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Surviving Depression in Japan
by Robert L. Seltman

Being sad is understandable. A careful reflection of our love, financial, or professional lives will bring most of us into the doldrums. We know, theoretically, angst is an integral part of what makes life interesting. At least half of good drama is tragedy. Yet when despair gets us in her claws, draining all the little joys that make our life worth living, a major dose of ‘happy-help’ is in order.

Do not waste time blaming yourself. Forget about drowning yourself in booze, alcohol exacerbates depression and undermines medication. Instead, head directly for a complete medical check-up. While depression is a "whole-body" disorder, involving body, mood, and thoughts, your depression may be rooted in a physical condition. Check here first.

Women may have a depression triggered by hormonal changes from oral contraception, monthly menstrual cycles, during or after pregnancy, and at menopause. Men hormone levels fluctuate too. Some diseases cause depression. Your drinking or obsessive working may be hiding important symptoms that need attention. The point is to verify your physical condition and then, if depression persists, ask your physician to recommend a clinic specializing in psychotherapeutic or psychopharmacologic treatment.

Both cognitive and interpersonal therapies can help depression, but you may find that you have gone beyond ‘talking it out’ and may need a chemical solution. Antidepressants are not ‘happy pills’ nor are they addictive, proven by the fact that there are no dope dealers selling bags of it downtown. Antidepressants are not a fast fix, taking from two to eight weeks to work by subtly increasing our neurotransmitters in the brain (most often serotonin, norepinephrine, and dopamine). Depression medication needs to be administered quickly and consistently, and monitored carefully to be of any use. Antidepressants are not a cure-all but they can be a god-sent when used properly.

There are therapy centers for English speakers in Kansai such as Aoibashi Clinic in Kyoto (075-441-9373) or in Tokyo the Tokyo Counseling Services and Inochi no Denwa (Lifeline Telephone Service): Japan 0120-738-556/Tokyo 3264-4343 or TELL Tokyo English Life Line 03-5774-0992 providing immediate advice, but most likely you will need a Japanese clinic for medication. A caring love-one, or sympathetic friend, may be willing to come with you for at least the initial visit. Visit an international religious service if you are in need of a helping hand from someone familiar with Japan.

One can not emphasize enough how important it is in Japan to express yourself clearly and persistently. Clinics are busy here. This is a fast lane high anxiety society, with many people needing and seeking treatment, be assertive and keep the doctor up-to-date on your condition. Anti-depressants affect us all somewhat differently, and the doctor will need to know exactly how you are feeling to appropriately prescribe your dosage. Don’t fade behind your illness; tell your doctor everything!

You may want to cut back from an active social and professional schedule, yet do not hide completely. Networking with others can be helpful. Taking time, even if it means mustering up all your energy, to contact old friends, prepare special foods, to keep your journal, hug your kitten, or any other self-therapeutic treats ‘your heart desires’ can make a world of a difference. Though it may not seem easy at first, keep going for tender loving self-care.

The best source of timely and comprehensive information, in any language, is the Internet. Here you can find the exact chemical make-up of the dosage administered by your doctor, the generic and brand names used in each country, all the potential side-effects, and even the opinion of various people ‘pro and con’ who have used it.

Each medication has at least two names, for example Prozac is Fluoxetine, and Wellbutrin is Bupropion. Once in therapy these different medications may become part of your vocabulary but initially ask your doctor to translate the katakana name. Sometimes the pill packaging will have the name printed. Type this into a good search engine and follow the links for an expanding world of information. Also, by typing ‘Depression’ into LookSmart.com, or your favorite search engine, you will find comprehensive sites in England, the US, Australia, and elsewhere dealing with depression and its cures.

There is a hearty assortment of national and international support groups, many for particular disorders, such as, ‘Depression After Delivery’, ‘Emotions Anonymous’, ‘National Depressive & Manic-depressive Association’, ‘NOSAD’ (‘Seasonal Affective Disorder,’ for people seriously affected by season changes) and many more.

Via computer you can chat with others in a like situation, for example alt.support.depression is a newsgroup of people worth visiting. They provide the latest on related medical research, ‘Frequently Asked Questions,’ recommended book lists, self-help suggestions, and a ‘Who’s Who’ list of famous folk who have been where you are.

If you are comfortable in Japanese you may want to take advantage of clubs set up as outpatient centers. For example in northern Kyoto City ‘You-You’ Club ( Yu Yu Kan 075-721-6861) meets daily in their own suburban neighborhood house, where outpatients mix with a trained staff over coffee. Many hospitals have similar facilities. Caseworkers can be very experienced with the way depression impacts people’s lives and make concrete suggestions.

There has been a long-standing stigma attached to seeking help for psychological problems, but this is changing. Still, we dread the thought that people we work with may consider us less than ‘normal’ and this prevents us from getting the help we need. A dangerous trap, indeed. Suppressed anxiety builds, until we delude ourselves into believing the sad reality we are experiencing is universal and irreversible. Low self-esteem, anxiety, work stress, complicated by a sudden hormonal or emotional shock, like childbirth or the death of a parent, can tumble us into deep despair.

Last year the suicide of several professors shook our small academic community here in Kyoto. Could confession and communion with a good listener, blended with appropriate medication, have brought in enough fresh air to save these lives? When feeling down, check your general health first, next check the Internet for diverse opinions, and seek professional counsel. Take the medication prescribed while keeping the doctor informed of your condition, and treat yourself to continuous tender-loving care. Happiness is real, worthwhile, and accessible, and you deserve it.

Copyright©2000 Robert L. Seltman. All rights reserved.

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