And Mourners to and fro

「私は頭の中で葬式を感じた

Kept treading - treading - till it seemed

会葬者たちがあちこちと

That Sense was breaking through -

歩き回り､歩き回って とうとう

And when they all were seated,

意識がぼやけてしまった

A Service, like a Drum -

会葬者たちが席に着くと

Kept beating - beating - till I felt

太鼓の音のような弔いが

My mind was going numb -

うち響き､うち響いて とうとう

And then I heard them lift a Box

心が凍ってしまった

And creak across my Soul

その時 棺が持ち上げられ

With those same Boots of Lead, again,

私の魂を横切って いつもの

Then Space - began to toll,

鉛の靴が音をたてて通り過ぎた

As all the Heavens were a Bell, And Being, but an Ear,

すると あたりで鐘が鳴りだした

And I, and Silence, some strange Race,

まるで天国がひとつの鐘になって

Wrecked, solitary, here -

存在が耳と化したような感じ

(Just) then a Plank in Reason, broke,

私と沈黙はここでは

And I dropped down, and down -

打ちひしがれたよそ者なのだ

And hit a World, at every plunge,

その時 理性の板が壊れ

And Finished knowing - then -"

私は下へ下へと落ちて行った

We know depression through metaphors.

そして落ちるたびに別の世界にぶつかり

Emily Dickinson was able to convey it in language,

とうとう何もわからなくなった」

Goya in an image.

私たちは鬱というものを 隠喩を通して理解しています

Half the purpose of art is to describe such iconic states.

エミリー・ディキンソンは 詩という形で言葉にし

As for me, I had always thought myself tough,

ゴヤは絵画で表現しました

one of the people who could survive if I'd been sent to a concentration camp.

芸術における大半の目的とは

In 1991, I had a series of losses.

こんな象徴的なものを 描き出すことではないでしょうか

My mother died, a relationship I'd been in ended,

私の場合 常に自分はタフな人間だと思ってきました

I moved back to the United States from some years abroad,

強制収容所なんかに送られても

and I got through all of those experiences intact.

絶対に生き延びるタイプだろうと

But in 1994, three years later, I found myself losing interest in almost everything.

1991年から私が経験したことは

I didn't want to do any of the things I had previously wanted to do, and I didn't know why.

母の死に始まります

The opposite of depression is not happiness, but vitality.

恋人と別れ

And it was vitality that seemed to seep away from me in that moment.

この時 数年の海外生活を経て

Everything there was to do seemed like too much work.

アメリカに帰国しました

I would come home,

そして なんとか乗り越えることができました

and I would see the red light flashing on my answering machine,

しかし３年後の1994年のことです

and instead of being thrilled to hear from my friends,

自分が ほぼ何もかも 興味を失っていることに気づきました

I would think, "What a lot of people that is to have to call back."

以前やりたいと思っていたことが

Or I would decide I should have lunch,

何一つやりたくなくなり

and then I would think, but I'd have to get the food out

その理由さえ分かりませんでした

and put it on a plate and cut it up and chew it and swallow it,

鬱の反対は幸福ではなく

and it felt to me like the Stations of the Cross.

活力です

And one of the things that often gets lost in discussions of depression

そして活力こそが

is that you know it's ridiculous.

当時の私から 消え去っていったもののように思います

You know it's ridiculous while you're experiencing it.

目の前のやるべきことが

You know that most people manage to listen to their messages and eat lunch

全て大仕事のように思えました

and organize themselves to take a shower and go out the front door,

自宅に戻ると

and that it's not a big deal, and yet you are nonetheless in its grip,

留守番電話の赤いライトが 点滅しています

and you are unable to figure out any way around it.

友達からのメッセージに 心躍らせる代わりに

And so I began to feel myself doing less and thinking less and feeling less.

私はこう考えました

It was a kind of nullity, and then the anxiety set in.

「なんて多くの人たちに 返事をしなくちゃいけないんだ」

If you told me that I'd have to be depressed for the next month,

またある時は ランチをとろうとするものの

I would say, "As long I know it'll be over in November, I can do it."

それには食べ物を取り出して

But if you said to me, "You have to have acute anxiety for the next month,"

お皿に盛りつけて

I would rather slit my wrist than go through it.

