東京都港区麻布十番2-3-8 OTMビル4階
診療案内
Target diseases at our hospital
About developmental disorders
About ADHD
Attention-Deficit Hyperactivity Disorder (ADHD) is a condition in which a child has persistent difficulties in daily life due to the following characteristics: difficulty sustaining attention that is disproportionate to the child’s developmental level, difficulty in orderly behavior, restlessness, impatience, and difficulty in inhibiting behavior. A diagnosis is made when these behavioral characteristics have been present since before the age of 12 and difficulties are observed in multiple settings such as school, home, and work.
The degree of the disorder is too severe to accept ADHD symptoms as part of a person’s personality. They are not accepted by others at school or work, and they lose confidence and motivation. As a result, nothing goes well and they are in trouble.
However, even if they are told that they need to take medication, they don’t think that the condition is that severe.
They have been diagnosed with ADHD, but how should they proceed with treatment to improve their lives?
In my daily consultations, I feel that patients with moderate ADHD seem to be the most troubled.
After listening to the opinions of people with ADHD, I have come to the conclusion that it is difficult to improve with medication alone or counseling alone, and that taking both medication and behavioral therapy at the same time is a shortcut, even though it may seem like a detour.
At our hospital, we prescribe medication that is appropriate for the patient and at the same time strive to provide tips for dealing with ADHD problems.
For pediatric patients up to 15 years old, we provide educational advice to parents on how to deal with their children. It is difficult to improve the lifestyles of ADHD patients by simply prescribing medication.
Please feel free to consult with us about tailor-made improvement measures. We look forward to helping you.
About ASD
What is pervasive developmental disorder (autism spectrum disorder)?
Pervasive developmental disorder, also known as ASD, was previously known as autism or Asperger syndrome. It is said to be caused by a subtle abnormality in the brain that is present in the body. Many people with ASD have difficulty living in society due to poor communication skills and strong, unique obsessions.
Symptoms of Pervasive Developmental Disorders
There are two main symptoms of pervasive developmental disorders.
Decreased social skills due to impaired communication skills
Difficulty in social adaptation due to unique obsessions
Specific symptoms that often come up are as follows:
Inability to read the atmosphere
Inability to understand ambiguous nuances
Weak imagination
Difficulty in viewing oneself and the surroundings from an objective perspective
Inability to respond flexibly
Strong attachment to fixed methods and habits
Extreme bias in interests and concerns
Preoccupation with the same movements
Extremely sensitive or insensitive to sensations
Clumsy, poor motor skills
Decreased social skills due to impaired communication skills
About insomnia
There are four types of insomnia symptoms. Some people have multiple problems.
Difficulty falling asleep 2. Waking up in the middle of the night 3. Waking up early in the morning 4. Daytime effects
①Difficulty falling asleep
Type that takes a long time to fall asleep
I can’t fall asleep for more than 30 minutes after getting in bed, and it’s painful
②Waking up in the middle of the night
Once you fall asleep, you wake up many times during the night and have difficulty getting back to sleep
③ Early morning awakening
I wake up early in the morning and can’t go back to sleep, so my sleep time is very short and I don’t feel like I’ve had a good night’s sleep.
④Day-to-day impact
Symptoms include daytime sleepiness, difficulty concentrating, irritability, depression, and impaired work or academic performance.
About Adjustment Disorder
The symptoms first appear mentally, and if you continue to ignore them, physical symptoms will appear.
① Emotional symptoms
- Depressed mood: Feeling down and unmotivated. You may feel particularly bad in the morning when it’s time to go to work or school, and there may be days when you can’t go.
- Anxiety: Just thinking about the source of stress (in interpersonal relationships, the other person) causes tension and anxiety.
- Irritability: You become more irritable than usual and lose peace of mind.
- Suicidal thoughts: You may start to think that you would rather die than go to school (work).
② Physical symptoms
- Changes in appetite: Loss of appetite, or conversely, overeating to relieve stress.
- Decreased quality of sleep: Difficulty falling asleep and waking up multiple times during the night. Conversely, some people sleep too much to escape reality.
- Fatigue: Easily tired and feeling heavy.
- Autonomic nervous system symptoms: Nausea (some people actually vomit), palpitations, cold sweats, tinnitus, trembling hands, and other various ailments may appear.
- Other: Headaches, stomachaches, stiff neck and shoulders, etc.
