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Mental health and medication 2021/10/30 18:25
About a decade ago I used to work in the mental health field in the US, but made a career change and now teach university in Japan. When I first came to Japan, everyone (both Japanese and foreign) would tell me how behind the mental health field was in Japan compared to the US. Therapists, psychiatrists, crisis intervention, and especially medication wasn't common. The medications for depression, anxiety, and panic attacks that Americans considered normal were rarely prescribed here. Whether any of that is true, I don't know because I never sought it out myself. However, I still hear this today.

Is this just a myth now though? Because the past two years, especially because of COVID, family, friends, and coworkers have been very forthcoming about their mental health and there seems to be a common occurrence... Doctors are more than happy to prescribe rather heavy medications with little to no discussion!

My partner lost his father due to COVID and sought out therapy to help deal with it. At the first appointment the therapist suggested my partner go to a psychiatrist for medication. My partner was confused, but went anyway. The psychiatrist asked a few questions and then asked my partner if he'd like to try some medication. The psychiatrist suggested that if he thinks he's depressed, anxious, or having panic attacks, he can try ABC, OPQ, or XYZ. This was my partner's first interactions with the mental health field and he didn't feel comfortable diagnosing himself and choosing his own medication, so he turned it down and is now looking for a new therapist.

My best friend, who got divorced, and my coworker, who has depression, both had the same experience as well. They went to a therapist, the therapist recommended a psychiatrist, and the psychiatrist asked if they'd like to try some medication. Like my partner, they didn't feel comfortable diagnosing themselves and choosing their own medication.

Another coworker of mine was at the urologist and in passing conversation mentioned how work has been pretty hectic and it's causing him some anxiety. The urologist gave him Xanax for it. Now my coworker goes to the urologist for Xanax. A friend of mine had a similar experience at the gastroenterologist with Xanax.
by BDL (guest)  

Re: Mental health and medication 2021/10/31 11:37
I'm only a science teacher who taught in Japan previously, but I find that there is a big difference between medicating a patient and treating them.

When it came to diagnosing both English speaking and Japanese speaking students for disorders or mental health problems in the middle 2010's in Tokyo, the list of people who were recommended was very small. At the time - the lack of knowledge was based on English speaking country methods. An examples might be diagnosing a students for ADHD or for being on the autism spectrum.

I can't talk in relation to mental health medication, but I did find that doctors in China, Japan and Taiwan tend to over-medicate even when it was a viral infection.

It should be noted that I have hold strong views that Japan is not as progressive when it comes to mental health as some other western countries.

However - this information could only really be known from a English/Japanese speaking person who speaks both languages, has dealt with mental health issues in both countries (or works in the industry) and knows the societal differences between the cultures.

For example - I know that Japan has a strong societal culture to conform but also allows people to express individuality in much more extreme ways than we often see in the west (aka - the Rockabily dancers in Tokyo, dressing up in cosplay etc). As such - it's a difficult question to answer. I do however know that Covid has made it much more acceptable in both asia and the west to talk about mental health issues in public - which can only be a good thing.
by mfedley rate this post as useful

Re: Mental health and medication 2021/10/31 12:16
One of my acquaintances was suffering from depression of some kind, which didnft improve with the initial medication, and the doctor suspected a tendency of ADHD as well, and the doctor is trying out different medications like every two weeks to see what works. It didnft sound very trust-inspiring, but that just might be the way things are handled here. Or just at that clinic, I donft know.
by AK rate this post as useful

Re: Mental health and medication 2021/10/31 22:16
I often hear that some (or many?) hospitals and clinics make profits by selling medicines more than needed, or even selling unnecessary medicines. Usually good 'consumers' for them are those who have mental problems and elders. Elders sometimes can't manage which and when they should take. Such hospitals or clinics don't see the patients properly. And that is why there are also healthy people who take advantage of such hospital or clinic in order to be diagnosed a mental ill for something.

Some hospitals are even worse, they just lock down the patients without explanation and agreements. Not only schizophrenia patients who have lost control but also those who are depressed/anxious and need a good listener rather than any medication. There are people who are not allowed to go out and have been 'living' in the hospital (institution) for more than 10years.

They also do something, which they say 'proper medication'. A few years ago, an English teacher from NZ who worked in Japan and hospitalized lost his life due to that
many Japanese people around me seemed to think it was reasonable.

There are issues which should be improved in my opinion. However, I wouldn't say whole mental helth related things are not civilized nor must be same as western countries' way. My country is even worse, many people don't know asperger, many hotels refuse people with mental problem to stay. LD was not known even by teachers in the western country where I studied.
by Asiansenior (guest) rate this post as useful

Re: Mental health and medication 2021/11/1 02:55
There is more stigma associated with mental illness in Japan than in US, so many Japanese do not seek help. Also, in Asian medicine, there is a tendency to find and cure the cause, rather than treating the symptom. In my experience, I got the impression that mental illness diagnosis is highly subjective (e.g., there is no lab test to verify PTSD), thus the treatment depends a lot on the psychiatrist. One medication may work well on Patient A, but not necessarily on Patient B. So there are lots of trial and error iterations.

by Azuma (guest) rate this post as useful

Re: Mental health and medication 2021/11/1 05:13
I don't know about the U.S., but here in Japan, a lot of people tend to have second thoughts about starting medication. There is always risk of addiction and side effects in one way or another.

As a result, patients would ask doctors questions regarding the issue, while doctors try to make sure if the patient wishes to be treated with medication or not. And it's not just about mental health. I have a friend with physical conditions who say they could've relied on stronger medication, but decided to rely on helpers and family instead.

As for myself, I once happened to do a self-check on the internet, and the result told me that I'm suffering heavy depression so I should visit a doctor immediately. I did, and the doctor hardly listened to my story before he looked into the book and said he'll prescribe me medication A. Then he phoned a couple of drug stores and learned that they didn't carry the drug or closed for the day, so he looked up the book again and changed to medication B, and then was turned down again, so he changed to medication C.

I paid the doc and bought the drug, but by then I was scared enough not to swallow the pill. Instead I made a reservation for free counselling at my local city hall. The reserved date came a couple of months later and I was still fine. A professional psychiatrist listened to my story at the city hall, and told me that it was okay for me to not take those drugs. Then he gave me a few specific tips to make my life easier. After the session, I found myself crying alone at the lobby and happy.

So, experiences like that may lead people to avoid drugs and rely on talking instead. But I do have a couple of friends who were hospitalized from mental illness, and have been on medication since then. They've been doing alright for years now without being hospitalized any more.

On a related note, just because medication is not as common, that doesn't mean that mental health treatment isn't. A lot of Japanese people, including people I directly know, visit mental clinics casually nowadays. They just don't talk about it unless they're asked. But mental clinics cost, and amid Covid the free counselling services can't catch up with the great demand.
by Uco rate this post as useful

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