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홍차넷
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티타임
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- 다양한 주제에 대해 자유롭게 글을 작성하는 게시판입니다.
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전체기타일상/생각꿀팁/강좌방송/연예도서/문학영화의료/건강문화/예술경제생활체육과학/기술철학/종교정치요리/음식역사여행육아/가정IT/컴퓨터음악창작게임스포츠사회오프모임
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| Date |
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| Name | Obsobs |
| Subject | 망상장애에 대한 경험과 생각들. |
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3년간 나라의 부름에 답한 뒤 정신과 전문병원에서 일하는 초짜 정신과 전문입니다. 최근 일어난 강남의 살인 사건도 있었고, 저도 최근 망상장애로 의심되는 분들을 만나다보니 이런저런 생각들이 많이 들더군요. 망상장애는 쉽게 말씀드리자면 "망상"이 주 증상인 정신장애입니다. 망상을 보이는 정신장애야 정신분열병으로 불리던 조현병 부터 시작해서 주요우울증, 양극성정동장애(조울병) 등 여러 질환에서 나타날 수 있습니다. 망상장애가 다른 질환과 다른 점은 조현병에서 나타나는 환청이나 기이한 행동 및 사고장애가 없고, 주요우울증이나 양극성정동장애에서 나타는 기분증상이 두드러지지 않는다는 점입니다. 즉 이러한 정신장애를 가지신 분들은 "망상"자체 이외에는 별다른 문제가 없어 보이는 사람이라는거죠. 망상 자체가 굉장히 기이하고 이상하다면야 조현병쪽이 아닐까 의심해볼 수 있지만, 특정 망상이 심화된 상태라면 망상장애 쪽이 더 가깝다고 볼 수 있죠. (특정 누군가가 자신을 도청한다고 생각하는 사람의 망상이 심화되어 눈에 보이지 않는 도청장치가 자신에게 심어져 있다라고 생각하는 경우) 망상장애로 병원까지 오시는 분들은 정말 심해질 대로 심해진 분들이긴 합니다. 망상을 가지는거 자체야 개인의 머리 속에서 일어나는 것이니 그것 자체가 무슨 문제가 되겠습니까. 하지만 그 망상의 내용으로 인해 일상생활에 문제가 굉장히 많이 일어나는 것이 문제죠. 부정망상 (배우자의 부정행위를 한다는 망상)이 있으신 분들은 배우자를 다그치거나 위협을 하는 등의 행동문제(그냥 단순한 위협이 아닙니다...), 피해망상이 있으신 분들은 충분한 근거자료 없이 고소 고발을 남발하거나 위해를 가하기도 하구요. 병원에 모시고 오실 때 알아보면 망상들이 남몰래 몇년, 길게는 수십년까지 이어져온 것을 그제서야 알아채기도 합니다. 머리 속에서 그냥 어느 정도 수준에서 납득을 하다가 허용못할 수준이 되어 터져버리던가, 여러 스트레스 요인들이 망상을 방어하는 요인들을 약화시켜 버릴 수도 있죠. 게다가 가족들이 데리고 와서 치료를 할라 치면 극구 반항합니다. 자기 기준에서는 자기 자신이 극히 정상이거든요. 본인과 보호자에게 환자의 병력을 들어보면 정말 망상과 관련된 문제 말고는 극히 정상같아 보이거든요. 회사생활도 잘 하고, 가족들과도 잘 지내고, 개인 사생활도 별 문제 없어보이고. 그런데 완전히 문제없느냐. 그건 또 아닙니다. 위에서 말씀드린 것 처럼 망상의 내용에 따라 생기는 문제영역들이 하나씩은 있을 수 밖에 없습니다. 하지만 본인은 그게 정당하다고 보니깐 자신이 병이라는 인식을 하지 못하죠. 치료는 약물과 상담을 병행합니다. 하지만 약을 쓴다고 모두 해결되지는 못합니다. 본인 스스로가 정상이라 생각하니 약물 순응도 문제도 당연히 있구요. 게다가 망상이라는 것 자체가 어떤 "믿음"의 수준이다보니 이걸 어떻게 바꾸기가 쉽지 않습니다. 어떤 증거를 들이대어도 다 자기 망상체계 안에 넣어서 해석해버리니깐 말이죠. 멋모르고 망상에 대해서 파악한다고 이리저리 질문하다 보면 정말 망상이라는 큰 벽을 두고 이야기하는 것 같은 느낌을 받을 때가 종종 있습니다. 결국은 치료과정에서 조기탈락하거나, 어떻게 치료를 끌고가더라도 지난한 과정을 이끌어갈 수 밖에 없습니다. 그럼 망상장애라는게 치료가 불가능하냐? 꼭 그렇지만도 않습니다. 아예 자신의 망상을 포기하는 분들도 계시구요(그 자체를 병으로 받아들이시는 분). 아니면 망상에 대해서 단지 그때의 착각이었다고 치부하시고 현재 그 문제에 대해서는 언급을 안 하시는 분들도 있습니다. 어떤 분들은 망상 자체를 포기하지 않으시지만 그것 때문에 일어나는 문제들이 너무 크기 때문에 묻어놓고 사시기도 합니다. 아니면 망상을 끝까지 놓지 못하고 그 상태에서 적응해버리고 사시는 분들도 계시구요.(이런분들은 치료받으러 오시지 않겠죠.) 정신과 의사 서천석 선생님의 페북글(https://m.facebook.com/seoulmind/posts/1068268153231442)에서 "망상은 사회적 맥락이 있다"고 이야기를 하죠. 당연한 말이긴 하지만 개인적 맥락도 있습니다. 환자분들의 이야기를 들어보면 그러한 망상을 가질 수 밖에 없는 개인적인 이유도 있고, 그걸 포기하지 못하는 이유도 있습니다. 한편으로는 그걸 포기하도록 만드는 이유도 있습니다. 가족이든 사랑하는 사람이든 개인의 미래이든 이루고 싶은 어떤 것이든 자신의 건강이든 뭐든 간에요. 결국은 그러한 개인적인 맥락 속에서 망상장애를 가진 분이 망상의 영향력에서 최대한 벗어날 수 있게 도와드리는 것이 그나마 제가 할 수 있는 일이 아닌가 생각하며 망상장애 환자분들을 보고 있습니다. 약물치료든 상담이든 정신치료든 말이죠. 약이야 내가 쓰든 다른 의사가 쓰든 상관없을거긴 한데, 그것조차 효과가 있으려면 환자분을 얼마나 '잘'대하느냐가 중요하니깐요. 늘 능력의 한계를 늘 경험하고 살고 있습니다.ㅠㅠ Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 133 Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 146 Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 161 7
이 게시판에 등록된 Obsobs님의 최근 게시물
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Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 599
