TOKYO – Not long after Japan stepped up its fight against the coronavirus last spring, Nazuna Hashimoto began suffering from panic attacks. The gym in Osaka where she worked as a personal trainer suspended operations and her friends stayed home on the recommendation of the government.
Fearing being alone, she called her boyfriend of a few months and asked him to come over. Even then, sometimes she couldn’t stop crying. His depression, which had been diagnosed earlier in the year, skyrocketed. “The world I lived in was already small,” he said. “But I felt it was getting smaller.”
In July, Ms. Hashimoto saw no way out and tried to commit suicide. Her boyfriend found her, called an ambulance, and saved her life. She is now speaking publicly about her experience because she wants to remove the stigma associated with talking about mental health in Japan.
While the pandemic has been difficult for many in Japan, the pressures have been compounded for women. As in many countries, more women have lost their jobs. In Tokyo, the country’s largest metropolis, about one in five women lives alone, and exhortations to stay home and avoid visiting family have exacerbated feelings of isolation. Other women have struggled with profound disparities in the division of household chores and childcare during the work-from-home era, or have experienced an increase in domestic violence and sexual assault.
The rising psychological and physical toll of the pandemic has been accompanied by a worrying rise in suicides among women. In Japan, 6,976 women took their own lives last year, almost 15 percent more than in 2019. It was the first year-over-year increase in more than a decade.
Every suicide, and every suicide attempt, represents an individual tragedy rooted in a complex constellation of reasons. But the rise among women, which spanned seven consecutive months last year, has concerned government officials and mental health experts who have worked to reduce what had been among the highest suicide rates in the world. world. (While more men than women committed suicide last year, fewer men did so than in 2019. Overall, suicides were up just under 4 percent.)
The situation has reinforced long-standing challenges for Japan. Talking about mental health problems or seeking help is still difficult in a society that emphasizes stoicism.
The pandemic has also amplified stress in a culture that relies on social cohesion and relies on peer pressure to push for 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 somehow fail to adhere to these measures or become infected with the coronavirus.
“Women bear the burden of virus prevention,” said Yuki Nishimura, director of the Japan Association for Mental Health Services. “Women have to take care of the health of their families, they have to take care of cleanliness and they can be despised if they are not doing it well.”
In a widely publicized account, a woman in her 30s who had been recovering from the coronavirus at home committed suicide. Japanese media seized on her note by expressing distress at the possibility that she had infected other people and caused them problems, while experts questioned whether embarrassment 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 has investigated suicide. Dr. Ueda found in surveys last year that 40 percent of those surveyed were concerned about social pressure if they contracted the virus.
“Basically, we don’t support him if he’s not ‘one of us,'” Dr. Ueda said. “And if you have mental health problems, you are not one of us.”
Experts are also concerned that a succession of Japanese movie and television stars who took their own lives last year may have sparked a string of copycat suicides. After Yuko Takeuchi, a popular and award-winning actress, took her own life at the end of September, the number of women who committed suicide in the following month increased by about 90 percent compared to the previous year.
Shortly after Takeuchi’s death, Nao, 30, began writing a blog recounting her life-long battles with depression and eating disorders. He wrote candidly about his suicide attempt three years earlier.
Such openness about struggles for mental health is still relatively rare in Japan. The celebrity suicides prompted Nao, whose last name has been withheld at her request to protect her privacy, to ponder how she might have reacted if she had reached her emotional low point during the pandemic.
“When you’re home alone, you feel very isolated from society and that feeling is really painful,” he said. “Just imagining if I was in that situation right now, I think the suicide attempt would have happened much earlier, and I probably think it would have succeeded.”
Writing about her challenges, Nao, who is now married, said she wanted to help other people who might be feeling desperate, particularly at a time when so many people are alienated from friends and colleagues.
“Knowing that someone went through or is going through something similar to you, and knowing that someone is looking for professional help for that and that it really helped, would encourage people to do something similar,” said Nao, who said she wanted to help eliminate the taboos associated with mental illness in Japan.
Nao’s husband could see how much she struggled with the long work hours and brutal office culture at the consulting firm where they met. Then when he stopped smoking, he felt adrift.
During the pandemic, women have suffered disproportionate job losses. They made up the majority of employees within the industries most affected by infection control measures, including restaurants, bars and hotels.
About half of all working women have part-time or contract jobs, and when business stagnates, 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 quit her consulting job to seek psychiatric treatment, she remembers feeling tormented by insecurity as she could no longer pay the rent. When she and her then fiancé decided to accelerate their wedding plans, her father accused her of being selfish.
“I felt like I had lost everything,” he recalls.
Those feelings, she said, triggered the depression that led to her suicide attempt. After spending some time in a psychiatric hospital and continuing on the medication, her self-confidence improved. You found a four-day-a-week job working the digital operation of a group of magazines and can now 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 recession in 2008.
During these periods, men were the most affected by job loss and those who committed suicide in the highest proportion. Historically, suicides of men in Japan have outnumbered those of women by a factor of at least two to one.
“They became more desperate after losing their jobs or fortunes,” said Tetsuya Matsubayashi, a political science professor 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 years of age increased the most. More than two-thirds of the women who committed suicide in 2020 were unemployed.
Among women under 40, suicides increased by about 25 percent, and among teenage girls, the number of high school girls who took their own lives doubled last year.
In Ms. Hashimoto’s case, fears of financial dependency contributed to her sense of hopelessness.
Even when she reopened the gym where she worked as a personal trainer, she didn’t feel emotionally stable enough to return. Then she felt guilty for trusting her boyfriend, emotionally and financially.
He met Nozomu Takeda, 23, who works in the construction industry, at the gym, where he was his training client. They had only been dating for three months when she confided in him that her depression was becoming unbearable.
Unable to pay for therapy and suffer severe anxiety attacks, she said she identified with other people who “felt very cornered.”
When she tried to commit suicide, the only thing she could think about was releasing Mr. Takeda from the responsibility of caring for her. “I wanted to take the burden off him,” he said.
Even those who have not lost their jobs may have suffered additional stress. Before the pandemic, working from home was extremely rare in Japan. Then all of a sudden, women 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 more vulnerable to the virus.
Expectations to excel did not change, but her contact with friends and other support networks 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 feel pressured or depressed, said Kumiko Nemoto, a sociology professor 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 issues and connect them with professionals.
Takeda says she appreciates how Ms. Hashimoto talks openly about her depression. “She is the type of person who really shares what is needed 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 call Bloste (short for “let off steam”), to connect therapists with those seeking counseling. Ms. Hashimoto is trying to recruit both seasoned professionals and those early in their careers, who are more likely to charge affordable rates to young clients.
Eventually, she would like to train herself as a therapist, with a special focus on women.
“The country has primarily focused on promoting women in career and financial well-being,” said Ms Hashimoto. “But I would like to emphasize the mental health of women.”