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甲状腺、失眠和精神错乱:疾病的共性

Thyroid, insomnia, and the insanities: Commonalities in disease

甲状腺、失眠和精神错乱:疾病的共性

by Raymond Peat

SOME FACTORS IN STRESS, INSOMNIA AND THE BRAIN SYNDROMES:压力、失眠和大脑综合症的一些因素:

Serotonin, an important mediator of stress, shock, and inflammation, is a vasoconstrictor that impairs circulation in a great variety of circumstances.

血清素是应激、休克和炎症的重要介质,是一种血管收缩剂,在许多情况下会损害循环。

Stress impairs metabolism, and serotonin suppresses mitochondrial energy production.

Stress and shock tend to increase our absorption of bacterial endotoxin from the intestine, and endotoxin causes the release of serotonin from platelets in the blood.

压力会损害新陈代谢,血清素会抑制线粒体能量的产生。

压力和休克倾向于增加我们对肠道细菌内毒素的吸收,内毒素导致血液中的血小板释放血清素。

Schizophrenia is one outcome of stress, both cumulative and acute. Prenatal stress commonly predisposes a person to develop schizophrenia at a later age.

Serotonin’s restriction of circulation to the uterus is a major factor in toxemia of pregnancy and related complications of pregnancy. Hypothyroidism increases serotonin activity in the body, as it increases estrogen dominance.

精神分裂症是压力的一种结果,包括累积的和急性的。产前压力通常会使一个人在晚年容易患精神分裂症。

5 -羟色胺限制子宫循环是妊娠毒血症和妊娠相关并发症的主要因素。甲状腺机能减退会增加体内血清素的活性,因为它增加了雌激素的支配地位。

Estrogen inhibits the enzyme monoamino oxidase (MAO), and is highly associated with increased serotonin activity. Progesterone has the opposite effect on MAO.

The frontal lobes of the brain are hypometabolic in schizophrenia. Serotonin can cause vasoconstriction in the brain.

Serotonin release causes lipid peroxidation.

Schizophrenics have high levels of lipid peroxidation.

Antioxidants, including uric acid, are deficient in schizophrenics.

Therapies which improve mitochondrial respiration alleviate the symptoms of schizophrenia.

Energy depletion leads to brain atrophy, but with normal stimulation and nutrition even adult brains can grow.

Schizophrenics and depressed people have defective sleep.

Increasing the body’s energy level and temperature improves the quality of sleep.

雌激素抑制单氨基氧化酶(MAO),与血清素活性的增加高度相关。孕酮对MAO有相反的作用。

精神分裂症患者的大脑额叶是低代谢的。5 -羟色胺能导致大脑血管收缩。

血清素释放导致脂质过氧化。

精神分裂症患者的脂质过氧化水平很高。

抗氧化剂,包括尿酸,在精神分裂症患者中是缺乏的。

改善线粒体呼吸的疗法可以缓解精神分裂症的症状。

能量消耗会导致大脑萎缩,但在正常的刺激和营养下,即使是成年人的大脑也能生长。

精神分裂症患者和抑郁症患者有睡眠缺陷。

提高身体的能量水平和温度可以提高睡眠质量。

Everyone is familiar with the problem of defining insanity, in the case of people who plead innocent by reason of insanity. The official definition of insanity in criminal law is “the inability to tell right from wrong.” Obviously, that can’t be generalized to everyday life, because any sane person realizes that certainty is impossible, and that most situations, including elections, offer you at best the choice of “the lesser of two evils,” or the opportunity to “do the right thing,” and to “throw your vote away.” People who persist in doing what they know is really right are “eccentric,” in the sense that they don’t adapt to society’s norms. In a society that chooses to destroy ecosystems, rather than adapting to them, the question of sanity should be an everyday political issue.

每个人都熟悉定义精神错乱的问题,在人们以精神错乱为由辩护无罪的情况下。刑法中对精神错乱的官方定义是“无法辨别是非”。显然,这不能推广到日常生活中,因为任何理智的人都意识到,确定性是不可能的,而且大多数情况,包括选举,最多只能给你“两害相权取其轻”的选择,或者是“做正确的事”和“扔掉你的选票”的机会。坚持做自己认为正确的事情的人是“古怪的”,因为他们不适应社会规范。在一个选择破坏生态系统,而不是适应它们的社会中,心智健全的问题应该是一个日常的政治问题。

The use of medical terms tends to give authority to the people who are in charge of defining the terms, and it can give the impression of objectivity when there really isn’t any scientific validity behind the terms. In their historical senses, “crazy” (flawed) and “insane” (unsound) are probably more objective terms than the medically-invented terms, dementia praecox (premature idiocy) or schizophrenia (divided mind).

