Doug Berger*, Douglas Eames, Pablo Prados-Ruano
Meguro Counseling Center, Tokyo, Japan Received 3 April 2008; accepted 9 April 2008 Abstract This paper describes the current state of mental health care for Western expatriates in Tokyo, Japan. Types of therapists, patient demographics, illness breakdown, and psychiatric medications in Japan are discussed and problems in the system and potential remedies are presented. ª 2008 Elsevier Ltd. All rights reserved. Read Entire Article: https://dougbergertokyopsychiatrist.files.wordpress.com/2016/09/travelmed.pdf Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders.
A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems. People seek psychiatric help for many reasons. The problems can be sudden, such as a panic attack, frightening hallucinations, thoughts of suicide, or hearing “voices.” Or they may be more long-term, such as feelings of sadness, hopelessness, or anxiousness that never seem to lift or problems functioning, causing everyday life to feel distorted or out of control. Read Entire Article: https://www.psychiatry.org/patients-families/what-is-psychiatry Doug Berger, MD, PhD
Dr Berger is in private practice in Japan. Article originally published in May 12, 2009, in Psychiatric Times “An Epidemic of Depression” by Wakefield and Horwitz (Psychiatric Times, November 2008, page 44) raised the issue that DSM does not take into account the context in which symptoms arise for the diagnosis of MDD. The authors opine that the diagnosis should require that symptoms be “excessive” or “unreasonable” relative to the context in which they arise, and that “the efficacy of these medications for the treatment of normal sadness is often overstated.” This is really a discussion of whether first–episode reactive depression should be considered a type of MDD, even if the symptoms are considered “excessive” given the context. (Certainly, persons with recurrent endogenous depression do not need much stress to have a relapse). Some persons react to high stress levels and develop a disorder and some do not (it is now known that holding the short form of the serotonin transporter gene is a risk factor for MDD). While the authors note that a few symptoms of sadness related to “overwhelming” distress may be “too often treated as a mental disorder,” they do not operationally define “a few symptoms of sadness.” If the stress is “overwhelming,” then it makes sense that many persons will succumb to MDD as a result. I think that most psychiatrists would only give an antidepressant to someone with a first episode of reactive depression in which there are concerning cognitive and/or vegetative symptoms that persist despite psychotherapy; in this setting, they may also consider a short course of a soporific or minor tranquilizer. My vote is that each patient needs to be looked at individually and treated based on the clinical judgment of the physician, who should take past and family history into account. Including criteria for excessive reaction to stress in DSM goes against the recent genetic and neuroscience findings that support the clinical experience of MDD seen in a variety of stress contexts and may lead to a delay in medical intervention when needed. Read Original Article: http://www.psychiatrictimes.com/display/article/10168/1413504 The most commonly prescribed psychiatric drugs are antidepressants. They treat depression and anxiety. The first ones, isoniazid and iproniazid, were discovered by accident. They were developed after the Second World War by a Swiss pharmaceutical company (from leftover German V2 rocket fuel!) as tuberculosis treatments. Some tubercular patients taking the drugs became energetic and even rowdy, and so a few curious doctors tested the drugs on psychiatric patients in 1952. Their potential as ‘psychic energisers’ received press attention. Many doctors began prescribing them to treat depressed patients in mental hospitals even though they were not officially approved for psychiatric use.
Pharmaceutical companies quickly became interested in developing drugs targeting depression. They started in the 1950s with the class of drugs called tricyclics. In the mid 1960s brain scientists hypothesised that iproniazid, the anti-tuberculosis drug, improved a patient’s mood by slowing an enzyme that breaks down the neurotransmitter serotonin. The hypothesis led to a second major class of antidepressants called monoamine oxidase inhibitors (MAOIs) which targeted the same enzyme. Despite justifiable concerns about side effects, both types of antidepressant remained drugs of choice among psychiatrists for over two decades. Their use declined after selective serotonin reuptake inhibitors (SSRIs) such as Prozac were introduced. These worked faster with fewer side effects. SSRIs also had a larger market because they treated anxiety (previously the domain of the minor tranquilisers) as well as depression. Read Entire Article: http://www.sciencemuseum.org.uk/broughttolife/techniques/antidepressants Imagine being so overwhelmed with fear and anxiety that you never venture outside of your house and that, being so overcome by social anxiety, you withdraw completely from any social interaction. This is the harsh reality for a growing number of people made completely immobilized by their mental health condition.
It’s difficult to find detailed statistics related to the number of people suffering from this debilitating social anxiety, in part because most reports include those with the issue in the general depression group, which now tops more than 350 million people of all ages and ethnicities around the globe. Hermit, recluse, and lone wolf are only a few of the terms used to describe those with severe social anxiety. Although most people think of North America when social psychological issues are mentioned, the 2013 article, Japan: a haven for the psychologically troubled written by Japan Times reporter, William Bradbury, crowns the Asian country as home to a growing demographic of citizens combatting a variety of social and mental health issues. Read Article: http://www.groundreport.com/doug-berger-tokyo-psychiatrists-must-continue-define-hikikomori/ |
Author - Douglas BurgerBilingual Psychiatrist located in Tokyo. Archives
June 2018
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