Pan, a magical boy who never grows old, created by J.M. Barrie in 1902.

彼得潘综合症虽然并非公认的医学诊断结果，但却是一个广为认知的心理学术语，用来描述难以长大的成年人。这一名称源于1902年J.M. Barrie所创作的一个虚构人物，一个永远不会长大的会魔法的小孩——彼得潘。

People with this syndrome exhibit a series of social behaviors, ideologies and traits that are considered immature. In most cases, they may struggle with commitment, maintaining employment, doing chores, keeping up with responsibilities and having purposeful direction in their lives. Although it’s more common in cisgender men and people assigned male at birth (AMAB), anyone of any sex or gender can develop the behaviors associated with the syndrome.

这一症状患者会表现出一系列被视为不成熟的社交行为、意识形态和特征。大多情形下，他们可能很难专一投入、很难维系一份工作，不会做家务，不承担个人责任，人生无富有意义的方向目标。尽管这在顺性别（天生拥有该性别生理特征，与跨性别相对）男性和AMAB（出生指派性别为男性）的群体中更为常见，但任何性别群体中都可能会发展出与这种综合症相关的行为。

“Much like Peter Pan, these individuals experience a failure to launch or a refusal to grow up,” says Natacha Duke, Registered psychotherapist. “There’s sort of an egocentric nature to them and they continuously avoid responsibility and commitment and don’t take on those adult responsibilities that most people do.”

“与彼得潘很相似，这些人会无法正常迈入社会（Failure to Launch“无法启动”综合症，指一些年轻人不愿或无能力承担成人责任或进入成人角色）或拒绝长大”，注册心理咨询师 Natacha Duke表示，“他们有种自我中心的本性，而且他们会一直回避责任和努力，而且不会像大多数人一样承担成人责任。”

Wendy syndrome
温迪综合症

Because of their inability to take on adult tasks, people with PPS will often seek out others who have what’s called Wendy syndrome. Named after Barrie’s fictional character Wendy Darling, who was created in 1904 as Peter Pan’s friend, Wendy syndrome also isn’t an official diagnosis, but a popular psychology term used to describe an adult who is empathetic, nurturing and even self-sacrificing. Although more common in cisgender women and people assigned female at birth (AFAB), anyone of any sex or gender can exhibit these behaviors.

由于无法承担成人任务，PPS患者通常会寻找”温迪综合症“患者。这一名称源自彼得潘的朋友Wendy Darling。温迪综合症同样也并非正式诊断结果，而只是一个常用的心理学术语，用来指代具有同理心，照顾别人，甚至自我牺牲的人。尽管这一综合症常见于顺性别女性和AFAB（出生指派性别女性）群体，但任何性别群体都会发展出与其相关行为。

“People who have PPS tend to gravitate toward people who have Wendy syndrome, people who are highly nurturing and want to be of service to others,” says Duke.

“PPS患者通常会被很擅长体贴照顾他人，想要服务他人的温迪综合症患者吸引。” Duke说到。

“In the beginning, it’s a match made in heaven. You have someone with PPS who’s really fun and charismatic that draws this other person in, and the person who has Wendy syndrome is able to be there for them, support them and offer suggestions to try to better them. But the problem is that it eventually backfires, and the person with Wendy syndrome inevitably starts to feel taken advantage of.”

“在最初，这当然是天作之合。一方是既有趣又富有魄力的PPS患者，另一方被吸引的则是能够支持他们，照顾他们，提供建议提升他们的温迪综合症患者。但问题是，这通常会适得其反，温迪综合症患者不可避免地会感到被利用。”

With the Peter Pan and Wendy syndromes, the relationship ultimately falls apart when both people are at odds with each other’s behaviors.

彼得潘综合症和温迪综合症患者之间的感情，当两人对彼此行为有意见时，这段感情最终将会崩塌。

“People with Wendy syndrome tend to experience emotional burnout because they’re constantly feeling like they’re giving and giving and not getting anything in return,” notes Duke. “At the same time, people with PPS may feel that their partner is controlling, trying to change them or smothering them.”

“温迪综合症患者通常会有一种情绪上的倦怠感，因为他们不断感到自己在付出，但却毫无回报，”Duke说到，“同时，彼得潘综合症患者可能会感到对方控制欲强，总是试图要改变自己或让自己透不过气。”

As people with PPS have difficulty maintaining healthy boundaries, they’ll often jump from one person or relationship to the next in search of people who enable their behaviors and support them in all the ways they have difficulty supporting themselves.

PPS患者通常难以维持健康界限，他们通常会从一个人或一段感情跳到另一个人身边或另一段感情中，去寻找能够纵容他们行为，以他们自身无法企及的方式为他们提供支持的人。

“What happens is that in the end, there’s never really any learning happening on either side,” says Duke.

“而最后，双方实际上彼此都从未学到任何东西，”Duke说。

Is Peter Pan syndrome real?
彼得潘综合症真实存在吗？

Although Peter Pan syndrome isn’t a diagnosable condition, it has quite a bit of overlap with narcissistic personality disorder (NPD). While people with NPD exhibit a similar pattern of selfishness as people who have PPS, they also tend to hold a much higher degree of self-importance and entitlement.

尽管彼得潘综合症（PPS）并非一种可诊断的病症，但却与自恋人格障碍（NPD）有很多重叠之处。NPD患者表现出同样类型的自私，而PPS患者往往还会有着远远更高程度的自以为是和特权感。

“With NPD, the person is not just egocentric but there’s a greater sense of manipulation,” clarifies Duke. “Someone with NPD tends to be very sensitive to criticism and can turn to rage in a flash.”

“NPD患者不仅只是自我为中心，而且还有更强的操纵意识，” Duke解释说，“NPD患者还往往对批评非常敏感，而且这种敏感会在一瞬间转变为愤怒。”

People with PPS may not be so quick to anger or revenge, but they do tend to be avoidant when it comes to conflict resolution and are more apt to rely on unhealthy coping mechanisms.

PPS患者可能并不会如此快速愤怒或报复，但在需要解决冲突时，他们往往会选择逃避，而且更易于采用不健康的应对机制。

“There’s this tendency to want to escape and avoid commitment,” says Duke.

“这里就看到了他们的倾向：他们倾向于逃避，倾向于躲避专一。”Duke说。

The Cause Of Peter Pan Syndrome
彼得潘综合症起因

It's hard to tell what exactly causes someone to want to avoid responsibilities on this great scale, but there are a few theories.

很难确切说有哪些原因导致了一些人如此严重逃避责任，但在这方面的确有一些理论。

A Spoiled Childhood.
被宠溺的童年

You may know someone whose parents rarely said "no." They may have seldom disciplined their child or taught them life skills, and when they became adults, their parents may have still coddled them. While children should have a childhood to call their own, being raised without any boundaries or responsibilities can lead to not wanting to take responsibility. The sudden shift from having everything done for you to have to work and pay bills can be jarring for many people. They were not gradually introduced to adult concepts, and avoidance – coupled with enabling from others – kept them from transitioning into functioning adults.

你可能知道这么一个父母对其几乎百依百顺的人。其父母可能几乎从未教过孩子规矩，也从未教过孩子生活技能。当这个孩子成年后，其父母可能依旧宠你他。虽然说孩子应该有自己的童年，但是如果不设立界限或责任，那么就会导致孩子不想承担责任。从一切都被安排好，到需要自己工作和支付账单，这种天翻地覆的变化对很多人而言都是可怖的。他们并没有被逐步教导一些成人概念，他们的回避，辅以其他人的纵容，则会让他们无法逐渐过渡演变为正常的成年人。

An Abusive Childhood.
虐待型童年

On the other end of the spectrum, someone who was abused as a child may feel like they need to "catch up" on their childhood once they became an adult. They're away from their parents and have more control over their life, so they may regress into a child to feel safe. Perhaps the most famous example is the King of Pop, Michael Jackson. He lived through an abusive childhood and was pushed to be a star. As he grew up, he wanted to regress into the role of a child. He named his estate the Neverland Ranch, and it wasn't unheard of for him to dress up as Peter Pan.

