02/28/2012

 

The Fukushima Psychiatrist

'It's Amazing How Traumatized They Are'

DPA

Since the Fukushima catastrophe almost one year ago, Jun Shigemura has been providing psychological care to workers from the stricken nuclear facility. In an interview with SPIEGEL ONLINE, he tells of the immense challenges facing TEPCO employees -- and why most of them have elected not to quit their jobs.

SPIEGEL ONLINE: Since May, you have been providing psychological assistance to workers in the stricken Fukushima nuclear power plant. How did you end up with such a job?

 

Shigemura: Actually it is a bit sad that I am in charge of the workers' mental health. But TEPCO had lots to take care of and didn't have enough capacity to provide mental health services. Before the quake, a part-time psychiatrist looked after the workers in Daiichi and Daini. But he is from Minamisoma and it takes him too long to get to work now because of the exclusion zone. A few nurses in the health center for the two plants read my publications and contacted me. Then TEPCO sent for me. I am there as a volunteer.

 

SPIEGEL ONLINE: You don't get paid for your work?

Shigemura: Not by TEPCO, but I wouldn't want that. It would hurt my position. I don't want to be involved in the profit-making nuclear industry, even more so because workers' wages have been cut by 20 percent. That's why I made a government project out of this. TEPCO has yet to find a psychiatrist who wants to take over the job. Most of them are probably worried about radiation and their image. Furthermore there are not enough psychiatrists in Japan. After the Kobe earthquake in 1995, more people began to understand how important psychological assistance is. But many still think that those who go to a psychiatrist must be crazy. I hope that things will improve further after this catastrophe.

SPIEGEL ONLINE: Aren't you worried about radioactivity yourself?

Shigemura: I am not afraid, but that doesn't mean I am not anxious. I haven't been in Fukushima Daiichi facility. The health center is at the Daini plant, about 10 kilometers away. Radioactivity levels are low there, but my wife isn't very happy about my new job. In the beginning she said: "Me or the nuclear plant." I have made several trips since then, so I hope my wife has accepted it to some extent.

SPIEGEL ONLINE: What have the workers gone through since the accident?

Shigemura: They thought that they would die when the reactors exploded in May. But they still had to continue their work, to save their country. Many come from the area around the plant, the tsunami washed away their homes, their families had to evacuate. The workers have lost their homes, their loved ones are far away and the public blames them, because they work for TEPCO. Many think that TEPCO is responsible for the catastrophe. The workers weren't seen as heroes as they were in Europe. One time, somebody donated fresh vegetables for the workers, because TEPCO at that point wasn't able to provide fresh food inside the evacuation zone. But the donation was made anonymously, because those who gave it didn't want to be caught helping TEPCO workers.

SPIEGEL ONLINE: How are the workers today?

Shigemura: It is amazing how traumatized they are. Two to three months after the quake, I carried out a survey among 1,800 TEPCO workers in Daiichi and Daini. When a catastrophe like the tsunami hits a community, about 1 to 5 percent of the general population suffers long-term traumatization. Among police, fire-fighters and other disaster workers, it is about 10 to 20 percent. Among TEPCO workers the percentage is much higher.

SPIEGEL ONLINE: What consequences does such a level of traumatization have?

Shigemura: I am currently treating a man in his early forties. He had a house on the coast close to Daiichi that was destroyed by the tsunami. That's when he lost his 7-year-old son. The man had to flee and he tried to rent an apartment somewhere else. But the landlord rejected him because he works for TEPCO. When he finally found a flat the neighbors posted a paper on his door: TEPCO workers get out. Because the man received quite a high dose of radiation, he had to change to another department. Now he's got a desk job that he doesn't enjoy and isn't trained for. He is afraid that he might get ill with cancer, he is in financial difficulties because his salary was cut and he lost his house. He also has problems with his family. His mother lost her husband to the tsunami and she feels guilty, because she couldn't save him and her grandson. She cries a lot. When my patient gets home after work, he doesn't feel comfortable there either.

SPIEGEL ONLINE: Why don't these people simply quit their jobs with TEPCO?

Shigemura: There are many reasons for this. Those I have spoken to are loyal to their company and want to save it. Others do it for money. About 3,000 workers go to Daiichi every day. The complicated jobs are done by employees of TEPCO and other firms like Hitachi and Mitsubishi. The simple jobs are done by people hired by sub-subcontractors. My team of seven psychiatrists prioritizes workers with higher levels of responsibility, which alone amounts to more than 1,000 people. Within that group, we treat special risk cases, meaning people who have lost their colleagues, their families or who are in financial difficulties. Of course I would like to see all the workers, but that would be impossible. We had to make compromises.

