May disease remedy

Tokugawa Ieyasu's cure for depression

By William Wetherall

Drafted 16 March 1988
Posted 4 February 2006

Spring is the season for new life, a time for the earth to thaw, grass to grow, flowers to blossom. It is also a period for beasts of many kinds, including humans, to stir from their winter lairs in quest of food and mates, to plant new crops, to hunt, to love.

But spring's vast sea of fertility is not safe for all swimmers. The suicide rate of most northern hemisphere countries increases in March, April and May, while in most countries south of the equator it rises in September, October and November.

Most people who kill themselves are deeply depressed. The sense of despair and fatigue which characterizes depression can be triggered by many social and biological factors. And hopelessness likes the company of romantic self-pity.

People who feel that life is not worth living are prone to take flight in spring's beauty. Captivated by the warmth of the sun, the breeze, the smell of the air, they fantasize suspending the dream of life at a moment when nature is at its freshest and most embracing. Death, though still feared, comes to be seen as a passage -- a road, a river, a door, a tunnel -- to a better world, a utopia, a paradise.

For Japanese, Korean, and other youth in Japan, spring is also a time to worry about a new school or job. Some young people feel that life is unbearable if they cannot enter a chosen school or company. Yet many young people who do get into their school or occupation of choice become disillusioned about their studies or work. They feel that they have wasted their youth in preparation for future that turns out to be unsuitable or boring. But they also feel that they are on an irreversible, one-way course.

Some people go through life unhappy -- resigned, frustrated, angry, or alienated. Every spring that acute depressive syndrome called "May disease" drives a desperate few to suicide.

Between 15 and 25 out of 100,000 people kill themselves in Japan every year, depending on how the rate is computed. This is moderately high by world standards, but a number of European countries, like Sweden, have had consistently higher rates. Roughly three percent of all deaths are due to suicide.

For most age groups, the average rates for the past ten years are lower than they were for the first quarter century after World War II, when they were lower than during the twenty-five years before the war. The trend toward higher rates among the middle aged, especially men but also women, seems to be a problem mainly for the prewar born and wartime educated, aggravated but not caused by their present-day lives.

But even when suicide rates are not climbing, more suicides could be prevented if everyone was more patient with their own problems, and more sensitive to the problems of others. When someone with a personal problem says that they want to die, or blankly stares out the window, you should take them seriously.

Such verbal and nonverbal signs are associated with suicidal behavior in hindsight. In foresight, too, they should be taken as possible premonitions of the presence of suicide ideation, the first (however unconscious) step to contemplation and attempt, the classic presymptoms, the cries for help of people who are ambivalent about life, who really want to live but do not know how.

With few exceptions, suicidal behavior at any age implies a mental health problem, a spiritual crisis if not a recognized mental illness. Compulsive and manic concern with status and success are time bombs in the minds of people who have not learned how to deal with failure and disappointment. Obsessions with getting into the most prestigious schools and companies compel some children and parents to rush to death rather than accept other choices.

No individual's future should be presented as all or nothing. No child should be protected from the opportunity to try many paths and learn from those they fail to reckon or navigate.

To borrow the words of Benjamin Franklin: society can guarantee only the freedom to pursue happiness; it is up to the individual to catch up with it. So true happiness should be in the pursuit itself.

A poem written by Tokugawa Ieyasu may be the surest guide to happiness in the world. Its words appear on a signboard halfway up the long stone steps that lead to his mausoleum behind the Toshogu Shrine at Nikko. They tell us that there is more to life than achieving rigid goals -- that life is a trip, not a destination.

Jinsei wa Life,
omoni o oute like going
tooki michi o down a long road
yuku ga gotoshi with a heavy burden,
isogu bekarazu. should not be hurried.