うつ病について
うつ病の症状
精神症状と身体症状に分けることができます。
Psychiatric symptoms
●Feeling depressed
● Blaming yourself excessively
● Loss of concentration
● Loss of interest in things
● Thinking negatively about things
● Feelings like “I want to die” or “I want to disappear”
Physical symptoms
●Inability to sleep
Lack of appetite or overeating
Painful palpitations
Continuous nausea and diarrhea
Weight loss
Loss of sex drive
Specifically, this is a depression rating scale.
www.mhlw.go.jp/bunya/shougaihoken/kokoro/dl/02.pdf
About bipolar disorder (manic depression)
Manic depression (bipolar disorder) is a disease in which the mood fluctuates dramatically, with repeated cycles of “manic states” (highs) and “depressive states.” There are also cases in which people who are initially diagnosed with depression are later rediagnosed as manic depression (bipolar disorder).
Symptoms of bipolar disorder
Mood swings are not typical of daily ones, but rather tend to go up and down every few weeks to months.
Manic state
It’s an extremely emotional and excited state, making you feel energized, overly confident and like you can do anything.
- Excessive self-confidence, making statements that make oneself appear grandiose (delusions of grandeur)
- Insomnia (not feeling sleepy, living without rest)
- Talkative, becoming irritated when interrupted
- Incessant thoughts that come to mind one after another (flights of ideas)
- Impulsive behavior (overspending, excessive sexual behavior, dangerous driving, flashy clothing)
Depression
Persistent extreme moodiness and lethargy.
- Loss of interest or pleasure
- Tiredness
- Sleep problems (insomnia or hypersomnia)
- Changes in appetite (decreased appetite or overeating)
- Suicidal thoughts or self-harming behavior
About Anxiety Disorders
Anxiety disorders are a general term for illnesses in which persistent or intermittent anxiety or worry leads to physical symptoms. Anxiety disorders are classified into “generalized anxiety disorder (long-term anxiety about daily life)”, “social anxiety disorder (fear of being in front of people)”, “panic disorder (sudden anxiety attacks)”, and “obsessive-compulsive disorder (fear of uncleanliness, checking too much)”.
Main symptoms of anxiety disorders
- Excessive anxiety and worry
Your mind is caught up in small events in your daily life, and you feel strong anxiety and worry. With generalized anxiety disorder, you continue to worry so much that people at school or work wonder, “Why are you so anxious?” The person understands that there is no need to feel anxious, but they cannot stop worrying.
- Physical symptoms
Autonomic nervous system symptoms such as shortness of breath, palpitations, nausea, sweating, trembling hands, hyperventilation, headaches, stomachaches, and trembling voice appear. Even if you visit an internal medicine doctor, the test results are often normal, and you are often recommended to visit a psychiatrist or psychosomatic medicine department. When a panic attack occurs, symptoms such as sudden breathlessness may occur, and you may be dominated by a sense of fear that you are going to die. This panic disorder is also one of the anxiety disorders.
- Avoidance behavior
Typical examples include avoiding riding the train because you feel sick, or staying at home because you are afraid of speaking in front of people. This interferes with daily life, and many people suffer from it.
◎ People with social anxiety disorder have an abnormal level of tension when talking to others, and may become withdrawn at home. This can lead to problems such as not being able to give a speech or presentation at work when it is necessary.
◎ People with obsessive-compulsive disorder have obsessive beliefs (compulsions) that cause changes in daily behavior and interfere with their life. They may become overly concerned about uncleanliness, or worry about whether they locked the door, turned off the gas, or turned off the lights, and spend time checking. Obsessive-compulsive disorder is also classified as a type of anxiety disorder.
About Obsessive-Compulsive Disorder
Obsessive-compulsive disorder is a disease in which a person repeatedly engages in actions that they cannot stop, even though they know there is no point in doing them. The thoughts or images that cannot be removed from the mind are called “obsessions.” And the actions taken to drown out the emotions that arise from them are called “compulsions.”
The image is a repeat of dirty (obsession) → washing hands (compulsion) → dirty (obsession) → washing hands (compulsion).
Main symptoms of obsessive-compulsive disorder
Fear of dirt
Symptoms include believing that a certain place, object, or part of one’s body is “dirty,” and feeling uneasy unless one washes one’s hands repeatedly, bathes for a long time or repeatedly, and eats while wearing gloves.
For example, one cannot touch train straps, cannot eat food cooked in the kitchen at home because it is dirty, but can eat food from a family restaurant or convenience store, cannot sit in the living room because it is dirty and unclean, but is okay to use a chair in one’s room, etc., and one’s own rules are established and one cannot bend the rules drastically.
One patient could not touch the doorknob or sit on a chair in the examination room, and had to receive treatment in the hallway while standing, but after treatment, he or she was able to live a normal life at home.