ナイフで切って 噛み砕いて 飲み込まなくてはいけないと考えるのです

It was the feeling all the time, like that feeling you have if you're walking,

すると それが十字架ほどの重圧に感じました

and you slip or trip, and the ground is rushing up at you,

鬱に関する議論を行う際に

but instead of lasting half a second, the way that does, it lasted for six months.

上手くいかない理由の一つは

It's a sensation of being afraid all the time, but not even knowing what it is that you're afraid of.

当人が馬鹿馬鹿しいと 認識していることです

And it was at that point that I began to think that it was just too painful to be alive,

実際に なんて愚かだと分かっているんです

and that the only reason not to kill oneself was so as not to hurt other people.

普通の人たちは

And finally one day, I woke up, and I thought perhaps I'd had a stroke,

留守電のメッセージを聞いて ランチをとって

because I lay in bed completely frozen, looking at the telephone, thinking,

シャワーを浴びて

"Something is wrong and I should call for help,"

玄関から出かける それが当たり前のことだと分かっています

and I couldn't reach out my arm and pick up the phone and dial.

玄関から出かける それが当たり前のことだと分かっています

And finally, after four full hours of my lying and staring at it,

それでも鬱と決別できません

the phone rang, and somehow I managed to pick it up,

そして どうあがいても 解決できなくなります

and it was my father, and I said,

こんな調子で 私はやることが だんだん減ってきて

"I'm in serious trouble. We need to do something."

思考も鈍くなり

The next day I started with the medications and the therapy.

感情も失っていきました

And I also started reckoning with this terrible question:

無に近づいていたように思います

If I'm not the tough person who could have made it through a concentration camp, then who am I?

そこに不安が襲います

And if I have to take medication, is that medication making me more fully myself,

もし来月中は ずっと うつ状態でいてくれと

or is it making me someone else?

言われたら こう返答するでしょう

And how do I feel about it if it's making me someone else?

「11月に終わるのであれば できますよ」と （10月に撮影）

I had two advantages as I went into the fight.

でも もし

The first is that I knew that, objectively speaking, I had a nice life,

「来月はずっと極度の不安を 抱えていてくれ」と言われれば

and that if I could only get well,

やり遂げる前に 手首を切ってしまうでしょう

there was something at the other end that was worth living for.

いつも感じていたのは

And the other was that I had access to good treatment.

歩いたら 滑ったり

But I nonetheless emerged and relapsed, and emerged and relapsed,

つまづいたりして

and emerged and relapsed, and finally understood

地面が迫ってくる感覚で

I would have to be on medication and in therapy forever.

この感覚が一瞬ではなく

And I thought, "But is it a chemical problem or a psychological problem?

半年も続いているように感じるのです

And does it need a chemical cure or a philosophical cure?"

常に不安を抱えているというのは 異常ですが

And I couldn't figure out which it was.

不安の対象が何であるのかすら 分からないのです

And then I understood that actually,

この時 私が思い始めたのは

we aren't advanced enough in either area for it to explain things fully.

生きることは ただ辛すぎるということ

The chemical cure and the psychological cure both have a role to play,

自殺をしなかった 唯一の理由とは

and I also figured out that depression was something that was braided so deep into us

周りの人を悲しませたくなかったからです

that there was no separating it from our character and personality.

ある日 目を覚ました私は

I want to say that the treatments we have for depression are appalling.

脳卒中を起こしたかもしれないと 思いました

They're not very effective. They're extremely costly.

ベッドに横たわる身体は 凍り付いていたからです

They come with innumerable side effects. They're a disaster.

電話を遠目に こう考えます

But I am so grateful that I live now and not 50 years ago,

「何かがおかしい 助けを呼ばなくては」

when there would have been almost nothing to be done.

でも腕を伸ばして

I hope that 50 years hence, people will hear about my treatments

受話器を取って ダイアルすることができません

and be appalled that anyone endured such primitive science.

横たわりながら電話を見つめること ４時間

Depression is the flaw in love.

ついに電話が鳴りました

If you were married to someone and thought, "Well, if my wife dies, I'll find another one,"

なんとか受話器を上げると

it wouldn't be love as we know it.

