Busting 5 Mental Health Myths — and How Japan’s Unique Culture Shapes Them
Have you ever heard someone say, “Just tough it out,” or “You don’t need therapy, you just need to stay busy”?
Around the world — and especially here in Japan — mental health myths still shape how people think, feel, and seek help. Whether it’s the pressure to appear strong or the belief that only specialists can help, these misconceptions can stop people from getting the care they need.
We’re working to change that. Our licensed therapist, Lindsey Thomas, offers therapy and counseling that combine evidence-based approaches with an understanding of Japan’s unique cultural context. We also provide direct billing for the American Foreign Service Protective Association (AFSPA).
Let’s look at five common myths about mental health — and how research and Japanese cultural insights help us separate fact from fiction.
Myth #1: “Mental health issues are a sign of personal weakness”
This is one of the most pervasive ideas globally, and it has particular resonance in Japan. A review of studies on stigma in Japan found that many people believe mental illness is due to a personality weakness rather than a biological or situational trigger. PubMed+2ResearchGate+2
Moreover, the same research highlighted that Japanese people were less likely than people in some neighbouring countries to believe recovery is possible. PubMed+1
Why the myth persists:
In Japanese culture, maintaining harmony ("wa") and avoiding bringing shame to the group is valued; admitting to mental struggle can feel like disrupting the group.
The term “weak character” still shows up in attitudes about mental illness in Japan. Sci-Hub
Older generations and men in Japan show higher levels of negative attitudes toward seeking help. SciELO España+1
Reality check:
Mental health difficulties are not a character flaw. They arise from a complex interplay of biology (genes, brain chemistry), life experiences (stress, trauma), environment (work culture, social isolation) and culture. Recognizing them early and seeking help are signs of resilience, not weakness. If anything, the “weakness” myth only keeps people feeling stuck and prevents opportunities for personal growth.
Myth #2: “You should only see a ‘specialist’ psychiatrist; your general doctor can’t help with medications”
This myth often prevents early intervention. Many people think: “I must go straight to a psychiatrist for antidepressants or anxiety meds,” so they delay seeing anyone.
What the evidence says:
According to the article “Can a Primary Care Physician Prescribe Antidepressants?” the answer is yes — primary care physicians (PCPs) in many cases do prescribe antidepressants, manage dosage, monitor side-effects, and refer on when needed. AllCare
How this connects in Japanese context:
In Japan, many people first present to general physicians for physical symptoms when the root is psychological (e.g., headache, insomnia). Waiting until “seeing a psychiatrist” can delay care.
Also, because of stigma (see myth #1), people may avoid “psychiatry” but are okay seeing their usual doctor; educating general practitioners and integrating care helps bridge that.
Bottom line:
If you’re noticing persistent changes in mood, sleep, appetite, concentration — don’t wait. Your general doctor can be the gateway to help, whether via counseling, lifestyle change or- yes- medications if needed, with referral.
Myth #3: “If I’m feeling down I just need to ‘snap out of it’ or willpower will solve it”
In Japan this gets wrapped up in cultural expectations: endure (gaman), do your best, don’t complain. If you’re struggling mentally, you might think you should just keep going and you’ll be fine. But the research shows this is unrealistic and can worsen things.
Relevant studies:
A study of attitudes toward help-seeking in Japan found that fear of stigma and a desire to remain in the same neighborhood (i.e., avoid being singled out) were significant predictors of negative attitudes toward psychiatric services. SciELO España
Other work shows public beliefs in Japan often emphasize weaker personality as cause, which leads to “whyness” of blame rather than compassion. PubMed
Why the myth is harmful:
It delays treatment: “I should be able to handle this myself” → weeks/months pass.
It ignores that mental health issues can have biological, social and environmental roots.
It can lead to self-blame when the “just try harder” approach fails.
What to do instead:
Recognize that just like a broken bone needs support, emotional/mental distress sometimes needs help. Taking that step is courageous and should be a sign of healthy self insight.
