Dealing with Depression in Japan

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October 3, 2017

The day of Sep. 25 marked exactly 11 years since I first arrived in Japan. In the years between then and now, I’ve had some amazing experiences and faced some unexpected challenges. However, without a doubt, the most challenging — and for a time the most debilitating — battle I have faced in my years living in Japan has been my battle with depression.

I enjoy interacting with an ever-expanding community here on GaijinPot through its social media and the many comments people leave on my posts. Through this, one of the more comforting things I’ve learned is that I’m certainly not the only one. There are a great many of us here in Japan (and elsewhere) who live with depression. It’s the source of many posts and even more questions.

Here are some of the most common questions I receive and my best attempts to answer them.

1. What’s the difference between depression and culture shock?

To the uninitiated, depression and culture shock can seem very similar. Both conditions breed a deep feeling of isolation, helplessness and unhappiness; however, they are actually very different.

Culture shock is a temporary state. It comes and goes. Check out my previous post on the condition for advice on how to deal specifically with it.

Depression can be triggered by many things: imbalances in the brain, work-related stress, trauma or even just a genetic trait of vulnerability. My father has faced depression before, too, so it’s likely I may have inherited some of my susceptibility from him.  

Culture shock only comes from one source: the struggle to acclimatize to a new, foreign environment.

2. I think I may be suffering depression, what should I do?

The first step is to seek out the advice of a medical professional.

Treatment of mental illnesses may not be as progressive here as it is in other nations, but things are rapidly improving. Depression is finally being taken seriously in Japan and there are new options and services available to tackle it. If possible, I recommend seeking out a younger doctor or perhaps one who has been educated overseas. They are likely to be more open in their outlook and, as such, better positioned to make a firm diagnosis and suggest effective treatment options.

My own doctor here in Osaka is Dr. Woon Joo Lee (www.goleeclinic.org) He was educated abroad and is fluent in English, Chinese and Korean. Dr. Lee was extremely helpful the last time I had a bout of depression, introducing me to both medicinal and counseling options.

3. OK. I’ve been diagnosed with depression. Should I tell my boss?

This is a really tricky one to answer. It comes down to best practice versus practical reality. Official guidance will say that you should inform your employer if you have a mental illness but from my own experiences, I probably wouldn’t.

When I was working for a local city board of education several years ago, I was diagnosed with stress-induced depression. I was instructed to take at least six weeks off work to recover and get the therapy I needed.

The board of education called me every day that I was off, wanting to know when I was coming back to work. Upon my return (much earlier than was medically advisable), I was scheduled to teach six classes per day, though the limit was supposed to be four since they hadn’t bothered to bring anyone in to cover me while I was absent. I was also given the cold shoulder by my colleagues, which I later learned was because management hadn’t told them about my reason for being away. Instead, they said that I had taken six weeks off “for no particular reason.”

Treatment of mental illnesses may not be as progressive here as it is in other nations, but things are rapidly improving.

A few months later, I was told my contract would not be renewed due to  “extremely poor performance in my evaluation” — an evaluation that I was never allowed to see and for which no scoring criteria was ever explained.

[Editor’s note: It’s worth mentioning that GaijinPot contacted Andrew Grimes, the director of Tokyo Counseling Services, regarding the legalities of taking time off work for medical reasons. He confirmed that in a Japanese workplace, you are entitled to medical leave.: “With an official letter from your doctor, you can legally take at least two months off from work. Stay with the doctor’s expert opinion on how long you need to rest and have a break from work. Only return to work with your doctor’s agreement.”

He said: “With an official letter from your doctor you can legally take at least two months off from work. Stay with the doctor’s expert opinion on how long you need to rest and have a break from work. Only return to work with your doctor’s agreement.”]

As I and many of my friends have learned in Japan down the years, if a company wants to get rid of a teacher, they will find a way — legal or otherwise. There’s not a doubt in my mind that my honesty about my depression cost me that job. But then again, why would I want to work for an organization so backward and ignorant?

So really, it’s up to you whether you tell the boss or not — but be prepared for the possible consequences if you do.

4. Should I stay or should I go?

Again, this is a personal choice. I guess I’ve always been rather stubborn and this has served me well in my fight against depression. I refuse to let an illness dictate my future, but of course, we are all different.

For some, going home to regroup and get therapy in a more familiar environment may be the best way forward. It’s not weak to ask for help and it’s not a failure if you decide to go home for a time and regroup. Japan isn’t going anywhere and it will all still be here once you get well.

5. My Japanese friends say I just need to pull myself together and stop complaining.

OK. I’m probably going to get flamed for this but it needs to be said: cultural differences are no excuse for ignorance!

If these so-called “friends” refuse to acknowledge the seriousness of your condition or comment dismissively on it without doing any actual research, they are unworthy of your friendship. I’ve lost friends because of depression in the past. In truth, though, I didn’t lose anything of value. Instead, I gained something. I gained the knowledge of who my true friends really were, who was worthy of my friendship and who needed to be cut loose.

I’m not going to say it’s easy. It isn’t. As I said at the beginning of this piece, overcoming depression is probably the biggest challenge I have ever faced, and it’s an ongoing battle. But, there’s plenty of help out there. Here are a few resources in Japan of the many out there internationally:

  • TELL (Tokyo English Lifeline) has a variety of resources available to help you at a time of crisis. Give them a call on 03-5774-0992. They are open every day until 11 p.m.
  • Tokyo Counseling Services, provides individual counseling, couples counseling, marriage and family counseling, group therapy and psychotherapy services. Counseling and therapy services are available in English, French, German, Korean, Chinese, Japanese and Portuguese for all residents living in the Tokyo Metropolis and Kanto region.s another option. Tel: (03) 5439-3196. Email: tokyocounselingservices@gmail.com. Twitter: @tokyocounseling.
  • There’s also general mental health information on Japan Health Care Info‘s website.
  • The Japan Helpline has info and resources for areas across the country for everything from medical help to other emergencies.

Whatever you do, please do something. Any step, however small and however insignificant it may seem, is a step toward something better.

This article is provided as general information only. If you are in need, please contact a mental health professional. 

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Teacher, journalist and now blogger.

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