父からでした

There's no such thing as love without the anticipation of loss,

私は「深刻な問題を抱えている

and that specter of despair can be the engine of intimacy.

助けが必要だ」と話しました

There are three things people tend to confuse: depression, grief and sadness.

翌日から 投薬とセラピー治療が

Grief is explicitly reactive.

始まりました

If you have a loss and you feel incredibly unhappy, and then, six months later,

そして ゾッとするような

you are still deeply sad, but you're functioning a little better, it's probably grief,

こんな自問も始めたのです

and it will probably ultimately resolve itself in some measure.

もし自分が強制収容所で

If you experience a catastrophic loss, and you feel terrible,

生き延びられるような タフな人間でなければ

and six months later you can barely function at all,

この私は誰だ？

then it's probably a depression that was triggered

もし この薬を飲めば

by the catastrophic circumstances.

もっと自分らしくなるのだろうか？

The trajectory tells us a great deal.

それとも別人になってしまうのだろうか？

People think of depression as being just sadness.

もし違う人間にしてしまうのなら

It's much, much too much sadness,

私は どうなるんだろう？

much too much grief at far too slight a cause.

この戦いを始めるにあたり 私には２つの強みがありました

As I set out to understand depression, and to interview people who had experienced it,

まずは客観的に見ても

I found that there were people who seemed, on the surface,

私はよい人生を送っていました

to have what sounded like relatively mild depression

そして回復さえすれば

who were nonetheless utterly disabled by it.

その先には 生きがいがある

And there were other people who had what sounded

生活が待っていると分かっていました

as they described it like terribly severe depression, who nonetheless had good lives

もう１つは 良い治療への アクセスがあったことです

in the interstices between their depressive episodes.

それにもかかわらず 症状はぶり返し

And I set out to find out what it is that causes some people to be more resilient than other people.

あらわれては ぶり返し

What are the mechanisms that allow people to survive?

あらわれては ぶり返しました

And I went out and I interviewed person after person who was suffering with depression.

ついに悟ったのは

One of the first people I interviewed described depression as a slower way of being dead,

投薬とセラピー治療に

and that was a good thing for me to hear early on

一生頼らなければいけない ということでした

because it reminded me that that slow way of being dead

そこで考えたのは 「これは化学的問題か

can lead to actual deadness, that this is a serious business.

それとも心理的問題なのか？

It's the leading disability worldwide, and people die of it every day.

化学療法と心理療法の どちらが有用なのだろうか？」と

One of the people I talked to when I was trying to understand this,

結局どちらが効果的なのか 分かりませんでした

was a beloved friend who I had known for many years,

そこで理解したことは

and who had had a psychotic episode in her freshman year of college,

実は どちらの専門領域でも

and then plummeted into a horrific depression.

この病気を十分に解明できないのだと

She had bipolar illness, or manic depression, as it was then known.

でも化学療法と心理療法は どちらも担うべき

And then she did very well for many years on lithium,

役割があります

and then eventually, she was taken off her lithium

また私が気づいたのは 鬱とは

to see how she would do without it, and she had another psychosis,

私たちの 深部に編みこまれたもので

and then plunged into the worst depression that I had ever seen,

個性や性格と

in which she sat in her parents' apartment,

不可分であるということでした

more or less catatonic, essentially without moving, day after day after day.

現代の鬱の治療法とは

And when I interviewed her about that experience some years later,

酷い状況です

she's a poet and psychotherapist named Maggie Robbins, when I interviewed her, she said,

効果的でないし

"I was singing 'Where Have All The Flowers Gone,' over and over, to occupy my mind.

とても高額です

I was singing to blot out the things my mind was saying,

数え切れない副作用も伴います

which were, 'You are nothing. You are nobody. You don't even deserve to live.'

本当に最悪です

And that was when I really started thinking about killing myself."

それでも現代に生きることができて 感謝しています

You don't think in depression that you've put on a gray veil

50年前だったら

and are seeing the world through the haze of a bad mood.

ほとんど 手の施しようが無い

You think that the veil has been taken away, the veil of happiness, and that now you're seeing truly.

症状だったろうと思うからです

It's easier to help schizophrenics who perceive

ですから50年後の人たちが

that there's something foreign inside of them that needs to be exorcised,

私が受けている治療法を聞いて

but it's difficult with depressives, because we believe we are seeing the truth.

