Depression in Japan

Depression in Japan: Psychiatric Cures for a Society in Distress

Junko Kitanaka
Copyright Date: 2012
Pages: 264
https://www.jstor.org/stable/j.ctt7rrv0
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  • Book Info
    Depression in Japan
    Book Description:

    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 Japanexplores 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 Japanuncovers the emergence of psychiatry as a force for social transformation in Japan.

    eISBN: 978-1-4008-4038-0
    Subjects: Anthropology, Psychology, History

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. List of Illustrations
    (pp. ix-x)
  4. Acknowledgments
    (pp. xi-xvi)
  5. CHAPTER ONE Introduction: Local Forces of Medicalization
    (pp. 1-18)

    In Japan, the termkarōshi, 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 werekarō jisatsu, or overwork suicide, referring to the suicide of people who are driven by excessive work to take their own lives, andkarō utsubyō, 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...

  6. Part One. Depression in History
    • CHAPTER TWO Reading Emotions in the Body: The Premodern Language of Depression
      (pp. 23-39)

      Anthropologists of medicine have long asked how it is that some medical concepts travel well—and become integrated into local knowledge—while others, when transferred to another culture, seem to remain alien, experience-distant, even incommensurable. While anthropologists have traditionally interpreted a failure of translation as a sign of fundamental cultural difference, more recently they have questioned the cultural essentialism lurking behind such a claim and instead begun to explore the issue of power in translation. By investigating initial moments of concept transfer historically, anthropologists have asked what forces are at play in adopting a certain medical concept—or a language...

    • CHAPTER THREE The Expansion of Psychiatry into Everyday Life
      (pp. 40-53)

      Rising concern over the increase of depression marks a new phase in the history of Japanese psychiatry, a transformation from the time when it was rarely used as a treatment for “ordinary” Japanese. In this chapter, I examine this transformation by dividing the history of psychiatry into three phases, each contributing to the expansion of psychiatry into the realm of everyday distress. The first (1870s to the 1930s) was in the prewar era, when the state introduced psychiatry as a force for modernization. The view that mental illness was a biological—and often hereditary—disease displaced the previous notion in...

    • CHAPTER FOUR Pathology of Overwork or Personality Weakness?: The Rise of Neurasthenia in Early-Twentieth-Century Japan
      (pp. 54-66)

      Before we examine the history of depression in Japan, I would like to call attention to the fact that, although psychiatry has only recently begun to expand institutionally into the realm of everyday discourse via depression, there was a time when it held a considerable conceptual influence over the way ordinary Japanese talked about their everyday distress in the popular discourse. This was during the alleged “epidemics” of neurasthenia at the turn of the twentieth century, the risk of which was elaborated upon and widely cautioned against by not only medical experts but also influential intellectuals at the time. As...

    • CHAPTER FIVE Socializing the “Biological” in Depression: Japanese Psychiatric Debates about Typus Melancholicus
      (pp. 67-82)

      As the current medicalization of depression has been spurred on by the advent of new antidepressants, North American critics have expressed concern that psychiatry is promoting a form of biological reductionism. By reducing the complex causality of depression to “chemical imbalance” and disseminating the idea of the “neurochemical self ” (see Rose 2007), psychiatry—these critics argue—serves to impoverish people’s understanding of depression, thereby homogenizing the diverse local resources from which they have dealt with life’s hardships (see Elliott and Chambers 2004). During my fieldwork in Japan, however, I found that medicalization does not necessarily promote the same old...

  7. Part Two. Depression in Clinical Practice
    • CHAPTER SIX Containing Reflexivity: The Interdiction against Psychotherapy for Depression
      (pp. 89-106)

      I chose to do my fieldwork in the psychiatric department at JP Medical School¹ because of its emphasis on psychopathology (seishin byōrigaku). Psychopathology, a subfield of clinical psychiatry, developed by scholars who drew upon phenomenology and psychoanalysis, might be hard to grasp for those who are used to the American opposition between biopsychiatry and psychoanalysis. Based on German neuropsychiatry, psychopathology is not opposed to the use of biology in psychiatry but rather regards it as an integral part of it. It involves a particular way of performing clinical observation and a diagnostic method that emphasizes phenomenological approaches in an attempt...

    • CHAPTER SEVEN Diagnosing Suicides of Resolve
      (pp. 107-128)

      Under the expanding power of psychiatry in Japan, few subjects have so thoroughly resisted medicalization as that of suicide. Early-twentieth-century Japanese psychiatrists adopted the biological view of suicide then dominant in the West, and proposed that it should be understood as a matter of a diseased brain or a genetic predisposition (Kure 1900, Miyake 1900). This biological determinism provoked a heated debate in Japan for a few decades, but since has had little persuasive power over lay people beyond the narrow circles of biological psychiatry. This may be because Japanese, according to Maurice Pinguet (1993) inLa mort volontaire au...

    • CHAPTER EIGHT The Gendering of Depression and the Selective Recognition of Pain
      (pp. 129-150)

      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...

  8. Part Three. Depression in Society
    • CHAPTER NINE Advancing a Social Cause through Psychiatry: The Case of Overwork Suicide
      (pp. 155-173)

      As discussed at the beginning of the book, overwork suicide and overwork depression have emerged as national concerns in 2000, when the Supreme Court ordered Dentsū, Inc., Japan’s largest advertising agency, to pay the sum of 168,600,000 yen (approximately US$1,560,000 at the time) to the family of a deceased employee, Ōshima Ichirō.¹ This represents the highest amount ever paid for a worker’s death in Japan. The Supreme Court determined that the cause of Ichirōʼs suicide was clinical depression, and that his depression had been produced by long and excessive overwork (Asahi, June 23, 2000). After the precedent-setting verdict, a number...

    • CHAPTER TEN The Emergent Psychiatric Science of Work: Rethinking the Biological and the Social
      (pp. 174-192)

      Back in the 1990s, my North American colleagues would appear incredulous upon hearing me talk about overwork depression and suicide in Japan. They would ask how it is that Japanese could be so blind and so unreflective as to work themselves into depression, even driving themselves to suicide? In France, the idea of “overwork death” itself was apparently curious enough thatLe Monderan a number of articles about this Japanese phenomenon (e.g., Brice 1999). A decade later, however, the news of a spate of suicides among employees of France Telecom made headlines around the world—suicides that were attributed...

    • CHAPTER ELEVEN The Future of Depression: Beyond Psychopharmaceuticals
      (pp. 193-200)

      I began this book with the question of how Japanese have come to embrace the psychiatric view of depression so suddenly, despite their long resistance to psychiatric intrusion into everyday life. As the book has demonstrated, this is partly due to the way psychiatry in Japan has been able to create a language of depression that speaks to people’s sense of social distress (cf. Kleinman 1986, Lock 1987, Young 1980, 1995). By linking with grassroots movements, psychiatry has come to provide a means by which people can seek social legitimation of their distress and challenge the increasingly oppressive culture of...

  9. References
    (pp. 201-230)
  10. Index
    (pp. 231-243)