而这一谱段的另一端，则是童年时曾遭受虐待之人。他们可能觉得自己在成年后，需要弥补自己的童年。他们远离了父母，而且对自己生活有更多控制权，因此他们可能会退行至童年角色，以此来给自己一种安全感。可能最著名的例子就是摇滚天王迈克尔·杰克逊了。他童年时饱受虐待，被逼迫成为明星。长大之后，他想要重新退行到孩子角色，他将自己的宅邸命名为永无乡牧场，（永无乡是彼得潘居住的海岛名称），而且据说他也曾装扮成彼得潘的样子。

Yearning For Nostalgia.
怀旧

Feeling nostalgic for your childhood is a phenomenon experienced by many people, not just those who have Peter Pan Syndrome. There is something comforting in remembering and wanting things from when you were growing up. However, someone with Peter Pan Syndrome can become obsessed with this feeling and recreate it. They may promote shows, music, and games from that era, and many discuss how society has changed for the worse. It's okay to be nostalgic, but when you're looking back too much on the past and view the present as somehow lesser or negative, you may not see what's ahead or fear embracing the changes in the world and in yourself.

很多人都曾怀念童年，并不仅仅只是PPS患者们。回忆并渴望再次得到童年时期的一些东西，这会给人一种抚慰感。但彼得潘综合症患者却会执迷于这种感受，而且会将其重现。他们可能会强烈安利那个时代的节目，音乐和游戏，而且很多人还会谈论社会如何世风日下。怀旧并无不妥，但当你过于沉溺往昔，对当下只是失望不满，那么你可能就无法看到未来，或害怕拥抱世界和自身所发生的变化。

Economic Distress.
经济困境

In recent years, jobs and their paychecks seem to be taking their toll on some. Many workers are faced with long hours, little pay, and greater difficulty with reaching and progressing toward life goals due to these factors. If one cannot progress, one may instead regress. They may feel they need an escape from their lives and their realities. Escapism can be a good thing from time to time, but when you're not taking on any responsibilities, it can become a huge problem.

近年来，一些人似乎备受职场和薪酬之困。很多职员面临着工作时间过长，低薪酬等问题，而且这些因素又导致他们难以向前迈进实现个人人生目标。如果一个人无法前进，那么可能就会退行。那么你可能会觉得自己需要逃离自己生活和现实。逃离主义有时会有益，但当你不承担任何责任时，就会成为一个巨大的问题了。

Adult Skills Not Being Taught.
未被教导成人技能。

You may have heard the term "adulting" before. This is a term used to describe basic adult skills and adult trials. Examples include making your own doctor's appointment, doing your taxes, and paying your bills. The term is mostly used ironically, but some people are serious about it. In today's world, it's easy to see why. Many schools don't teach adult skills and how to become a productive part of society. Because people feel ill-equipped to be adults, some may choose instead to not take on adult responsibilities.

你可能听过“Adulting”这个词。它是指基本的成人技能和尝试成人角色。比如：自己预约医生，自己报税，自己支付自己的账单。这个词通常是做反语使用，但一些人也对其很重视。在当今世界，很容易明白为什么。很多学校并不教成人技能，以及如何成为社会有用的一员。因为觉得自身能力并不足以应付成年角色，因此一些人可能就会选择逃避这些成年责任。

Other contributing factors may include childhood trauma. And while the road to Peter Pan syndrome may look different for everyone, social pressures and online acceptance of youthful behavior, freedom and adventure often play supportive roles in developing such behaviors.

其他一些因素可能还包括童年创伤。尽管彼得潘综合症起因因人而异，社会压力，网络上对青少年般行为，自由和冒险行为的认可度等，通常都会助长彼得潘综合症相关行为的形成 。

Peter Pan syndrome warning signs and symptoms
彼得潘综合症警示迹象与症状

Regardless of the potential contributing factors for developing this syndrome, at the core of these behavioral patterns exists a difficulty with distress tolerance or the ability to tolerate uncomfortable feelings.

尽管存在各种潜在的助长因素，但这些行为模式的核心却是难以忍受痛苦，无法忍受不适感受。

“These uncomfortable feelings can be associated with anxiety, sadness, loneliness or even when we’re being criticized,” states Duke. “For people with Peter Pan syndrome, their distress tolerance is very low, which leads them to avoid certain situations because there’s this tendency to not be able to hold onto or tolerate these more difficult feelings.”

“这些不适感受可能与焦虑，悲伤，孤独或甚至被批评相关，” Duke说，“彼得潘综合症患者的痛苦耐受度非常低，这就导致他们会因为无法忍受一些较难处理的感受，而回避某些特定情形。”

Symptoms Of Peter Pan Syndrome
彼得潘综合症症状

As this is not a clinically classified syndrome, there is no official list of symptoms to identify individuals who have this condition. Below are a few symptoms and their explanations.

由于这并非正式医疗病症，因此并没有正式的诊断症状对照表。以下是该综合症的一些症状以及相关说明。

Lack Of Career Interest.
对工作无兴趣

Many jobs are not fun. It’s understandable why a person would not be interested in having a career if they do not enjoy their job or see others struggling with work fulfillment. However, it’s a part of life. Someone with Peter Pan Syndrome may be unmotivated to get a job. When they do have a job, they may slack off, put little effort into advancing their careers, or continually get fired from different jobs. Or they may have a part-time job and refuse to work full-time; without having to work full-time, they can still participate in escapism.

很多工作都并不有趣，而且如果看到有人因为不喜欢自己工作或因为看到其他人很难在工作中获得圆满感，从而对职业不感兴趣，这完全可以让人理解。但这是生活的一部分。彼得潘综合症患者可能完全没有找工作的主动性。当他们的确找到一份工作时，他们通常会懈怠，毫无上进心，或不断在不同工作中被开除。或者他们可能选择兼职而非全职。不需要全职工作，他们就依旧可以践行“逃离主义”。

Not Being Able To Handle Situations.
无法应对棘手情形

As adults, we face stressful situations that we must learn how to handle. However, a person with Peter Pan Syndrome may find it hard to deal with these situations. Instead, they may scream and throw an adult tantrum, or they may yell to resolve problems instead of having a proper conversation, or they may simply avoid the problem altogether. Most people have an occasional breakdown, so just because someone did this once doesn't mean they have Peter Pan Syndrome.

作为成年人，我们会面对一些我们必须学会如何应对的高压力情形。但彼得潘综合症患者可能发现自己很难应对这些情形。相反，他们可能试图以大喊大叫，大发脾气或怒吼他人的方式来解决问题，而不是通过正当对话的方式。他们可能还会选择干脆回避整个问题。大多数人都偶尔会崩溃，只是因为一个人这样做过一次，并不意味着他就患有彼得潘综合症。

Trouble With Commitment.
难以专一投入

Someone with Peter Pan Syndrome may be interested in relationships or sex, but not for long. They may get into casual relationships or promise that they'll be committed, then break up with their partner after a short period. While there are plenty of reasons why people may not want to be in a committed relationship, it can also sometimes be a symptom of Peter Pan Syndrome.

彼得潘综合症患者可能会对恋情或性爱感兴趣，但却不会持久。他们可能会随便就开始一段感情，并许诺会专一，但很快就会与对方分手。尽管人们有很多理由不进入一段专一稳定的感情，但有时这也可能就是彼得潘综合症的症状之一。

Drug And Alcohol Abuse.
吸毒和酗酒

Alcoholism is not uncommon for adults who have Peter Pan Syndrome. They want an escape, and alcohol or drugs provide it. During a person's teens and early adulthood, many people may party, drink a lot, and experiment with drugs. However, if this is still regularly happening far into adulthood, then the person may have an addiction or doesn't want to take on adult responsibilities.

彼得潘综合症患者中不乏酗酒者。他们想要逃离，酒精和毒品就为他们提供了一种逃脱感。在一个人的青少年和刚成年时期，很多人可能会参加派对，大量饮酒，尝试毒品，但在进入成年阶段很久之后如果依旧经常发生，那么这个人可能就已经成瘾，或者并不想承担成人责任。

Unreliable.
不可靠，不可信赖。

Someone with Peter Pan Syndrome is often unreliable. They may promise to do something for you, and when the time comes, they're nowhere to be found. If they make plans to do something with someone, they may bail on those plans often. They may make an underwhelming excuse or be someone who doesn't bring it up at all. Look for this to be a constant pattern in a person's life.

