In the past few decades, the spread of American culture has reached every continent, filling countries with new fast food chains and music genres. Along with globalizing fashion, movies and food, American culture has also imposed new health treatments in less medically advanced countries in order to mitigate and purge the effects of various illnesses.
In the essay “The Mega Marketing of Depression in Japan”, Ethan Watters provides insight into how GlaxoSmithKline (a pharmaceutical company) took a relatively rare metal illness in Japan and morphed it into one of the country’s most common health issues through amplifying the symptoms of depression. Thus making depression a disease in Japan regardless of whether it was medically. After reading “The Mega Marketing of Depression in Japan”, it is evident that as society changes, it constantly molds new perceptions of disorders and cultural beliefs.
Before the antidepressant marketing, the Japanese had a strong relationship with sadness. For them sadness was associated with religion, peace and a sense of morality; it was “quintessentially Japanese… in some ways, an enlightened state” (522). Being constantly upset and always having high order of tidiness is often associated with mental illnesses in the west, but it was sought after as a prized trait in the Japanese culture. While the moderate and subtle variation of depression, typus melancholicus was accepted in Japan as a normality (and even sought after! , the other variation of depression known as endogenous depression was rare, seen as ‘psychotic’ and of no concern to the general public (522).
In a society where one type of depression was revered and the other ignored, there was no market to sell antidepressants. Eli Lilley stated that in Japan “the people’s attitude towards depression was very negative”, and since Japan’s awareness of depression was different from the West, it would be hard to sell drugs successfully (515). Not only was the idea of depression unpopular, but the symptoms of depression were also varied greatly between the West and other cultures.
Feelings such as fatigue and pessimism are thought of as mild signs of anxiety and depression but in other cultures emotions like these are simply just gut feelings or part fa person’s ‘moral compass’. Watters mentions a quote from Kirmayer:” By applying a one-size-fits-all notion of depression around the world… we run the risk of obscuring the social meaning and response the experience might be indicating,” (518). Related to the issue of different symptoms, there was also an issue with how the mentally ill were cured.
In Japan “talk therapy was all but nonexistent” and if someone was mentally ill they would be checked into the hospital for a month rather than be given a prescription for an anti-depressant (516). With all these cultural differences between Japan and the West even the most prominent psychiatrists believed that American resources and ideas such as the Diagnosis of Depression were vague, expansive and did not amount to anything (521). To combat these issues and criticisms, the pharmaceutical companies decided to change the existing cultural notions and views on depression.
GlaxoSmithKline in particular wanted to understand why exactly the Japanese had such different views on depression and psychological impairments. They managed conferences with scholars of Japanese culture and various business moguls to plan their marketing strategy and to hone in on their expected problems. During their informative sessions, GlaxoSmithKline also weeded out future ideas for marketing. One in particular had to do with the Japanese suicide rates. The pharmaceutical company found that it’s quite easy to change the public’s view.
During a time of high suicides rates, highlighting cases of suicide and connecting them with depression as a motive (even if it was not) gained their product and ideas more attention. After publishing studies on this, “Japan Times [stated that] ‘90%of those who commit suicide are considered to suffer from one kind of mental illness… 70% of suicides are attributed to depression” (526). Media coverage and false studies were the sort of tactics that preceding in changing the Japanese’s mindset about depression.
Before delving into the pharmaceutical companies methods of symptom amplification, it is important to know whether depression is a disease or not. According to the Webster dictionary, a disease is “a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms”. That means in order for a condition to be a disease, a physical organ or part of the body must be repeatedly reacting to a stimuli. On the other hand, there is no body part associated with the pain and symptoms of depression.
One can argue that while being depressed or mentally ill, biochemical levels in the brain change, however science has not gotten far enough to prove that if it is exactly a result of depression. The pharmaceutical companies such as GlaxoSmithKline used the process of symptom amplification in order to sell their products. Simply put, symptom amplification is when small random effects are ‘amplified’ into bigger reoccurring symptoms. For example, if the average Japanese is quiet moody, the market may target this as a huge symptom of mental illness that could cause death.
This may seem like a far-fetched example, but the Japanese citizens were starting to see something they did that was normal being marketed as a symptom of a ‘disease’ everyday via articles in newspapers, magazines, bestselling books, web quizzes, adverts etc. The marketing was also done sneakily through disguised forums in which advocates (people that worked with the pharmaceutical companies) would interact with the visitor and show “a series of articles on depression driving home the key points of the campaign, including the idea that it was a common illness [depression) and that antidepressants bring the brain’s atural chemistry back into balance,” (525).
All of the company’s tactics turned to work out in their favor, especially when they started spreading the idea that “financially successful Americans” and the Crown Princess Masako used antidepressants (526). By marketing and introducing the idea of depression as a harmful yet treatable disease in Japan, where the culture is closely associated to sadness, pharmaceutical companies where slowly able to meld the society’s perception on how the viewed depression.
Watters states “cultural beliefs about depression and the self are malleable and responsive to messages that can be exported from one culture to another. One culture can reshape how… another culture categorizes a given set of symptoms,” (519). The society in Japan went from ignoring depression and seeing certain symptoms (those according to the West as a sign of depression) as positive to buying antidepressants and believing that depression is potentially deadly. In conclusion, it is obvious that symptom amplification in Japan’created’ a disease out of depression.
By marketing depression through almost every media outlet in a vague way, pharmaceutical companies were able to make people believe that depressants were to only way to be successful. It’s not farfetched to say that, in trying to create and sell pills, the companies unfortunately created a new common ‘disease’. Unfortunately, the side effects of drugs such as Paxil have been swept under the rug. If the West still has unreliable methods and medicine it is not be wise for them to export these to other cultures, even with selfish motives such as gaining a profit.
