DEPRESSION or melancholia, is a state of sadness, decreased initiative, and introversion. Modern psychiatry differentiates between reactive depression, which is caused by events unpleasant to the patient, and endogenous depression, which is caused by physiological changes.

抑郁或抑郁症，是一种悲伤、缺失主动性和内向性的状态。现代精神病学将其分为由患者的不愉快事件导致的反应性抑郁症和由生理变化导致的内源性抑郁症。

Depression is ordinarily a reaction to a sense of loss; as such, it may be a normal response to a real personal tragedy, such as the death of a loved one. Normal depression may be useful if it hastens the individual’s adjustment to a necessary change in his life-style. But when the depression is unrelated to any actual event or is grossly excessive in proportion to its apparent cause then it reflects some form of mental illness. Normal and abnormal reactive depressions are not clearly distinguishable, differing mainly in degree and duration. They range from neurotic reactions in which there is no serious disturbance in thinking to psychotic reactions in which there are delusions and other signs of loss of contact with reality.

抑郁一般是对失落感的反应；就其本身而言，它可能是一个真实的个人悲剧反应，比如一位所爱之人的去世。如果它加速了个人对生活方式必要改变的适应，那么正常的抑郁可能有用。但当抑郁与任何实际事件无关时，或者与其明显的原因极不成比例时，那么它就反映了某种精神疾病。反应性抑郁症的正常与不正常尚无法明确的区别，主要不同在于程度和持续时间。它们的范围从思维未受到严重干扰的神经质反应到出现妄想和与现实失去联系的其它迹象的精神病反应。

Endogenous depressions take various forms. Agitated depression is a syndrome characterized by depression with feelings of worthlessness and despair, although the patient is overactive and talkative. In manic-depressive psychosis, during the depressive phases, the patient is lethargic and has feelings of hopelessness and delusion of guilt for imagined sins and shortcomings. Patients may become depressed to the point of stupor, failing to respond to external events and losing interest in eating and exertion of any kind. Involutional melancholia is a form of depression usually occurring in women near menopause. It is uncertain whether this psychosis results from biological changes or from anxiety and dissatisfaction over growing old.

内源性抑郁症有各种形式。焦虑性抑郁症是以一种毫无价值和绝望之感的抑郁为特征的综合症状，尽管患者过于活跃且很健谈。在躁狂抑郁症中，在抑郁阶段，患者无精打采，有绝望之感，且幻想想象中的罪恶和缺点。患者可能将抑郁发展到麻木的程度，无法回应外部事件，并对饮食和任何努力失去兴趣。更年期抑郁是一种通常发生在接近更年期妇女的情形。这种精神疾病是否起因于生物学的变化，或是对过度衰老的焦虑和不满尚无法确定。

Psychoanalytically, depression is held to result from guilt feeling arising from the redirection against the self of unconscious hostility to others. Biochemically, it seems to be related to abnormal metabolism of naturally occurring amines in the brain. Residual intracellular sodium is increased and intracellular potassium reduced. To treat depression, antidepressant drugs have been found effective, and electroshock therapy is also used. Psychotherapy is useful in all cases, often in conjunction with drugs or shock.

从精神分析的角度讲，抑郁症被认为是源自对他人无意识敌意的自我转向引起的内疚感。从生物化学角度说，它似乎与大脑中自然产生胺类的代谢紊乱有关。细胞内残留钠的增加和细胞内钾的减少。为治疗抑郁症，发现抗抑郁药是有效的，也可以使用电击疗法。心理疗法在任何时候都是有用的，时常与药物或电击疗法配合使用。

                        AUSTIN E. GRIGG, University of Richmond

                        奥斯丁·E. 格里格，里奇蒙大学

                                       2023年3月30日译

（译者注：该词条位列《大美百科全书》1985年版，第8卷，第747-749页）