彼得潘综合症患者通常并不可靠。他们可能会做出许诺，但当需要兑现时，他们就会消失得无影无踪。如果他们计划和某人一起做某事，他们可能经常会反悔。他们可能会找一个蹩脚的借口，或对该事绝口不提。注意这是否是一个人的常见行为模式。

It's Everyone Else's Fault.
都是其他人的错。

Taking responsibility is a difficult thing for many people to do, but someone with Peter Pan Syndrome may rarely or never take responsibility for their actions or mistakes. Instead, it's typically another person's fault, even if all the evidence points to the person with Peter Pan Syndrome.

对很多人而言，承担责任都并非易事，但彼得潘综合症患者却几乎很少或从不为自己的行为或错误承担责任。相反，他们通常会说是其他人的错，尽管所有证据都表明是他自身的错。

Doesn't Want To Improve.
不想提升自我。

Finally, someone with Peter Pan Syndrome usually doesn't want to improve themselves. They may never self-correct or want to grow as a person. Instead, they may want to remain as carefree as possible with as few responsibilities for the foreseeable future.

最后，彼得潘综合症患者通常不想自我提升。他们可能从未自我矫正，从未想要成长为更好的人。他们只是想要在可预见的未来内，尽可能摆脱责任牵绊，尽可能无忧无虑。

These are just a few examples. Some adults may have a few symptoms or tendencies but may not be full-blown Peter Pan. As this isn't a recognized syndrome, it's a bit subjective. However, if they exhibit these symptoms to an extreme degree, they may be experiencing this condition.

以上只是寥寥几例而已。一些成年人可能具有一些症状或倾向，但可能并非完全就患有彼得潘综合症。由于这并非公认病症，因此有些主观。但如果他们所表现出的这些症状已经到了极端程度，那么可能就患有这一综合症。

Signs in a relationship
感情中的迹象

In the earliest stages of a relationship, people with PPS may attract a lot of attention because of their charisma, sense of adventure and fly-by-the-seat-of-their-pants mentality. They’re fun to be around and fun to explore new activities with, and their childlike nature is almost endearing.

在一段感情最早阶段，PPS患者通常会因为自身魄力，冒险精神和随性思维而备受关注。与他们相处或一起探索新活动都很有趣，他们孩子一般的本性也很招人喜爱。

On the surface, it may feel natural to help them when they’re in a bind or support them when they inevitably fall into a rough spot with work, family or other adult responsibilities. Often, someone with this syndrome may ask for help with such things because of a low level of distress tolerance — and if someone enables that behavior by taking ownership of those responsibilities, a codependent relationship is often the outcome.

表面上，当他们处于困境时，你可能就感觉自然而然要帮助他们；当他们在工作，家庭或其他成人责任方面遇到问题时，也很自然想要为他们提供支持。通常，彼得潘综合症患者在上述问题方面寻求帮助，是因为他们对痛苦的耐受度很低——如果有人帮他们承担这些责任，从而纵容对方这种行为，那么通常就会导致病态共同依赖型感情模式。

“But what typically happens over time in these relationships is that the person supporting the individual with PPS gets to a point where they say, ‘Enough is enough,’” says Duke. “The person with PPS has too much reliance on their partner to handle difficult tasks like writing a resume, paying a bill or looking for a job. That can get old for the supporting partner really quickly.”

“在这类感情关系中，通常随着时间推移，一直在帮助PPS患者的那一方会逐渐觉得：够了！” Duke说，“患有PPS的那一方在面对困难任务时往往过于依赖另一方，比如写简历，支付账单或找工作等。一直扮演支持角色的那一方很快就会厌倦。”

When conflicts arise or the person who has PPS is confronted about their lack of maturity, even having a healthy, productive conversation may prove to be difficult.

在这种感情中，当产生冲突或另一方直截了当质问PPS患者为何如此不成熟时，他们即使只是想要一段健康，有建设性的对话，也是很难实现的。

“There’s a lot of blaming other people for their shortcomings or their behaviors and a lack of personal insight,” explains Duke. “Without being able to tolerate distress, it’s really hard to hear any criticism and therefore it becomes really difficult to have mature conflict resolution.”

“PPS患者会习惯将个人缺点或个人行为归咎于对方，并且缺乏内省能力。” Duke解释说，“由于无法忍受痛苦感受，他们往往听不得批评，因此和他们很难以成熟的方式解决冲突。”

Because of this, you may see someone with PPS jumping from one relationship to the next in a very short-lived amount of time. Ghosting a relationship is also a common practice for people with PPS.

鉴于此，你可能会看到一些PPS患者在很短时间内不断从一段感情跳入另一段感情。玩消失，也是PPS患者在结束感情时的一种常见行为。

Signs at work
职场中的迹象

Because there tends to be a lack of commitment, people with PPS may often have problems with employment and difficulty handling authority. Even starting the application process may prove to be difficult, but if they do find employment and they’re faced with conflict, they may abandon ship and run to the next job they can find without taking accountability for their actions.

由于PPS患者往往缺乏专一性，他们通常存在就业问题，或难以应对权威。甚至开始申请工作对他们来说都存在困难，但如果他们找到了工作但面临冲突时，他们可能就会撂挑子不干，迅速找下家，并且对个人行为不承担任何责任。

“Part of being an adult is accepting that there are things in life that are very mundane. You have to sometimes go to work when you don’t feel like it,” says Duke. “People who have this syndrome don’t accept that.”

“作为成年人，需要接受生活中一些事情就是非常无聊这一事实。有时虽然你并不想，但也必须要去工作，” Duke说。但彼得潘综合症患者并不接受这一点。

How to overcome Peter Pan syndrome
如何克服彼得潘综合症

You can’t remain childlike and exist in goblin mode forever — at least not if it’s causing serious problems in your relationships or your overall ability to function. Like most things related to psychology, the characteristics of Peter Pan syndrome exist on a spectrum, and what’s problematic for some may not be problematic for others.

你不能一直保持儿童状态，一直生活于小精灵模式中，至少当这样会给你的感情和整体机能造成严重问题时，你不能这样。同很多与心理学相关的概念相同，彼得潘综合症的各种特征也存在在一个谱段上。一些对某些人存在问题的特征对其它一些人可能就并无大碍。

“Sometimes, these types of behaviors are non-problems if they don’t affect someone’s life or functioning in at least one significant area,” notes Duke. “With Peter Pan syndrome, often someone else is bringing you to therapy or encouraging you to go to therapy because there is a lack of personal insight into what’s really happening.”

“有时，如果这类行为并没有在任何关键领域影响到别人的生活或正常机能，那么它们就并无问题。” Duke说，“对于彼得潘综合症患者而言，通常是别人带他们去接受心理咨询或鼓励他们接受心理咨询，因为他们自身通常缺乏自省能力，无法认识到事实。”

When a loved one has Peter Pan syndrome
当你爱的人患有彼得潘综合症

Broaching the topic and pointing out the issues associated with this syndrome can be difficult.

According to Duke, “In general, people are very defensive because there is a lack of insight into the difficulty that surrounds their behaviors.”

提起这一话题并指出与这一症状相关问题，可能会很困难。

And while you can’t force someone to get involved in therapy, you can set your own personal boundaries to protect yourself and hold the other person accountable when things don’t go well. Stop enabling the person. Do not give them handouts or support unless they support you back. Healthy relationships are reciprocal, not one-sided.

尽管你无法强迫一个人参加心理咨询，但你可以为自己设定个人界限，保护自己，并在对方侵犯你的个人界限时让对方承担后果。不要继续纵容对方。不要继续再救济或支持对方，除非对方也对你提供支持。健康的感情关系是相互付出，而非单方面付出的。

“If there’s a behavior the person is exhibiting and you’re uncomfortable with it, or they keep lashing out at you or they’re treating you disrespectfully, the best thing you can do is to start by labeling that behavior as ‘not OK’ because of your own self-respecting boundaries, and then second, to encourage therapy,” advises Duke.