使用医学术语往往会给负责定义术语的人以权威,当术语背后没有任何科学有效性时,它会给人以客观的印象。从历史意义上讲,“疯狂”(有缺陷)和“疯狂”(不健全)可能比医学发明的术语、早发性痴呆(过早的白痴)或精神分裂症(分裂的思维)更客观。

“Odd Speech” is one of the dimensions used in the diagnosis of insanity. I am reminded of William Wordsworth’s dismissal of William Blake as insane after failing to understand some of Blake’s poems–Wordsworth was conventional enough to become England’s Poet Laureate, and to his limited perspective, Blake’s clear verses were incomprehensibly odd.

Whenever a trusted government employee decides to blow the whistle on criminal activities, his agency invariably puts out the information that this now discharged employee is psychologically unbalanced. Dissent, in other words, is easy to dispose of by psychiatric tainting.

If we are going to speak of mental impairment, then we should have objective measures of what we are talking about. Blake unquestionably could do anything better than Wordsworth, because he was neither stupid nor dishonest, and it’s almost a rule that ordinary employees are more competent than the administrators who evaluate their work. Objective standards of mental impairment would be more popular among patients than among diagnosticians, judges, and lawmakers.

“古怪言语”是诊断精神错乱的一个维度。这让我想起了威廉·华兹华斯(William Wordsworth)在读不懂布莱克(William Blake)的一些诗后,曾把他斥为疯子——华兹华斯的传统足以让他成为英国桂冠诗人,而在他有限的视角下,布莱克清晰的诗句显得不可思议地古怪。

每当一位受信任的政府雇员决定检举犯罪活动时,他所在的部门总会公布这样的信息:这位现已被解雇的雇员心理失衡。换句话说,异议很容易通过精神污染来处理。

如果我们要谈论精神损害,那么我们应该对我们所谈论的东西有客观的衡量标准。毫无疑问,布莱克在任何事情上都比华兹华斯做得好,因为他既不愚蠢,也不不诚实,而且普通员工比评估他们工作的管理人员更有能力,这几乎是一条规则。精神障碍的客观标准将在患者中比在诊断医生、法官和立法者中更受欢迎。

In a famous test of the objectivity of diagnosis, a filmed interview with a patient was shown to British and U.S. psychiatrists. 69% of the Americans diagnosed the patient as schizophrenic, but only 2% of the British psychiatrists did.

The strictly medical/psychological definition of insanity is still, despite the existence of the International Classification of Diseases, and in the U.S. the Diagnostic and Statistical Manual, which enumerate a large number of “mental disorders,” a crazily indefinite grouping of symptoms, and hasn’t made diagnosis more objective.. For example, in the last 30 years autism has been separated from childhood schizophrenia, but now the tendency is for both of them to be called developmental brain disorders. Both schizophrenia and autism are now often described in terms of a “spectrum of conditions,” which hardly matters, since they are not understood in terms of cause, prevention, or cure.

The problem is in the history of psychosis as a medical idea. About 100 years ago, attempts were made to classify psychoses by their symptoms, unifying a great variety of old diagnostic categories into two groups, manic-depressive mood disorders, and “dementia praecox,” or schizophrenia, which (as indicated by its name, premature dementia) was considered to be progressive and incurable. Several kinds of mental disorder were found to have clear causes, including vitamin deficiencies and various poisons and infections, but the idea of a certain thing called schizophrenia still persists.

在一项著名的诊断客观性测试中,英国和美国的精神科医生观看了一段病人访谈的录像。69%的美国人诊断患者为精神分裂症,但只有2%的英国精神病学家这么做。

尽管有《国际疾病分类》(International Classification of Diseases)和美国的《诊断与统计手册》(Diagnostic and Statistical Manual),其中列举了大量的“精神障碍”,但对症状的严格医学/心理学定义仍然存在,并没有使诊断更加客观。例如,在过去的30年里,自闭症被从儿童精神分裂症中分离出来,但现在倾向于两者都被称为发育性脑障碍。精神分裂症和自闭症现在经常被描述为“一系列病症”,这几乎无关紧要,因为人们不了解它们的病因、预防或治疗。

问题在于精神病作为一个医学概念的历史。大约100年前,人们尝试根据症状对精神病进行分类,将各种旧的诊断类别统一为两类:躁狂抑郁性心境障碍和“早老性痴呆”,即精神分裂症,这种疾病(正如其名称所示,早老性痴呆)被认为是进行性的、无法治愈的。几种精神障碍被发现有明确的原因,包括维生素缺乏、各种中毒和感染,但精神分裂症的概念仍然存在。

The unitary concept of psychosis grew up in a culture in which “endogenous insanity” was a “hereditary taint,” that for a time was “treated” by imprisonment, and that more recently has been treated with sterilization or euthanasia to eliminate the “insanity genes.”

精神病的单一概念是在这样一种文化中成长起来的,在这种文化中,“内生的精神错乱”是一种“遗传的污点”,有一段时间是通过监禁“治疗”的,最近则是通过绝育或安乐死来消除“精神错乱基因”。

The idea that the disease is “in the genes” now serves the drug industry well, since they offer chemicals that will correct the specific “chemical error.”

