5 ideas
Japanese psychiatry reframed depression not as private weakness but as the result of social pressure, especially excessive labor, a move Kitanaka calls the 'socialization' of depression. Locating the cause in the workplace rather than the individual lowered stigma and made the diagnosis acceptable to patients who would otherwise reject a psychiatric label.
In 1991 a young employee at the advertising firm Dentsu killed himself after chronic extreme overtime. His family sued, and in 2000 the Supreme Court held the company liable for his death. The ruling established legally that overwork can cause depression and depression can cause suicide, turning a psychiatric theory into grounds for corporate responsibility and state compensation.
When SSRIs entered Japan in 1999, drug-company campaigns promoted the phrase 'depression is a cold of the heart.' The slogan presented depression as common, mild, and treatable. That framing widened the pool of people willing to seek diagnosis and helped the number of depression patients rise sharply within a few years.
Japanese psychiatry drew on theories such as Shimoda's immodithymic type and Tellenbach's typus melancholicus to describe a person prone to depression. This personality is diligent, orderly, responsible, and overcommitted. Framing it this way cast the depressed person as a virtuous worker exhausted by devotion rather than someone who is weak, so the illness confirmed moral character instead of undermining it.
In Japan, framing depression as a brain-chemistry disorder did not displace social explanations; the two frames worked alongside each other. Biological language made depression seem a real, blameless illness, while social language tied its cause to working conditions, supporting both medication and claims against employers. Kitanaka also cautions that this medicalisation of work stress risks extending psychiatric monitoring into the workplace.