人と接するのが苦手、不安や緊張、恐怖感がある。もしかして社交不安症、回避性パーソナリティ障害かも　概論および違い、治療法　#精神科医 #益田裕介 / Social anxiety disorder

01:52 Social Anxiety Disorder and Avoidant Personality Disorder 04:12 Differences in Treatment 06:19 Tailoring Treatment to the Individual 07:21 Why are you uncomfortable around people? 09:16 Treatment progresses as you talk about everything Today's video is for people who have difficulty speaking in public or interacting with others. Your symptoms may be due to a psychiatric illness called "social anxiety disorder" or "avoidant personality disorder." I'll briefly explain the symptoms and treatment options available. If you think you might have this condition, please feel free to visit a psychiatrist. If you have a family member with this condition, please encourage them to visit. Medication and counseling can alleviate or improve symptoms, so please feel free to come and see us. ■Social Anxiety Disorder and Avoidant Personality Disorder I believe there are many people who are extremely anxious or uncomfortable speaking in public. It's difficult to explain what is normal and what is an illness. Roughly speaking, if you have strong anxiety that prevents you from living your daily life satisfactorily and enjoying yourself, if it prevents you from getting good grades on tests, makes you timid during presentations, or makes you feel depressed the day before, the day before, or even a week before a presentation, then I would say it's an illness. Simply put, both social anxiety disorder and avoidant personality disorder are illnesses that make people have difficulty interacting with others, but the degree of severity varies. Think of social anxiety disorder as being milder and avoidant personality disorder as being more severe. "Social anxiety disorder" is a type of anxiety disorder, so it can be thought of as being limited to certain situations and periods. The diagnosis does specify that the anxiety period must last for six months or more, but that's just the general idea. "Avoidant personality disorder" is an illness that shows this tendency in all aspects of life and living. In the case of social anxiety disorder, the focus is on emotions, but in the case of avoidant personality disorder, the core of the problem is the behavior of avoidance. Even with this explanation, it's still hard to understand, isn't it? You may wonder if this explanation will be understood even when you explain it yourself. As I'll explain later, this requires experience. Patients probably won't understand this either. As I've treated several people with social anxiety disorder and several people with avoidant personality disorder, I've begun to see or understand the boundaries of personality disorders, although this varies from therapist to therapist. People with personality disorders tend to be avoidant, have difficulty interacting with others, and seem to avoid people in all situations. The image is that people with anxiety disorders have limited abilities and that this doesn't happen with close friends. The image is that people with personality disorders are more rigid and inflexible, while people with anxiety disorders are more adaptable. It's difficult. ■Differences in Treatment There are also some differences in the treatment methods. For social anxiety disorder, the main treatment is "exposure therapy." In other words, it's about getting the person used to it. If you don't like speaking in front of a large group of people, you might start by practicing speaking in front of one or two people. If you don't like crowds or school, you might start by attending a free school. On the other hand, for avoidant personality disorder, exposure therapy can be strict. That's why we first try to get the person used to going to clinic. If the therapist responds normally, the person might think, "I might not like you" or "I might be rejected," and won't continue. With people with avoidant personality disorder, you need to be especially careful, offering praise wherever possible, and making sure to convey that you don't feel uncomfortable around them and that you are friendly. It's these small interactions like these that make the difference in the treatment of both disorders. You might think that friendly interactions are extended to everyone, but that's not the case. To put it simply, people with avoidant personality disorder tend to be more exaggerated, while people with anxiety disorders don't express their affection as dramatically as they would any other person, so they don't need to be so dramatic. As I've said many times, this requires empirical evidence, so it's difficult to say which is which. Don't worry too much about it. ■ Tailor treatment to the individual The reason is that psychiatric treatment is based on tailoring treatment to the individual. A diagnosis is merely a hint. Psychiatrists don't think, "This person has XX disorder, so let's give them this kind of treatment." A diagnosis is merely a hint, and we treat them while thinking, "I guess XX is this kind of person," or "If I say this, XX wi...