Working in a fast-paced environment such as tech, combined with moving to a homogenous country as a foreigner (such as Japan where standing out is not considered to be an exceptionally good thing) understandably takes a toll on someone’s mental health. At the same time, language and cultural barriers can make it harder to get proper treatment here.
I personally have gone through the mental health support system here, and though navigating it was challenging, going through it has put me in a better situation.
I’ve written this article to give people a better idea of the challenges they may face, and the available resources. It covers the following sections:
- My Personal Journey with Mental Health in Japan
- Mental Health Challenges Faced by Foreign Workers in Tech
- The Japanese Mental Health Support System
- Improvements To Japan’s Mental Health Care System
- Mental Health Resources for English Speakers in Japan
My Personal Journey with Mental Health in Japan
The state of mental health in a lot of countries (particularly Asian countries) seems bleak.
Growing up in the Philippines, I had no idea about the actual implications of having mental health problems. I grew up hearing that those who claim to be depressed are only saying so because they’re bored or are attention-seeking.
What’s even worse is that in high school, when I shared with some older peers that I was somehow struggling with my emotions and might have anxiety and/or depression, they told me that I’m being brainwashed by the media and that I’m too young to experience any form of depression or anxiety because I’ve never experienced what “real life” is like. That it’s all because of people’s obsession with labeling everything, and that it’s just a fad that will probably disappear soon.
From someone who was struggling a lot with all these pent-up frustrations and mixed feelings, I was told that “Mental Health problems are only for those who can afford a therapist. For us who is just one hospitalization away from bankruptcy, we just have to suck it up”. So like every older person who I asked, I chose to suck it up and proceeded with life as everyone knew it.
But navigating life as an adolescent in a new country with a completely different culture became a trigger for me to confront my situation head-on.
I moved to Japan at the age of 22, not knowing anyone when I came here. For the first 4 months of moving here, I had no one I could really talk to and always felt like I was alone in whatever I was going through. Working in tech most especially made me feel like I couldn’t easily make friends outside of my work place.
As I grew older, I found it harder to focus on one thing for a long time and also had a hard time retaining information from new lessons (whether they be on Japanese or technology). I suspected something was going on, so I tried to ask my doctor if their clinic was able to diagnose if I had Adult ADHD (Attention Deficit/Hyperactivity Disorder) or some other kind of condition, but he told me that it’s impossible for me to have seeing as it should have manifested in the form of being “disruptive” when I was younger.
Last year, on January 2022, I decided to start consulting a counselor regarding my problems. Then after a few sessions and understanding that maybe I need further help, I asked an HR personnel for help to look for clinics. I felt shame and fear that I may be judged, but they were very supportive and were able to help me get in touch with a psychosomatic doctor. Since then I’ve been taking medication to help with my symptoms.
It was a small change that I didn’t know I needed in my life. Even my long-time friends have noticed the big improvement in my mood and behavior. But maybe if I didn’t have such a supportive friend circle, I wouldn’t have tried to seek help.
Mental Health Challenges Faced by Foreign Workers in Tech
According to BIMA’s Tech Inclusivity & Diversity Report, 52% of tech workers have suffered from anxiety or depression.
In foreigners working in tech and then moving to a new country more specifically, their mental health may be in a more vulnerable state. Possible reasons are:
- Separation from loved ones or trusted people
- Not having a sense of community that you can reach out to, especially if you’re living here as a sexual or racial minority
- Adjusting to a new environment/society
- Language Barrier
- Cultural Barrier
- Sedentary Lifestyle
- Most tech jobs function like regular 9-to-6 office jobs, wherein there’s not a lot of opportunities to meet new people and you’re always facing your computer
- Constantly having to catch up with the rapid pace of technology
- Increase in Complexity of Work
- Pressure (from bosses, peers, or even from yourself)
The pandemic that brought about new technologies and more cases of physical and social isolation have also heightened the issues that foreign software developers experienced in Japan. From lack of emotional and financial support to being afraid of being shunned by their employers, tackling with mental health problems while having to work everyday as if nothing is wrong is an entirely different beast in it of itself.
According to a survey by AppDynamics, “Eight in 10 technologists say their job became more complex during 2020, a consequence of quick innovation and a sprawling technology stack”.
The Japanese Mental Health Support System
Just like a lot of Asian countries, discussions on mental health in Japan is taboo. There was (and still is) a fascination for character tropes or subcultures like Menhera-chan within the manga and anime circles starting a while back, but that does not consequently mean that there is a wider and better reception of mental health topics.
