FacebookTwitterRedditEmail

The Social Burden of Depression in Japan

Depression is widespread, largely undiagnosed, and rarely treated in Japan. Until the late 1990s, depression was largely ignored outside the psychiatric profession. Depression has been described as “kokoro no kaze” (a cold of the soul) and only recently it is being accepted in Japan as a medical condition that shouldn’t provoke shame in those suffering from it. In Japan, it is estimated that one in five people will experience some form of depression during their lifetime.

Depression is a state of low mood which can affect a person’s thoughts, behavior, feelings, and sense of well-being. Its symptoms include sadness, inactivity, difficulty in thinking and concentration, and altered appetite and sleep. Many depressed people have feelings of dejection and hopelessness that may drive them to suicide.

Depression can manifest at any age. It can begin during childhood or the teenage years. As happens also among adults, girls are more likely to experience depression than boys. Among women, one in seven experiences post-partum depression; about half of them start experiencing symptoms during pregnancy.

Clinical depression among the elderly is also common, affecting 6 million Americans ages 65 and older. Among the elderly, depression is frequently confused with the effects of other illnesses. Studies in nursing homes of elderly patients with physical illnesses show that depression substantially increases the risk of dying from those illnesses.

In most cases, depression can be treated. The U.S. FDA (Food and Drug Administration) recent approval of the drug esketamine will be a significant advance in the treatment of depression. Esketamine is particularly effective for those who have been resistant to conventional treatment, or who are at imminent risk of suicide.

Like ketamine, a related drug, esketamine, in addition to its anesthetic effects, is a rapid-acting antidepressant, whose medical use was started in 1997. On February 12, 2019, an independent panel of experts recommended that the Food and Drug Administration (FDA) approve the use of esketamine, as long as it is administered in a clinical setting to ensure patient safety. Esketamine may bring relief to millions of patients all over the world, particularly in Japan, where depression is widespread and largely neglected.

One of the reasons for this neglect is the feeling of shame associated with mental health issues. Many of those who suffer from depression prefer to think that there is something wrong with them, rather than that they suffer from a medical condition which can be treated. In most cases, people resort to a cultural impulse known as “gaman” or the will to endure.

Depression has been called a “democratic disease” because it affects people of all social and economic strata. According to the World Health Organization (WHO) estimates, more than 300 million people were affected by depression worldwide in 2015, equivalent to 4.4 percent of the world’s population. Nearly 50 percent of all people diagnosed with depression are also diagnosed with an anxiety disorder.

Depression is also a major contributor to suicide. According to WHO, almost 90 percent of people who attempt suicide suffer from depression. There are approximately 800,000 suicides globally every year. In Japan, although the total number of suicides has diminished in recent years, the high number of suicides among children and teenagers is a cause for concern.

Aside from the effects on health and on people’s well-being, depression exacts a heavy economic toll on individuals, families and on society as a whole. In Japan, the London School of Economics has estimated that the economic cost of depression is over $14 billion annually, compared to $210 billion in the U.S. That includes decreased productivity, medical expenses, and indirect medical costs. In Japan, some of those costs are more difficult to estimate because of the cultural issues surrounding depression and mental health in general.

It remains necessary to raise awareness of depression in the general population of Japan, through massive health communication campaigns, alerting on the seriousness of the untreated cases and about the possibility now of addressing the problem effectively. As depression is on the rise globally, the approval of a drug to treat cases resistant to treatment is a reason for hope.

More articles by:

Dr. Cesar Chelala is a co-winner of the 1979 Overseas Press Club of America award for the article “Missing or Disappeared in Argentina: The Desperate Search for Thousands of Abducted Victims.”

August 13, 2020
David Correia, Justin Bendell, and Ernesto Longa
Nine Mile Ride: Why Police Reform Always Results in More Police Violence, Not Less
Vijay Prashad
Why a Growing Force in Brazil Is Charging That President Jair Bolsonaro Has Committed Crimes Against Humanity
Brett Wilkins
Teaching Torture: The Death and Legacy of Dan Mitrione
Joseph Scalia III
Yellowstone Imperiled by Compromise
Binoy Kampmark
Don’t Stigmatise the Nuke! Opponents of the Nuclear Weapons Ban Treaty
Margot Rathke
The Stimulus Deal Should Include Free College
Thomas Knapp
America Doesn’t Have Real Presidential Debates, But It Should
George Ochenski
Time to Face – and Plan for – Our Very Different Future
Ted Rall
Joe Biden’s Vice Presidential Pick is … ZZZZZ
Purusottam Thakur
‘If We Don’t Work, Who’ll Produce the Harvest?’
Robert Dreyfuss
October Surprise: Will War with Iran Be Trump’s Election Eve Shocker?
Gary Leupp
The RCP, Fascism, and Chairman Bob’s Endorsement of Biden for President
James Haught
The Pandemic Disproves God
Robert Koehler
Election Theft and the Reluctant Democracy
August 12, 2020
Melvin Goodman
Trump’s War On Arms Control and Disarmament
P. Sainath
“We Didn’t Bleed Him Enough”: When Normal is the Problem
Riva Enteen
Kamala Harris? Really? Desperate Times, Desperate Measures
Kenneth Surin
The Decrepit UK Political System
Robert Hunziker
Freakish Arctic Fires Alarmingly Intensify
Ramzy Baroud
The Likud Conspiracy: Israel in the Throes of a Major Political Crisis
Sam Pizzigati
Within Health Care USA, Risk and Reward Have Never Been More Out of Kilter
John Perry
The US Contracts Out Its Regime Change Operation in Nicaragua
Binoy Kampmark
Selective Maritime Rules: The United States, Diego Garcia and International Law
Manuel García, Jr.
The Improbability of CO2 Removal From the Atmosphere
Khury Petersen-Smith
The Road to Portland: The Two Decades of ‘Homeland Security’
Raouf Halaby
Teaching Palestinian Children to Love Beethoven, Bizet, and Mozart is a Threat to a Depraved Israeli Society
Jeff Mackler
Which Way for Today’s Mass Radicalization? Capitalism’s Impending Catastrophe…or a Socialist Future
Tom Engelhardt
It Could Have Been Different
Stephen Cooper
Santa Davis and the “Stalag 17” Riddim
August 11, 2020
Richard D. Wolff
Why Capitalism is in Constant Conflict With Democracy
Paul Street
Defund Fascism, Blue and Orange
Richard C. Gross
Americans Scorned
Andrew Levine
Trump and Biden, Two Ignoble Minds Here O’erthrown
Patrick Cockburn
The Rise of Nationalism Has Led to the Increased Repression of Minorities
Sonali Kolhatkar
Trump’s Presidency is a Death Cult
Colin Todhunter
Pushing GMO Crops into India: Experts Debunk High-Level Claims of Bt Cotton Success
Valerie Croft
How Indigenous Peoples are Using Ancestral Organizing Practices to Fight Mining Corporations and Covid-19
David Rovics
Tear Gas Ted Has a Tantrum in Portland
Dean Baker
There is No Evidence That Generous Unemployment Benefits are Making It Difficult to Find Workers
Robert Fantina
War on Truth: How Kashmir Struggles for Freedom of Press
Dave Lindorff
Trump Launches Attack on Social Security and Medicare
Elizabeth Schmidt
COVID-19 Poses a Huge Threat to Stability in Africa
Parth M.N.
Coping With a Deadly Virus, a Social One, Too
Thomas Knapp
The “Election Interference” Fearmongers Think You’re Stupid
Binoy Kampmark
Mealy-Mouthed Universities: Academic Freedom and the Pavlou Problem Down Under
FacebookTwitterRedditEmail