“如果对方表现出某种让你感到不适的行为，或对方不断向你发脾气，或他们对你不尊重，你的最佳做法是，首先告诉对方这些行为‘不可以’，因为他们侵犯了你出于自我尊重而设立的健康个人界限。第二步，鼓励对方接受心理治疗。” Duke说。

“If a person doesn’t want to go to therapy and doesn’t want to make any changes, then you need to determine what your own barometer for that behavior is and what you are and are not OK with accepting.”

“如果一个人不想接受心理治疗，也不想做出任何改变，那么你需要判断自己对其行为的接受尺度，以及你可以接受什么，不可以接受什么。”

Suggesting individual, family or couples therapy could be a beneficial start for all involved because it will help shed light on how their accumulated life experiences have gotten them to this point and how some of the behaviors they exhibit are not serving them well.

一开始，可以建议个人/家庭/夫妻心理咨询，这对所有相关者都有益，因为这有助于让他们看到一直以来的生活经历是如何让他们走到这一步，以及他们所表现出的一些行为是如何给他们带来损害的。

“For therapy to work, they need to be willing to recognize and discuss what changes they want for their life and the cost of continuing if they do not make these changes,” she adds.

“想要心理咨询奏效，患者必须愿意认可并讨论他们想要做出的改变，以及如果不做这些改变，他们所必须付出的代价”

When you have Peter Pan syndrome
当你自己患有彼得潘综合症

Since Peter Pan Syndrome is not a clinically recognized medical diagnosis, there is no “official” treatment, but some types of therapy – including cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) – have been shown to help.

由于这一综合症并非正式医学诊断，因此并没有正式疗法。但一些心理咨询类型——包括意识行为疗法（CBT）和辩证行为疗法（DBT）——都被证明有效。

CBT helps patients learn to think differently about situations, whereas DBT is a form of CBT designed especially for those individuals with more extreme emotions. CBT is probably the most widely used form of psychotherapy because it works well for a variety of mental health conditions, including people experiencing Peter Pan Syndrome. DBT has been shown to help patients reduce substance abuse, increase confidence, and better deal with their emotions, among other things.

CBT可以帮助患者学会以不同方式思考具体情形，而DBT则是CBT中一种专门针对情绪更极端患者的咨询方式。CBT可能是应用最广泛的心理咨询形式了，因为它在各种各样精神疾病中都卓有成效，其中就包括彼得潘综合症患者。DBT也被表明可以帮助患者减少物质滥用，增加自信，更好地应对个人情绪等。

KEY POINTS
要点

Breathlessness, chronic fatigue, and other long-COVID symptoms may slowly improve. However, brain fog may worsen with time.
呼吸困难，长期疲劳以及其他新冠长期后遗症（长期新冠）症状可能会缓慢好转，但脑雾却会逐渐恶化。

Although brain fog in long COVID may look like ADHD, Mild Cognitive Disorder, or other neurological disorders, the underlying mechanisms differ.
尽管新冠长期后遗症中的脑雾症状看起来可能像是ADHD（注意力缺陷多动障碍，多动症），轻微认知障碍或其他神经障碍，底层机制却并不相同。

An ADHD medication, Guanfacine, and antioxidant, NAC, were used on a small sample to treat long-COVID brain fog.一种ADHD药物，胍法辛和抗氧化剂NAC在一个小规模样本中被用于治疗新冠长期后遗症脑雾症状。

Future treatments should target brain inflammation to address the currently known causes of long-COVID cognitive deficits.
在应对新冠后遗症认知缺陷症状的当前所知原因方面，未来治疗方案应围绕大脑炎症来治疗。

Sufferers of long COVID experience symptoms that may persist for weeks, months, or even years after contracting the COVID virus. Some researchers and clinicians have listed as many as 200 long COVID symptoms. The most frequently reported symptoms are breathlessness, chronic fatigue, and brain fog. The breathlessness, chronic fatigue, and other symptoms may slowly improve; however, brain fog may worsen with time.

新冠长期后遗症患者所表现出的症状可能会延续数周、数月甚至数年。一些研究人员和临床医生已经列出了高达200种新冠长期后遗症症状。人们报告最多的症状是呼吸困难、长期疲劳和脑雾。前两种和其他症状可能会缓慢好转，但脑雾症状却可能会逐渐恶化。

Brain fog is a foggy term. It is not specific, which makes it challenging to study. Another way of describing the commonly reported cognitive issues is cognitive impairment or deficits. I also don't believe that conceptualizing the post-COVID brain changes as impairments, deficits, or dementias is accurate. Post-COVID cognitive changes may look like other neurological disorders, such as dementia, ADHD, or traumatic brain injury. But it is important to keep in mind that the underlying biological mechanisms may not be identical. This is an important consideration for treatment.

脑雾，是一个并不明确和具体的术语，因此对这一症状的研究也就充满挑战。对于普遍报告的认知问题，另一种描述词汇是认知损伤或缺陷。但我也不认为将新冠后的大脑变化定义为损伤、缺陷或痴呆是精准的。新冠后认知能力变化可能看起来像是其他的神经障碍，如痴呆，ADHD或创伤性大脑损伤等。但需要记住其底层生物机制可能并不相同。这是治疗中的一个重要考量因素。

Many people who suffer from neuro-long COVID indeed perform like those with mild cognitive impairment on neuropsychological assessments. This is certainly concerning enough for researchers to find mechanisms and treatments based on this understanding.

受神经性新冠长期后遗症困扰的人的确在神经心理评估中表现得类似轻微认知损伤患者。这足以引起重视，研究人员需要基于这一发现来寻找致病机制和治疗方案。

These long-COVID symptoms can look like attention deficit disorder (ADHD). The hallmark symptoms of ADHD are difficulty focusing, short attention span, difficulty multitasking, and executive dysfunction. One can use the vague term "brain fog" to also describe a person's experience with ADHD. Pathologies in the brain's dopamine and norepinephrine systems have been proposed as the underlying mechanisms of ADHD. Hence, the management of ADHD symptoms has focused on amplifying the dopamine and norepinephrine brain signals.

这些新冠长期后遗症症状看起来会像是ADHD（注意力缺陷障碍）。ADHD的标志症状是难以集中精力、注意力集中时间短，难以同时处理多项工作以及执行功能障碍（大脑控制情绪、行为和想法的功能存在障碍，其中包括难以规划、启动和完成需要达成某种目标的活动等）。人们也可以用脑雾这一模糊术语来描述ADHD的患病体验。大脑多巴胺和去甲肾上腺素系统疾病被认为是ADHD的底层机制。因此，对ADHD症状的管控一直是基于放大多巴胺和去甲肾上腺素大脑信号这一方法。

A new study
一项新研究

To connect all these observations, a study on a very small sample size tested a currently used ADHD medication for long COVID (N=12).1 Guanfacine was approved for the treatment of ADHD in 2009. It was developed in the lab of Amy Arnsten, one of the authors of this report. The medication is combined with N-acetylcysteine (NAC-600 mg), an antioxidant for treating Traumatic Brain Injury (TBI). Eight out of the 12 patients studied reported improvements in memory, organizational skills, and ability to multitask. No objective tests were used to verify the patients' reported improvements. Two patients were unavailable for follow-up; the other two discontinued the medication due to intolerable side effects, such as low blood pressure and dry mouth.

为将这些发现联系起来，一项在小规模样本(12人)中开展的研究测试了将当前所用的一种ADHD药物用于治疗新冠长期后遗症。2009年，胍法辛被批准用于治疗ADHD。该药物由 Amy Arnsten 的实验室研发。Amy Arnsten也是本报告的作者之一。该药物与N-乙酰半胱氨酸（NAC-600mg）（用于治疗创伤性脑损伤的一种抗氧化剂）共同使用。12位受试者中有8位报告了记忆力、组织能力和多任务处理能力有所改善。但并未开展客观性测验来确认患者所报告的这些改善。两位患者无法参加后期追踪，另外两位因为无法忍受的副作用，比如低血压和口干症而终止服用药物。

This is not a placebo-controlled study and is considered anecdotal. Double-blind and placebo-control studies with much larger samples should be conducted before prescribing ADHD medications to long COVID sufferers. Also, one of the report's authors receives royalties from the U.S. sales of Intuniv (extended-release guanfacine).