そんな原始的な科学に耐えていたのかと

But the truth lies. I became obsessed with that sentence: "But the truth lies."

驚愕してくれることを願います

And I discovered, as I talked to depressive people, that they have many delusional perceptions.

鬱とは愛の欠陥です

People will say, "No one loves me."

結婚している男性が

And you say, "I love you, your wife loves you, your mother loves you."

「もし奥さんが死んだら 他を探そう」と思うなら

You can answer that one pretty readily, at least for most people.

私たちが信ずる愛とは程遠いです

But people who are depressed will also say, "No matter what we do, we're all just going to die in the end."

失うことが決してない愛など

Or they'll say, "There can be no true communion between two human beings.

ありえないし

Each of us is trapped in his own body." To which you have to say, "That's true,

絶望への不安は

but I think we should focus right now on what to have for breakfast."

愛情をより深くさせる 原動力にもなります

A lot of the time, what they are expressing is not illness, but insight,

皆さんが混同しがちなことが ３つあります

and one comes to think what's really extraordinary

鬱､苦悩､悲しみです

is that most of us know about those existential questions, and they don't distract us very much.

苦悩とは明らかに呼応するものです

There was a study I particularly liked,

皆さんが誰かを失って 極度に不幸だと感じているとします

in which a group of depressed and a group of non-depressed people

でも半年後に

were asked to play a video game for an hour, and at the end of the hour,

深い悲しみは残っても 少しずつ元の生活に戻れるようなら

they were asked how many little monsters they thought they had killed.

それは苦悩でしょう

The depressive group was usually accurate to within about 10 percent,

この場合 何らかの形で

and the non-depressed people guessed between 15 and 20 times as many little monsters, as they had actually killed.

自ずと癒されるはずです

A lot of people said, when I chose to write about my depression,

もし皆さんが悲劇的な形で 誰かを失って

that it must be very difficult to be out of that closet, to have people know.

極度に落ち込んで

They said, "Do people talk to you differently?" I said, "Yes, people talk to me differently."

半年後に日常生活も ままならないようなら

They talk to me differently insofar as they start telling me about their experience,

悲劇的な状況下によって 誘発された

or their sister's experience, or their friend's experience.

鬱である可能性が高いです

Things are different because now I know that depression is the family secret that everyone has.

どのような軌跡を辿るかが 大いに関係しているのです

I went a few years ago to a conference, and on Friday of the three-day conference,

多くの人が うつ病とは ただ悲しみに暮れることだと考えています

one of the participants took me aside, and she said,

ですが実際は想像以上に深い悲しみで

"I suffer from depression, and I'm a little embarrassed about it,

大きすぎる苦悩なのです

but I've been taking this medication, and I just wanted to ask you what you think?"

そして遠巻きに見ると 小さすぎる原因に端を発したものです

And so I did my best to give her such advice as I could.

私は鬱を理解するため

And then she said, "You know, my husband would never understand this.

その経験を持つ人たちに インタビューを始めました

He's really the kind of guy to whom this wouldn't make any sense,

それで分かったことは

so, you know, it's just between us." And I said, "Yes, that's fine."

表面的には比較的

On Sunday of the same conference, her husband took me aside,

軽度のうつ病を患っている人も

and he said, "My wife wouldn't think that I was really much of a guy if she knew this,

この病気によって 大きな支障を被っているということです

but I've been dealing with this depression and I'm taking some medication, and I wondered what you think?"

その一方で 本人の説明によれば

They were hiding the same medication in two different places in the same bedroom.

重度のうつ病を

And I said that I thought communication within the marriage might be triggering some of their problems.

患っているように聞こえても

But I was also struck by the burdensome nature of such mutual secrecy.

暗いエピソードの隙間から よい生活を送っている様子を

Depression is so exhausting.

垣間見ることがあります

It takes up so much of your time and energy, and silence about it,

そこで次に調べたのは

it really does make the depression worse.

ある人たちが

And then I began thinking about all the ways people make themselves better.

他の人たちに比べて より回復力がある要因です

I'd started off as a medical conservative.

人々を生き延びさせるような

I thought there were a few kinds of therapy that worked.