Not all psychiatrists and psychologists subscribed to the idea of a unitary psychosis, defined by a variety of symptoms. A positive contribution of Freudian psychoanalysis (and its congeners and competitors) was that it made people think in terms of causes and the possibility of cures, instead of hopelessness, stigmatization, isolation and eradication. Although Freud expressed the thought that biological causes and cures would eventually be found, the profession he founded was not sympathetic to the idea of physiological therapies.

Looking for general physiological problems behind the various symptoms is very different from the practice of classifying the insanities according to their symptoms and the hypothetical “brain chemicals” that are believed to “cause the symptoms.” The fact that some patients hallucinate caused many psychiatrists to believe that hallucinogenic chemicals, interfering with nerve transmitter substances such as dopamine or serotonin, were going to provide insight into psychotic states. The dopamine excess (or serotonin deficiency) theories developed at a time when only a few “transmitter substances” were known, and when they were thought to act as very specific on/off nerve switches, rather than as links in metabolic networks. The drug industry helps to keep those ideas alive.

The idea that the brain is like a computer, and that the nerves are like wires and switches, is behind all of the theories about transmitter substances and synapses. If this metaphor about the nature of the brain and the organism is fundamentally wrong, then the theories of schizophrenia based on nerve transmitter substances can hardly be right. Another theory of schizophrenia based on the computer metaphor has to do with the idea that nerve cells’ wire-like and switch-like functions depend on their membranes, and, in the most popular version, that these all-important membranes are made of fish oil. The supporting evidence is supposed to be that the fish-oil-like fatty acids are depleted from the tissues of schizophrenics. Just looking at that point, the “evidence” is more likely to be the result of stress, which depletes unsaturated fatty acids, especially of the specified type, in producing lipid peroxides and other toxic molecules.

这种疾病“在基因中”的观点现在很适合制药业,因为他们提供的化学物质可以纠正特定的“化学错误”。

并不是所有的精神病学家和心理学家都赞同由多种症状定义的单一精神病的观点。弗洛伊德精神分析(及其同辈和竞争对手)的一个积极贡献是,它让人们从原因和治愈的可能性的角度思考问题,而不是绝望、污名化、孤立和根除。尽管弗洛伊德表达了生物学病因和治疗方法最终会被发现的想法,但他创立的这个行业并不赞同生理疗法的想法。

寻找各种症状背后的一般生理问题,与根据症状和假想的“大脑化学物质”对精神错乱进行分类的做法是非常不同的。一些病人产生幻觉的事实使许多精神科医生相信,产生幻觉的化学物质会干扰神经传递物质,如多巴胺或血清素,这将为了解精神病状态提供线索。多巴胺过量(或血清素缺乏)理论是在只有少数“传递物质”已知的时候发展起来的,当时它们被认为是非常具体的开启/关闭神经开关,而不是代谢网络中的链接。制药业帮助这些想法存活下来。

大脑就像一台电脑,而神经就像电线和开关,这是所有关于递质物质和突触理论的基础。如果这个关于大脑和有机体本质的比喻从根本上是错误的,那么基于神经递质物质的精神分裂症理论就很难是正确的。另一个基于计算机隐喻的精神分裂症理论与神经细胞的线状和开关状功能依赖于它们的细胞膜有关,最流行的说法是,这些非常重要的细胞膜是由鱼油构成的。支持的证据应该是精神分裂症患者组织中的鱼油类脂肪酸被消耗殆尽。仅从这一点来看,“证据”更有可能是压力的结果,压力会消耗不饱和脂肪酸,尤其是特定类型的不饱和脂肪酸,产生脂质过氧化物和其他有毒分子。

In one of its variations, the “essential fatty acid deficiency” doctrine suggests that a certain prostaglandin deficiency is the cause of schizophrenia, but experiments have shown that an excess of that prostaglandin mimics the symptoms of psychosis.

The drug industry’s effect on the way the organism is commonly understood has been pervasively pathological. For example, the dogma about “cell surface receptors” has sometimes explicitly led people to say that the “brain chemicals” are active only at the surface of cells, and not inside the cells.

其中一种变体是“必需脂肪酸缺乏”学说,它认为某种前列腺素缺乏是精神分裂症的原因,但实验表明,过量的前列腺素类似精神病的症状。

制药业对人们普遍理解生物体的方式的影响是普遍的病态的。例如,关于“细胞表面受体”的教条有时明确地导致人们说,“大脑化学物质”只在细胞表面有活性,而不在细胞内部。

The consequences of this mistake have been catastrophic. For example, serotonin’s precursor, tryptophan, and the drugs called “serotonin reuptake inhibitors,” and other serotonergic drugs, and serotonin itself, are carcinogenic and/or tumor promoters. Excessive serotonin is a major factor in kidney and heart failure, liver and lung disease, stroke, pituitary abnormalities, inflammatory diseases, practically every kind of sickness, at the beginning, middle, and end of life. In the brain, serotonin regulates circulation and mitochondrial function, temperature, respiration and appetite, alertness and learning, secretion of prolactin, growth hormones and stress hormones, and participates in the most complex biochemical webs. But the pharmaceutical industry’s myth has led people to believe that serotonin is the chemical of happiness, and that tryptophan is its benign nutritional precursor, and that they are going to harmlessly influence the “receptors on nerve membranes.”