该研究并无安慰剂对照组，被认为只是基于主观观察和汇报。在将ADHD药物用于新冠患者之前，需要在更大样本中开展双盲测试和安慰剂对照研究。另外，本报告的作者之一也是美国Intuniv（缓释胍法辛）销售市场中专利使用费受益人之一。

As explained earlier, the proposed mechanism of ADHD cognitive symptoms (attention, focus, and memory) is dopaminergic/adrenergic pathologies. We have begun to understand the underlying mechanisms of long COVID. A recent paper proposed six underlying mechanisms of long-COVID cognitive changes:

如前所述，ADHD认知症状（注意力、聚焦力和记忆力）的致病机制被认为是多巴胺/肾上腺素疾病。我们对新冠长期后遗症的致病机制也开始有了一定理解。一项近期的论文提出了新冠长期后遗症认知能力变化的6种底层机制：

1. Immune system's response to the virus increases molecules such as cytokines and chemokines, which can put the brain on fire (neuroinflammation).

免疫系统对病毒的反应增加了细胞因子和趋化因子等分子数量，这些分子会引发大脑炎症（神经炎症）

1. The virus itself can directly infect the brain.

病毒本身会直接感染大脑。

1. The virus can give rise to an autoimmune response where the brain attacks its own cells.

病毒会引发一种自身免疫反应，让大脑攻击自己细胞。

1. The virus can wake up dormant herpesviruses, like the Epstein-Barr virus, damaging the brain and leading to cognitive impairments.

病毒会唤醒潜伏的疱疹病毒，如EB病毒，这会损伤大脑，引发认知受损。

1. The virus and the resulting biological response can impair blood circulation, which provides the conduit of nourishments to brain cells.

病毒和其所导致的生物反应会损伤血液循环，从而影响对大脑细胞的营养输送。

1. Multi-organ dysfunctions in severe COVID cases can cause hypoxemia (a below-normal level of oxygen in your blood, specifically in the arteries) and metabolic disturbances that deprive brain cells of oxygen and nourishment and, in turn, provoke cell death.

新冠重症患者种的多器官功能障碍会引发低血氧（血液中，尤其是动脉中氧含量低于正常水平）和新陈代谢紊乱，从而导致大脑细胞缺乏氧分和营养物质，从而引发细胞死亡。

Where can we go from here
未来可以依循怎样的研究方向

It would be more beneficial to target the currently known mechanisms of brain changes in long COVID to search for efficient and effective treatments. Specifying the exact brain changes in long COVID using sensitive neuropsychological tests is crucial. The symptoms reported by long COVID patients, such as memory problems, might result from dysfunctions in other faculties, such as attention, default mode network, processing speed, neuroplasticity, neuro-inflammation, etc. Also, following the trajectory of these cognitive symptoms is essential. Cognitive deficits do not always lead to dementia or permanent decline.

建议在寻找高效和有效治疗方法时，应着眼于新冠长期后遗症大脑变化的目前已知致病机制。通过敏感神经心理测试来明确界定新冠长期后遗症中的大脑变化，这一点至为关键。新冠长期后遗症患者所报告的症状，比如记忆问题等，可能来自于其他机能的功能失调，比如注意力、默认模式网络、处理速度，神经可塑性，神经炎症等。另外，追踪这些认知症状的发展轨迹也至关重要。认知缺陷并非都会导致痴呆或永久退化。

As a sufferer of long COVID since 2020, the problem with my long-COVID brain is not one of memory deficit. It is more like the time scale used by the brain is much slower than the actual time. By the time the next moment begins, I am still processing the previous one. Or I stop processing the previous one in favor of hoping to catch the next one fully.

作为自2020年以来新冠长期后遗症患者，我的新冠后大脑的问题并非是记忆缺陷，而更像是我的大脑所采用的时间标尺要比实际时间缓慢。在下一时刻开始之前，我还依旧在处理之前时刻的信息。或者我会为了充分赶上下一时刻，而直接终止对之前信息的处理。

Also, the long-COVID brain struggles with multitasking, tasks requiring a long attention span, and intense focus. The byproduct of this slowing of brain machinery is memory deficits. While using strategies to improve memory would help, addressing the more direct mechanism would be better.

另外，新冠长期后遗症患者大脑会难以同时处理多项任务，或者需要长时间集中注意力的任务，或者精力的高度集中。大脑机器变得迟缓所带来的副产品是记忆缺陷。尽管一些记忆提升策略会有帮助，但如果能针对其更为直接的产生机制，则会更有效。

If you’re the parent of a teen, chances are you have had plenty of occasions to feel frustrated, confused and worried about how s/he is behaving. That is just how parenting teens goes – as they struggle, we do too.

如果你有一个十几岁的孩子，那么可能很多时候你都会感到挫败，疑惑和担忧。这是养育青春期孩子的正常现象——当他们在痛苦挣扎时，我们也同样如此。

The pandemic of COVID-19 has brought myriad parental challenges from distance learning to social isolation. Pandemic parenting has allowed many of us to see first hand more of what our teen’s life is, leaving us even more confused about what’s a normal reaction to a challenging time, and what’s not.

新冠疫情为父母带来了各种各样挑战，从网课到社交隔离等。疫情期间也让我们很多人对自己青春期孩子的生活有了更多的亲身体会，但同时也让我们更加困惑，不知道对这一棘手时期，哪些反应正常，哪些属于不正常范畴。

Teenage angst is the feeling of being overwhelmed, anxious, rejected, or even unwanted. Teens can feel better by understanding what is common, and what are greater concerns than the average teenage development.

青春期焦虑是一种感到无力应付、焦虑、被拒绝甚至被嫌弃的感受。如果青少年们理解哪些是正常现象，哪些远非青少年发育过程中普遍现象，应该引起重视，这会有助于改善他们的感受。

What is Teenage/Teen Angst
什么是青春期焦虑

Angst is a concept derived from existential anxiety referring to anxiety about one’s existence. Teenage angst involves frustration, rebellion, attitude and an overall irritable outlook on life. The teenage years are a period in your child’s life when they move beyond innocent childhood and start to test limits and boundaries as they approach adulthood. Teenage angst can happen as a result of disappointment in being told no when limits and boundaries are denied. Teenagers crave independence and freedom without the true ability to understand or predict all of the responsibilities that get factored in, as brain development is not fully complete until 24 years of age.

Angst（焦虑）是一个源于存在焦虑的概念，存在焦虑是指一个人关于自身存在而产生的焦虑。青春期焦虑包含挫败感、叛逆、不配合和整体上对生活持易怒暴躁态度。青少年时期，孩子离开单纯童年时期，随着接近成年，开始不断测试限度和界限。当被拒绝时，他们会感到失望，然后就可能会让他们感到青春期焦虑。青少年们渴望独立和自由，但却尚无真正能力去理解或预测所涉及到的所有责任，因为大脑直到24岁才会完成发育。

What Causes Teen Angst
青春期焦虑的起因

Teens experience angst for many different reasons.

青少年焦虑的产生有多种不同原因。

Some of these changes are obvious because they affect the size and shape of our teen’s bodies and voices. The fact that our teens struggle at times with these changes is easy to understand because we can see the changes too. Their bodies develop quickly, their voices change, and their skin often becomes an intense focus as their hormones drag their young bodies to adulthood.

一些变化很明显，它们发生于孩子的身体和声音。这些变化有时会让孩子觉得难以应对，因为我们也能看到这些变化，所以我们能很容易理解。随着荷尔蒙将他们的身体拽入成年时期，他们的身体飞速发育，他们声音发生变化，他们通常会对自己的皮肤密切关注。

Other changes are happening internally. Teenagers’ brains go through tremendous growth and rewiring, a phase of growth second only to infancy. As the teen brain neurologically “updates,” the “lower” more emotional regions update before the “higher” more cognitive ones.

