Modern-Type Depression as an “Adjustment” Disorder in Japan: The Intersection of Collectivistic Society Encountering an Individualistic Performance-Based System

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Japan has recently seen an increase in cases similar to that of Mr. A, especially among young adults, a syndrome referred to as "modern-type depression" (MTD) (1).Characteristics of MTD include situation-dependent depressive state, blaming others, and strong avoidant tendencies (2, 3).Individuals with MTD display absenteeism from work or school, complaining "Mr.A" is a 35-year-old company employee living with his wife and son.He had no notable developmental problems.His father was a traditional Japanese company employee who was often absent from home because of work.His mother, a stay-at-home mom, had high expectations for Mr. A's academic success and sent him to cram school from an early age.He participated in school sports clubs but spent the majority of his time playing video games.He was never enthusiastic about academics but did relatively well.After high school, he entered a well-known university and started to live alone.He had no specific aspirations in life, but, following others, he applied to some well-known companies.He accepted a job at a company that "happened to" offer him a career-track position.For a few years, he did relatively well under a good mentor who guided him.In his fifth year, he was reassigned to a new division, where he was often required to express his own opinion, which he found difficult.His supervisor scolded him sharply at times, which is not uncommon in Japan but which left Mr. A feeling unhappy and dissatisfied.Having been an A student, this was virtually the first time he had received a stern reprimand.He started experiencing headache, angst, and insomnia, and he frequently arrived late or was absent for work.He himself suspected depression and sought help at a psychosomatic medicine clinic, expressing his wish to take leave from work.His doctor granted a 3-month sick leave for "depressive state."Immediately, Mr. A felt well and would sometimes attend parties with coworkers, which led them to doubt whether he actually had depression.