For 10 years, Rei Ueno, 40, worked hard as a freelance writer. He took on almost every job that came to him. It was not unusual for him to make it home after midnight — he also played hard.
That was until five years ago, when a panic attack paid Ueno a surprise visit. He was unable to get up in the morning to go to work. Checking newspapers and the morning TV shows became a kind of torture, making him feel left behind.
He was so plagued by anxiety and guilt he even blamed himself when the bus he was riding in got stuck in traffic.
What helped him emerge from his deep depression, Ueno now says, was the support of his wife, Yoshie.
While depression these days is treatable to a certain extent by medication, thanks to the great advances in antidepressants, Ueno and many other depressives who have survived the darkest phase of their illness say the understanding and support of families and friends is still indispensable.
The World Health Organization estimates that 3 percent to 5 percent of the world population suffers from depression. It predicts the malady will become by 2020 the second-greatest cause of disability and premature death worldwide.
Ueno, who recently published a book on how to cope with depressed people based on his experiences, said what relieved him most was his wife’s words: “Everything is going to be all right.”
“Depressed people constantly blame themselves and become more and more introverted . . . they especially feel sorry toward their families,” Ueno said. “So the family saying, ‘Everything is going to be OK,’ or ‘Let’s cope with it together,’ or ‘You’ll feel better’ can be a huge emotional support.”
Most depressives are said to have by nature a strong sense of responsibility and a tendency to take things seriously. They thus condemn themselves for being unable to function properly however hard they may try.
“I had a strong sense of hopelessness that I had completely broken down,” Ueno recalled. “The harder I forced myself to do something, the rougher things got for me.”
Depressives and doctors agree that encouraging depressed people to try something, or worse, nagging them, only exacerbates their condition.
This is the most basic and important rule of coping with depressives, which may appear simple but is often neglected by many who do not know better.
Ueno was lucky in this regard. His wife picked up some basic knowledge about depression from books Ueno kept at home because his mother suffered from manic depression.
Hideo Hosaki, a 76-year-old psychiatrist and professor emeritus of Keio University who has treated hundreds of mental patients, said he has seen many cases in which family support was difficult to obtain.
“In the case of long-standing depression, family members become tired, too. Despite knowing that pushing patients is taboo, they might say things like, ‘How long are you going to play dead?’
“There are also families that do not accept the fact that depression is an illness, so they consider their partner or child simply to be lazy.”
Hosaki used to write that depression is like a cold anyone can contract at some point in their lives. But he recently stopped using this description for fear people might get the wrong idea about the malady.
Depression is a disease, both Hosaki and Ueno said, that should be taken neither too seriously nor too lightly.
In the worst case, depressives take their own lives to end their unbearable agony. And this is no rare thing. Suicidal thoughts are almost common among depressives, according to patients and doctors, especially when they are in the early recovering stages.
At the worst of times, they find they lack even the power to kill themselves.
Ueno was no exception. When he experienced his first breakdown, he was so overwhelmed by frustration and anxiety that in a panic he swallowed more than 20 tranquilizer tablets.
He was taken to a hospital unconscious, but luckily the dose he took was not fatal, and he was released three days later.
To prevent such actions, families and friends should repeatedly make clear to patients verbally that they do not want them to die, Ueno said. When the risk is considered high, they should not allow depressives to be alone and should hide anything that could be a suicidal weapon, psychiatrists said.
While Ueno and doctors stress the importance of respecting the feelings of depressives and listening patiently to what they say during their early and worst stages, they also warn not to let depressives become too dependent once they show signs of recovery.
Depression is, after all, an individual problem, and unless the sufferer faces it there can be no solution, they explain.
Yet, finding the right way is not easy. Ueno said that he and his wife did not know what to do at first and that it was only gradually that they developed their own unique approach.
Ueno and psychiatrists insist that taking patients to a doctor as early as possible is the first step. This is partly because it takes about two to three weeks before drugs can have an effect.
They also stress the importance of keeping in touch with the doctor for the benefit of both the patients and the family, who may otherwise feel alone in the battle with the mental illness.
Cooperation with the doctor is important in terms of consistency as well. People saying different things confuse depressives, leaving them at a loss as to whose advice they should follow, Ueno said.
Ueno still suffers occasional bouts of hopelessness, but after studying and learning about the condition, he said he can now deal with most of his own depression.
He publishes his diary daily on his Web site www.u-rei.com (Japanese only) where he also offers bulletin board space, though that portion of the site is now temporarily closed, to share his experience as a depressive with fellow sufferers.
Ueno believes depression has, in a certain way, given him an opportunity to reflect on his life and find a comfortable way to live.
He said depression is a signal for people to modify their lives amid the shifting realities of a society full of economic uncertainties and conflicting pressures.
“You can no longer build your life around work and ignore the family,” he said.
Psychiatrist Hiroko Mizushima agrees. She contends that depression in Japan is partly a product of the nation’s rigid social system, in which men are supposed to be strong and support their family while women are pressured to take care of the home.
Having recognized the limits of what a psychiatrist can do in a clinic, she successfully ran for a Diet seat two years ago. Now a Lower House member with the Democratic Party of Japan, Mizushima recently drew up a DPJ plan to push social reforms to match the nation’s current diversified lifestyles.
Ueno still works as a freelance writer but says he now does so at a slower pace.
“It was good to me, having the time to look back on my life and consider how to live my life from now on,” he said. “(Depression) wasn’t a drag on my life.”
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