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Comment by irishjohnnie | Hacker News Reader

Plus the Japanese diet tastes better than a fish oil gel cap ... speaking of which, does this mean that the incidence of depression in Japan is low?

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Well, according to this article about a recent study:

http://www.washingtonpost.com/blogs/worldviews/wp/2013/11/07...

Japan has the lowest rate of diagnosed cases of depression of any country in the world (<2.5%). Of course, there could be other causes for this, and the accuracy of how well the diagnosed rate represents the actual rate is an open question. In particular, in east asian countries thre seems to be a cultural taboo against admitting mental illness and seeking treatment in order to get diagnosed in the first place. The fact that Japan has one of the highest suicide rates of any country in the world is an especially telling statistic that the diagnosed rate may not be telling us everything.

A healthy diet is really not a remotely sufficient substitute for a healthy social context.

One of the reasons there's a link at all is because we often eat with people.

It may not be that deterministic, as if it's either diet or social context. One thing can feed on the other.

It can start as an emotional response, deflagrating an inflammatory process, revealing the nutritional deficiency. Or it can start with a nutritional deficiency, deflagrating an inflammatory process, which the brains reads as depression.

This mechanism is already seen regarding stress and magnesium. High stress -> Mg depletion. Low Mg -> Stress symptoms.

I wonder if we can make the assumption that a suicide must have come from depression. Or at least, I'm not sure if the reasons/depressions experienced in Japan are comparable to other countries. I'd also agree that the admittance of mental illness may be lower than the actual. There are some pretty strange conditions out there, like hikikimori.

Right, I'm not saying that suicide necessarily comes exclusively from depression. Obviously there are other cultural factors at play in Japan that may lead to higher suicide rates. Just that the massive discrepancy between suicide rates and diagnosed depression rates is suggestive of the fact that the actual depression is at least somewhat higher than what we see.

I work in the pharma industry in Japan and I can confirm that depression is massively under-diagnosed, and that the market for depression treatment is expected to boom in the coming years. So much, that they are now doing TV campaigns to encourage people to be diagnosed. So yeah, don't count on the current statistics to tell you anything significant, there are many cultural barriers at play in Japan, just like for many other aspects of the Japanese life.

> I work in the pharma industry in Japan

I wonder if we've crossed paths in some way before. I also work in the pharma industry (peripherally?).

Maybe we have? :) We should exchange contacts :)

I just realized why your username looks familiar -- we just talked in the Kyoto HN Meetup thread the other day.

Indeed - if you ever come to any HN Kansai event you'll probably see me there :)

How can I get in touch with you?

get on pandoralive.info and hit the "about us" section and there is a contact form there :)

So you will be working hard to make sure that Japan knows that it is depressed, and your pills will solve the problem for them, eh? Sounds honorable, kimosabe.

There's nothing wrong with using pills. I've had severe MDD (clinical depression) since childhood and my mum is the last person who would resort to feeding me pills; they were the only things that were effective enough to let me live my life somewhat normally. They still are.

I tried to substitute them a few times with more exercise, herbs, teas, voodoo, and comedies. I'd be OK for a week or two, but I'd eventually start degrading into a shit state.

Thank the fuck and heavens for the pharmaceutical industry.

First, I don't work on Depression so I can't really answer your comment in any sensible way. I was just sharing my knowledge of the market. Besides, there are conditions where you need treatment. I don't know if you have ever met REAL people suffering from depression but basically when you have that condition you can't function at all anymore. You can't work, you can't have friends, you can't communicate well anymore and when you reach that point I tell you you'd be glad to be able to take some pills to make you a normal person with normal emotions again. Your comment makes me think you don't really know what you are talking about, because depression can lead to suicide and having the right drug at the right time can really save you. I'm not saying the solution is ONLY about drugs, but when you hit the bottom, it's helpful to get back up.

Might be nice if societies didn't develop dependencies on massive, corrupt, for-profit, international pharmaceutical agencies though, wouldn't you think?

While we’re all for disruption here at hacker news, the International Socialist Revolution variant of it seems to not be as popular in these parts.

(Un)fortunately, depending on whether you consider previous implementations the best possible ones or not.

Hey, whatever your -ism, there's still gotta be a Dealer in the addict equation, right? Its not like these things synthesize themselves...

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