憂鬱 (Yuutsu): When Mental Health Is Mistranslated

How could I navigate my Japanese-language emotions in pursuit of a Western psychiatric label?

This is Mistranslate, a monthly column by Nina Li Coomes about language, self-expression, and what it means to exist between cultures.

In college I majored in Comparative Human Development, an intersectional field of study unique to the University of Chicago that draws from biology, sociology, psychology, and anthropology. The department defines itself as “an interdisciplinary department at the critical edge of thought and research in the social sciences, who believe that social life is too complex and too exciting to be left with any single discipline.” In one class, I’d listen to a bespectacled public policy professor lecture about inequality in public schools; in another, I’d take notes while a tiny birdlike anthropologist talked about the relationship between magic and bees. One particularly memorable professor was a woman I privately called The Frizz, after Ms. Frizzle from The Magic School Bus, due to her eccentricity and enthusiasm. Often she would begin a lecture at her podium and end it pacing wildly back and forth, the tips of her curly hair dyed purple, bobbing up and down as if for emphasis.

I took two classes with The Frizz; one on pediatric psychological pathology, and another on the different cultural understandings of mental health. The second has stayed with me ever since. I still think about the week we were assigned to read Ethan Watters’s Crazy Like Us, a book that discusses the relationship between global capitalism and psychological diagnoses. With examples ranging from competing understandings of schizoid hallucinations in Madagascar to notions of body image infecting China and Brazil, Watters argues that through globalization of certain Western ideas, a largely pathologized Western notion of psychiatry was being imported to non-Western countries. In class, The Frizz discussed the book heatedly, walking to and fro in front of the chalkboard, her hands flying upward with every exclamation. Sitting at the back corner of the class, I felt a mixture of indignation and fascination as she talked about one particular example: the marketing of antidepressants in Japan through the subversion of the Japanese word 憂鬱 (yuutsu).

憂鬱 (yuutsu) is a word that requires a metaphorical definition, even in Japanese. The Shogakukan Daijisen—the Japanese equivalent of the Merriam-Webster dictionary—defines it as “気持ちがふさいで、晴れないこと,” or “the sensation that your feelings/emotions are blocked, and cannot break into sun,” invoking a persistently clouded sky to further illustrate the sensation. Other sources describe it as melancholy, gloominess, depression, a dampness of the soul. Broken down into parts, the first character, 憂 (yuu) is used to describe something sad, or difficult. The second character, 鬱 (utsu), has a wider range of meaning, stretching from blocked, smelling badly, to steaming (specifically, the kind of steaming in a hot room where air cannot freely move). When the character for utsu is added to a second character, 病, meaning illness, we get the word most commonly used nowadays to refer to clinical depression: 鬱病 (utsubyou), which literally translated becomes “blocked sickness.”

The focus on this latter character—鬱 (utsu)—is part of what Watters discusses in his book, and what had me angrily squirming in The Frizz’s class. Specifically, in the 1990s, when GlaxoSmithKline was first trying to market its antidepressant Paxil in foreign markets, Japan with its economic downturn and high suicide rate seemed ideal for their purposes. But what was expected to be a relatively easy entry into the marketplace turned out to be more complicated: Japan lacked a historical cultural understanding of depression as pervasively bad. Part of this was due to words like yuutsu, which gave depression a place in everyday life as opposed to framing it as something to be pathologized or immediately medicated. In order to combat this perceived lack of a pharmaceutical category, GlaxoSmithKline came up with a different strategy, repackaging depression via a marketing catchphrase: “鬱は心の風邪” (“Depression is the common cold of the heart”). By associating depression and depressive feelings with the common cold, GlaxoKlineSmith succeeded in creating a category of emotions that offered themselves up to systematic diagnosis and medication.

In its first year on the Japanese market, Paxil made $96.5 million, or 12 billion yen, due in part to a marketing campaign based on mistranslating a Japanese understanding of emotion for the purposes of capitalism. While antidepressants are now mainstream in Japan, this association with the common cold has done little to actually alleviate Japanese social stigma surrounding mental illness or mental health, and in my view may even have exacerbated it. In a society in which uniformity and pleasantry are prized, yuutsu acted as a social exception, allowing for conversations about sadness that could be unruly and inexplicable. Aligning it with the sale of a drug, thereby creating the association that yuustu is not meant to be felt but rather immediately solved, feels false somehow—a deliberate mistranslation.

*

As I write this, I can feel myself becoming unnecessarily circumspect. Why am I summarizing a textbook, relaying anecdotes of an undergraduate class I took nearly five years ago? Why should I care how antidepressants are marketed in Japan? Shouldn’t conversations about mental health be destigmatized, access to medication widespread?

Perhaps I am talking in circles because I also struggle to speak openly about my own mental health. For that same class with The Frizz, we were required to purchase a copy of the DSM, otherwise known as the Diagnostic and Statistical Manual of Mental Disorders. I remember spending hours flipping through its pages, looking for a set of characteristics that might define my own dysfunction: the feelings of isolation and loneliness, the mistranslated body and tongue yearning to belong. I waited for a moment of recognition, an aha! moment on page 135 where a bulleted menu of behaviors might spell out everything tangled within me and all I could do to fix it. Instead, the DSM provided only disappointment. Awash in checklists and qualifiers, all I found were metrics for what an insurance company would pay for and what amount of distress would fall under the category of “Mental Disorder.”

Even so, later that semester I found myself in the waiting room of the undergraduate mental health center, wishing I had found a label to describe how I felt, so I could stride into the office, sit in the chintz armchair and spit out a diagnosis, easy to understand and easy to treat. I was left only with confusion for how to translate this yuutsu. How could I navigate my Japanese-language emotions in pursuit of a Western psychiatric label? Did my heart have a cold? Should I be medicated, in therapy, or both? Was I depressed, anxious, or disordered? I tried each word out, spinning them like coins on the tip of my tongue. Every time, they fell flat and false.

*

Since then, I have seen my fair share of different counselors and therapists. Some have struggled to understand, trying to find convenient explanations for my problems. One of them memorably proclaimed that my discomfort in my own body was due to my “Japanese upbringing”: In Japan, she explained, “people are tiny.” Others have been wonderful, spending countless thoughtful hours with me.

Recently, I learned that there exists another very uncommon “spelling” of yuutsu: 幽鬱. The second character is still utsu, the kanji that is used to denote depression and means “to block.” But the first character is no longer 憂, meaning sad or difficult, but 幽, meaning spirit or soul (frequently used to describe ghosts). Yuutsu retains the same meaning even with this spelling: an amalgam feeling of sadness, anxiety, bitterness, nostalgia, and discontent. But this alternate spelling with its use of 幽 creates a more specific implication, chalking up the emotion to a blocked or stifled spirit.

These days, I don’t see a therapist but I’ve noticed that lately I feel a certain heaviness again, as if a slow suffocation of spirit. I feel doubtful of my writing, of my claim to writing, of my claim to myself and identity. I find myself fearful that people will think I’m a fraud—that as a half-American, half-Japanese person navigating the mistranslated area between two identities, I do not have a right to write about Japan, or the Japanese language, or really much of anything. I am doubtful and discouraged more often than I am not. I see yuutsu edging in on my emotional periphery.

And yet, in the midst of all this, the concept of manifold depression as one’s spirit getting stuck somewhere is heartening to me, somehow. It implies that, at some point, there is release. It speaks to the particular way that I feel this sadness: a heaviness of spirit, cloaking me so that the only thing to do is to wait until I can outrun the weight, setting the ghost of myself free.