2024.12.23ブログ
統合失調症の中核症状である自我漏洩症状、薬ではなんともなっていない気がする
統合失調症の中核症状である自我漏洩症状、薬ではなんともなっていない気がする
今回は、統合失調症の中核症状である自我漏洩症状、薬ではなんともなっていない気がする、について解説します。
どの病気にも中核症状というものがあります。
統合失調症の場合、それは自我漏洩症状です。
他者、外の世界と自分を分かつ壁が自我障壁だったとして、それに穴があいたり、くずれたりすると、他者の思考や考えが自分の中にはいったり、逆に自分からもれでたりする、ように感じます。
その他の症状に幻覚、妄想などがあります。
幻覚、妄想には内服も多少効果があるようには思います。
ドパミンを減少させると、このあたりには少しいいのでしょう。
ドタミンを増やす覚せい剤が、この症状を出すのの反対に行くって感じです。
しかし自我漏洩症状については、あまり効果ないと思います。
本人が言わないだけで、ずっとそれを感じています。
ドパミンをブロックする薬を使うと単純に元気なくなりますから、自我漏洩症状があったとしても行動範囲も狭くなるので、それ自体が生活に支障がでないからかもしれません。
だが確実にメインの症状には今の薬はあまり意味がないように私は思っています。
もちろんいくつかの症状を抑えるために統合失調症の方には内服は必要だと思います。
ですが今の内服は、人の自我機能みたいなものにまで干渉できるほど、よくできていません。
シンプルな作りです。
脳は複雑な臓器です。
脳の機能障害を改善できるほど、まだ医学は進歩していない。
治療のアプローチとしては、ダメージをうけた脳細胞を修復する再生医療側からの方が、統合失調症の中核症状の改善には近いのかもしれません。
統合失調症はほんとに不思議な病気です。
たぶん今の診断基準の中にはいっているのは、１つの疾患ではないでしょう。
ごちゃっといれたれていると思います。
それが細分化されるのも、かなり先になるような気がします。
しかし治療の方がなんかのきっかけで先にできるということもあります。
いまは手持ちの武器の中でやれることをやるしかないでしょう。
Today, I’ll discuss the core symptom of ego leakage in schizophrenia and why it seems that current medications are not effectively addressing this issue.
Understanding Ego Leakage as a Core Symptom of Schizophrenia
Every disorder has its core symptoms. In schizophrenia, ego leakage is one of the central features.
Ego leakage can be described as the collapse of the boundary between the self and the external world, often referred to as the "ego barrier." When this barrier becomes perforated or breaks down, the individual may:
Feel that other people’s thoughts or ideas are intruding into their mind.
Perceive their own thoughts or feelings as leaking out and becoming accessible to others.
This is distinct from other schizophrenia symptoms like hallucinations and delusions, which appear more amenable to current pharmacological interventions.
Limitations of Current Medications
Effectiveness on Hallucinations and Delusions
Antipsychotic medications, particularly dopamine antagonists, show some efficacy in reducing hallucinations and delusions.
These drugs block dopamine receptors, mitigating the hyperactivity of dopamine pathways often associated with these symptoms.
Ineffectiveness on Ego Leakage
Current antipsychotic medications seem to have little to no direct effect on ego leakage symptoms.
Many patients silently endure these experiences, as medications may not alleviate the fundamental disturbance in self-boundaries.
Medications may dull a patient’s energy and narrow their activity range, indirectly reducing the impact of ego leakage on daily life, but they fail to address the core issue.
Why Current Medications Fall Short
Simplicity of Current Medications
Antipsychotics mainly target dopamine dysregulation, but the brain’s functions are far more complex.
The intricate network of self-awareness, thought integration, and external interaction involved in ego function is beyond the scope of these drugs.
Complexity of the Brain
The brain is an extraordinarily complex organ, and our understanding of its intricate interplay of neural circuits remains limited.
Addressing core self-function disturbances like ego leakage likely requires a more advanced therapeutic approach than what is currently available.
Alternative Approaches: The Potential of Regenerative Medicine
Regenerating Damaged Neural Networks
Schizophrenia involves structural and functional abnormalities in brain networks.
Regenerative therapies, such as stem cell-derived treatments or exosome therapies, may offer a way to repair or restore these damaged circuits.
Beyond Neurotransmitters
Current medications primarily modulate neurotransmitters, but regenerative approaches could potentially repair the cellular and network-level damage underlying core symptoms like ego leakage.
Schizophrenia as a Complex Syndrome
Schizophrenia may not be a single disease but rather a collection of conditions with similar symptoms bundled under one diagnosis. This diversity makes treating the "core" symptoms challenging:
Fragmentation of Diagnostic Criteria: A more precise classification of subtypes is likely far off.
Treatment Innovation Before Diagnostic Clarity: It’s possible that breakthroughs in treatment, rather than diagnosis, will drive progress.
Conclusion
Ego leakage, a core symptom of schizophrenia, remains largely unaddressed by current pharmacological treatments. While antipsychotics are indispensable for managing other symptoms like hallucinations and delusions, they lack the sophistication needed to repair the complex disruptions in ego function.
Future advances in regenerative medicine and neurorepair therapies may offer hope for these challenging symptoms. For now, clinicians must work within the limitations of available treatments, adapting and optimizing care to each individual’s unique needs.
Schizophrenia is truly a mysterious disorder, but understanding and treatment may leap forward unexpectedly through innovation. Until then, we do the best with the tools we have.
If you or your loved one is struggling with schizophrenia and would like to explore new treatment options, please feel free to reach out to our clinic.