这个错误的后果是灾难性的。例如,5 -羟色胺的前体,色氨酸和被称为“5 -羟色胺再吸收抑制剂”的药物,以及其他5 -羟色胺能药物,以及5 -羟色胺本身,都是致癌和/或肿瘤促进剂。在生命的开始、中期和末期,过量的血清素是肾脏和心脏衰竭、肝脏和肺部疾病、中风、脑下垂体异常、炎症性疾病以及几乎所有疾病的主要因素。在大脑中,5 -羟色胺调节循环和线粒体功能、温度、呼吸和食欲、警觉性和学习、泌乳素的分泌、生长激素和应激激素,并参与最复杂的生化网络。但是制药业的神话让人们相信血清素是快乐的化学物质,而色氨酸是它良性的营养前体,它们将无害地影响“神经细胞膜上的受体”。

A particular drug has many effects other than those that are commonly recognized as its “mechanism of action,” but when an “antidepressant” or a “tranquilizer” or a “serotonin reuptake inhibitor” alleviates a particular condition, some people argue that the condition must have been caused by the “specific chemistry” that the drug is thought to affect. Because of the computer metaphor for the brain, these effects are commonly thought to be primarily in the synapses, the membranes, and the transmitter chemicals.

一种特殊的药物除了通常被认为是其“作用机制”之外,还有许多其他的作用,但是,当“抗抑郁剂”、“镇静剂”或“血清素再摄取抑制剂”缓解某种特定情况时,一些人认为,这种情况一定是由药物被认为影响的“特定化学物质”引起的。由于计算机对大脑的隐喻,这些影响通常被认为主要是在突触、膜和化学递质中。

The argument for a “genetic” cause of schizophrenia relies heavily on twin studies in which the frequency of both twins being schizophrenic is contrasted to the normal incidence of schizophrenia in the population, which is usually about 1%. There is a concordance of 30% to 40% between monozygotic (identical) twins, and a 5% to 10% concordance between fraternal twins, and both of these rates are higher than that of other siblings in the same family. That argument neglects the closer similarity of the intrauterine conditions experienced by twins, for example the sharing of the same placenta, and experiencing more concordant biochemical interactions between fetus and mother.

精神分裂症的“遗传”原因的论点在很大程度上依赖于对双胞胎的研究,在这些研究中,双胞胎患精神分裂症的频率与人群中精神分裂症的正常发病率(通常约为1%)形成了对比。同卵(同卵)双胞胎之间的一致性为30% - 40%,异卵双胞胎之间的一致性为5% - 10%,这两种比率都高于同一家庭中的其他兄弟姐妹。这种观点忽略了双胞胎在子宫内经历的更接近的情况,例如共享同一个胎盘,胎儿和母亲之间经历更和谐的生化相互作用。

Defects of the brain, head, face, and even hands and fingerprints are seen more frequently in the genetically identical twin who later develops schizophrenia than the twin who doesn’t develop schizophrenia. Of the twins, it is the baby with the lower birth weight and head size that is at a greater risk of developing schizophrenia.

Oliver Gillie (in his book, Who Do You Think You Are?) discussed some of the fraud that has occurred in twin studies, but no additional fraud is needed when the non-genetic explanation is simply ignored and excluded from discussion. The editors of most medical and scientific journals are so convinced of the reality of genetic determination that they won’t allow their readers to see criticisms of it.

在同卵双胞胎中,大脑、头部、面部甚至手和指纹的缺陷在后来患精神分裂症的双胞胎中比没有患精神分裂症的双胞胎中更常见。在这对双胞胎中,出生时体重和头部较小的婴儿患精神分裂症的风险更大。

Oliver Gillie(在他的书《你认为你是谁》中)讨论了双胞胎研究中出现的一些欺诈,但当非基因解释被简单地忽略并排除在讨论之外时,就不需要额外的欺诈了。大多数医学和科学杂志的编辑对基因决定的现实深信不疑,以至于他们不允许读者看到对它的批评。

Prenatal malnutriton or hormonal stress or other stresses are known to damage the brain, and especially its most highly evolved and metabolically active frontal lobes, and to reduce its growth, relative to the rest of the body.

众所周知,产前营养不良或荷尔蒙压力或其他压力会损害大脑,尤其是其高度进化和代谢活跃的额叶,并降低其相对于身体其他部位的生长。

The standard medical explanation for the association of pregnancy toxemia and eclampsia with birth defects has been, until recently, that both mother and child were genetically inferior, and that the defective child created the pregnancy sickness. The same “reasoning” has been invoked to explain the association of birth complications with later disease: The defective baby was the cause of a difficult birth. That argument has recently been discredited (McNeil and Cantor-Graae, 1999).

Schizophrenics are known to have had a higher rate of obstetrical complications, including oxygen deprivation and Cesarian deliveries, than normal people. Like people with Alzheimer’s disease, the circumference of their heads at birth was small, in proportion to their body weight and gestational age.