但在他们身体内部，也在发生着其他变化。这一时期，青少年的大脑进入仅亚于婴儿时期的飞速发育和重塑期。随着青少年大脑神经系统的升级，较低级的情绪区域的升级要早于较高级的认知区域。

Because of this linear brain development, teens are exposed to intense and mature emotions without the benefit of a fully mature thinking brain. The part of the brain that manages insight, judgment and behavioral control (the prefrontal cortex) will take many more years to fully update.

由于大脑的这种线性发育过程，青少年需要面对强烈和成熟的情绪，但大脑思考能力却尚未完全成熟。负责管理洞察力、判断力和行为控制（前额叶皮层）的大脑区域还需要很多年才能完全升级。

There may also be situational causes of teen angst, like lack of sleep. With all the brain development going on during this time, teens need adequate sleep. NIMH recommends teens get about 9-10 hours of sleep a night. With proper care and support they’ll be a successful adult in no time. Teenagers face a lot of changes throughout this time, from the change of schools, friendships, and even their interests. They begin to find themselves thinking more and more about the future, which can bring on feelings of anxiety and uncertainty.

另外还有一些客观原因，如睡眠不足。这段时期大脑飞速发育，因此青少年需要充足睡眠。美国国家心理健康研究所建议青少年睡眠时间每晚应在9-10个小时。如果得到充分的照顾和支持，他们很快就会成为一个成功的成年人。在这一时期，青少年面临很多挑战，从学校的变化，到友情的变化，甚至自身兴趣爱好也会发生变化。他们开始发现自己开始更多地思考未来，这可能也会带来焦虑感和不确定感。

Teens feelings therefore are intense, driving powerful creativity and motivation, but also frustration and overwhelm. These emotional changes can be scary for teens, and are fundamental to how we understand what is teenage angst.

因此，青少年的感受是非常强烈的，从而会催生强大的创造力和驱动力，但同时也会带来挫败感和力不从心感。这种情绪上的变化对青少年来说会是很可怕的，而且也是我们理解青少年焦虑的基础所在。

Angst can span a gamut from normal insecurity to more acute feelings of anxiety or apprehension that can be accompanied by depression. It can also be a frustrating, painful and frightening challenge for parents as well, as we can struggle to understand what is teenage angst, and what is something more serious.

从正常不安全感，到可能伴随着抑郁感的强烈焦虑感或担忧，青春期焦虑涵盖范围很广。这对父母而言，也可能会是一种令人沮丧、痛苦和可怕的挑战，因为我们可能很难辨别青春期焦虑和更严重问题。

Clarifying the range from normal to more serious can help parents feel more confident navigating this complicated developmental stage.

明确了解从正常现象到更严重问题之间的范畴，这有助于让父母更自信地应对这段复杂的发育阶段。

What Is “Normal” Teen Angst & What’s a Problem
什么是“正常”的青少年焦虑&什么时候需要引起担忧

You know your child best, and witnessing your child’s attitude and behavior change, perhaps seemingly overnight, may come as a shock. While “normal” is subjective and questionable, there are common characteristics and signs of teenage angst. When these behaviors start to become extreme and disruptive and interfere with daily life, is when it starts to become more of a cause for concern, and grounds to seek professional help and support.

你最了解你的孩子，目睹孩子的态度和行为变化，而且甚至可能看起来仿佛一夜之间就发生变化，这可能会让人惊愕不已。尽管“正常”这个词是主观且并不可靠的，但青少年焦虑的确存在一些普遍的特点和迹象。而当这些行为开始变得极端、破坏干扰日常生活时，这就需要引起担忧，或寻求专业帮助或支持。

Here are some of the more common and “normal” signs of teen angst:
以下是青春期焦虑的一些较为普遍和“正常”的迹象：

Changes in interests (such as music, hobbies, activities)
兴趣（如音乐、爱好、活动）发生变化

Changes in friend groups
交友圈发生变化

Changes in clothing style
穿衣风格发生变化

Changes in sleeping patterns
睡眠模式发生变化

Changes in mood
情绪变化

Changes in academic performance
学习成绩发生变化

Being more secretive or dismissive of information
不愿吐露信息，或对信息不屑一顾。

Increase in rebellious behavior and rule-breaking
叛逆行为或不遵守规则行为增多

However, if these behaviors continue or become extreme, it can be a sign of more serious mental health issues such as depression, anxiety and/or self-harm and suicidality, and may require professional help.

但如果这些行为继续存在或变得极端，可能意味着存在一些更严重的精神健康问题，如抑郁、焦虑和/或自我伤害或自杀倾向，而且可能需要专业人士帮助。

Signs That It’s More Than Teenage Angst
比青春期焦虑更严重问题的迹象

If angsty behaviors continue or worsen, you may need to watch for signs of depression, anxiety, or potential for self-harm behavior. Signs may include extreme sensitivity, difficulty concentrating, poor personal hygiene, or avoidance behaviors. There is a lot of overlap in emotional and behavioral changes that occur in a teen experiencing depression, anxiety, self-harm and/or suicidality. Keep in mind they don’t have to experience all of these changes in order for your teen to receive help from a professional.

如果青春期焦虑行为持续存在或恶化，你可能需要留意是否有抑郁症、焦虑或自我伤害行为的迹象。这些迹象可能包括：极端敏感、难以集中注意力，不注意个人卫生，或回避行为。对于有抑郁、焦虑、自我伤害和/或自杀倾向的青少年，不同潜在严重问题所导致的情绪和行为上的变化在一些方面是重叠的。

Potential Signs of Depression
潜在的抑郁症状

Emotional changes such as:
情绪变化示例：

• Crying for no reason
无缘无故哭泣

• Feeling worthless or guilty
感到自己毫无价值或内疚

• Difficulty thinking, concentrating, and remembering things
难以思考/集中精力或记忆里变差

• Irritability and quick to become frustrated or overwhelmed
易怒，很容易就感到挫败或无力招架

• Extreme sensitivity to rejection or need to receive frequent reassurance
对拒绝极度敏感，或需要不断频繁寻求肯定

• Grim and bleak perspective on life
感觉人生前景一片灰暗

Behavioral changes such as:
行为变化示例：

• Changes in sleep patterns, either insomnia or sleeping too much,
睡眠模式发生变化，或是失眠或是睡眠过多

• Marked restlessness and inability to sit still,
很明显无法安静下来，无法安静坐着。

• Changes in appetite, either resulting in weight loss or weight gain
胃口变化，从而导致体重降低或体重增加

• Use of alcohol and/or drugs,
开始饮酒和/或使用毒品

• Noticeable decrease in school performance and enthusiasm,
学习成绩和学习热情明显下降

• Social isolation from both friends and family,
对朋友和家人开始自我隔绝

• Less care of physical hygiene and appearance
对个人卫生和外貌不再那么在意

Potential Signs of Anxiety
潜在的焦虑迹象

Emotional changes such as:
情绪变化示例：

• Fear of being away from parents
害怕离开父母

• Extreme fear about specific things or situations
对特定事物和情形极端恐惧

• Frequent worry and fear about the future
频繁为未来感到担忧和恐惧

• Hyperfixation of their appearance
过度关注自己外貌

• Verbalizing frequently concern that something bad is going to happen
经常说可能会发生不好的事

• Sudden, intense and unexpected fear that often result in physical symptoms
突如其来的强烈恐惧感，且这种恐惧感通常会导致一些生理症状的出现。

Behavioral changes such as:
行为变化示例：

• Sleep problems
睡眠问题

• Chronic complaints of stomach aches or headaches
经常抱怨胃痛或头痛

• Fatigue
感到疲劳

• Avoidance of activities
回避各种活动

• School avoidance and/or refusal
回避和/或拒绝去学校

• Drastic changes in routines
日常生活习惯发生剧烈变化

Potential Signs of Self-Harm & Suicidality
自我伤害&自杀倾向的潜在迹象：

Emotional changes such as:
情绪变化示例：

• Verbalizing feeling trapped or hopeless, either in general or about a specific situation
说感到被困住或无望，这或是在谈论整体感受，或是在谈论某一具体情形

