Pharmaceuticalization and Social Inequalities: An Examination of Problems Relating to Depression in Japan

The growing number of people suffering from depression has become a social problem in Japan. Over the last decade, the number of those consulting medical institutions about depressive symptoms has more than doubled, and the number of those taking sick leave from work due to depression has increased. Accordingly, mental health strategies have become an important issue for both the nation and companies. The problems associated with depression in Japan have been influenced by the pharmaceuticalization of mental health. This trend further promotes the individualization of social problems and encourages people to seek hospital consultations. Since selective serotonin reuptake inhibitors were introduced to Japan’s pharmaceutical market in 1999, demand for anti-depressant medications has rapidly expanded. It seems likely then that the efforts of pharmaceutical companies, as part of their marketing strategies, to increase people’s awareness of mental illness have led people who are not actually depressed to have medical consultations and drug treatments for it. This phenomenon is known as 'disease mongering' and has been reported on. Problems exist from the medical perspective also and include the following: expansion of the diagnostic criteria for depression as formulated in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders; treatments that rely heavily on drugs; and biomedicalization. Another reason for the increase in medical consultations is the declining function of communal bodies such as companies and local community, a move that has left individuals to deal directly with organizational and social problems. This has resulted in individuals struggling psychologically, for example, with anxiety, worry, and depression. In summary, this sociological research has analyzed the problems of depression in Japan and revealed how the pharmaceuticalizaion of mental health accelerates the individualization of social problems, thereby creating new social problems and social inequality.