Selected Columns
Kaleidoscope of the Heart: Toward an anti-depression society
A few days ago, the Ministry of Health, Labor and Welfare released a survey of patients in Japan.
The survey, produced every three years, showed the number of mood disorder cases in 2008 had sharply increased from 2002, breaking the 1 million mark -- over half of which were cases of depression. The number of mood disorder cases is a startling 2.4 times greater than it was 10 years ago.
Most psychiatrists would agree that this startling statistic does not mean that there are more than twice as many depressed people as there were 10 years ago. Rather, thanks to awareness-raising campaigns, public understanding of the condition is improving and even patients with minor conditions don't hesitate to seek treatment. Furthermore, as new antidepressants hit the market, major "early detection, early treatment" campaigns have bumped up the numbers. Many psychiatrists point out there are cases of doctors diagnosing even people who do not need medication as depressives, and prescribing drugs.
I must admit that I, too, tend to diagnose first-time patients with depression when I have a full waiting room and am trying to economize on time spent with each person. Even if by chance a patient comes in with a different condition with depression-like symptoms, often some of the new brands of anti-depressants are effective in combating such ailments as well, so I tell myself, "I'll arrive at a correct diagnosis as I watch this patient over the long haul." I have had to reflect privately on not using greater discretion.
Even saying all that, I also believe that real cases of depression are on the rise.
The number of depression patients has jumped suddenly since the 2002 study. At the same time, major companies have been shifting to performance-based pay structures. In the examination room, too, I hear more patients worrying about becoming "losers" if their job performance doesn't improve, and I have now seen many depression cases that I believe stemmed from overwork as patients sought to raise their value as employees. Japan recorded its highest number of suicides in 2003.
Now, six years later, there seems no sign that the trend to a "survival of the fittest" mentality is about to change, and it's no surprise to me that cases of depression are on the rise.
This year, a new government came into power, and if the new administration really puts its "friendship society," stressing support and mutual aid, into effect, I think cases of clinical depression could drop.
What will the numbers look like when the ministry releases its next patient survey in 2012? There are those who say the Democratic Party of Japan-led government will not survive that long, but as a psychiatrist, I hope I will be able to say, "Since we returned to a gentler society, I'm so pleased that the number of depression cases has dropped." (By Rika Kayama, psychiatrist)
(Mainichi Japan) December 13, 2009