• Frequent mood swings
情绪频繁波动

• Extreme sensitivity to feedback or rejection
对反馈和拒绝极端敏感

• Changes in appetite
胃口变化

• Decrease in motivation or interests
主动性和兴趣降低

Behavioral changes such as:
行为变化示例：

• Social isolation from peers and family
对家人朋友开始自我隔绝

• Talking or writing about suicide – such as making statements like “I won’t be around much longer”
在言语和文字中会谈到自杀，比如会说/写“我很快就会不在了”

• Increase in use of alcohol and/or drugs
饮酒量和/或使用毒品量增加

• Wearing long sleeves, hoodies, pants, etc. in warmer climates to hide physical signs of self-harm (cutting, burning, picking, etc.)
在温度较高天气穿长袖衣服，带帽卫衣，长裤等，以遮住自我伤害痕迹（如割伤，烧伤，指甲抠伤等。）

• Engaging in self-destructive or risky behaviors
采取自我摧毁或危险行为等

• Giving away their possessions without any reason
毫无缘由送出自己的物品

• Sudden burst in happiness (often occurs right before a plan to die by suicide)
突然表现出很快乐（通常发生于计划自杀之前）

10 Tips for How to Help Your Angsty Teen
10条帮助建议

Before you begin jumping to conclusions and forcing your teen to open up to you, you have to take a few minutes for some self-reflection. Are you approachable and nonjudgmental? Are you offering solutions or advice without permission? Are you continuing to bring things up after your teen has asked you to stop? These are some of the more common barriers that my teenage clients share during sessions. Having open and clear communication is the first step in building trust and connection.

在你开始仓促下结论，强迫你的青春期孩子向你吐露心扉之前，你需要先花几分钟时间自我反思一下。你是否亲近随和且不会对别人妄加评判？你是否在没获得允许的情况下提供解决方案或建议？在孩子要求你停止之后你是否还继续在这些话题上喋喋不休？这些都是我在治疗的青少年患者在心理治疗过程中所讲述的较为普遍的障碍。坦诚明确的沟通是建立信任和理解的第一步。

1. Make Time for Them

为他们留出时间

As the world continues to turn, and tension rises, make sure you and your teen find things to do together. Some families may be blended, or welcoming younger sibling(s). It’s normal for the attention to shift, but making a point to make time for your teen is valuable.
生活依旧在继续，压力不断增加，但确保你和你的青春期孩子找到一些可以一起做的事情。一些家庭可能是重组家庭，一些可能即将迎来弟弟妹妹，注意力转移很正常，但特地给你处于青春期的孩子留出时间，这一点极其重要。

Pro tip/专业建议：

showing genuine interest in things that they enjoy goes a long way—yes… even TikTok.
对孩子喜欢的事物发自内心流露出兴趣会带来莫大收益——是的，哪怕是抖音。

1. Encourage Healthy Sleep Habits

鼓励养成健康的睡眠习惯

This one is scientifically backed, but much more difficult to practice. Helping your teen build a sleep routine will help them in the long run! Recalling all of the development that happens to the adolescent brain, overall functioning improves when we have adequate sleep.
这一点是有科学证据支持的，但却很难付诸实践。帮助孩子建立良好睡眠习惯可以让他们长期受益。想一下青春期大脑所经历的发育过程，就会知道当我们睡眠充足时，整体机能都会得到提升。

Pro tip/专业建议：

Model positive sleep habits yourself by using guided meditation for deep sleep, reading a book or drinking some calming tea. Teens already know they need more sleep, but modeling this behavior with them helps them follow through.

以身作则养成良好睡眠习惯，方法可以是在指导下进行冥想，从而获得深度睡眠，或读书，或喝一些具有镇静作用的茶。青少年本身知道他们是需要更多睡眠的，但如果你能以身作则，会帮助他们坚持这一习惯。

1. Give Your Teen the Space They Need

给孩子所需的空间

It may be difficult as their parent or guardian to watch your teen struggle with their feelings, but allowing them the opportunity to problem-solve on their own will encourage them to take one more step closer to independence. As a therapist, I give teens the space that they need during sessions, helping them express their need for space with their parents, while also figuring out ways to cope with their stressors.
当看到孩子在自己感受中挣扎时，父母或其他看护人都会心里不好过，让给孩子独立解决问题的机会，会鼓励他们更进一步走向独立。作为心理医生，在治疗期间，我会给青少年患者们他们所需的空间，帮助他们向他们的父母表达对个人空间的需求，同时也会想办法应对他们的压力源。

Most of the teens I see share a similar desire of wanting space to be able to think and reflect on their own, and at times may have difficulty admitting they may need your guidance. The thing about giving your teen space is that they know they can come to you when they need to. This happens because of the trust and open communication you developed earlier.

我的大多数青少年患者都透露了想要能够让自己思考的个人空间的这一愿望，而且有时很不愿意承认他们“可能”需要你的指引。给青春期孩子个人空间，关键的一点，在于他们知道当他们需要你帮助时他们随时都可以求助于你。这一点的实现，需要你们在此之前就已建立信任和坦诚沟通氛围。

Pro tip/专业建议：

stop pushing when they say “stop” or state they don’t want to talk about it right now.

当孩子叫停或表示现在不想和你再继续讨论这一问题时，就不要再继续逼迫孩子。

1. Ask Your Teen Directly How You Can Help

直接询问孩子你可以如何给予帮助

Your teen usually knows how they want to be helped, and you may be surprised by their response. Most of the time they’re not looking for a solution, per say, but rather space to be heard. Sometimes they just want a hug and to be told that their feelings will pass or are validated. Sometimes they need to drive around with you and grab a snack. It is more than okay for your teen to not know how they can be helped either.

你的青春期孩子通常知道他们需要怎样的帮助，而且他们的回答可能会令你感到惊讶。很多时候他们并不是在寻找一个解决方案，而是想要一个能够被倾听的空间。有时他们只是想要一个拥抱或有人告诉他们这些感受都是暂时的或者都是很正常的。有时他们需要和你兜兜风一起吃点东西。但如果你的孩子不知道自己想要怎样的帮助，也完全很正常。

If they’re not bringing up seeing a therapist, ask them if they think talking to someone who isn’t their parent or guardian might be helpful. Do not be afraid to be the one to begin tough conversations about mental health. If you feel it is helpful, ask your teen if they want to hear how you handled a similar situation when you were their age.

如果他们没有主动说想看心理医生，问他们是否会觉得跟父母或看护人之外的人聊一聊会对他们有帮助？不要害怕主动提起关于精神健康的棘手话题。如果你觉得这会有帮助，可以问孩子他们是否想听听你在他们年龄时是怎样应对一个类似情形的。

Pro tip/专业建议：

even if your situation may not have been handled in the best way, you can share how you wish you could’ve handled it differently knowing the things that you know now.

即使你当年对当时那一情形的处理方式并不理想，你依旧可以告诉孩子，在现在的你看来，希望当时本可以怎样处理。

1. Try Journaling to Express Thoughts & Feelings

尝试用记日记的方式表达想法和感受

Your teen may already be doing this on their own, but if not, encourage them to think about using a journal to express their thoughts and feelings, a great mindfulness practice. Journaling does not look the same for everyone, and allow your teen to develop a style on their own. Offer to help them buy a journal or even self-help workbooks or journal prompt books.

你的孩子可能已经有记日记习惯了，但如果没有，可以鼓励孩子用日记来表达个人想法和感受，这也是一种非常棒的正念练习。不同的人对日记有着不同的理解，因此孩子有自己的记日记方式。主动提议帮他们购买日记本或自励书籍或日记指导书籍。

Again, a major theme is space and privacy, especially when it comes to their journals. Allow your teen the freedom to share what they’ve written or drawn, only if they choose to do so – no snooping!

再说一遍，一个重要的主题是，空间和隐私，尤其是关于他们的日记时。如果孩子愿意，可以听孩子讲他们写下或画的内容。但是，不要偷看！

Pro tip/专业建议：

It is healthy for everyone to find some sort of outlet to not bottle up emotions, and journaling is one of the best ways to do so.

