Saturday, February 17, 2018

Four things you may be missing in long-lasting depression

I am involved in clinical trials of some newly developing drugs. For evaluating the effect of the substance (or placebo), I often interview with patients. In these cases, I assess the patient's status and daily life in the neutral position because I never intervene the treatment.


I found some common things that patients suffering from long-term depression have. Most of them are likely to be underestimated by the patients and even by the doctor in charge. Unfortunately, I cannot tell them directly to each patient because it will violate regulation of the clinical trial. Instead, I mention them on the web as a general description.

1. Many treatment-resistant depression is not depressive disorder

A major depressive episode lasts a half years or more if appropriate treatment is not provided. On the other hand, it is very rare that it lasts three years or more. If you are suffering from depression for more than three years, you might be misdiagnosed. Indeed, a-third of diagnosis of depression is incorrect, according to latest statistics.

You may have bipolar disorder, especially you always sleepy, tired, and anxious. It is quite questionable that antidepressants are effective for bipolar disorder. Talk to your doctor in charge as soon as possible.

2. Depressive patients seldom experience happy events due to their behaviors, not by depression

If your mood is elevated after a joyful event, your depression may be rather mild. Therefore, I ask patients, "Does your feeling get better after a happy event?" But most patients do not answer yes or no. They say, "A happy event never occurs to me."

But does it true? Of course, depressive patients hardly feel happy even if luck visits them. However, a more common reason is that depressive people seldom do light activity.

In a severe depressive state, you cannot do anything, and it is good to stay on the bed. But, in many cases, you should do more valuable things even if you feel depressed.

3. Lay on the bed is the last solution for anxiety

Depressive patients frequently feel anxious. It often causes a panic attack. They are frightened by anxiety and irritability. And most of the patients go to bed to keep their body and mind safe.

However, it is not a good treatment for anxiety. Lowered activity will enhance your ability to sense abnormal signs in your body. As a result, you will be sensitive to tiny stimuli. Also, the sleep-wake cycle will be disrupted. When you feel anxious, the best thing is to continue concentrating on what you were doing before. If it is difficult, light exercise, deep breathing, and showering are also beneficial.

4. Going to bed too early is no good

Patients with depression have insomnia. I wrote the treatment of sleep disorder before on this blog. Trying to go to bed earlier according to the fear of total insomnia is a very bad behavior. If you are not sleepy, you need not sleep immediately. Sit on the sofa, to read a novel or a comic book to kill the annoying time.

Friday, February 16, 2018

Innovation Index revealed

The 2018 Bloomberg Innovation Index was published. The nation winning the top is South Korea. It keeps the triumph for years.

Bloomberg: The U.S. Drops Out of the Top 10 in Innovation Ranking

In this year, the US dropped the rank by two. Finland, Canada, and New Zealand were also declining. In contrast, France, China, Ireland, and Italy are climbing the ladder.


The Bloomberg Innovation Index is a compilation of several key elements. R&D intensity, manufacturing value-added, productivity, high-tech density, tertiary efficiency, researcher concentration, and patent activity are all important for development. But, how do each nation enhance the quality of these topics are various.

Bangkok Post: South Korea tops, Thailand drops in innovation index

For example, South Korea is the top-ranked at patent activity this year. Indeed, Korean companies gain a significant amount of new patents in recent years. However, the quality of each idea is questionable. Samsung, LG, and other companies had adopted the follower strategy. And finally, Samsung defeated Apple in some regions. But I am doubtful it has developed truly innovative products.

On the other hand, Japan has a problem with which innovation is hardly born. People are often too conservative and risk-avoidant. Although the development level of the technology is almost highest in the world, Japanese seldom create innovation such as Facebook, iPhone, or Bitcoin. Each nation has their own challenges.

Thursday, February 15, 2018

Computer-free cafe

Nowadays, we receive maximum benefit from the IT and computers. Many people look almost always at the screen of the smartphone unless they are sleeping. At the same time, there is a backlash against excessive reliance on the modern technology. Some people are fond of abandoning PC and smartphones at least during a particular time such as at lunch or relaxation.

This dispute also occurs in the cafe. Recently, many cafe and restaurants offer Wi-Fi connecting service to the customers for free. In contrast, there are some places prohibiting the use of computers and electric devices.


The reason for inhibiting the use of computers is various. Since talking with a smartphone is annoying for other guests, most shops prohibit calling on the seat in general. Some cafes dislike customers who stay for many hours with ordering only one cup of coffee. In contrast, some owners seem to believe using an electronic device in their cafe looks not cool.

The Guardian: No laptops allowed – the cafes bringing back the art of conviviality

In my sense, laptop-free space is also cool. But, it is doubtful such places will be dominant in the future. Traditionally, a gentleman spent afternoon time with reading a book in a cafe. In recent, the book is replaced to iPad. That's it. Indeed, I read e-books on my iPad in Starbucks.

Talking with friends is another issue. I think face-to-face talk is different from chatting on the internet. Skype interview is similar to real talk, but also not the same. Regardless of the development of the modern technology, the happiness of talking with your lover will be unique forever.

Wednesday, February 14, 2018

Potato may be not harmful to the human health

In the academic region of nutrition, yesterday's common sense is often today's nonsense. Just recently, the adverse influence of eating eggs on your blood cholesterol was proven to be false.