SPIEGEL ONLINE: What do you say to those who can't go on?

Shigemura: The most important message is that of appreciation and support for what they have accomplished. Very rarely do we advise them to take a rest. It is better for the workers if they can stay at work. Otherwise their colleagues would think they are weak and they would be stigmatized as mentally ill. Also it motivates them to belong to a group. Staying away from work is a last resort.

SPIEGEL ONLINE: How afraid is the population of radioactivity?

Shigemura: People are confused and suspicious of the authorities. In such an environment, rumors and misinformation spread quickly. In a crisis, communication needs to be quick, transparent and accurate. If you want to prevent panic, you should release as much information as possible so the people can understand and assess the danger. But the government doesn't know much about this kind of risk communication. They kept silent about a meltdown, and people became even more anxious.

SPIEGEL ONLINE: What psychological consequences has the catastrophe had in the affected regions?

 

Shigemura: It will be years before all the psychological consequences become apparent. I am sure the suicide rate will increase in the northeast. Even before the catastrophe there were many suicides there: the winters are long and cold, there isn't much work and people are known for their perseverance, meaning they often don't speak about their problems. On top of this you have the fear of radiation, which cuts some communities in Fukushima in half. In Tamura one part wants to leave, one part wants to stay. This can also mean a crisis for families and friends. Maybe the wife wants to leave and the husband wants to stay. Social relationships can break apart over this question.

 

SPIEGEL ONLINE: How can such conflicts be overcome?

Shigemura: I don't have an answer for that. Of course I can't say: "It is okay for you to return to your village." In every case, people should be offered a broad choice on where and how they want to live. And jobs need to be created to give them a new perspective. Unemployment is a big problem among refugees. It is difficult for them to find permanent work, because nobody knows when they will return -- after a year, after 10 years. Or never.

Interview conducted by Heike Sonnberger Der Speigel

http://www.spiegel.de/international/world/0,1518,818054,00.html

 

PTSD

New technique to write off anxiety / PTSD sufferers encouraged to keep journals to help treat their disorders

Michio Watanabe / Yomiuri Shimbun Staff Writer

Sufferers of post-traumatic stress disorder are being encouraged to write about their trauma in a journal and then read their entries out loud, as part of a new treatment technique.

Masaru Horikoshi, a doctor at the National Center for Neurology and Psychiatry in Kodaira, Tokyo, says this fresh approach to mental health therapy can help PTSD sufferers recover from the disorder.

PTSD is an anxiety disorder that develops after someone experiences an incident that is beyond their ability to recover from, leading to severe psychological trauma.

"In some cases, the disorder can't be overcome by avoiding [dealing with the event]. By writing down what they feel about the incident, sufferers face painful experiences, put these into perspective and become strong enough to deal appropriately with them." Horikoshi said.

PTSD cases often involve those who have experienced a disaster, accident, sexual assault or another crime. Sufferers commonly develop sleeping difficulties and experience flashbacks of the traumatic incidents. These people tend to avoid things that remind them of the trauma and may erase part of the incident from their memory. PTSD is diagnosed when sufferers experience these symptoms for more than a month.

Mental health practitioners most commonly treat PTSD patients by asking them to recall the events, which caused the disorder and discuss these in detail. This dialogue is used to heal the patients' emotional scars.

Using writing to treat PTSD is a relatively new practice. In the United States it has produced almost identical results to the dialogue method.

"Sufferers can decide how much they want to write about their experiences. So this method of treatment could be an option for those who find it difficult to speak about their traumatic experiences," Horikoshi said.

Horikoshi is part of a group of people that is creating a nontechnical guide to use this writing technique to treat PTSD called "Kokoro o Iyasu Noto" (A notebook to heal your mind), which will be published in March.

This book has a section in which users can write down traumatic experiences and answer questions that are designed to help them deal with their problems.

Horikoshi explained how to maintain a journal that can be used to help in the treatment of PTSD.

You begin by writing the things that have and have not changed following the traumatic event. This could be something to do with your personality, relationships, everyday life, philosophy and perspective of the world. This will help you think about the incident's significance to you. It's OK to stop if you are unable to write all of this information in one go. You may continue once more when you feel relaxed and have peace of mind.

"When writing about a traumatic experience, you might find it hard to continue writing if your emotions take over, and you begin experiencing anxious thoughts such as 'I can't trust anyone' or 'Nothing good will happen even if I keep going.' Draw a line on the page after your last word if you feel this way. This will help you understand what is bothering you and learn about things that you aren't sure how to feel about," Horikoshi said.

