適応障害について解説します #早稲田メンタルクリニック #精神科医 #益田裕介

00:00 OP 01:07 Differences between Depression and Adjustment Disorder 04:25 Treatment Progress 07:30 What is Life? 10:52 There's No Answer 12:09 Empathy and Listening? Today, I'll be explaining "adjustment disorder." You've probably heard of adjustment disorder before, haven't you? Famous people often suffer from it. Many people have publicly announced, "I was sick and resting due to physical and mental fatigue. The doctor at the hospital told me I had adjustment disorder," making it a well-known illness. However, I think many people still don't really understand the difference between it and depression. In this article, I'll explain what adjustment disorder is, how it differs from depression, how it's treated, what you need to consider, and key points in treatment. ■Differences between Depression and Adjustment Disorder I'd like to briefly review what mental illness is in the first place. Mental illnesses are basically caused by a combination of genetic issues, birth issues, and genetic issues plus environmental stress. Not everyone is born with it, nor is it the case that everyone develops it just because they're under stress. It depends on the balance between these factors. Even if you have strong genetics, you can develop an adjustment disorder if you're under a lot of stress, while someone with weak genetics can develop it even with little stress. Most people are within the "healthy" pool and try to aim for a more fulfilling side. They worry and go inward and win, or they lose and are pushed out of the "favourite" side, but stress can push them out of "healthy" and into a "high-stress state." And they end up suffering endlessly in this high-stress state. Working long hours, working more than 100 hours of overtime per month, being subjected to power harassment, and other stressful situations can lead to depression or an adjustment disorder. How is depression different from an adjustment disorder? The symptoms are basically the same. Symptoms include a low mood known as a "depressive state," loss of appetite, insomnia, low self-esteem, and loss of motivation and concentration. Clinically, depression is thought of as being a little more serious. It doesn't have to be severe, but that's just the image. Depression is thought of as being more of a "brain disease," and as something that recurs. The image of depression is that even if you get better, the symptoms tend to recur again. Adjustment disorder is a stress-related illness, so by being away from stress, you can return to your normal state relatively quickly. The image is that the symptoms of the illness go away. The image is that the depressed state can be relatively well-relieved by resting. It's a fairly fuzzy concept. In reality, the difference between the two is not fully understood from a neuroscience perspective, but clinically it is very easy to understand. There are people who feel better after taking a break, and others who don't get much better even after taking a break, and who say, "I guess it's depression after all," and slowly recover by taking medication. The difference is easy to see in the exam room, and you can roughly guess based on the lively way the person speaks, but it can be quite difficult to define and distinguish between the two neuroscientifically. There are probably a lot of different things happening in the brain. ■Treatment Process Treatment involves getting away from stress and resting. Basically, adjustment disorder does not require medication. If symptoms are severe, antidepressants may be used in part, or sleeping pills may be used if you can't sleep, but drug treatment is not generally necessary. The symptoms fluctuate, gradually decreasing and improving with rest. When you start taking a break, there is a sudden drop. When someone who has been working takes a break, they feel a little unwell. It's similar to running a full marathon. When you run a full marathon, you can run, even if it's just barely. But once you cross the finish line, you suddenly can't run. It's similar to that. Up until now, I've been able to work even when I'm not feeling well, but as soon as I start taking a break, I feel drastically worse and panic, wondering what's going on. But it feels like the tension I've been feeling is being released and my true self is coming out. Basically, I get better by sleeping. So I sleep during the day too. That's fine. You might think I'm slacking off, and some people say right after taking a break, "I want to study because this is a good opportunity," or "I want to study to change jobs," but I tell them that they can't do that. I say, "No, I can do it," but no, I can't. I mostly sleep. This is normal. I live a life where I sleep 10 hours a day, both during the day and at night, and once that's over, I finally feel better. The guidelines are said to be walks, cooking, and tidying up, but as I gradually get tired of sleeping and my mind and body start to recover, I start go...