Myth #4: “Mental health problems only affect certain types of people (e.g., weak, unemployed, isolated)”
This myth creates an “us vs them” mindset. In Japan, the workplace culture with long hours (karōshi: death by overwork), group pressure and societal conformity means many high functioning, employed individuals are silently at risk. Rieti
The idea that “it couldn’t be me” prevents early awareness.
Evidence & context:
A review noted that in Japan the social distance (i.e., how far people want to stay from someone with mental illness) was large; this underlines that “people like me” may not get seen. PubMed
Workplace stress in Japan has been studied with respect to employee mental health, turnover, and sick leave. Rieti
Reality check:
Mental-health challenges can affect anyone — students, salarymen, homemakers, retirees. The trigger might be job stress, social withdrawal, shame, life transitions. Recognizing that universal potential helps reduce stigma and fosters early care.
Myth #5: “If treatment doesn’t work right away, it means nothing will help”
This is a myth many of us fall into: one bad session, one ineffective medicine, and the belief that “well nothing works for me”. In Japan, where patience and perseverance are valued, this myth may mean people give up too quickly.
What the literature indicates:
While I don’t have a Japan-specific longitudinal medication study handy, globally we know treatment is rarely “one size fits all” — it takes time, sometimes trying different approaches (therapy, meds, lifestyle).
One relevant piece: stigma in Japan is greater when people believe mental illness is chronic or un-recoverable. PubMed
Key takeaway:
Persisting despite setbacks is part of the pathway. Instead try to see it as valuable information that you can incorporate on your journey.
Why the Japanese cultural context matters
Understanding Japanese culture helps us tailor care. Some specific cultural points:
The value of group harmony and fear of “burdening others” often leads to internalized distress. Arab News+1
Concepts such as “honest outward face” (tatemae) vs “true self” (honne) may mean people present differently than their internal state.
Traditional Japanese therapeutic models (like Morita Therapy) emphasize acceptance of feelings and purpose through action — a bridge between Western talk-therapy and Japanese culture. Verywell Mind
The stigma around mental health remains stronger in Japan than in some Western countries — meaning myths may persist more stubbornly. Sci-Hub+1
At Torii Health:
We incorporate cultural sensitivity into counselling: we recognize the pressures of work culture, the stigma of self-disclosure, the importance of community and identity. Lindsey works with clients to contextualize their experience, and help build realistic, culturally informed pathways forward.
Each myth has its roots in misunderstanding, cultural expectation and lack of awareness — and when we unmask them, we open new possibilities.
If you’re in Japan (or connected to Japan) and you’re experiencing persistent distress, low mood, anxiety, trouble sleeping, loss of interest, please reach out. Lindsey offers tailored therapy, direct-billing for AFSPA (which makes accessing care easier for Americans abroad), and a culturally informed approach.
You don’t have to go it alone—and debunking myths is the first step toward building mental-health literacy and resilience.
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References
Andō S., Yamaguchi S., Aoki Y., Thornicroft G. (2013). Review of mental-health-related stigma in Japan. Psychiatry and Clinical Neurosciences, 67(7), 471-482. DOI:10.1111/pcn.12086. PubMed+1
Yamawaki N., Pulsipher C., Moses J.D., Rasmuse K.R., Ringger K.A. (2011). Predictors of negative attitudes toward mental health services: A general population study in Japan. International Journal of Social Psychiatry, 58(2), 190-198. DOI:10.1177/0020764011398294. SciELO España
“Can a Primary Care Physician Prescribe Antidepressants?” AllCare Family Med Blog, Nov 1 2024. AllCare
“The Stigma of Mental Health and Sanity in Japan.” Arab News, May 25, 2022. https://www.arabnews.jp/en/features/article_72751/
Research Institute of Economy, Trade and Industry (RIETI). (2016). Work Stress and Mental Health in Japan. https://www.rieti.go.jp/jp/publications/dp/16e016.pdf
