Depression in Japan: Psychiatric Cures for a Society in Distress

Depression in Japan: Psychiatric Cures for a Society in Distress

Depression in Japan: Psychiatric Cures for a Society in Distress

Depression in Japan: Psychiatric Cures for a Society in Distress

Synopsis

Since the 1990s, suicide in recession-plagued Japan has soared, and rates of depression have both increased and received greater public attention. In a nation that has traditionally been uncomfortable addressing mental illness, what factors have allowed for the rising medicalization of depression and suicide? Investigating these profound changes from historical, clinical, and sociolegal perspectives, Depression in Japan explores how depression has become a national disease and entered the Japanese lexicon, how psychiatry has responded to the nation's ailing social order, and how, in a remarkable transformation, psychiatry has overcome the longstanding resistance to its intrusion in Japanese life.


Questioning claims made by Japanese psychiatrists that depression hardly existed in premodern Japan, Junko Kitanaka shows that Japanese medicine did indeed have a language for talking about depression which was conceived of as an illness where psychological suffering was intimately connected to physiological and social distress. The author looks at how Japanese psychiatrists now use the discourse of depression to persuade patients that they are victims of biological and social forces beyond their control; analyzes how this language has been adopted in legal discourse surrounding "overwork suicide"; and considers how, in contrast to the West, this language curiously emphasizes the suffering of men rather than women. Examining patients' narratives, Kitanaka demonstrates how psychiatry constructs a gendering of depression, one that is closely tied to local politics and questions of legitimate social suffering.


Drawing upon extensive research in psychiatric institutions in Tokyo and the surrounding region, Depression in Japan uncovers the emergence of psychiatry as a force for social transformation in Japan.

Excerpt

A Typus Melancholicus, at a big corporation, working
harder for three months after being promoted … develops
a clear case of depression. After taking antidepressants
and time off for half a year or so, he returns to work fully
recovered…. This is a typical depression in Japan.

—Kasahara Yomishi in Kasahara, Yamashita,
and Hirose, Utsuby ō (Depression) (1992:29)

When I first came to the hospital, I felt so liberated from my
work and my family that I immediately got better. But now
that I’ve started thinking about going back to work and
about what might await me upon my return …

—(a forty-three-year-old salaryman; a recovering
patient who became depressed again immediately
after receiving a call from his boss)

The Rise of Depression

IN JAPAN, THE TERM karōshi, or death from overwork, was coined in the 1980s to describe cases where people have essentially worked themselves to death. In the late 1990s, when Japanese began to see suicide rates skyrocket, other similar terms emerged and gained currency in the national media. These were karō jisatsu, or overwork suicide, referring to the suicide of people who are driven by excessive work to take their own lives, and karō utsuby ō, or overwork depression, clinical depression that is seen to underlie such an act. The concern about overwork suicide and overwork depression heightened in 2000, when Japan’s Supreme Court ordered Dentsū, the biggest advertising agency in the country, to compensate the family of a deceased employee with the largest amount ever to be paid for a worker’s death in Japan. While Dentsū argued that the employee’s suicide was an act of free will, the Supreme Court determined that it was a product of depression that had been caused by chronic and excessive overwork. After the precedent-setting verdict, a number of similar legal victories have followed, increasingly by workers who contend that their depression is work-induced. Alarmed by these legal disputes and the rising number of the depressed in society at large, the government has installed new mental health . . .

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