Compulsion to check
Everyone has thoughts like, “Did I turn off the lights?”, “Did I turn off the gas?”, and “Did I forget to lock the door?”, but in the case of patients with OCD, no matter how many times they check, they cannot be satisfied. The more you think about it, the more you feel like you haven’t done the work, so you have to go home and check it over and over again. Especially for those who live alone, the excessive checking can take an hour or two to leave the house, locking the door and checking the water main, making it difficult to carry out daily life.
Ritualistic behavior
You live your life bound by rules you have set for yourself. Many suffer from symptoms such as having to arrange your keys, wallet, smartphone, and watch in this order, putting on your shoes with your right foot first and leaving the front door with your left foot, being very particular about numbers and starting over if you get a “4” or “9”, doing housework, work, and studying in the same order every day.
Phobia of perpetrating
This is a symptom of anxiety about acts of violence that have not actually happened or that you do not intend to commit, such as “I might run someone over with my car,” “I might push someone on the train platform,” “I might abuse a child,” or “I might become a sexual predator.” When the patient is seriously ill, they may stop the car and go to check to see if they have hit anyone.
About Schizophrenia
Schizophrenia is a disease that develops in people in their teens to 30s, and causes mental symptoms such as disorganized thinking, hallucinations, and delusions. It is said to be caused by an excess of dopamine in the brain. It is difficult for people to realize they have the disease themselves, and they often visit a doctor at the recommendation of their family. Schizophrenia can also develop suddenly when there is a drastic change in their environment, such as before or after taking an exam or giving birth.
Main symptoms of schizophrenia
① Positive symptoms: Symptoms of something that does not exist
- Hallucinations: Mostly auditory hallucinations, but also visual and olfactory hallucinations. Sometimes you hear voices of people who are not there (conversational hallucinations), or voices criticizing or ordering you (critical or command hallucinations). You hear voices like “Go die” and the hallucinations get louder and louder.
- Delusions: The most common type of delusion is “I’m being watched” or “I’m being targeted by an organization.” People are troubled by things that are hard to imagine in reality, such as being the victim of group stalking, being targeted by political or religious groups, etc.
- Thought disorder: Because thoughts are not organized, people listening to the patient cannot follow the flow of the conversation (loose associations). As the symptoms progress, it can sometimes become a state where the patient is just stringing together unrelated words (disorganized thinking, word salad).
- Conversations start with things like “Hurry up and bring this to school.”
- Ego disorder: The patient feels that their thoughts are leaking out to those around them (thought propagation) and that they can receive them telepathically. They believe that they are being controlled by someone (factitious experience) and claim that they are being attacked by radio waves (somatic hallucination). “Unplug the TV! Everything is being heard! They are watching me through the TV!” etc. When the condition worsens, some people cut all the cords with scissors.
② Postgraduate symptoms: Symptoms of decreased emotion and motivation
- Flattened emotions: Emotions are less expressed. They appear to have no joy, anger, sadness, or happiness (blunted emotion).
- Loss of motivation: They lose motivation to do housework, childcare, work, study, hobbies, etc.
- Social withdrawal: Some people avoid interacting with others and stay shut up in their homes. (Autism)
③ Cognitive symptoms
- Decreased memory and attention: You become forgetful, distracted, and unable to concentrate for long periods of time.
- Decreased judgment: It becomes difficult to plan things and act in an orderly manner.
About adolescent outpatient care (school refusal/social withdrawal)
As the mother of an adolescent boy, our hospital director always considers what advice she would give to her own child when examining younger patients.
We have received support from patients ranging from kindergarteners to elementary school and high school students, and have treated over 2,000 cases of school refusal and social withdrawal.
Sometimes it is triggered by minor bullying, other times by deeply hurtful words or actions from a teacher, and sometimes it is due to the home environment, and for single parents raising children, a child’s school refusal can become a family problem.
At a child’s immature growth and development stage, the special environment and human relationships at school can cause mental illness, and our hospital has set up an adolescent outpatient clinic to deal with this.
What is an Adolescent Outpatient Clinic?
Who is eligible?
We are targeting children under the age of 18 from kindergarten to high school.
(We also welcome students who have failed entrance exams or are in college and are experiencing problems with social withdrawal.)
*We cannot treat patients who have difficulty communicating with doctors due to severe intellectual disabilities.
What symptoms are there?
-Suddenly stopped going to school
-Suddenly stopped talking at home
-Can no longer attend club activities or cram school
-Stopped playing with friends
-Low energy, has become a different person
-Can no longer sleep at night
-Can’t break free from smartphone/game addiction
-Maybe a developmental disorder
We also treat school-related issues and general psychiatric disorders.