直到最近,妊娠毒血症和子痫与出生缺陷之间的联系的标准医学解释是,母亲和孩子的基因都较差,有缺陷的孩子造成了妊娠疾病。同样的“推理”也被用来解释出生并发症与后期疾病的关系:有缺陷的婴儿是难产的原因。这种观点最近遭到了质疑(McNeil和Cantor-Graae, 1999)。

众所周知,精神分裂症患者比正常人有更高的产科并发症发生率,包括缺氧和剖腹产。与阿尔茨海默氏症患者一样,他们出生时头的周长与体重和胎龄的比例很小。

Animal studies show that perinatal brain problems tend to persist, influencing the brain’s metabolism and function in adulthood.

Like the other major brain diseases, shizophrenia involves a low metabolic rate in crucial parts of the brain. In schizophrenics, “hypofrontality,” low metabolism of the frontal lobes, is characteristic, along with abnormal balance between the hemispheres, and other regional imbalances.

动物研究表明,围产期的大脑问题往往会持续存在,影响成年后的大脑代谢和功能。

与其他主要脑部疾病一样,精神分裂症涉及大脑关键部位代谢率低。精神分裂症患者的特征是额叶的低代谢,以及大脑半球之间的异常平衡和其他区域的不平衡。

A very important form of prenatal stress occurs in toxemia and preeclampsia, in which estrogen is dominant, and endotoxin and serotonin create a stress reaction with hypertension and impaired blood circulation to the uterus and placenta.

一种非常重要的产前应激形式发生在毒血症和子痫前期,在这种情况下,雌激素占主导地位,内毒素和血清素产生应激反应,导致高血压和子宫和胎盘的血液循环受损。

The brain, just like any organ or tissue, is an energy-producing metabolic system, and its oxidative metabolism is extremely intense, and it is more dependent on oxygen for continuous normal functioning than any other organ. Without oxygen, its characteristic functioning (consciousness) stops instantly (when blood flow stops, blindness begins in about three seconds, and other responses stop after a few more seconds). The concentration of ATP, which is called the cellular energy molecule, doesn’t decrease immediately. Nothing detectable happens to the “neurotransmitters, synapses, or membrane structures” in this short period; consciousness is a metabolic process that, in the computer metaphor, would be the flow of electrons itself, under the influence of an electromotive force, a complex but continuous sort of electromagnetic field. The computer metaphor would seem to have little to offer for understanding the brain.

大脑,就像任何器官或组织一样,是一个产生能量的代谢系统,它的氧化代谢是极其强烈的,它比任何其他器官更依赖氧气来持续正常运作。在没有氧气的情况下,其特有的功能(意识)会立即停止(当血液停止流动时,大约三秒钟后失明开始,几秒钟后其他反应也会停止)。ATP被称为细胞能量分子,它的浓度不会立即下降。在这短时间内,“神经递质、突触或膜结构”没有任何可检测到的变化;意识是一个新陈代谢的过程,用计算机的比喻来说,就是电子本身在电动势(一种复杂但连续的电磁场)影响下的流动。计算机这个比喻似乎对理解大脑没什么帮助。

In this context, I think it’s necessary, for the present, to ignore the diagnostic details, the endless variety of qualifications of the idea of “schizophrenia,” that fill the literature. Those diagnostic concepts seem to tempt people to look for “the precise cause of this particular subcategory” of schizophrenia, and to believe that a specific drug or combination of drugs will be found to treat it, while encouraging them to ignore the patient’s physiology and history.

If we use the standard medical terms at all, it should be with the recognition that they are, in their present and historical form, not scientifically meaningful.

在这种情况下,我认为目前有必要忽略诊断细节,忽略文献中关于“精神分裂症”的各种各样的限制条件。这些诊断概念似乎诱使人们去寻找精神分裂症“这个特定子类的确切原因”,并相信一定会找到一种特定的药物或药物组合来治疗它,同时鼓励他们忽视患者的生理和病史。

如果我们要使用标准的医学术语,那就应该认识到,它们在目前和历史上的形式都没有科学意义。

The idea that schizophrenia is a disease in itself tends to distract attention from the things it has in common with Alzheimer’s disease, autism, depression, mania, the manic-depressive syndrome, the hyperactivity-attention deficit syndrome, and many other physical and mental problems. When brain abnormalities are found in “schizophrenics” but not in their normal siblings, it could be tempting to see the abnormalities as the “cause of schizophrenia,” unless we see similar abnormalities in a variety of sicknesses.

精神分裂症本身就是一种疾病,这种观点往往会分散人们对它与阿尔茨海默病、自闭症、抑郁症、躁狂症、躁狂抑郁症、多动症和其他许多身体和精神问题的共同之处的注意力。如果在“精神分裂症”患者身上发现了大脑异常,而在他们正常的兄弟姐妹身上却没有,那么很容易把这种异常看作是“精神分裂症的病因”,除非我们在各种疾病中都发现了类似的异常。

For the present, it’s best to think first in the most general terms possible, such as a “brain stress syndrome,” which will include brain aging, stroke, altitude sickness, seizures, malnutrition, poisoning, the despair brought on by inescapable stress, and insomnia, which are relatively free of culturally arbitrary definitions. Difficulty in learning, remembering, and analyzing are objective enough that it could be useful to see what they have to do with a “brain stress syndrome.”