"One of the purposes of this treatment is to understand what you are mentally unable to deal with. So it's important to write down your thoughts honestly, even if this is done gradually," he added.

After an entry in your journal is completed, read it out loud. This will enable you to think again about the meaning of what you have written down, while gradually getting used to the uncomfortable feelings and emotions that you normally want to avoid.

Once you are able to read the entry out loud without skipping any lines, try to write down the details of the event itself. This process pushes you to review your traumatic experience, develop a better understanding of what happened and deal with the feelings and emotions that may be bothering you. Again, read all the entries out loud after they are written.

In the United States, sufferers take 12 weekly writing therapy sessions where they are assisted by doctors and mental health practitioners. Japan's National Center for Neurology and Psychiatry is preparing a training course for medical staff so that the same program can be introduced nationally.

Horikoshi hopes his book will help sufferers escape the shackles of PTSD and achieve a well-balanced way of thinking.

 

Solar Cell Sales Rise 30%

Japan solar cell sales rise 30.7 pct in 2011

Wed Feb 15, 2012 6:22am GMT

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TOKYO Feb 15 (Reuters) - Sales of solar cells in Japan rose 30.7 percent in 2011 from the previous year to 1,296 megawatts, the first time sales have topped 1,000 MW, helped by a government scheme to promote renewable energy.

Sales in the October-December quarter rose 30.4 percent from a year earlier to 406.3 MW, Japan Photovoltaic Energy Association data showed on Wednesday, helped by subsidies to encourage home owners to install solar panels.

In a scheme expected to be launched in July, utilities must buy any electricity generated by solar, wind, biomass, geothermal and small hydro power plants at preset rates for up to 20 years.

Sales of solar cell are expected to rise further once details including pricing for each energy type are set by a panel appointed by parliament.

Solar cell exports for the whole of 2011 rose to 1,462.8 MW, up 1.2 percent from a year earlier, though they fell 13.5 percent to 321.3 MW in October-December.

Japan is overhauling its energy policies after the Fukushima radiation crisis, which shattered public confidence in nuclear safety and has kept reactors that were halted for routine checks from being restarted.

Only three of Japan's 54 nuclear reactors are now operating. Without approval for restarts, all of them could be shut by the end of April, boosting the use of fossil fuels and adding over $30 billion a year to the nation's energy costs, a government estimate said.

Resource-poor Japan had aimed to increase the share of nuclear power to more than half of its electricity supply by 2030 before the earthquake and tsunami last March wrecked the Fukushima plant and triggered reactor meltdowns, but now looks to instead raise the role of renewable sources such as wind and solar power.

The association includes major Japanese solar panel makers such as Sharp Corp, Kyocera Corp, Panasonic Corp and Mitsubishi Electric Corp, as well as foreign makers such as Suntech Power Holdings. (Reporting by Osamu Tsukimori; Editing by Michael Watson)

Japan Times:

http://af.reuters.com/article/commoditiesNews/idAFL4E8DF1DP20120215

Governor: Why No (TEPCO) Arrests Over Crisis?

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Wednesday, Feb. 15, 2012

Governor: Why no arrests over crisis?

By MINORU MATSUTANI

Staff writer

Saitama Gov. Kiyoshi Ueda wants to see Tokyo Electric Power Co. held criminally responsible for the Fukushima nuclear crisis.

At a regular news conference, he sharply criticized the utility and questioned why nobody in Tepco has been arrested.

"Tepco has caused this big trouble to everyone under the sun and nobody has been arrested. I want to ask, 'Doesn't anyone (in Tepco) want to turn themselves in?' " Ueda said Monday.

He was asked for comments about Tepco raising electricity bills for big users like corporations by 10 to 20 percent in April.

"Some people would be arrested if gas tanks explode or a fire breaks out in a department store," he said angrily, blaming Tepco for not taking full responsibility for the harm caused by the disaster at the Fukushima No. 1 plant. "The procedure of raising power bills without fully explaining it is unacceptable. It is extremely cruel treatment of (big users) who have been forced up to now to cooperate in saving electricity."

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Osaka Referendum

Japan group seeks local referendum on nuclear power

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* Osaka city assembly to decide on nuclear plebiscite

* Osaka mayor anti-nuclear but lukewarm on referendum

* Activists battle apathy a year after Fukushima crisis

By Yoko Kubota

TOKYO, Feb 14 (Reuters) - A group of Japanese activists submitted a petition to the western city of Osaka on Tuesday seeking a referendum on scrapping atomic power, a step some hope will boost a campaign that appears to be flagging a year after the Fukushima disaster.

