Anxiety

Provider (SP): How can I help you? 醫療人員： 今天有什麼我可以幫您的嗎？

Patient: The thing is that all night long last night, I was feeling nervous and jittery. I just couldn't relax. My wife was really worried. 病人： 情況是這樣的，昨晚一整夜我都覺得很緊張、心神不寧。我就是沒辦法放鬆下來。我太太真的很擔心。

Patient: I tried to go to bed and fall asleep, but I couldn't. Then, all of a sudden, I felt short of breath. I was gasping for air as if I were drowning... 病人： 我試著上床睡覺，但怎麼也睡不著。接著，突然之間，我感到呼吸急促。我拼命大口吸氣，感覺就像快溺水了一樣……

Provider (SP): Did you have any other physical symptoms like pain? 醫療人員： 您那時候還有其他身體症狀嗎？例如疼痛？

Patient: Yeah, I had a terrible headache back here in the nape of my neck. 病人： 有，我這裡痛得很厲害，就在我脖子後面的後腦勺（後頸部）。

Provider (SP): You said, Mr. [Smith], that you had been feeling bad for several days. What had you been feeling? 醫療人員： 史密斯先生，您剛才提到您已經連續幾天都感覺很不舒服了。您具體都有哪些感受呢？

Patient: At work, I couldn't concentrate at all. I was irritable with everyone. Every little thing would startle me. 病人： 工作的時候，我完全沒辦法集中精神。我對每個人都很不耐煩、易怒。一有風吹草動、任何小事都會嚇到我。

Patient: I didn't have any appetite. Whenever I would eat it would make me nauseous. But the worst thing is that I couldn't sleep at all. I think it's been like four nights now that I've hardly gotten any sleep. 病人： 我一點胃口也沒有。每次只要吃東西就會覺得噁心想吐。但最糟糕的是我根本睡不著。我想我已經連續四個晚上幾乎沒怎麼睡過覺了。

Provider (SP): Now, I see from your chart that you had been seen by a psychiatrist for anxiety in the past. Were you ever prescribed any medications for anxiety or depression? 醫療人員： 好的，我從您的病歷表上看到，您過去曾因為焦慮症看過精神科醫生。您當時有被開過任何治療焦慮或憂鬱症的藥物嗎？

Patient: Yeah, he gave me two pills, one was for a depression. I think it was called Zoloft. 病人： 有，他開了兩種藥丸給我，有一種是治憂鬱症的。我想那種藥叫做「樂復得」（Zoloft）。

Provider (SP): And the other one? 醫療人員： 那另外一種呢？

Patient: It was a little round one that was called loraza-something... 病人： 是一種小小的、圓圓的藥丸，名字叫「勞拉什麼」的……

Provider (SP): Lorazepam? 醫療人員： 勞拉西泮（Lorazepam / 安定文）嗎？

Patient: Yeah, that's it. 病人： 對，就是那個。

Provider (SP): Did they seem to help? 醫療人員： 這些藥那時候看起來有幫助嗎？

Patient: A little bit. The lorazepam one, the doctor took away. The other one I just stopped taking. 病人： 有一點點效果。勞拉西泮那種藥，後來醫生停掉了。至於另外一種，是我自己決定不吃的。

Provider (SP): Lorazepam is usually just taken short-term because it can cause dependency. What about the anti-depressant? Why did you stop taking that one? 醫療人員： 勞拉西泮通常只適合短期服用，因為它可能會引發藥物依賴（成癮）。那抗憂鬱劑呢？您為什麼決定停藥？

Patient: The thing is that I took it for several days and it really didn't seem like it was helping much. It just made me feel tired and numb all the time. I don't know how to describe it。 病人： 問題是我吃了好幾天，感覺真的沒什麼效果。它只讓我整天都覺得很累、整個人麻木呆滯。我也不知道該怎麼形容。

Patient: It was hard to concentrate at work. I was scared that I was going to get fired and I really can't afford to lose my job, so I just decided not to take it anymore. 病人： 這讓我很難在工作時集中注意力。我很害怕自己會被解雇，而我真的承受不起失去這份工作的代價，所以我乾脆決定不吃了。

Provider (SP): Well, anti-depressants can take several weeks to have an effect, so you really need to stick with it. I think it would be good for you to follow up with your psychiatrist again. 醫療人員： 嗯，抗憂鬱劑通常需要幾週的時間才能發揮藥效，所以您真的需要堅持服用。我想您最好還是再去向您的精神科醫生複診。

Provider (SP): There are many kinds of anti-depressants out there; maybe he can try a different one to see if helps you better. 醫療人員： 市面上有很多種抗憂鬱劑；也許他可以幫您換另一種試試，看會不會對您比較有幫助。

Provider (SP): Sometimes when people start taking medicine for depression, at the beginning they can feel worse, even suicidal, for which reason you'll need to stay in touch with the doctor and not miss your follow-up appointments. 醫療人員： 有時候，人們剛開始服用抗憂鬱藥物時，初期可能會感覺更糟，甚至會產生自殺傾向，這就是為什麼您必須和醫生保持聯絡，並且絕對不能錯過複診預約的原因。

Patient: OK. The problem is that because I missed a few appointments, supposedly that psychiatrist doesn't want to see me anymore. 病人： 好吧。但問題是，因為我之前錯過幾次預約，據說那位精神科醫生現在已經不想看我了。

Provider (SP): If you give me a couple minutes I can make some calls and see if you can be seen again in that clinic. 醫療人員： 如果您給我幾分鐘，我可以幫您打幾通電話，看看您能不能重新回那間診所看診。

Provider (SP): At this point, Mr. Smith, the most important thing for you is to get regular outpatient care to get your anxiety under control. Give me a few minutes to make some calls and I'll come back and let you know what I find. Sound good? 醫療人員： 史密斯先生，在目前這個階段，對您最重要的事情是接受定期的門診治療，好把焦慮症控制住。給我幾分鐘打個電話，我回頭再告訴您進展。這樣好嗎？

(醫療人員離開房間後再度返回)

Provider (SP): I called them and they are not able to see you again at that clinic. We have a clinic associated with our hospital. 醫療人員： 我幫您打過電話了，那間診所沒辦法再讓您掛號了。不過，我們醫院有附設一間相關的診所。

Provider (SP): I will make you an appointment at that clinic if that is OK with you. We use interpreters at that clinic too. All right? 醫療人員： 如果您可以接受的話，我會幫您在那間診所預約看診。我們那間診所也有提供口譯員服務。這樣可以嗎？

Patient: That should be OK. I will try to do better this time getting to my appointments. Thanks for everything. 病人： 那應該沒問題。我這次會努力改進，準時赴約的。謝謝妳幫忙這一切。

Anxiety 焦慮 / 焦慮症

Jittery 心神不寧的 / 緊張焦躁的

Short of breath / Gasping for air 呼吸急促 / 喘不過氣、大口吸氣

Nape of my neck 後頸部 / 後腦勺

Irritable 易怒的 / 躁動不安的

Psychiatrist 精神科醫生

Outpatient care 門診治療 / 門診照護

Dependency 藥物依賴 / 成癮性

Zoloft (Sertraline) 樂復得（一種常見的選擇性血清素再吸收抑制劑抗憂鬱藥）

Lorazepam 勞拉西泮（一種常用於抗焦慮、鎮靜的苯二氮䓬類藥物，具成癮性，僅建議短期使用）