就目前而言,最好先从最普遍的角度来考虑,比如“大脑压力综合症”,这将包括大脑衰老、中风、高原反应、癫痫、营养不良、中毒、不可避免的压力带来的绝望,以及失眠,这些都是相对没有文化上任意定义的。学习、记忆和分析方面的困难是足够客观的,因此了解它们与“大脑压力综合症”有什么关系是很有用的。

Stress damages the energy producing systems of cells, especially the aerobic mitochondria, in many ways, and this damage can often be repaired. The insanities that are most often called schizophrenia tend to occur in late adolescence, or around menopause, or in old age, which are times of stress, especially hormonal stress. Post-partum psychosis often has features that resemble schizophrenia.

压力会在许多方面损害细胞的能量产生系统,特别是有氧线粒体,而这种损害通常可以修复。通常被称为精神分裂症的精神错乱往往发生在青春期后期,或更年期前后,或老年,这是压力的时期,尤其是荷尔蒙压力。产后精神病通常具有类似精神分裂症的特征。

Although the prenatal factors that predispose a person toward the brain stress syndrome, and those that trigger specific symptoms later in life, might seem to be utterly different, the hormonal and biochemical reactions are probably closely related, involving the adaptive responses of various functional systems to the problem of insufficient adaptive ability and inadequate energy.

虽然使一个人容易患上大脑压力综合症的产前因素,和那些在生命后期引发特定症状的因素,似乎完全不同,但激素和生化反应可能是密切相关的,涉及到各种功能系统对适应能力不足和能量不足问题的适应反应。

By considering cellular energy production, local blood flow, and the systemic support system, we can get insight into some of the biochemical events that are involved in therapies that are sometimes successful. A unified concept of health and disease will help to understand both the origins and the appropriate treatments for a great variety of brain stress syndromes.

通过考虑细胞能量生产、局部血流和系统支持系统,我们可以了解一些生化事件,这些事件涉及治疗,有时是成功的。一个统一的健康和疾病概念将有助于理解各种脑应激综合征的起源和适当的治疗。

The simple availability of oxygen, and the ability to use it, are regulated by carbon dioxide and serotonin, which act in opposite directions. Carbon dioxide inhibits the release of serotonin. Carbon dioxide and serotonin are regulated most importantly by thyroid function. Hypothyroidism is characterized by increased levels of both noradrenalin and serotonin, and of other stress-related hormones, including cortisol and estrogen. Estrogen shifts the balance of the “neurotransmitters” in the same direction, toward increased serotonin and adrenalin, for example by inhibiting enzymes that degrade the monoamine “neurotransmitters.”

氧气的简单获得和使用能力,是由二氧化碳和血清素调节的,它们的作用方向相反。二氧化碳会抑制血清素的释放。二氧化碳和血清素是由甲状腺功能调节的。甲状腺机能减退的特征是去甲肾上腺素和血清素水平升高,以及其他与压力有关的激素水平升高,包括皮质醇和雌激素。雌性激素通过抑制降解单胺“神经递质”的酶,使“神经递质”的平衡向同一方向改变,即增加血清素和肾上腺素。

When an animal such as a squirrel approaches hibernation and is producing less carbon dioxide, the decrease in carbon dioxide releases serotonin, which slows respiration, lowers temperature, suppresses appetite, and produces torpor.

当动物(如松鼠)接近冬眠,产生的二氧化碳减少时,二氧化碳的减少会释放血清素,而血清素会减缓呼吸、降低温度、抑制食欲,并导致麻木(躺平)。

But in energy-deprived humans, increases of adrenalin oppose the hibernation reaction, alter energy production and the ability to relax, and to sleep deeply and with restorative effect.

In several ways, torpor is the opposite of sleep. Rapid eye movement (REM), that occurs at intervals during sleep and in association with increased respiration, disappears when the brain of a hibernating animal falls below a certain temperature. But torpor isn’t like “non-REM” deep sleep, and in fact seems to be like wakefulness, in the sense that a sleep-debt is incurred: Hibernating animals periodically come out of torpor so they can sleep, and in those periods, when their temperature rises sharply, they have a very high percentage of deep “slow wave sleep.”