The world's worst nuclear crisis in 25 years after an earthquake and tsunami wrecked the Fukushima plant spurred anti-nuclear movements, previously seen as the preserve of left-leaning activists.

Plebiscites are rare in Japan -- three have been held on nuclear power as well as a number of others -- and no law exists for a national referendum. But campaigners in Osaka, Tokyo and the western prefecture of Shizuoka are taking advantage of rules that allow for referendums if the local assembly gives the nod.

Osaka, the core of Japan's second biggest metropolitan area with 2.7 million residents, receives its electricity from Kansai Electric, Japan's second-biggest utility operating 11 reactors at three plants near the city.

If a plebiscite takes place, residents will vote on whether to scrap Kansai-operated nuclear power plants.

"Deciding such an important issue should be in the hands of the voters," said Hajime Imai, an organiser of the group.

The role of nuclear power is now under debate by the central government, which has abandoned a pre-Fukushima goal of boosting atomic energy's share of electricity demand to 50 percent by 2030 from 30 percent before the accident.

The industry is under intense scrutiny, with many reactors undergoing computer-simulated tests to ensure they could withstand a new disaster. Only three of 54 reactors are on stream at the moment.

The activists submitted to Osaka City 55,430 signatures of residents, or 2.1 percent of the city's population, above the 2 percent required by legal regulations.

 

CITY ASSEMBLY DIVIDED

Osaka Mayor Toru Hashimoto must now present a motion to the city assembly for a vote on whether a referendum should be held.

Hashimoto, a reform-minded former TV celebrity who has set up a new political party, wants to reduce dependence on nuclear power and has vowed to exert the city's right as a holder of about 9 percent of Kansai Electric's shares.

But he has shown little enthusiasm for a costly referendum.

Imai said the campaign faced a tough battle in the Osaka assembly, where major parties are split over the issue.

The anti-nuclear side has won all three referendums already held. The votes had little direct impact on national policies, although a groundswell of similar ballots could make a difference.

Imai's group is also collecting signatures for a national referendum, though parliament would have to pass a law in order for such a national vote to take place.

Fukushima shattered Japan's myth that nuclear energy was cheap, clean and safe, but the absence of a legal framework means a national vote is unlikely.

Opinion polls show about three-quarters of the public favour at least a gradual exit from nuclear power. But enthusiasm for active campaigning is waning and many voters appear to be losing hope that their opinions matter.

"I don't think that people believe in democracy much," said Jeffrey Kingston, director of Asian studies at Temple University in Japan. "A lot of people are turned off by politics and think the government does what it wants anyway."

Imai echoed the concern. "Our biggest enemy has been apathy," he told Reuters.  

Depression

Sunday, Feb. 12, 2012

COUNTERPOINT

Depression is a national ailment that demands open recognition in Japan

By ROGER PULVERS

Special to The Japan Times

The greatest public health issue facing the people of Japan today is not cancer. It is not vascular diseases than can cause heart attacks and strokes. It is not the prevalence of Alzheimer's disease in the ever-rising number of the elderly.

It is depression in its many forms and guises.

Depression is the big gorilla on the basketball court, the one that's stealing the ball but isn't seen because everyone is willfully looking the other way.

The causes of depression can be biological, psychological, social or a combination of these. It affects young people to a much greater degree than they or their elders imagine. The elderly are particularly vulnerable. In fact, according to the Health and Consumer Protection Directorate-General of the European Commission, "depressive illness is the most frequent mental disorder among older people."

Name any significant social pro

Name any significant social problem — alcoholism and other drug-related illnesses, homelessness, teenage pregnancies, self-harm, domestic violence, child abuse, suicide — and you are more than likely to find some form of depression or serious mood disorder as a cause.

According to the World Health Organization, the international health burden brought on by clinical depression is enormous when measured by "cause of death, disability, incapacity to work and the use of medical resources." And this does not take into account the hidden costs, such as those borne by unpaid caregivers, nor the heartrending toll on sufferers' families.

Here in Japan, where a conservative estimate is that 1 in 5 people will experience one or another form of depression in their lifetime, the abiding societal postulate is: Keep it to yourself (KITY). In fact, this principle is applicable to the appearance of many social ills. If you don't ask and you don't tell, then it's as if through such deceptions the problem will somehow slip below the tatami and disappear from sight.

