{"id":609,"date":"2024-10-25T14:12:34","date_gmt":"2024-10-25T05:12:34","guid":{"rendered":"https:\/\/wako-psy-clinic.com\/kimoto\/?p=609"},"modified":"2024-10-25T14:12:34","modified_gmt":"2024-10-25T05:12:34","slug":"%e3%81%86%e3%81%a4%e7%97%85%e3%81%ae%e8%a8%ba%e6%96%ad%e5%9f%ba%e6%ba%96%e3%82%92%e6%ba%80%e3%81%9f%e3%81%97%e3%81%a6%e3%81%84%e3%81%aa%e3%81%84%e7%8a%b6%e6%85%8b%e3%81%a7%e3%81%ae%e8%96%ac%e7%89%a9","status":"publish","type":"post","link":"https:\/\/wako-psy-clinic.com\/kimoto\/blog\/609.html","title":{"rendered":"\u3046\u3064\u75c5\u306e\u8a3a\u65ad\u57fa\u6e96\u3092\u6e80\u305f\u3057\u3066\u3044\u306a\u3044\u72b6\u614b\u3067\u306e\u85ac\u7269\u7642\u6cd5\u306b\u3064\u3044\u3066"},"content":{"rendered":"\n
\u3046\u3064\u75c5\u306e\u8a3a\u65ad\u57fa\u6e96\u3092\u6e80\u305f\u3057\u3066\u3044\u306a\u3044\u72b6\u614b\u3067\u306e\u85ac\u7269\u7642\u6cd5\u306b\u3064\u3044\u3066


\u4eca\u56de\u306f\u3001\u3046\u3064\u75c5\u306e\u8a3a\u65ad\u57fa\u6e96\u3092\u6e80\u305f\u3057\u3066\u3044\u306a\u3044\u72b6\u614b\u3067\u306e\u85ac\u7269\u7642\u6cd5\u306b\u3064\u3044\u3066\u89e3\u8aac\u3057\u307e\u3059\u3002


\u5927\u3046\u3064\u75c5\u6027\u969c\u5bb3\uff08Major Depressive Disorder, MDD\uff09\u306eDSM-5\uff08\u300e\u7cbe\u795e\u969c\u5bb3\u306e\u8a3a\u65ad\u3068\u7d71\u8a08\u30de\u30cb\u30e5\u30a2\u30eb\u7b2c5\u7248\u300f\uff09\u306b\u304a\u3051\u308b\u8a3a\u65ad\u57fa\u6e96\u306f\u4ee5\u4e0b\u306e\u901a\u308a\u3067\u3059\u3002

\u5927\u3046\u3064\u75c5\u30a8\u30d4\u30bd\u30fc\u30c9\uff08Major Depressive Episode\uff09\u306e\u8a3a\u65ad\u57fa\u6e96\uff1a
\u4ee5\u4e0b\u306e9\u3064\u306e\u75c7\u72b6\u306e\u3046\u3061\u3001\u5c11\u306a\u304f\u3068\u30825\u3064\u304c2\u9031\u9593\u4ee5\u4e0a\u306e\u9593\u306b\u307b\u307c\u6bce\u65e5\u5b58\u5728\u3057\u3001\u304b\u3064\u4ee5\u524d\u306e\u6a5f\u80fd\u30ec\u30d9\u30eb\u304b\u3089\u306e\u5909\u5316\u3092\u793a\u3059\u3053\u3068\u304c\u5fc5\u8981\u3067\u3059\u3002\u305d\u306e\u3046\u30611\u3064\u306f\u2460\u6291\u3046\u3064\u6c17\u5206\u304b\u2461\u8208\u5473\u307e\u305f\u306f\u559c\u3073\u306e\u55aa\u5931\u3067\u3042\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002

\u6291\u3046\u3064\u6c17\u5206\uff1a\u307b\u3068\u3093\u3069\u306e\u6642\u9593\u306b\u304a\u3044\u3066\u6182\u9b31\u3001\u60b2\u3057\u3044\u3001\u307e\u305f\u306f\u7a7a\u865a\u306a\u6c17\u5206\u3092\u611f\u3058\u308b\u3002\u81ea\u5206\u81ea\u8eab\u306e\u5831\u544a\u3084\u4ed6\u8005\u304b\u3089\u306e\u89b3\u5bdf\u306b\u3088\u3063\u3066\u78ba\u8a8d\u3055\u308c\u308b\u3002

\u8208\u5473\u307e\u305f\u306f\u559c\u3073\u306e\u55aa\u5931\uff1a\u65e5\u5e38\u306e\u6d3b\u52d5\u3084\u8da3\u5473\u306b\u5bfe\u3059\u308b\u8208\u5473\u3084\u559c\u3073\u3092\u611f\u3058\u306a\u304f\u306a\u308b\u3002

\u4f53\u91cd\u5909\u52d5\u307e\u305f\u306f\u98df\u6b32\u306e\u5909\u5316\uff1a\u610f\u56f3\u3057\u3066\u3044\u306a\u3044\u4f53\u91cd\u306e\u5897\u6e1b\uff081\u30f6\u6708\u9593\u306b5%\u4ee5\u4e0a\uff09\u3084\u98df\u6b32\u306e\u5909\u5316\u304c\u898b\u3089\u308c\u308b\u3002