但对于缺乏能量的人来说,肾上腺素的增加会对抗冬眠反应,改变能量的产生和放松的能力,以及深度睡眠的恢复效果。

在很多方面,麻木(躺平)是睡眠的反面。冬眠动物的大脑温度低于一定温度时,睡眠中每隔一段时间发生的、与呼吸增加有关的快速眼动(REM)就会消失。但躺平不像“非快速眼动”深度睡眠,事实上似乎像觉醒,从这个意义上来说,睡眠债发生:冬眠动物周期性的躺平,这样他们就可以睡觉,在这些时期,当他们的温度急剧上升,他们有一个非常高的比例的深“慢波睡眠”。

Although it is common to speak of sleep and hibernation as variations on the theme of economizing on energy expenditure, I suspect that nocturnal sleep has the special function of minimizing the stress of darkness itself, and that it has subsidiary functions, including its now well confirmed role in the consolidation and organization of memory. This view of sleep is consistent with observations that disturbed sleep is associated with obesity, and that the torpor-hibernation chemical, serotonin, powerfully interferes with learning.

虽然是很常见的睡眠和休眠状态变化在节约能量消耗的主题,我认为,夜间睡眠的特殊函数最小化的压力黑暗本身,和它的子公司功能,包括现在确认的整合和组织记忆。这种关于睡眠的观点与以下观察结果是一致的:睡眠紊乱与肥胖有关,而昏睡-冬眠化学物质血清素严重干扰学习。

Babies spend most of their time sleeping, and during life the amount of time spent sleeping decreases, with nightly sleeping time decreasing by about half an hour per decade after middle age. Babies have an extremely high metabolic rate and a stable temperature. With age the metabolic rate progressively declines, and as a result the ability to maintain an adequate body temperature tends to decrease with aging.

婴儿的大部分时间都在睡觉,在一生中,睡眠的时间会减少,中年后每晚的睡眠时间每十年减少约半个小时。婴儿有极高的代谢率和稳定的体温。随着年龄的增长,代谢率逐渐下降,因此维持适当体温的能力也会随着年龄的增长而下降。

(The simple fact that body temperature regulates all organic functions, including brain waves, is habitually overlooked. The actions of a drug on brain waves, for example, may be mediated by its effects on body temperature, but this wouldn’t be very interesting to pharmacologists looking for “transmitter-specific” drugs.)

(体温调节包括脑电波在内的所有有机功能这一简单事实常常被忽视。例如,药物对脑电波的作用可能是由其对体温的影响介导的,但这对寻找“传递特异”药物的药理学家来说不是很有趣。)

Torpor is the opposite of restful sleep, and with aging, depression, hypothyroidism, and a variety of brain syndromes, sleep tends toward the hypothermic torpor.

躺平是安静睡眠的对立面,随着衰老、抑郁、甲状腺功能减退和各种大脑综合症,睡眠倾向于体温过低的麻木。

An individual cell behaves analogously to the whole person. A baby’s “high energy resting state” is paralleled by the stable condition of a cell that is abundantly charged with energy; ATP and carbon dioxide are at high levels in these cells. Progesterone’s effects on nerve cells include favoring the high energy resting state, and this is closely involved in progesterone’s “thermogenic” effect, in which it raises the temperature set-point.

The basal metabolic rate, which is mainly governed by thyroid, roughly corresponds to the average body temperature. However, in hypothyroidism, there is an adaptive increase in the activity of the sympathetic nervous system, producing more adrenalin, which helps to maintain body temperature by causing vasoconstriction in the skin. In aging, menopause, and various stressful conditions, the increased adrenalin (and the increased cortisol production which is produced by excess adrenalin) causes a tendency to wake more easily, and to have less restful sleep.

单个细胞的行为与整个人相似。婴儿的“高能量静息状态”与充满能量的细胞的稳定状态是平行的;ATP和二氧化碳在这些细胞中含量很高。黄体酮对神经细胞的影响包括促进高能量静息状态,这与黄体酮的“生热”效应密切相关,在这种效应中,黄体酮提高了温度的设定值。

基础代谢率与平均体温大致相当,主要由甲状腺控制。然而,在甲状腺机能减退症中,交感神经系统的活动会有适应性的增加,产生更多的肾上腺素,肾上腺素通过引起皮肤血管收缩来帮助维持体温。在衰老、更年期和各种压力条件下,肾上腺素的增加(以及肾上腺素过量产生的皮质醇的增加)会导致人们更容易醒来,睡得更少。

While the early morning body temperature will sometimes be low in hypothyroidism, I have found many exceptions to this. In protein deficiency, sodium deficiency, in menopause with flushing symptoms, and in both phases of the manic depression cycle, and in some schizophrenics, the morning temperature is high, corresponding to very high levels of adrenalin and cortisol. Taking the temperature before and after breakfast will show a reduction of temperature, the opposite of what occurs in simple hypothyroidism, because raising the blood sugar permits the adrenalin and cortisol to fall.

虽然清晨的体温有时会在甲状腺功能减退时很低,但我发现了许多例外情况。蛋白质缺乏,钠缺乏,更年期潮红症状,躁狂抑郁周期的两个阶段,还有一些精神分裂症患者,早晨的体温很高,与肾上腺素和皮质醇水平相当。在早餐前后测量体温会显示体温下降,这与单纯的甲状腺机能减退相反,因为升高的血糖会导致肾上腺素和皮质醇下降。

The characteristic sleep pattern of hypothyroidism and old age is similar to the pattern seen in schizophrenia and depression, a decrease of deep slow wave sleep. Serotonin, like torpor, produces a similar effect. In other words, a torpor-like state can be seen in all of these brain-stress states. Several studies have found that anti-serotonin drugs improve sleep, and also reduce symptoms of schizophrenia and depression. It is common for the “neuroleptic” drugs to raise body temperature, even pathologically as in the “neuroleptic malignant syndrome.”