Whether you analyze this national trait as coming from an ancient Buddhist notion according to which victims and their family are "responsible" for a blight, or simply as a factor of garden-variety prejudice against anything smacking of "abnormality," this society has long stigmatized anyone who might put a blot on the veneer of decorous harmony.

So, in actual fact, the working precept here is stigmatization. If you stigmatize someone in their milieu, they generally go away and hide (or die). Once they stigmatize themselves, you don't need to bother anymore. You can even pretend to be tolerant. It works like a charm.

Kenzo Denda, of the Department of Psychiatry at Hokkaido University Graduate School of Medicine, has reported that 1 in 12 elementary school pupils suffers from depression, while at the middle-school level the figure may be as high as 1 in 4. Studies show that at least one-third of the prison population is made up of the clinically depressed.

Statistics on depression for Japan are very similar to those in the developed West. Statistics published by the Japan Committee for Prevention and Treatment of Depression (JCPTD) show that 6.6 percent of Japanese have depression, while every year the reported incidence is 2.1 percent. The breakdown by gender is also similar to that in the West: Women with depression outnumber male sufferers by about 3 to 1. In the West, the incidence of depression is particularly high in the young, while in Japan, says the JCPTD, it is spread among young and old.

But these comparative statistics can be misleading. A joint Japan-Australia survey on mental health conducted in 2003 and 2004 indicated that, in the case of Japan, a great many actual cases of depression were put in the category of "psychological problems and stress."

Recognition is the crux of the problem. While big strides have been made in the treatment of depression in Japan over recent years, thanks in part to effective new drugs, the recognition of depression at the primary-care level is inadequate. General practitioners are not sufficiently trained to recognize depression. They too often attribute symptoms to other illnesses. The KITY meme exacerbates this. Japanese tend to be too reticent to divulge their true anxieties to anyone.

There has been an overemphasis in this country on male problems based on the stresses and strains of employment. Japanese women are traditionally told to grin and bear their suffering and not overburden others with their personal problems. Don't nag. Don't whinge. Just pull yourself together, sigh a big sigh and get on with your tasks.

Active for the last 40 years, JCPTD has held countless conferences, meetings and forums for health professionals and the public. The organization is proactive in trying to train doctors to recognize depression when they see it. National broadcaster NHK's educational channel has also had some amazingly frank shows about depression — including one in which female sufferers admitted to having sex with a great number of men in order to bolster their self-esteem. The courage of these women, who appeared under their own names, would be astounding in any country — let alone in Japan, where appearances count for so much.

But Japanese society will not come to terms with depression until very high-profile sufferers — whether royalty, movie stars or politicians — come out from behind the folding screen and openly talk about their illness. (Some people in show business have done this; and this has had a beneficial effect on public awareness.)

The task ahead for Japan is the total destigmatization of depression. This can only be achieved by opening the closet door and sharing the burden of illness throughout the entire society.

Writing in the February issue of the Japanese monthly news and current affairs magazine Wedge, freelance journalist Ryutaro Kaibe points out that every year between 800,000 and 1.2 million Japanese quit or stay away from work because of depression. The annual cost to the nation is an estimated ¥2.7 trillion.

To such costs must be added the human costs of suicides stemming from depression. Conservatively, 30 percent of the annual toll — more than 30,000 dead for 13 consecutive years — is due to depression. Most estimates indicate half, while some go as high as 80 percent to 90 percent.

It may be the sense of dignified self-restraint and prim respectability that compel Japanese people — particularly, as tradition has dictated, women — to de-emphasize their needs and display only the mildest forms of "proper" embarrassment. But when it comes to depression and the immense toll it is inflicting on individuals and society, it is time to abandon these shared virtues and go public.

Without mass public recognition of this ubiquitous problem, the good work being done by the psychiatric profession and NHK will prove ineffective.

As much as two-thirds of psychiatric disorders go untreated; and only one-fourth of sufferers receive some sort of medical help. This would imply that millions of people are still forced to suffer in silence.

All this makes depression the least prominent and most grave public health problem in the nation. Neglecting the people who need immediate treatment and care puts their lives in danger. It also imposes on all citizens an onus of silent guilt and widespread misfortune that can never be lifted.

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http://www.japantimes.co.jp/text/fl20120212rp.html

 

Depression

The greatest public health issue facing the people of Japan today is not cancer. It is not vascular diseases than can cause heart attacks and strokes. It is not the prevalence of Alzheimer's disease in the ever-rising number of the elderly.

It is depression in its many forms and guises.

Depression is the big gorilla on the basketball court, the one that's stealing the ball but isn't seen because everyone is willfully looking the other way.

