Notes on Japan, suicide and mental health after the earthquake

So I spent my time reading about Post Traumatic Stress Disorder. I find
reading psychiatric literature really interesting. The symptoms of this
diagnosis can easily be other diagnoses however the important thing is
the traumatising event. if it's a minor event then the differential
suggests an adjustment disorder diagnosis. PTSD is about a life
threatening situation which triggers a short term natural reaction of
psychiatric symptoms which in the long term may not subside and cause a
problem to the person's life which is when it becomes PTSD. So an
earthquake is obviously a life threatening event. The diagnosis also
allows PTSD for certain circumstances such as a woman who watches her
husband go through lots of amputations.

Japanese psychiatrists would obviously be able to best understand how
the symptoms of PTSD would present in Japan. Reading DSM or ICD criteria
and assuming these are what Japaense people would experience may be a
false assumption.

Detection should be relatively easy for Japanese people who stay in
Japan. Some may leave and psychiatrist across the world need to be
watchful for Japanese patients (or other people who lived in Japan at
the time) who they see later on this year or next year presenting with
symptoms.

I didn't get very far in my reading yesterday because I ended up
chatting to the pseudo-homeless man. (We agreed to meet up tomorrow
evening in the same place and I'll try to confirm more about my
suspicions. I can be wrong.) One thing which is obvious but I wouldn't
think about is people who've been injured are significantly more likely
to get disabling PTSD in the long term. It means Japanese mental
healthcare services need to screen these people six months, a year and
two years (or whatever is suitable) for symptoms which may develop as a
result of their injuries and the real fear of their life being ended.

What's been hardest is reading this information and thinking about
someone I care about very deeply. She went through a very physical
health crisis last year. The doctors still don't know what's up. She's
had some therapy and it's helped in some ways but she's still presenting
with problems of insomnia. There are other symptoms which someone might
pathologise but I don't. It's just how she is and I love her for it. Her
sleep problems she's explained to me may be coming from the trauma of
the event which lead to her treatment and the problems of treatment for
her physical health. I'm no doctor but I ain't stupid either and neither
is she. I think she understand that her sleeping problems are related to
her treatment and physical illness crisis. My love for her wants me to
be ok but I know her suffering may also be an important part of a
developmental process essential to her life. Thank fuck I'm not a
psychiatrist. They have to make real decisions about this.

I'ved not yet got to the bit on the book on treatment yet.

Onwards ever onwards.