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 599
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 600
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 600
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 605
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 605
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 609
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 609
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 614
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 616
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 618
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 618
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 612
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 612
Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 620
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 628
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 628
Warning: Use of undefined constant HTTP_HOST - assumed 'HTTP_HOST' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 640
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 644
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 646
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 646
Warning: Use of undefined constant HTTP_HOST - assumed 'HTTP_HOST' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/cmt_replace.php on line 3
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 6
Warning: Use of undefined constant file_name - assumed 'file_name' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 28
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 65
40932 class="iamcmt" style="display:none;"> Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 66
40932 class='vcm '>
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 70
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 71
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 76
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 117
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 118
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 119
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 120
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 121
40932'> jsclub
Warning: Use of undefined constant mod_date - assumed 'mod_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 133
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 140
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 140
Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 142
16/05/22 16:21
40932>삭제 주소복사
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 150
피해망상이 약간있는것같은데
예를들면 사업이 잘안되는 이유를 정부탓 한다던가...
어느정도 되면 치료받아야 하는걸까요?
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 158
Warning: Use of undefined constant password - assumed 'password' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 166
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 171
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
예를들면 사업이 잘안되는 이유를 정부탓 한다던가...
어느정도 되면 치료받아야 하는걸까요?
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 158
Warning: Use of undefined constant password - assumed 'password' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 166
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 171
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
40932>
40932>