The causes of depression can be biological, psychological, social or a combination of these. It affects young people to a much greater degree than they or their elders imagine. The elderly are particularly vulnerable. In fact, according to the Health and Consumer Protection Directorate-General of the European Commission, "depressive illness is the most frequent mental disorder among older people."

Name any significant social problem — alcoholism and other drug-related illnesses, homelessness, teenage pregnancies, self-harm, domestic violence, child abuse, suicide — and you are more than likely to find some form of depression or serious mood disorder as a cause.

According to the World Health Organization, the international health burden brought on by clinical depression is enormous when measured by "cause of death, disability, incapacity to work and the use of medical resources." And this does not take into account the hidden costs, such as those borne by unpaid caregivers, nor the heartrending toll on sufferers' families.

Here in Japan, where a conservative estimate is that 1 in 5 people will experience one or another form of depression in their lifetime, the abiding societal postulate is: Keep it to yourself (KITY). In fact, this principle is applicable to the appearance of many social ills. If you don't ask and you don't tell, then it's as if through such deceptions the problem will somehow slip below the tatami and disappear from sight.

Whether you analyze this national trait as coming from an ancient Buddhist notion according to which victims and their family are "responsible" for a blight, or simply as a factor of garden-variety prejudice against anything smacking of "abnormality," this society has long stigmatized anyone who might put a blot on the veneer of decorous harmony.

So, in actual fact, the working precept here is stigmatization. If you stigmatize someone in their milieu, they generally go away and hide (or die). Once they stigmatize themselves, you don't need to bother anymore. You can even pretend to be tolerant. It works like a charm.

Kenzo Denda, of the Department of Psychiatry at Hokkaido University Graduate School of Medicine, has reported that 1 in 12 elementary school pupils suffers from depression, while at the middle-school level the figure may be as high as 1 in 4. Studies show that at least one-third of the prison population is made up of the clinically depressed.

Statistics on depression for Japan are very similar to those in the developed West. Statistics published by the Japan Committee for Prevention and Treatment of Depression (JCPTD) show that 6.6 percent of Japanese have depression, while every year the reported incidence is 2.1 percent. The breakdown by gender is also similar to that in the West: Women with depression outnumber male sufferers by about 3 to 1. In the West, the incidence of depression is particularly high in the young, while in Japan, says the JCPTD, it is spread among young and old.

But these comparative statistics can be misleading. A joint Japan-Australia survey on mental health conducted in 2003 and 2004 indicated that, in the case of Japan, a great many actual cases of depression were put in the category of "psychological problems and stress."

Recognition is the crux of the problem. While big strides have been made in the treatment of depression in Japan over recent years, thanks in part to effective new drugs, the recognition of depression at the primary-care level is inadequate. General practitioners are not sufficiently trained to recognize depression. They too often attribute symptoms to other illnesses. The KITY meme exacerbates this. Japanese tend to be too reticent to divulge their true anxieties to anyone.

There has been an overemphasis in this country on male problems based on the stresses and strains of employment. Japanese women are traditionally told to grin and bear their suffering and not overburden others with their personal problems. Don't nag. Don't whinge. Just pull yourself together, sigh a big sigh and get on with your tasks.

Active for the last 40 years, JCPTD has held countless conferences, meetings and forums for health professionals and the public. The organization is proactive in trying to train doctors to recognize depression when they see it. National broadcaster NHK's educational channel has also had some amazingly frank shows about depression — including one in which female sufferers admitted to having sex with a great number of men in order to bolster their self-esteem. The courage of these women, who appeared under their own names, would be astounding in any country — let alone in Japan, where appearances count for so much.

But Japanese society will not come to terms with depression until very high-profile sufferers — whether royalty, movie stars or politicians — come out from behind the folding screen and openly talk about their illness. (Some people in show business have done this; and this has had a beneficial effect on public awareness.)

The task ahead for Japan is the total destigmatization of depression. This can only be achieved by opening the closet door and sharing the burden of illness throughout the entire society.

Writing in the February issue of the Japanese monthly news and current affairs magazine Wedge, freelance journalist Ryutaro Kaibe points out that every year between 800,000 and 1.2 million Japanese quit or stay away from work because of depression. The annual cost to the nation is an estimated ¥2.7 trillion.

To such costs must be added the human costs of suicides stemming from depression. Conservatively, 30 percent of the annual toll — more than 30,000 dead for 13 consecutive years — is due to depression. Most estimates indicate half, while some go as high as 80 percent to 90 percent.

