TOKYO – Shortly after Japan stepped up its fight against the coronavirus last spring, Nazuna Hashimoto began to suffer panic attacks. The gym in Osaka, where she worked as a personal trainer, suspended operations and her friends stayed at home on government recommendation.
Afraid to be alone, she called her boyfriend of only a few months and asked him to come. Even so, sometimes she couldn’t stop crying. His depression, diagnosed earlier this year, skyrocketed. “The world I lived in was already small,” she said. “But I felt it got smaller.”
In July, Ms. Hashimoto saw no way out and tried to kill herself. Her boyfriend found her, called an ambulance and saved her life. She is talking publicly about her experience now because she wants to remove the stigma associated with talking about mental health in Japan.
Although the pandemic has been difficult for many in Japan, pressures have increased for women. As in many countries, more women have lost their jobs. In Tokyo, the country’s largest metropolis, about one in five women live alone, and exhortations to stay at home and avoid visiting family have exacerbated the feeling of isolation. Other women struggled with deep disparities in the division of domestic work and child care during the age of home work, or suffered from the increase in domestic violence and sexual violence.
The psychological and physical increase in the pandemic was accompanied by a worrying increase in suicides among women. In Japan, 6,976 women took their lives last year, almost 15% more than in 2019. It was the first increase year after year in more than a decade.
Each suicide – and attempted suicide – represents an individual tragedy rooted in a complex constellation of reasons. But the increase among women, which spanned seven consecutive months last year, worried government officials and mental health experts who worked to reduce what had been one of the highest suicide rates in the world. (Although more men than women committed suicide last year, fewer men did so than in 2019. Overall, suicides increased slightly less than 4 percent.)
The situation reinforced Japan’s longstanding challenges. Talking about mental health problems or seeking help is still difficult in a society that emphasizes stoicism.
The pandemic has also increased stress in a culture that is based on social cohesion and depends on peer pressure to boost compliance with government requests to wear masks and practice good hygiene. Women, who are often designated as primary caregivers, sometimes fear public humiliation if they fail to comply with these measures in some way or become infected with the coronavirus.
“Women carry the burden of preventing the virus,” said Yuki Nishimura, director of the Japanese Association of Mental Health Services. “Women have to take care of the health of their families, and they have to take care of cleaning and they can be despised if they don’t do it right.”
In a widely publicized report, a 30-something woman who was recovering from the coronavirus at home committed suicide. Japanese media took the note by expressing anguish at the possibility that it had infected others and caused problems, while experts questioned whether shame had driven her to despair.
“Unfortunately, the current trend is to blame the victim,” said Michiko Ueda, an associate professor of political science at Waseda University in Tokyo, who researched suicide. Dr. Ueda found in surveys last year that 40% of respondents were concerned about social pressure if they contracted the virus.
“Basically, we don’t support you if you’re not ‘one of us’,” said Dr. Ueda. “And if you have mental health problems, you are not one of us.”
Experts also fear that a succession of Japanese film and television stars who took their own lives last year may have spawned a series of imitation suicides. After Yuko Takeuchi, a popular and award-winning actress, took her life in late September, the number of women who committed suicide the following month increased by almost 90% compared to the previous year.
Shortly after Takeuchi’s death, Nao, 30, started writing a blog to narrate his lifelong battles with depression and eating disorders. She wrote frankly about her suicide attempt three years earlier.
This openness about mental health struggles is still relatively rare in Japan. Celebrity suicides prompted Nao, whose family name was withheld at his request to protect her privacy, to reflect on how she might have reacted if she had reached her peak. emotional low during the pandemic.
“When you’re at home alone, you feel very isolated from society and that feeling is very painful,” she said. “Just to imagine if I were in this situation now, I think the suicide attempt would have happened much earlier, and I probably think I would have succeeded.”
Writing about her challenges, Nao, who is now married, said she wanted to help others who may be feeling desperate, especially at a time when so many people are isolated from friends and colleagues.
