ほほえみうつ病について精神科医が解説します。

Good evening, I'm Takahiro Haga, a psychiatrist. Today, I'd like to talk about "smiling depression." Smiling depression is a colloquial term used to describe a condition in which a person appears cheerful and smiling from the outside, but is deeply depressed on the inside. Since it's not an official academic diagnosis, it doesn't mean someone has been diagnosed with smiling depression. However, it's a commonly used term to succinctly describe the suffering of depression. Approximately one in ten people will experience depression in their lifetime. However, rather than being "fully cured and completely free of the illness," depression can often leave behind "temperaments and vulnerabilities" that make it prone to relapse if certain conditions are met. Therefore, the goal of treatment is "continuous prevention of relapse." When depression is at its most severe, symptoms include a "mask-like face," where the energy needed to make facial expressions is depleted and the face becomes rigid, and "mental paralysis," where thinking slows to a halt. Meanwhile, in the mild to moderate stage, some people are able to express their distress to those around them, while others choose to hide it. The latter may be able to smile and work hard at work, but be completely exhausted and unable to function when they get home—this condition is often referred to as "smile depression." And this is the most difficult part. If you can smile in public, others may misunderstand and think, "She looks fine" or "Is she really depressed?" While the individual may be putting on a false bravado simply to avoid worrying others, their efforts may backfire and they may be perceived as "slacking off." Similar terms include "new-type depression" and "atypical depression." These concepts tend to focus on the aspect of "not being able to do stressful tasks but still being able to do the things you love (hobbies and leisure activities)." Smile depression focuses on the ability to "work hard in front of others," while new-type depression tends to focus on the ability to "do the things you love." As both conditions worsen, they can even become unable to pursue hobbies, ultimately leading to the same "severe depression." So what kind of treatment is there? The basic approach, just like with regular depression, is based on three main pillars. The first is medication. Antidepressants act on the serotonin system in the short term, promoting brain recovery (neuroplasticity mediated by BDNF, etc.) over time. For those who are suitable for them, it is a treatment worth carefully considering. The second is lifestyle habits: sleep rhythm, nutrition, and exercise. Humans are creatures that thrive on movement, so it's very important to get into the habit of moving your body as much as possible. And the third is counseling (cognitive behavioral therapy-style intervention), which is particularly important for smile depression. At the core of smile depression often lies the perception that "complaining is a nuisance," "I'm afraid people will worry about me," and "I'll be disliked if I ask for help." However, in reality, when a sincere person finally opens up and complains, many people will think, "I'm glad they told me." Since cognitive distortions may be involved here, it's effective to gradually correct them through metacognition (practicing thinking from another person's perspective). You can practice this even with an AI, and if possible, it's even more effective to work with a counselor, carefully adapting to each situation. Another important factor is the "balance of appeal." While excessive appeal can damage relationships, under-appealing can make life difficult by preventing help from reaching you. Objectively assess whether you are someone who "says too much" or "says too little," and work toward a middle ground. This is also a good example of cognitive behavioral therapy. To summarize: Smile depression is not an official medical term, but it aptly describes the condition in which mild to moderate depression manifests itself as "appearing cheerful in public." It fits well with Japanese values ​​such as "don't complain" and "don't cause trouble." Because it's easily misunderstood, it's important for both the sufferer and those around them to understand the "invisible suffering." Treatment is the same as for regular depression, with medication, lifestyle changes, and counseling. In particular, practicing "putting your thoughts into words appropriately so that help can arrive" is key. Finally, I hope that my book, aimed at people suffering from suicidal thoughts or desire to die, will reach those who need it. Thank you again today. This is psychiatrist Haga Takahiro. See you again tomorrow at 7pm. Until next time.