It may be the sense of dignified self-restraint and prim respectability that compel Japanese people — particularly, as tradition has dictated, women — to de-emphasize their needs and display only the mildest forms of "proper" embarrassment. But when it comes to depression and the immense toll it is inflicting on individuals and society, it is time to abandon these shared virtues and go public.

Without mass public recognition of this ubiquitous problem, the good work being done by the psychiatric profession and NHK will prove ineffective.

As much as two-thirds of psychiatric disorders go untreated; and only one-fourth of sufferers receive some sort of medical help. This would imply that millions of people are still forced to suffer in silence.

All this makes depression the least prominent and most grave public health problem in the nation. Neglecting the people who need immediate treatment and care puts their lives in danger. It also imposes on all citizens an onus of silent guilt and widespread misfortune that can never be lifted.

via japantimes.co.jp

Japan

A recent spate of articles in The New York Times comparing Japan's overall condition with America's was so welcome in Japan that the gist of the initial article was read out by a questioning lawmaker in the Diet.

The article by Eamonn Fingleton (New York Times, Jan. 6) painted a rosy picture of Japan. Fingleton's update of Ezra Vogel's "Japan as Number One" study was an answer to TV analysts like David Gergen, who described Japan on CNN as "a very demoralized country."

The articles were partially a response to rightwing American pundits like Gergen who insist that Japan is more failure than success. The truth lies somewhere in the middle.

Japan's economy and society have major weaknesses obvious to both inside and outside observers, but its strengths are easy to overlook. Japan's current condition offers important lessons that need balanced consideration.

Japan's housing market has never recovered from the boom years, nor has the Tokyo stock market. Yet Japan has not fallen into the kind of housing and loan crisis that persists in the United States. The austerity measures inciting European street demonstrations and the injustices fueling the Occupy Wall Street movement have not exploded in Japan, where debt is just as much of a threat. The fiscal deficit in Japan has not caused enough suffering to provoke public protest, though that may not last for long.

The articles fail to mention that the economy of Japan is now composed of more irregular workers than ever before — more than 30 percent of all workers. One out of four workers in Japan has an annual income of less than ¥2 million.

Japan has staved off large-scale unemployment through the soft measures of tolerating job insecurity and minimizing income, in essence spreading the pain throughout the workforce. These tactics will not provide a fundamental solution to unemployment problems.

Just as problematic is that large corporations have done little to update their workplace culture. Overtime hours and out-of-date hiring practices remain entrenched. Women have yet to be fully brought into the current economy. The lack of transparency in corporate practices have led to serious scandals at Olympus Corp. and Tokyo Electric Power Co. (Tepco), the latter's incompetent leadership and top-down management style having come to light after the Fukushima nuclear catastrophe.

The articles rightly pointed out that Japan's society continues to be a generally lively one. Life expectancy here is one of the highest in the world, and large cities are as bustling and vibrant as ever. Japanese culture continues to produce more than its share of exportable movies, manga and fads, and restaurants draw plenty of review stars. On the other side, Japan's suicide rate is one of the world's highest, a sign of widespread depression and alienation. Other social problems such as hikikomori social recluses and bullying at school reveal that affluence does not translate into mental well-being.

Japan's oft-cited technophilia continues with more and better high-tech devices and higher rates of Internet connectivity than in most developing countries. Japan's electricity output, a measure of consumer activity, has risen faster than most developed countries over the past several decades.

Transportation facilities continue to be upgraded in a striking contrast to languishing infrastructure growth in the United States.

Japan's companies have started to replace labor-intensive production with production of advanced materials and precision equipment, a forward-looking view.

All the issues raised by the New York Times articles are perhaps more nuanced and double-sided when viewed from inside Japan. For example, the response to the tsunami and earthquake clearly showcased the impressive sense of restraint, hard work and group spirit of Japanese. At the same time, the government's muddled response, poor planning and years-long failure to oversee Tepco are blatant examples of just what is wrong.

These long-view, big-picture evaluations should be cause for neither celebration nor lament; they should instead help identify specific problems and reconsider the right solutions from a realistic, balanced point of view. The lost decade from 1990 to 2000, and the almost-lost decade from 2000 to 2010, produced terrible effects that rattled the entire socioeconomic structure of Japan. Yet Japan has not exhibited the large scale of suffering that can be seen in American and Europe, either.

Japan is not declining, nor is it ascending. Japan is neither an ideal model nor a bad example. Its strengths and failures are instructive. The free-market, laissez-faire ideas so beloved by American rightwing economists and think-tank analysts would not have helped Japan. Rather, Japan's successes come from careful long-range planning, a willingness to engage in social negotiations, and a less self-centered view of the world than there is in the West.

