Phobias and major depression are both relatively common and can occur together. It could be that there are common biological and psychological factors between the two conditions or that there are sociocultural factors that make phobias more damaging in some cultures than in others. A team of researchers from Japan studied 2,436 people and looked into the links between specific phobias (e.g. spiders, dogs, lifts), agoraphobia, social phobia, and depression. The study found that social phobia was linked to a fourfold increase in the risk of depression whereas the other phobias had little effect. The researchers thought that because Japan is a relatively collectivist culture the social problems linked to social phobia could make it a more powerful cause of depression in Japan than in other countries.
Tsuchiya, Masao ... [et al] - Lifetime comorbidities between phobic disorders and major depression in Japan: results from the World Mental Health Japan 2002-2004 survey Depression and Anxiety October 2009, 26(10), 949-955
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Social Phobia can lead to complete withdrawal from society and so some people in Japan suffering from this disorder may become part of the hundreds of thousands of people who live in a complete state of social withdrawal which is referred to in Japanese as Hikikomori. Living at home for months and in some cases for years, sometimes alone in one room with little contact with parents or other family members, can in itself be a cause of depression.
I would also like to suggest that as many Japanese people have very high reading skills in English that any articles dealing with mental health disorders in Japan could usefully provide contact details for hotlines and support services for people who are depressed, suffering from social anxiety disorder, hikikomori or feeling suicidal.
Useful telephone number for Japanese residents of Japan who speak Japanese and are feeling depressed or suicidal:
Inochi no Denwa (Lifeline Telephone Service)：
Japan: 0120-738-556
Tokyo: 3264 4343
Andrew Grimes
Tokyo Counseling Services
http://tokyocounseling.com/english/
http://tokyocounseling.com/jp/
http://www.counselingjapan.com
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