試從佛教教理剖析「憂鬱」的源由與預防－－以《阿含經》為主

「憂鬱」（Depression），在這步伐匆忙的時代，是耳熟能詳的心理狀況。根據「世界衛生組織」（World Health Organization, 2012），這是一種常見的心理障礙，其特徵包括：悲傷、失去生活興趣、罪惡感或自我貶低等等。這些特徵更進而影響當事人的睡眠與食慾。「憂鬱」有輕重之別，但不論輕重都必須給予重視。因為一個人若長時間處於心情低落的狀況，是極可能從輕度憂鬱而演變為重憂鬱症以致影響其日常活動，有些更嚴重到有自殺的傾向。根據臺灣林口長庚醫院有關「憂鬱症」的報告顯示：臺灣人罹患憂鬱症的比例是逐年升高，約有13%至20%的成年人會產生與憂鬱症相關的症狀。資料中更顯示憂鬱症的自殺成功率高達15%，並以男性居多。「憂鬱」，是否僅僅是近代的論題？本文以「憂鬱」為主軸，先就近代心理學界對「憂鬱」的研究成果，探討其種類並彙整其起因。再追溯到佛陀的時代（約西元前五世紀），從佛教的《阿含經》探討「憂」這一語詞的應用與詮釋。另一方面，由於「憂鬱」對現代人存在著非同小可的影響，所以其「預防」與「療癒」也是大家熱衷討論的課題。關於「療癒法」── 藥物治療或心理諮商，近代臨床與心理學界都有相當豐富的研究成果，由於篇幅所限所以不是本篇的論述範疇。本文著重於「預防」，試提出「四預流支」── 親近善士、聽聞正法、如理思惟、法隨法行 ── 作為預防「憂鬱」之方法。本文之撰寫因緣，除了希望拉近佛教界與心理學界的距離以外，筆者也自我期許透過整理與撰文，讓自己更融會貫通過去於此二界之所學，更期望可以整理出更多有效的預防與療癒法，造福人群與社會，落實佛教慈悲拔苦的精神。

關鍵字

憂鬱；沮喪；低落性情感；情感性疾患；四預流支

並列摘要

According to the World Health Organization (WHO), ＂depression＂ is a common mental disorder with symptoms of sadness, loss of interest, guilt or self-deprecation. These characteristics tend to affect one's sleep and appetite. A long period of time in the depressed condition can evolve from a subclinical depression to a state of clinical depression which will seriously affect one's daily activities. Furthermore, some cases of depression would result in suicidal tendencies. According to Chang Gung Memorial Hospital in Linkou, the report on ＂depression＂ shows that in Taiwan the population suffering from depression is increasing yearly, indicating that approximately 13-20% of adults have depression-related symptoms. Furthermore, the data shows that depression-caused suicide success rates are 15%, which involve mostly male patients. Thus, depression is indeed a serious topic of the modern society that should not be overlooked. Is ＂depression＂ just a modern issue of concern? In this research, I will first investigate the definition and classification of ＂depression＂ in modern clinical psychology. Moreover, this research will collect and compile the causes of depression found from scholarly sources as reliable references. Secondly, this research will also examine the application and interpretation of the word ＂depress＂ from early discourses by tracing back to the Buddha's era such as the Agama. Furthermore, the prevention and treatment for depression is also a keen topic of discussion nowadays. In terms of treatment, there are drug therapies and psychological counseling; on top of that, the rich studies conducted in modern clinical psychology have resulted in more solutions in this field. Hence, instead of the discussing above, this research will focus on the aspect of ＂prevention＂, which is suggested by the ＂Four Factors for Stream-entry＂- (1) association with good-knowing advisors, (2) hearing the true Dharma, (3) proper consideration, and (4) practicing in accordance with the Dharma- as the prevention of ＂depression.＂ Of course, within the vast teachings of the Buddha, I believe that there are many other theories and methods other than the ＂Four Factors for Stream-entry＂ that can be applied to the prevention and treatment of ＂depression.＂ In order to avoid complex and lengthy narratives, this research will mainly illustrate the aspect of ＂prevention＂ instead. I hope this paper will narrow the distance between the Buddhist community and the psychology field, while establishing a platform for more interaction and exchange for both sectors in the future. As for my personal expectations, my goal is to bring forth discoveries and continuous growth in effective preventions and therapies related to depression from Buddhist discourses for the benefit of all mankind and society. Lastly, I wish for my research to implement the spirit of Buddhist compassion.