Neither the pro-Japan nor "Japan as fallen giant" factions mentioned what is most needed for Japan to get out of its current slump and to restore vitality — government and corporate transparency and accountability, and a new spirit of openness and optimism. Removing the monolithic grip of bureaucratic power and reinstating the force of the people's democratic will would be the first best step.

via japantimes.co.jp

Grief Professionals

Kaleidoscope of the Heart: Saying yes to grief is a step to recovery

http://mdn.mainichi.jp/perspectives/news/20120205p2a00m0na002000c.html

Rika Kayama

Separation from family, being diagnosed with a serious disease, a sudden natural calamity -- life is full of bitter experiences.

But, quite surprisingly, "mental" specialists in the past didn't think very deeply of ways to help people pushed to the verge of a mental collapse by a devastating life experience.

The job of mental health specialists such as psychiatrists is to cure a disease. Therefore, when a patient comes and says, "I've been suffering so much since my mother passed away," specialists have become used to telling them that this is part of life and everyone goes through it, and we say things like, "You have to endure that."

However, especially in cases when people have lost their loved ones suddenly to a natural disaster, a crime, or a suicide, or when parents have lost their children, for example, they should be treated with special care.

Such special treatment, known as "grief care," is finally gaining real traction in the mental health community.

In fact, a number of grief care advocates in Japan have for many years made vocal appeals for its importance. Yoshiko Takaki, head of the Sophia University Grief Care Research Institute, is one of them.

During her life as a Catholic nun who has helped many to overcome grief, Takaki became aware that such people need special professional care to help them deal with the pain they have built up from the shock they have experienced. Based on rich practical experience, research, and training of specialists, Takaki has become a leading grief care expert.

When I met Takaki recently, she kindly gave me four books she wrote starting last year. After the enormous losses the Japanese people endured in the March 11, 2011 triple disasters, a number of publishing companies have asked her to write books on overcoming grief.

What struck me right away was that among the four books, three had titles that included the word "grief" -- "It's OK to be grieving" (Kanashindeii) and "On how to overcome grief" (Kanashimi no Norikoekata), for example.

Takaki, dressed in the simple outfit of her order and her eyes always sparkling like a little girl's, told me:

"See, I told the publisher that I doubt people would buy a book titled 'It's OK to be grieving.' But he told me, 'That's fine. This is exactly what people need right now.'"

It seems to me that until now, we have all forced ourselves into some kind of faux stoicism.

However, when we face a shock or unbearable pain, there is no need to pretend that everything is fine. We should openly admit that we are having problems, and people should respond by saying, "We know, it must be really hard for you right now." People should help others and stick with them until their tears are dry.

If I think about it that's exactly what we have done naturally in the past.

It's not bad to encourage a grieving person by saying things like "Chin up!" However, at times we can also say, "It's OK to feel down."

We should also all acknowledge our own feelings and honestly say that we are not happy when we aren't. I believe this is the first step in grief care. (By Rika Kayama, psychiatrist)

Click here for the original Japanese story

(Mainichi Japan) February 5, 2012

 

Frozen Fukushima leaking (Radioactive) Water

Frozen Fukushima leaking water

The crippled Fukushima Dai-ichi nuclear power station is seen through a bus window in Okuma (AFP Photo / TEPCO)

TRENDS:Fukushima nuclear disaster

TAGS: Ecology, Health, Nuclear, Accident, Japan

Up to 8.5 tons of radioactive water have leaked from Japan's crippled Fukushima nuclear plant. TEPCO, the plant’s operator, failed to winterize the reactor’s cooling system, leading to fractures in its pipes due to frozen water inside.

TEPCO claims that most of the leaked water is not radioactive, and has come from a dam. Though the company admitted that some of the water could be radioactive, it stressed that none of it has leaked to the sea.

Acknowledging its insufficient planning, TEPCO began replacing older pipes with new, plastic versions to prevent further leaks, while all leaks discovered so far have been stopped.

Many of the cooling system's pipes are exposed to the outside – and can run for several kilometers without insulation. 

Some of the plant's workers reportedly informed TEPCO's managers about the possibility of such a problem during the summer.

“It was predicted that the pipes would freeze and cause water leakage,” said one TEPCO employee cited in fukushima-diary.com.

The Fukushima Daiichi nuclear power plant was damaged by a devastating earthquake and tsunami that hit Japan last March. Radiation leakage forced tens of thousands of people to leave their homes in and around the Fukushima region in central Japan.

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