It takes a while for changes in societal views to take root in a place, especially with the older generation having this perception of how things are and how they should be. But as it looks like, things are beginning to slowly change for the better and the stigma of going to a mental health care provider is starting to go away.
In Japan, mental health care is generally divided into three groups – Psychiatrists, who specialize in the diagnosis and treatment of various mental health conditions; Psychosomatic Medicine Doctors, who treat physical problems caused by psychological stress (e.g. insomnia); and Clinical Psychologists, who perform psychological tests and face-to-face counseling services, but not prescribe medication.
There are only a few facilities in Japan that offer healthcare in foreign languages, and clinics offering mental health advice in multiple languages are even scarcer. Although clinics like Yotsuya Yui Clinic in Shinjuku and PSI Clinic in Ginza are offering English support for their services, it’s difficult to find clinics in areas outside of Tokyo, where lots of foreign residents are also residing. Getting an interpreter who can help with translating necessary information is a great need for most clinics, but most of the time, it’s more likely that the foreign patient will be the one to carry the burden of the costs of paying for the interpreter.
Access to medical help is generally difficult for foreigners living in Japan due to the language barrier, but differences in culture could further become a barrier in proper diagnosis of the patient. “People describe their symptoms in different ways according to their culture. Although it has become common in the West for people to say they feel depressed… residents of Asian and African countries are more likely to describe their symptoms in terms of physical complaints like headaches, stomachaches, or a lump in the throat.” Taisho University professor Ukawa Ko explains.
To add to this, neurodivergence doesn’t look like it’s a well-known topic in the country.
According to Cleveland Clinic, the term “neurodivergent” describes “people whose brain differences affect how their brain works. That means they have different strengths and challenges from people whose brains don’t have those differences. The possible differences include medical disorders, learning disabilities and other conditions.”
I know some people living outside Japan who have been diagnosed with Adult ADHD and also found this study on the increase of diagnoses for ADHD in adults within Japan.
Looking into it further, I found out that Adult ADHD mostly goes undiagnosed in Japan and doctors only prescribe medication to those who have been previously diagnosed (as children or as adults, from another country). You have to bring proof of your diagnosis for the clinic to get a prescription as well.
Furthermore, despite being diagnosed previously with a type of mental health problem that requires medication with stimulants, it is quite difficult to obtain this type of medication in Japan, as all medications containing stimulants are prohibited in the country. This includes Adderall which is a standard medication used to treat ADHD symptoms in the USA. Adderall contains amphetamine, which is a strictly controlled substance in Japan.
Accredited clinics need to issue a license to prove that you’re allowed to take the medication containing stimulants, and even then, the pharmacy that you’re buying the medication from also needs to have the license to sell the medication.
Japan could still use a lot of improvements on developing a more multicultural healthcare system that could help address the needs of its growing foreign resident population.
Improvements To Japan’s Mental Health Care System
Aside from the Japanese government, some NGOs and private practitioners are also working towards being able to provide a more robust mental health care system not only for Japanese professionals, but for foreign nationals working and living in Japan as well.
But what can we, as individuals, do to help?
- Normalize talking about it. Create an open space for discussion and help reduce the stigma surrounding mental health.
- Mindfulness. Recognize the signs of a mental health crisis, and be able to identify when you or other people around you are suffering from mental health crisis so that you may seek for guidance from the appropriate people
- Help spread resources and awareness. Japan has health care providers and support groups, but not all of them are easily accessible to everyone.
- Support national or international initiatives in order to de-stigmatize mental health.
I’m not sure if it’s just a Filipino thing, but most people I know would never go to the doctor unless their symptoms are so bad that they can’t physically take it anymore. It shouldn’t be like that for anyone. Once you feel some symptoms, it’s better to have it checked by a qualified professional and get diagnosis.
As an employee, mental health care is also part of your compensation (it’s covered under most, if not all Japanese health insurance providers), so be sure to make use of these benefits and seek help if you need it.
Mental Health Resources for English Speakers in Japan
If you or someone you know needs mental health resources, please help refer them to the following resources so that they can get the help that they need.
- TELL JP
- Tokyo Counseling Services
- Japan Health Info
- International Mental Health Professionals Japan - Guide for Finding a Therapist
- Stonewall Japan
- Tokyo Mental Health
Mental health care is not a one-size fits all solution–each person may require mental health support under a generalized umbrella of terminology, but it still depends on a case-by-case basis on how the person should be treated.
Everyone is struggling through their own battles, so always choose to be kind.