Depression in Japan: Psychiatric Cures for a Society in Distress

By Junko Kitanaka | Go to book overview

CHAPTER EIGHT
The Gendering of Depression and the Selective
Recognition of Pain

The Peculiar Gendering of Depression in Japan

DEPRESSION HAS LONG BEEN represented in the West as a quintessential female malady, where women are said to be twice as likely as men to become depressed. This gender ratio has been cited by some feminists to argue that depression epitomizes women’s suffering (Jack 1991, cf. Showalter 1985). Japan poses a challenge to this characterization, however, because until recently rates of male depression have been as high as—sometimes even higher than—those of women. Throughout the twentieth century, numerous Japanese psychiatrists have commented on this statistical anomaly (e.g., Hirasawa 1966, Naka 1932, Matsumura 1937, Shinfuku et al. 1973, Nakane et al. 2004).1 As Margaret Lock called to our attention in 1993, Japan was the only one out of the twelve countries that participated in the 1973 WHO crossnational survey on depression, where slightly more men than women suffered depression (Lock 1993, Nakane et al. 1994). While this data was recently challenged by the epidemiological community survey on depression, which indicated a gender ratio akin to that suggested by the Western data (Kawakami et al. 2002, 2005),2 and there has certainly been an increase of women with depression during the 2000s, there have been few empirical investigations into what created this peculiar gendering at the epidemiological level.3

1 On gender and mental illness, also see Suzuki Akihito’s historical analysis of the asylums in the early twentieth-century Japan (Suzuki 2005). On the politics of gender representation in psychiatry, see Micale 1995, 2008, Showalter 1985.

2 In one recent epidemiological study—conducted for the first time in a long while in Japan— Kawakami et al. (2002, 2005) showed that depression rates may not be so different in Japan from those in the United States. These statistics urge us to seriously examine whether or not the longheld Japanese psychiatrists’ clinical observations about gender were indeed just a matter of social accessibility to psychiatry and of experts’ selective attention, or if the number of depressed people has itself changed rapidly of late. (As Lock [1993] has suggested, there is a possibility that Japanese women may have had cultural resources that have long protected them from social isolation and a sense of alienation—and perhaps from the experience of depression itself.) Experts also ask if increased rates of depression are merely the result of a new “operational diagnosis” (i.e., the DSM), which gives the false impression of there being an actual biological entity when in fact the definition of depression itself has been significantly changed to include a wide variety of subjective complaints (this has left many Japanese psychiatrists debating the validity of such a diagnosis).

3 Note that one way in which biological standardization of depression is being quickly estab-

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