うつ病の治療の流れ、スケジュール　#早稲田メンタルクリニック #精神科医 #益田裕介 　＃メンタルヘルス大全

01:38 Early Stage of Depression 03:34 Acute Stage 05:34 Recovery Stage 08:06 Relapse Prevention Stage 09:53 Social Welfare System Today, I will be discussing the topic of "The Flow of Depression Treatment." Depression treatment is divided into four stages: early stage, acute stage, recovery stage, and relapse prevention stage. This entire process is sometimes called a "depressive phase." Repeating this depressive phase is called "depression." About half of people experience recurring episodes of this phase. Taking medication significantly shortens this depressive phase. The severity of the depression also decreases. That is the effect of drug treatment. It doesn't mean that depression is eliminated or that the medication makes depression disappear. The effect of antidepressant medication is that it shortens the duration, reduces symptoms, and extends the relapse prevention stage. Depression doesn't just magically disappear after 2-3 weeks of taking medication. Therefore, it is said that medication, time, and rest are important in treating depression. Let's look at each phase of depression one by one. ■Early Stage of Depression First, let's look at the early stage of depression. You feel down, but there are some fluctuations. Some types have no fluctuations at all, but it feels like there are fluctuations. Therefore, the whiteboard is drawn to show fluctuations. Patients sometimes ask if they have bipolar disorder rather than depression because their mood swings are so extreme. That's incorrect. In bipolar disorder, the mood swings are divided into depressed and manic phases. You might feel depressed for about six months, then be energetic for two or three months. It's like the character "Sleeping Taro." The image of bipolar disorder is that you feel unwell for about three years, then suddenly your eyes light up, and you work non-stop for two or three months. Therefore, extreme mood swings within a single day do not indicate bipolar disorder. The initial image of depression is one of over-adaptation, where one works to the absolute limit, pushing oneself to the very end, even though the body is worn out. In this situation, there is no mental capacity left, leading to irritability and anger. Therefore, those around the person might say, "That person is angry, but they seem fine, so they can't be depressed," but this is completely wrong; these are symptoms of depression. Spontaneous crying is also an early sign. Often, those around the person notice in the early stages. Fortunately, they are referred to a psychiatrist, diagnosed with depression, and told they should rest, which they do. ■Acute Phase And after resting, the acute phase begins. Therefore, the patient's condition drops sharply. The patient thinks they can finally rest, but instead of improving, it drops dramatically. They feel worse and might think that what Masuda said was a lie, that they were tricked by the doctor after being told they would get better with rest. However, it's not that they were being tricked; they were simply under immense strain until the very limit. When you're running a full marathon, you can run the last kilometer. But after you cross the finish line, you can't run anymore. It's the same thing; you suddenly drop off. You can rest after that sudden drop. However, things get worse once you start resting. Then, the acute phase lasts for 3 to 6 months. This is tough. You're restless, your mind isn't working properly, and you feel confused. Sometimes a day feels incredibly long, and other times, looking back, it feels incredibly short. This is the acute phase. It's difficult. During the acute phase, you feel like a completely different person. People say you feel like you've become a different person. Clinicalians only see the initial and acute phases, so they don't know the person's true self. It's only after recovery that you realize, "This person's true personality was like this." Even the person themselves often doesn't clearly remember the acute phase when they were feeling unwell once they've recovered. The human mind is truly mysterious. The fact that you have no memory is what makes it an illness. You feel like your mind isn't working properly. You can't remember, you can't think, you can't read books—that's the kind of period it is. ■Recovery Phase After a certain amount of time has passed, you transition to the "recovery phase." Taking medication shortens the acute phase, and the symptoms become less severe than they would normally be. As you get better, you enter the recovery phase. In the recovery phase, you go from not being able to sleep before to sleeping a lot. It's like eating and sleeping. It's common to sleep around 15 hours a day. Sleeping after breakfast, sleeping after lunch, and sleeping at night is characteristic of the recovery phase. Most hospitalized patients live this kind of life. They sleep a lot. Because they sleep so much, patients often become...