In old people, who lose heat easily during the day, their extreme increase in the compensatory nervous and hormonal adrenalin activity causes their night-time heat regulation (vasoconstriction in the extremities) to rise to normal.

Increased body temperature improves sleep, especially the deep slow wave sleep. A hot bath, or even warming the feet, has the same effect as thyroid in improving sleep. Salty and sugary foods taken at bedtime, or during the night, help to improve the quality and duration of sleep. Both salt and sugar lower the adrenalin level, and both tend to raise the body temperature.

甲状腺功能减退症和老年的典型睡眠模式与精神分裂症和抑郁症的模式相似,即深度慢波睡眠的减少。血清素和麻木一样,也会产生类似的效果。换句话说,在所有这些脑应激状态中都可以看到一种类似麻木的状态。几项研究发现,抗血清素药物能改善睡眠,还能减轻精神分裂症和抑郁症的症状。“神经安定”药物提高体温是很常见的,甚至在病理上如“神经安定恶性综合征”。

老年人在白天很容易失去热量,他们的代偿神经和荷尔蒙肾上腺素活动的极端增加导致他们夜间的热量调节(四肢血管收缩)恢复正常。

提高体温可以改善睡眠,尤其是深度慢波睡眠。洗个热水澡,甚至是暖脚,在改善睡眠方面与甲状腺有相同的效果。睡前或晚上吃含盐和含糖的食物有助于改善睡眠质量和持续时间。盐和糖都会降低肾上腺素水平,而且都倾向于提高体温。

Hypothyroidism tends to cause the blood and other body fluids to be deficient in both sodium and glucose. Consuming salty carbohydrate foods momentarily makes up to some extent for the thyroid deficiency.

In the peiodic table of the elements, lithium is immediately above sodium, meaning that it has the chemical properties of sodium, but with a smaller atomic radius, which makes its electrical charge more intense. Its physiological effects are so close to sodium’s that we can get clues to sodium’s actions by watching what lithium does.

Chronic consumption of lithium blocks the release of adrenalin from the adrenal glands, and it also has extensive antiserotonin effects, inhibiting its release from some sites, and blocking its actions at others.

甲状腺机能减退会导致血液和其他体液缺乏钠和葡萄糖。多吃含盐的碳水化合物食物可以在一定程度上弥补甲状腺不足。

在元素周期表中,锂位于钠的上方,这意味着它具有钠的化学性质,但它的原子半径更小,这使得它的电荷更强烈。它的生理作用与钠非常接近,我们可以通过观察锂的作用来了解钠的作用。

长期摄入锂会阻碍肾上腺素的释放,它还具有广泛的抗血清素作用,抑制某些部位的释放,并阻止其在其他部位的活动。

Lithium forms a complex with the ammonia molecule, and since the ammonia molecule mimics the effects of serotonin, especially in fatigue, this could be involved in lithium’s antiserotonergic effects. Ammonia, like serotonin, impairs mitochondrial energy production (at a minimum, it uses energy in being converted to urea), so anti-ammonia, anti-serotonin agents make more energy available for adaptation. Lithium has been demonstrated to restore the energy metabolism of mitochondria (Gulidova, 1977).

锂与氨分子形成复合物,由于氨分子模仿血清素的作用,特别是在疲劳时,这可能与锂的抗血清素作用有关。氨和血清素一样,会损害线粒体能量的产生(至少,它会消耗能量转化为尿素),所以抗氨、抗血清素制剂会为适应提供更多的能量。锂已经被证明可以恢复线粒体的能量代谢(Gulidova, 1977)。

Therapies that have been successful in treating “schizophrenia” include penicillin, sleep therapy, hyperbaric oxygen, carbon dioxide therapy, thyroid, acetazolamide, lithium and vitamins. These all make fundamental contributions to the restoration of biological energy. Antibiotics, for example, lower endotoxin formation in the intestine, protect against the induction by endotoxin of serotonin, histamine, estrogen, and cortisol. Acetazolamide causes the tissues to retain carbon dioxide, and increased carbon dioxide acidifies cells, preventing serotonin secretion.

已经成功治疗“精神分裂症”的疗法包括青霉素、睡眠疗法、高压氧、二氧化碳疗法、甲状腺、乙酰唑胺、锂和维生素。这些都对恢复生物能做出了根本性的贡献。例如,抗生素可以降低肠道内毒素的形成,防止内毒素对血清素、组胺、雌激素和皮质醇的诱导作用。乙酰唑胺使组织保留二氧化碳,增加二氧化碳酸化细胞,阻止血清素分泌。

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