While antidepressants have been popular in the West for some decades, there was originally next to no demand for them in Japan, as Japanese culture (which is based on Buddhism) had no concept of depression as an illness. Then, in 1999, a Japanese pharmaceutical company introduced the concept of depression to Japan, coining a name for it:
"kokoro no kaze", literally, "common cold of the soul":
For 1,500 years of Japanese history, Buddhism has encouraged the acceptance of sadness and discouraged the pursuit of happiness -- a fundamental distinction between Western and Eastern attitudes. The first of Buddhism's four central precepts is: suffering exists. Because sickness and death are inevitable, resisting them brings more misery, not less. ''Nature shows us that life is sadness, that everything dies or ends,'' Hayao Kawai, a clinical psychologist who is now Japan's commissioner of cultural affairs, said. ''Our mythology repeats that; we do not have stories where anyone lives happily ever after.'' Happiness is nearly always fleeting in Japanese art and literature. That bittersweet aesthetic, known as aware, prizes melancholy as a sign of sensitivity.
This traditional way of thinking about suffering helps to explain why mild depression was never considered a disease. ''Melancholia, sensitivity, fragility -- these are not negative things in a Japanese context,'' Tooru Takahashi, a psychiatrist who worked for Japan's National Institute of Mental Health for 30 years, explained. ''It never occurred to us that we should try to remove them, because it never occurred to us that they were bad.''
Direct-to-consumer drug advertising is illegal in Japan, so the company relied on educational campaigns targeting mild depression. As Nakagawa put it: ''People didn't know they were suffering from a disease. We felt it was important to reach out to them.'' So the company formulated a tripartite message: ''Depression is a disease that anyone can get. It can be cured by medicine. Early detection is important.''
It is arguable that Japan may have needed a concept of, and treatment for, depression, with its suicide rate being over twice the levels experienced in Western countries. Though one can't help but wonder whether the cultural change brought by introducing the concept of depression will result in Japanese culture losing something and becoming more like everywhere else (which is to say McWorld). And, if so, whether or not the gains will outweigh any loss.