Imagine being so overwhelmed with fear and anxiety that you never venture outside of your house and that, being so overcome by social anxiety, you withdraw completely from any social interaction. This is the harsh reality for a growing number of people made completely immobilized by their mental health condition.
It’s difficult to find detailed statistics related to the number of people suffering from this debilitating social anxiety, in part because most reports include those with the issue in the general depression group, which now tops more than 350 million people of all ages and ethnicities around the globe.
Hermit, recluse, and lone wolf are only a few of the terms used to describe those with severe social anxiety. Although most people think of North America when social psychological issues are mentioned, the 2013 article, Japan: a haven for the psychologically troubled written by Japan Times reporter, William Bradbury, crowns the Asian country as home to a growing demographic of citizens combatting a variety of social and mental health issues.
The young writer, who fights his own battle with mental health issues, relocated to Japan in his early adulthood. “Japan is a comfortable stomping ground for socially awkward people,” wrote Bradbury. “Serious character and personality defects go unnoticed or are put down to foreigner status, and rather than tarnishing your self-image, they can even help you romanticize yourself, with a bit of imagination,”
While Bradbury is a British expat, mental health issues are also prevalent in Japanese youth, especially adolescent boys. Intense social anxiety has become so widespread among Japanese boys aged 15 to 20 that a special term has developed to describe the anxiety: Hikikomori. It’s a term that’s translated to mean ‘pulling inward’ or ‘being confined’.
According to the Japanese Ministry of Health, Labor and Welfare, Hikikomori is a person who does not participate in society and has no desire or wish to. This isn’t merely someone who refuses to go out for the weekend — Hikikomori defines someone who for at least 6 months never leaves their home or bedroom and disengages from all social interaction with people outside of their immediate family.
A Hikikomori – which describes the condition and the sufferer as well – is also someone who doesn’t build, initiate, facilitate or engage in outside friendships and relationships.
Last year, the Daily Mail reported that as many as a million Japanese youth and young adults are Hikikomori. “It can be painful for families, but is also affecting the Japanese economy, with those suffering Hikikomori often referred to as the ‘missing million’.”
While coverage of the growing number of Hikikomori has become more common in the last five years, the term dates back to 1998. Bilingual Tokyo psychiatrist, Doug Berger, has also been advocating for more treatment on behalf of the Hikikomori community in Japan.
“The intense rise in Hikikomori cases has been linked to the rapid growth of the internet, smartphones and digital/virtual culture,” adds Dr. Doug Berger. “This allows these persons to interact with the world but only indirectly”.
A psychiatrist in Tokyo for many years who also offers ADD/ADHD Treatment in Tokyo, Dr. Berger goes on to explain that some Hikikomori are night owls, spending their waking hours in front of an array of digital screens and TVs.
Treating Hikikomori has proven difficult in many ways. For one thing, it’s hard to treat patients who don’t leave home and it’s also proven difficult to pinpoint the exact cause for the condition. In the United States, doctors are experimenting with exposure therapy, which is commonly used as a treatment for social anxiety there.
In Japan, it is more complex and nuanced, in part because Hikikomori has become so embedded in the culture.
“I think certain people are more prone to leave isolated lives. And certainly, the rise of digital culture in Japan has enabled more people to develop a Hikikomori lifestyle.” Dr. Doug Berger continues, “With that said, there’s more awareness around the condition and that always provides support for better possibilities of treatment. Some of these persons may actually suffer from schizophrenia, some from anxiety or depressive disorders, and some from attention deficit disorder. Intervention must proceed after a careful assessment. Counseling or family counseling, psychotherapy, social intervention or provision of school or work opportunity, and in some cases, psychiatric medication may be needed to help improve the psychiatric and behavioral symptoms that impairs these persons’ ability to function in society.”