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\u75b2\u52b4\u611f\u307e\u305f\u306f\u30a8\u30cd\u30eb\u30ae\u30fc\u306e\u55aa\u5931\uff1a\u307b\u307c\u6bce\u65e5\u306e\u75b2\u52b4\u611f\u3084\u30a8\u30cd\u30eb\u30ae\u30fc\u4e0d\u8db3\u304c\u3042\u308b\u3002

\u7121\u4fa1\u5024\u611f\u307e\u305f\u306f\u904e\u5270\u306a\u7f6a\u60aa\u611f\uff1a\u7121\u4fa1\u5024\u3060\u3068\u611f\u3058\u305f\u308a\u3001\u904e\u5ea6\u306e\u7f6a\u60aa\u611f\uff08\u73fe\u5b9f\u306b\u57fa\u3065\u304b\u306a\u3044\u3082\u306e\u3082\u542b\u3080\uff09\u304c\u3042\u308b\u3002

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\u6b7b\u3078\u306e\u57f7\u7740\uff1a\u7e70\u308a\u8fd4\u3057\u6b7b\u306b\u3064\u3044\u3066\u8003\u3048\u308b\u3001\u81ea\u6bba\u306e\u8a08\u753b\u3092\u7acb\u3066\u308b\u3001\u307e\u305f\u306f\u81ea\u6bba\u672a\u9042\u3092\u3059\u308b\u3002

\u305d\u306e\u4ed6\u306e\u8a3a\u65ad\u57fa\u6e96\uff1a
\u65e5\u5e38\u751f\u6d3b\u3078\u306e\u652f\u969c\uff1a\u3053\u308c\u3089\u306e\u75c7\u72b6\u304c\u793e\u4f1a\u7684\u3001\u8077\u696d\u7684\u3001\u307e\u305f\u306f\u305d\u306e\u4ed6\u306e\u91cd\u8981\u306a\u6a5f\u80fd\u9818\u57df\u306b\u304a\u3051\u308b\u969c\u5bb3\u3092\u5f15\u304d\u8d77\u3053\u3057\u3066\u3044\u308b\u3002

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Today, I would like to discuss the use of medication therapy for patients who do not meet the full diagnostic criteria for depression.

Diagnostic Criteria for Major Depressive Disorder (MDD) from DSM-5
To diagnose a major depressive episode, the following criteria must be met:

Five or more symptoms must be present almost every day for at least two weeks. These symptoms must represent a change from the individual's previous functioning, and at least one of the symptoms must be either:
Depressed mood
Loss of interest or pleasure
Here are the nine potential symptoms:

Depressed mood most of the day, nearly every day.
Diminished interest or pleasure in most or all activities.
Significant weight change or changes in appetite.
Insomnia or excessive sleep.
Psychomotor agitation or retardation (observable by others).
Fatigue or loss of energy.
Feelings of worthlessness or excessive guilt.
Diminished ability to think or concentrate.
Recurrent thoughts of death or suicidal ideation.
Other Criteria
The symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The episode is not attributable to substance abuse or another medical condition.
Exclusions
The depressive episode is not part of a psychotic disorder or schizophrenia.
The individual is not experiencing a manic or hypomanic episode (ruling out bipolar disorder).
Medication for Sub-Clinical Depression
For those who show mild depressive symptoms but do not meet the full diagnostic criteria for major depressive disorder, the effectiveness and safety of antidepressants remain unproven. The clinical trials that verify the efficacy and safety of these medications only involve patients who meet the diagnostic criteria.

Despite this, medication therapy is often prescribed to individuals who do not fully meet the criteria. This is a common practice, but it can lead to situations where the medication is not very effective and side effects are more prominent.

In many cases, patients report feeling lethargic or experiencing other adverse effects without substantial improvement in their symptoms. Since antidepressants primarily act on neurotransmitters such as serotonin, dopamine, and norepinephrine, these medications may not work effectively if there is no significant imbalance in these chemicals.

Alternatives to Medication
For individuals who do not meet the diagnostic criteria for depression, it is advisable to discontinue medication if it proves ineffective and seek alternative treatments. Options include psychotherapy, but for those who lack the energy or time to engage in therapy, or for those who need rapid improvement, we recommend TMS therapy, exosome therapy, or NMN IV drip therapy, all of which are rooted in regenerative medicine.

These treatments work at the cellular level to repair and regenerate damaged cells, including brain cells. By boosting the overall health of the body\u2019s cells, it is expected that various symptoms, including mood and motivation, will improve.

Integrating Regenerative Medicine into Psychiatry
After many years as a child psychiatrist, I have incorporated regenerative treatments like exosomes and TMS into my practice, as traditional psychiatric medicine alone often does not yield the desired results for some patients. I believe my approach is supported by the positive outcomes I've seen in my patients.

Though regenerative treatments like TMS or exosome therapy can be costly as they are not covered by insurance, they generally show significant improvement within 2-3 months. Compared to years of using psychiatric medications that may not work, these newer treatments can offer better results both financially and therapeutically.

If you are interested in learning more about these treatments, feel free to contact the clinic for further information.
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