This is in response to Michael Hoffman’s April 13 Big in Japan column, ” ‘Big Pharma’ manipulating the market? Now that’s depressing.” The role of pharmaceutical companies aside, we feel that the article does little to accurately discuss the complicated issue of depression and its treatment, or to dispel the stigma attached to mental health disorders in Japan.

TELL is a nonprofit organization dedicated to providing world-class, effective support and counseling services to Japan’s international community and to helping to address the country’s growing mental health care needs. We do so with a Lifeline — TELL counseling, which provides psychotherapy and treatment — and numerous outreach programs.

The World Health Organization lists depression, also referred to as major depressive disorder (MDD), as the most common form of disability worldwide. Nearly 1 in 5 people will experience an episode of depression at some point in their lives. The essential feature of a major depressive disorder is a period of at least two weeks during which there is either a depressed mood or the loss of interest or pleasure in nearly all activities. (DSM 5). Thoughts of death, suicidal ideation or suicide attempts are common.

Major depressive disorder can occur at any age, but the likelihood of onset increases after puberty. In most countries, the majority of cases of depression go unrecognized by family doctors, and in many cultures, physical symptoms such as insomnia, pain and loss of energy may be the initial complaints. How much depression interferes with daily functioning often depends upon the initial symptoms, but for many, depression interferes with social and family relationships, school and work. Having any other mental health disorder and having a substance abuse or alcohol problem increases the risk of depression. Many chronic medical conditions such as diabetes and chronic cardiovascular illness are often complicated by depression.

For many people, depression will be resolved with first-line treatments of psychotherapy and/or antidepressant medications. Many individuals need both counseling and medication. Treatment can be lifesaving. Unfortunately up to one-half of all people diagnosed with MDD will not respond to their initial choice of treatment.

Tragically a large number of people never seek treatment for depression and struggle with its debilitating effects.

In Japan, national insurance does not typically reimburse counseling except for the small number of psychiatrists certified in cognitive behavioral therapy. If you or someone close to you might be depressed, first take them to a medical doctor or mental health professional who can help determine the right course of treatment.

linda semlitz

The opinions expressed in this letter to the editor are the writer’s own and do not necessarily reflect the policies of The Japan Times.

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