Name: 精神科医だけど「メンタルヘルス」について質問ある？ | Tech Support | WIRED Japan
Uploaded: 2025-04-11T09:26:22.000Z
Duration: 19 min 47 s
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Let's answer your questions from the internet.

At Pink Penguin writes, someone please educate me, what does psychotic mean?

You are experiencing things that other people might not be.

That can include auditory hallucinations, hearing things other people might not be hearing, visual hallucinations, although those are rarer, you might have delusions, fixed false beliefs you believe are true despite other people showing you evidence that those aren't true.

Psychotic does not mean someone is going to commit crimes.

At Andrea H. Perez, how does depression make you exhausted but then sometimes I'm too sad to even sleep?

When you're depressed, your circadian rhythms are off.

In fact, one of the first things we ask patients about is sleep.

People don't realize that they have this picture that when you're depressed, you might sleep more, but in fact, it's the opposite.

You wake up early and people are like, why am I waking up at five o'clock in the morning not even setting an alarm?

It's because your sleep cycle has been phase shifted or phase advanced.

You go to bed earlier and you wake up earlier.

We think this has to do with a lack of neurotransmitters when you're depressed.

So there's less serotonin, norepinephrine, and there's less acetylcholine.

And for some reason, this makes us wake up early.

At Aten Supreme, anyone else think stress is contagious?

I'll tell you, watching high school students in the Bay Area go through the college application process,

I can absolutely tell you it is contagious.

There was a study that looked at an audience watching a speech being given by someone who was very anxious.

Saliva samples were then gathered from the audience as well as the presenter.

The saliva had increased cortisol levels, which is that stress hormone, not only in the presenter, but in the audience.

At Sayyibaby is asking, can depression be hypnotized out of you?

No, hypnotherapy is very effective for some things.

It can help people with smoking cessation.

It can help people decrease their temper.

Sometimes hypnotherapy can also be used to treat sleep disorders and insomnia.

It cannot change the level of neurotransmitters in your brain that are correlated with depression.

Some people are more hypnotizable than others.

When you look at this eye roll chart, it gives you a sense of a gradient, how hypnotizable somebody might be.

When they're looking straight ahead, that's a zero.

Then one is slightly, you start to see a little bit of white.

The scale goes all the way down to four, being you see mostly white, almost exorcist style.

There is a correlation between those that show a lot of white when they roll their eyes and being able to be hypnotized easily.

DJ Leapcard asks, what's the difference between a psychologist and a psychiatrist and which one do I need to see?

Well, a psychiatrist has gone to medical school, so they can prescribe medications.

If you're feeling overwhelmed and need to talk to somebody, a therapist would be fine.

That could be a psychologist or a psychiatrist.

If there's suspicion that medication is needed, then a psychiatrist is the one you'd wanna see.

At Bell Maps wants to know, question for psychiatrist counselors, how do you not cry?

Well, at Bell Maps, to be honest, sometimes I do get tearful with patients.

We are human after all, even though some people don't think we are.

At Mets4ninnen33, do personality disorders work on a spectrum?

Like, can you have mild disorder of narcissism?

You can absolutely have narcissistic traits.

When it's unhealthy is when you start to think only of yourself.

Fantasies and obsessions over unlimited power or beauty.

And then the full-blown disorder, you could go as far as to be a malignant narcissist.

You have a lack of empathy and don't really care about other people.

At ResilienceDoc, how do you think the brain-gut connection works?

Preclinical data, meaning data and research from animals, not people, shows that there's a relationship between the brain, the gut, and the microbiota, or the bacteria that populate your gut.

What we found was that in some stress-induced rodents, they ended up having short-chain fatty acids.

And what we find is there's actually less serotonin produced in the stress-induced rodents' guts.

Now, that's not the same serotonin that's in your brain.

Yes, it's the same structure, but that serotonin in your gut doesn't cross the blood-brain barrier.

However, what we find is that the inflammation that is caused during the stress causes the vagus nerve, which is involved in depression, to not fire the way it's supposed to.

And so as a result, this inflammation might have something to do with a depressive state.

It suggests that with a healthy gut and healthy microbiome, we can actually have improved mood.

AtDareisNobot wants to know, when did psychiatry start?

Well, formal psychiatry can be traced back to the 19th century.

We used to have a group of doctors called alienists, and their job was to understand and treat and be with people who had an alienation from the rest of society that was due to mental health issues.

Some consider that the birth of psychoanalysis.

Why does no one talk about how depression and anxiety can cause major memory loss?

Depression really can make us have memory issues.

What we think that has to do with is a lack of glutamate.

Glutamate is the excitatory neurotransmitter.

And when there's less of that, we find that people don't lay down memory.

Processing speed of somebody with a depressed mind can be 40% below what it is when they're not depressed.

There's something called pseudo-dementia, in fact.

This false appearance of dementia, but it could in fact be a depression.

AtMaggieMag26, you ever had a random ass thought that just won't leave your head?

First off, every human being has a random ass thought.

If we don't want them, they're called intrusive.

And then they can become obsessive if you can't let go of it.

And that's when it can start to go into the obsessive compulsive disorder range.

So the obsessive thought pathway starts with the connection between the orbitofrontal cortex and goes back to these areas here called the basal ganglia.

When that pathway is activated, there's a worry, but then the inhibitory pathway goes back to the orbitofrontal cortex and actually shuts it down.

In someone with an obsessive thought disorder where they keep worrying about the same thing, there's over-activation of that direct pathway back and under-activation of the inhibitory pathway.

It's like there's no brakes to stop this worry.

So we have this cycle that goes on and on and on and on.

Cognitive behavioral therapy or CBT is used to help somebody with these kinds of obsessions.

You can also do something called exposure and response therapy.

That's where you make a hierarchy of fears.

First rung on that hierarchy of fears might be, all right, let's talk about spiders.

The next thing might be going to the tarantula exhibit.

Then the last thing might be petting spiders and letting them crawl all over you.

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精神科医だけど「メンタルヘルス」について質問ある？ | Tech Support | WIRED Japan

anxiety

cognitive

absolutely

mental