And, potato seems to have been disgraced by a superstition. Latest studies suggest potato has a beneficial effect on you through lowering the risk of dementia.

New Zealand Herald: Researchers backtrack: Potatoes are actually good for you

Professor Derek Stewart in the James Hutton Institute in Scotland claims that you would not become ill if you eat no other than potatoes.

Potato has been a great source of energy since the beginning of the human civilization. Jared Mason Diamond mentioned in his writing that potato-eating fork finally defeated others who ate sweet potatoes. According to his opinion, the potato is still a strong ally of the human.

Tuesday, February 13, 2018

The best (and arrogant) way to mitigate stress from interpersonal relationship

You may often be frustrated by the interpersonal relationship.  You are scolded by your boss. Your comments are misunderstood by your subordinates. Your spouse is terrible at being supportive of you. You are suffering from relationship every day.

Indeed, the interpersonal relationship is the worst problem in labors, superior to low salary or excessive working time, as several studies suggest. The situation is similar in the family.

So, is it unrealistic for us to be relieved from such stresses? I have one solution. It is a very simple answer.

Believe that everyone other than you is a fool.

Fool people often become upset for silly reasons. Fool people are likely to fail to adhere the request. Their behaviors are troublesome. But, it is not to be blamed. A fool is a fool because of the lack of ability of understanding.


Rather, you should be shameful to have failed to make them work properly. You are always superior to other people. Thus, you have to do something for people around you. You must provide rational and easy to understand explanation to others. You have to accept their failures. They are "nobles oblige."

You may not be suffering from others against you. It belongs to your responsibility to make others cooperative. You have no time to blame others for being interrupted!

(I use the word "fool" for suggesting an abstract concept in this epigram. I have no intention to mock anyone.)

Monday, February 12, 2018

The reason Google's is the best among smart speakers

In recent years, smart speaker attracts attention in the IT industry. It equips an AI organizer to realize your requests orally ordered at home.


Currently, famous companies offer each device such as Google Home produced by Google, Amazon Echo by Amazon, and HomePod by Apple. Microsoft also released Harman Kardon Invoke last year in the US.

So, which should you choose? It depends on your living situation. But, as far as I know, I will choose Google Home if I decide it now.

Invoke is out of the question because it has not been released in Japan. Amazon Echo is available only for invited persons. Getting invitation letter is not so difficult for me, I guess. But, Amazon's Alexa is said not to be intelligent enough to understand any Japanese language.

Then, how is Apple's HomePod? According to the article, the quality is still underdeveloped.

The Conversation: Apple HomePod is already losing the smart speaker battle

So far, Apple has adopted vertical integration strategy. It means that every layer of services is provided by Apple. Instead, Apple is not willing to allow third parties to enter its ecosystem. For example, applications of iOS are not permitted to guide users to the payment managed by a third party. This restrictive policy inhibits a smart speaker from connecting several devices.

Actually, what I want the smart speaker to the most is to light the TV and air conditioner as soon as I get home. These works would not be realized unless the home electronic devices are smoothly connected to the smart speaker. I hardly believe Apple will address it. Among IT giants, Google is the best at being collaborative with external devices.

Sunday, February 11, 2018

Big five of mental disorders share genetic activity

Mental disorders are archenemies for the human because of their adverse impact on the quality of our life. We, psychiatrists, have been studying them to reveal the real figure and way to overcome any mental disorders.

It may be possible, however, that the archenemies are not multiple, but a single disease, according to some researchers who never form the majority. For example, there is a hypothesis that schizophrenia and bipolar disorder, the two major psychiatric diseases are the same illness. This concept has never been accepted in the academic field. But actually, I sometimes experience some patients who were diagnosed as schizophrenia show the symptoms which are usually seen in those with bipolar disorder.


Therefore, the borders of major psychiatric illnesses are still under discussion. And there are no definite criteria of each mental disorder. Thus, we label them through the clinical symptoms they have. And the symptoms occasionally alter.

Recently, a paper shedding light to this issue was published in Science, a world-famous academic journal. The author suggests that some mental disorders share the same genetic malformations.

The Washington Post: Five major psychiatric disorders have overlapping patterns of genetic activity, new study shows

According to the author, similar levels of particular molecules in the brain was found between autism, schizophrenia and bipolar disorder. Also, bipolar disorder and major depression, and major depression and alcoholism were matched in gene expression.

Science: Shared molecular neuropathology across major psychiatric disorders parallels polygenic overlap

Since rich knowledge is required to understand the concept of this article, I am not sure what the author has really proven. At least, the conclusion of this study seems to be consistent with the clinical findings. Other than schizophrenia and bipolar disorder, schizophrenia and autism are often difficult to be distinguished, major depressive disorder and bipolar disorder as well. Also, most patients with alcoholism suffer from depression. It is not surprising that these diseases share some organic malformations in molecular level.

On the other hand, I believe this issue will never be given decisive conclusion unless current diagnostic criteria are amended. DSM-5 and ICD-10 are excellent manuals for statistics and diagnoses of mental disorders. Nonetheless, there are limitations in classifying any mental disorders strictly. In the next era of psychiatry, some biological markers including genetic patterns will be necessary to diagnose mental disorders.