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Kaleidoscope of the Heart: Is talking about mental illness taboo?

Rika Kayama
Rika Kayama

It has already been two months since the beginning of the new Japanese school year. First year students at the university I teach at seem like they've got used to the campus, and have started talking to me casually.

One thing I have noticed at the university over the past several years is how many more students speak to me openly about their own illnesses, saying things such as, "You're a psychiatrist, right? Actually, I'm in treatment for depression." Most of these students are dressed well and greet the world with a smile, and at first glance it's impossible to see anything wrong. "I'm schizophrenic, actually. I was having delusions until just a little while ago," one says with a smile in a loud voice as those around us listen with natural interest. How times have changed.

When I first became a psychiatrist 25 years ago, such openness simply did not happen. Students with psychological problems would head to the hospital with their parents, looking like they were trying to avoid all eye contact. If I had to tell them that they needed treatment, both parents and child would ask sadly, "Is it better to give up university?" Even if I told them that they would probably only need a short break and then they could get back to school, many heartbroken young patients would say, "Whatever happens, I don't want the people at school to know. Isn't there any way to avoid missing school?"

Even in cases where students' conditions worsened, leading to skipped classes and reports not handed in, they could not talk openly to their professors about their problems. Unlike physical ailments, signs of mental illnesses cannot be seen from the outside, and some students suffered through being scolded by their instructors for lack of motivation.

Things are certainly better now, as students can speak of their problems with ease. However, perhaps they can speak to me because I am a psychiatrist. Perhaps some students with psychological problems still feel they can't reveal them to professors of economics or physics.

The National Police Agency recently released the latest suicide figures for Japan, and among the sad numbers the rising suicide rate among people in their 20s stood out in particular. I wonder if among those young women and men, there were students suffering from psychological problems who tried to keep on with school as normal, their conditions worsening as they tried to do the impossible, leading to the worst of all possible outcomes.

I hear that especially in the workplace mental illness is still taboo.

"I'd like you to know that I'm undergoing treatment for depression, so would it be all right to skip overtime for awhile?"

"I understand. No problem."

"That's a big help, thanks. I'll let you know as soon as I've improved."

"Well, don't push yourself too hard."

At Japanese companies, it may be a long time before such conversations between bosses and employees become natural. (By Rika Kayama, psychiatrist)

(Mainichi Japan) May 23, 2010

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