找到一个发泄渠道，不让情绪闷在心里，这对任何人都是健康的，而且记日记就是其中一种最好的方式。

1. Keep It Real

不遮掩实情

Teens are arriving at a point in their lives where some of their childhood fantasies and daydreams no longer feel realistic or possible. Teens are able to have a better grasp on reality and can often tell when adults in their lives are trying to hide things from them. Most of the time, adults do this to “protect” them, but trust me when I say this, your teen knows. They are no longer as naive as they once were, and the less you try to hide from them the better.

在青春期，孩子已经会觉得他们童年时期的一些幻想或遐想已经不再现实或可能。青少年能够更好地理解现实，而且当他们生活中的成年人试图向他们隐瞒时，他们通常也能够识别。大多时候，成年人之所以隐瞒，是想要“保护”他们，但相信我，你的青春期孩子什么都知道。他们已经不再是以前那个天真单纯的孩子，而且，你隐瞒的越少越好。

Of course, having boundaries is equally important and as their parent or guardian your job is not to be their best friend, but rather someone they can rely on. If something they are going through is tough, admit that, hold that space for them.
当然，建立界限也同样重要。作为他们的父母或看护人，你的职责并不是成为他们最好的朋友，而是成为他们可以依赖的人。如果他们在经历的某种情形很棘手，承认这一点，并为他们 “hold space”（这一概念是指在自己内心为别人留出一个空间，仿佛是创建一个安全的，充满爱和共情的容器或茧房，当对方和你在一起时，让对方感到能够自由对你倾诉，感到被理解，被倾听，而且你不会去带着自己看法去批判对方或给出建议）。

Pro tip/专业建议：

sugar coating and bandaids are no longer quick-fixes for heartbreak and stress relief.
裹“糖衣”或贴创可贴般的做法已经无法再对心碎和压力问题快速奏效了。

1. Cultivate an Attitude of Gratitude

培养感恩态度

Chances are your teen is feeling down about themselves in one area of their life or another. This can be feeling insecure about their looks, their friendships, their grades, or even their relationship with their family. Take a few minutes each day to remind your teen how much they matter to you and how much they mean to you.

可能你正处于青春期的孩子正因为生活中某些方面而感到难过，可能是对外貌，友谊/成绩甚至与家人之间关系有种不安全感等。每天花几分钟时间提醒孩子他们对你有多重要，对你有多么意义重大。

Some may tolerate the “mushy-gushy” verbal praise, and others might think you’re weird. However your language is to express gratitude, take some time to show it. Do not just assume your teen knows how much you love and care about them.
一些孩子可能会容忍你的腻腻歪歪情感泛滥的话，一些可能会觉得你有病，但无论你用什么语言来表达感谢，都花时间去展示出来。不要只是假设你正处于青春期的孩子知道你多么爱他/她，多么在乎他/她。

Pro tip/专业建议：

there’s more to be proud about than just good grades in school.
让你对他们感到自豪的，并不只有好的学习成绩。

1. Remember That It Isn’t Personal

別觉得是针对自己

Try your best to not take it personally during this season in parenthood. Chances are your teenager will have some “low-blows” and “painful digs” that hit home, but know that this is one of the most challenging and confusing parts of your child’s life. The way you navigate teenage angst is critical to the relationship you maintain in the future as they enter into adulthood.

在养育孩子的这一阶段，尽量不要觉得孩子都是在故意针对你。可能你的青春期孩子会有一些直击你痛处的“卑鄙招式”和“刻薄嘲讽”，但你要知道这段时间是孩子一生中最具挑战性，最让人困惑的一段时期。你应对孩子青春期焦虑的方式，对未来孩子进入成年后你和孩子的关系至关重要。

Keeping healthy boundaries and learning to let things go will be good for both you and your teen’s sanity. Taking it personally will only build resentment towards your teen.

保持健康界限，学会不计较，这对孩子和你的精神健康都有益处。对孩子的话太在意太当真，只会不断滋生你对孩子的恨意。

Pro tip/专业建议：

Give your teen and yourself the same grace by using affirmations that help you stay calm and help to maintain healthy boundaries. Try repeating phrases such as, “I know in my heart my teen loves and cares about me. I know that they are not trying to offend me.” “I choose to let go of the hurtful and painful things they have said to me and will not take it personally.”

使用可以帮助你保持镇静和维持健康界限的肯定言辞，放自己也放孩子一马。试着重复以下句子或其他类似言辞：

“我内心知道我的孩子爱我在乎我，我知道他们并不是在刻意冒犯我。”

“我选择不计较孩子对我说的那些刻薄攻击的话，而且不会觉得那是在刻意针对自己。”

1. Have a YES day

指定一个“YES”日

Similar to making time for your teen, have a designated day where you say “yes” to just about anything and everything that your teen wants to do. You may be surprised at what your teen says they want to do. Allowing your teen to be in charge of what you two do together for the day can be a really fun and engaging way to gain insight into your teen’s interests and decision making.

就像你特意给孩子留出时间，你也可以特意指定一天作为“Yes” 日，在这一天中，你对孩子想要做的事情都说“Yes”。孩子说的他们想做的事情可能会出乎你的意料。这一天中，让孩子负责规划管理你们共同做的事情，这会很有趣，而且你也可以在这一有趣过程中窥见孩子的兴趣和决策能力。

Pro tip/专业建议：

There could be some limitations and ground rules for what they can and cannot ask for, such as a new piercing or getting a tattoo. You can also create a budget on how much they can spend or how far they can travel. The idea is to allow your teen to experience freedom in a safe and supportive way.

对于孩子的要求，可以规定一些限制和基本准则，比如身体穿孔或刺青等。你也可以规定预算或出门距离。中心思想是，让孩子在安全、被支持的前提下体验自由。

1. Open Door & Code Words

开门政策&暗语

One of the best things you can do for your teenager is to establish an “open door policy” where your teen feels comfortable coming to you to talk about things that are troubling them. The more trust they have with you, the safer they will be in risky or dangerous situations.

父母对青春期孩子最值得建议的行为之一，就是建立“开门政策”，让孩子感到随时都可以毫无压力的来向你倾诉他们的困扰。他们对你越信任，他们在高风险或危险情形中就越安全。

You can even have a code word or phrase that your teen can use when around peers or in a situation where they feel uncomfortable. This often comes with a no-questions-asked, no lecture agreement. Your teen knowing that they aren’t going to be bombarded with questions or lectures will make them more likely to reach out and ask for help when it counts the most. Your teen will most likely open up to you about the situation that caused them to use the code word and chances are they are practicing good judgment by asking for help.

你们还可以约定一个暗语，可以是一个词也可以一句简短的话，让孩子在同伴周围或在自己觉得不舒服的情形中使用。但同时还应注意，对于孩子使用暗语，不要问问题，不要说教。如果你的孩子知道在之后不会被各种问题、说教炮轰，他们就更可能在自己最需要时主动向你寻求帮助。你的孩子很可能会主动向你讲述为什么当时会使用“暗语”而且也很可能，你会发现他们当时寻求帮助的决定是很明智的。

Pro tip/专业建议：

It may be difficult to not ask any questions or limit the lecture, but it is important in building trust and maintaining the open door environment you are trying to establish.

可能很难不去问问题或大肆说教，但对于建立信任和维系你所建立的“开门”政策氛围而言，这一点却至关重要。

Keeping communication lines open can help you and your teen maintain the communication you need to provide critical ballast during this time of transition. Despite their emerging independence, remember your teen still needs your support and love. Inside that alarmingly grown up body is still your vulnerable child and they need you.

保持沟通渠道的畅通，有助于让你和孩子之间保持充分沟通，足以为孩子这段汹涌变迁岁月提供至为关键的“压舱石”的沟通。尽管他们逐渐开始独立，但记住你的孩子依旧需要支持和爱。在他们迅猛发育的身体中，依旧是你那个脆弱的小孩，而且他们需要你。

Trust yourself to judge what is normal teen angst and what is something more serious. You know your child best, and maintaining your connection is one of the most powerful strategies you can employ to weather their angst.

相信你自己可以判断什么是正常青春期焦虑什么是更严重问题。你最了解你的孩子，维持你们之间的紧密关系，是成功应对这段焦虑岁月的最强大策略之一。