Depression in Japan: Psychiatric Cures for a Society in Distress

"This book is about depression in Japan. But also about how the idea of depression has changed historically in Japan. I’ve talked about how some old ideas still endure in Japan today. This book shows how the idea of depression has changed in Japan. When I was younger, people didn’t talk about depression at all. I am pretty sure that there were people with depression, but it was not common or acceptable for them to talk about it. But today lots of people casually talk about depression and being depressed. Medicines are available and you can really feel that the way Japanese people think about depression has changed. Kitanaka explains how this change was possible. She argues that depression has become not only an individual matter, but rather a social and national matter. Importantly, this change overlaps with the Japanese economic downturn that began in the mid-1990s. So it occurs when the Japan boom years ended, when lots of people lost their jobs or lost their lifetime employment—so they had to work harder without any extra pay. That kind of environment created ‘deaths from overwork.’ So depression was portrayed as the sign of a social disease in Japan. The overlapping idea is that Japan is sick. And individuals have become sick as a result of this broader social malaise, not simply individual traits or weaknesses. That is another interesting topic in this book. Although it was seen as a social disease, the treatment for it was focused on individuals’ bodies, looking at bodily symptoms. The medical profession doesn’t really talk about the social context, but they often talk about bad headaches or being tired. “The suicide rate is not particularly high as compared with other developed countries but, sadly, the highest cause of death among young Japanese people is suicide” And then, the best solution for this kind of depression is seen as rest—just rest for a week or two, and then you can go back to work again. It’s a sort of biological reductionism. They talk about it largely in terms of how your body feels. Maybe not as much as the US, but it’s certainly increasing. Kitanaka also shows that this increasing medicalisation is because of the ways psychiatrists destigmatised depression and framed it as a biological dysfunction. So, depression was no longer seen as an individual genetic problem. It was also called a ‘cold of the heart’, so it was like other physical illnesses—the heart had caught a cold. In Japan, the body and the mind are often seen as a unity. So, treating the bodies was thought as ultimately treating the mind. Yes, that is also discussed in the book. There was a historic Supreme Court case in the mid-1990s, in which it was established that suicide could be attributed to social causes. An employee of the company, Dentsu, committed suicide due to his depression and being overworked. Since then, the government installed some stress-check inspections within companies to prevent suicides and deaths from overwork The suicide rate is not particularly high as compared with other developed countries, but sadly, the highest cause of death among young Japanese people is suicide. Also, as this book shows, suicide was often seen as the last resort for people to express their own will in Japan. So, suicide itself was not always stigmatised, sometimes even romanticised, like Samurai cutting their bellies open. There was a social attitude that if someone commits suicide, others just leave them alone and leave them with their dignity. But now, since the court case, people have also came to recognise that suicide can be caused by mental illness, and is thus not an expression of will. Yes. Actually, my first book is coming out in July. It’s about transnational matchmaking practices between Japanese men and Chinese women. These are commercially brokered marriages. They are introduced through an agency and pay money to meet for around 20 minutes, then they decide whether or not to get married. That is probably the most frequent question I get. The simple answer is that Japanese men want to marry but can’t find a bride in Japan. And they often look for much younger women. They think Chinese women are almost like Japanese women, maybe they can pass as Japanese women. For the Chinese women, often they are seen as too old to marry in China, even if they are only in their late twenties. Some of them want to go to Japan to earn money. That is what people in their local communities always talk about. So economic inequalities between these Japanese men and Chinese women are a crucial background condition making these matchings possible. But, of course, no one wants to believe or say they are marrying for money or with money. The Chinese women are mainly from the area that constituted the former Japanese colonial project in Manchuria. So, they are very aware of Japan’s colonisation and very critical of Japanese imperialism. But at the same time, there were a lot of Japanese war orphans left behind in northeast China after the war. Those Japanese war orphans were raised by local Chinese families. Many people told me about these blood relations between Japan and China. Then, since the resumption of diplomatic ties between Japan and China, many people in those communities migrated to Japan. Yes, it started in the 1980s. First, it was those who were officially recognised as Japanese war orphans by the Japanese government and their Chinese families, those who married the war orphans. Then came other people from those communities who had heard that they can earn a lot of money in Japan, which was, to some extent, true during Japan’s economic boom years. Much later, especially for Chinese women, marriage came to be seen as another way to go to Japan. Well, that’s an interesting question. I don’t have an exact figure, but around 50% of the marriages I looked at survive. That’s almost the same as the US, even though they don’t speak the same language and they marry almost as strangers!"