“Knowing that someone has been or is going through something similar to you – and knowing that someone is looking for professional help for that and that really helped – would encourage people to do something similar,” said Nao, who said he wanted to help remove the associated taboos. to mental illness in Japan.
Nao’s husband realized how much she struggled with the long hours of work and the brutal culture of the office at the consulting firm where they met. Then, when she gave up, she felt adrift.
During the pandemic, women suffered disproportionate job losses. They made up the majority of employees in the industries most affected by infection control measures, including restaurants, bars and hotels.
About half of all women who work have part-time or contract jobs, and when business has stagnated, companies cut those employees first. In the first nine months of last year, 1.44 million of these workers lost their jobs, more than half of them women.
Although Nao voluntarily left consultancy to seek psychiatric treatment, she remembers being shattered by insecurity, as she was unable to pay the rent. When she and her then fiance decided to speed up their wedding plans, her father accused her of being selfish.
“I felt like I lost everything,” she recalled.
These feelings, she said, triggered the depression that led to her attempting suicide. After spending time in a mental hospital and continuing with the medication, his self-confidence improved. She got a job four days a week working in the digital operation of a group of magazines and is now able to manage the workload.
In the past, suicide rates in Japan have skyrocketed during times of economic crisis, including after the housing bubble burst in the 1990s and the global crisis in 2008.
During these periods, it was men who were most affected by job losses and those who committed suicide at higher rates. Historically, men’s suicides in Japan have outnumbered women by a factor of at least two to one.
“They became more desperate after losing their jobs or fortunes,” said Tetsuya Matsubayashi, a professor of political science at Osaka University who specializes in social epidemiology.
Last year, Dr. Matsubayashi noted that in Japanese prefectures with the highest unemployment rates, suicides among women under 40 have increased the most. More than two-thirds of women who committed suicide in 2020 were unemployed.
Among women under 40, suicides increased by about 25%, and among teenagers, the number of high school girls who took their lives doubled in the past year.
In the case of Ms. Hashimoto, the fear of financial dependence contributed to her feeling of hopelessness.
Even when the gym where she worked as a personal trainer reopened, she did not feel emotionally stable enough to return. She then felt guilty for trusting her boyfriend, emotionally and financially.
She met Nozomu Takeda, 23, who works in construction, at the gym, where she was her training client. They had been dating for only three months when she confided that her depression was becoming untenable.
Unable to pay for therapy and suffering from severe anxiety attacks, she said she identified with others who “felt trapped”.
When she attempted suicide, all she could think about was releasing Mr. Takeda from the responsibility of taking care of her. “I wanted to take the burden off him,” she said.
Even those who have not lost their jobs can be under extra stress. Before the pandemic, working from home was extremely rare in Japan. So, women suddenly had to worry not only about pleasing their bosses from afar, but also juggling new safety and hygiene protocols for their children, or protecting elderly parents who were most vulnerable to the virus.
Expectations to stand out have not changed, but contact with friends and other support networks has decreased.
“If they can’t get together with other people or share their stress with other people, then it’s not really surprising” that they are feeling pressured or depressed, said Kumiko Nemoto, professor of sociology at Kyoto University of Foreign Studies.
Having survived her own suicide attempt, Ms. Hashimoto now wants to help others learn to talk about their emotional problems and connect them with professionals.
Takeda says he appreciates the way Hashimoto talks openly about his depression. “She is the type of person who really shares what she needs and what is wrong,” he said. “So it was very easy for me to support her because she vocalizes what she needs.”
Together, the couple developed an app, which they are calling Bloste (short for “blow off steam”), to combine therapists with those seeking advice. Ms. Hashimoto is trying to recruit experienced professionals and those at the beginning of their careers, who are more likely to charge affordable prices to young clients.
Eventually, she would like to train as a therapist, with a special focus on women.
“The country has mainly focused on elevating women in their careers and in their economic well-being,” said Hashimoto. “But I would like to emphasize women’s mental health.”