I'm leaving Japan temporarily, because of changes to my mental health (and some changes to the way I think right now as a result). I need some time to take a step back and recover.
This here internet is full of articles on expat depression and handling your mental health overseas. What to do if you're depressed and living in a foreign country, like Japan. How to take your problems abroad without going over the cabin baggage weight limit.
Naturally, they're optimistic and encouraging things to read. They have to be. With more exercise, social events and exposure to daylight, you'll manage your condition and feel better in... a reasonable amount of time by most people's standards!
There's a downside to reading these articles. It makes having to leave an adopted country for mental health reasons feel like failure.
A lot can happen in half a year
The second half of 2019 hasn't been good to me, starting with the health issues I had over the summer. Some people could probably get over an episode like that without much difficulty. And hey, maybe I could've done too.
I visited my family yet again in September. I finally got some decent sleep there, and settled into a better frame of mind. I decided to come back to Japan, try and get back to normality as it is here, and seek more help if/when I needed to.
I returned to Osaka, suffered 4 solid nights of insomnia straight off the plane (that's got to be at least half jetlag's fault), relapsed badly, went to a mental clinic... and was promptly signed off work and put on antidepressants. Yay.
When you look at it like that, it's easy to assume being in Japan is the problem here. Slept well in my hometown, came back and boom! instant insomnia and depression, that's a no-brainer.
Now, I don't think Japan is my 'problem' exactly. But I don't think being here in this mindset's going to solve things for me as they stand, either.
Healthcare in Japan - your mileage will seriously vary
I'm lucky enough to come from the UK, where we have the NHS: free at the point of service, easy to access, there when you need it. I'm aware of how lucky I was to have that growing up, and to be able to go back and use it again while it still exists.
For someone like me, bits and pieces of the healthcare system in Japan are... lacking.
There's no real concept of A&E over here. Feel sick on a weekend, or a national holiday? Good luck with that. In the absence of a central record system, you'll repeat your medical history and symptoms over and over. You pay your medicine prescription per pill (capsule, packet, etc.). And the clinic or hospital you go to will charge you for everything - down to the last cotton swab.
To people from other countries, Japan's healthcare quality is often way better than in their homeland. It's so much cheaper! You have more options for care - want a second opinion? Look up another nearby clinic, and go there instead. Hospital stays aren't as stressful, medicine's easy to collect, and so on.
I can see advantages to how things work in Japan. Good luck phoning a UK doctor's surgery on a Friday afternoon and getting a non-emergency appointment for the following morning... that speed and convenience, I do like. And I appreciate a lot of the care I've received - I know damn well I'd be in an even worse place without it.
It really does depend where you've come from, and what your experiences with health services in other countries have been like. I'd say my current opinion of Japanese healthcare is about 50/50. The system's helped and looked after me to a certain extent.
"When you choose to live somewhere, you have to deal with the lows as well as the highs". Expats in any country will inevitably deal with this 'suck it up, kid' feeling.
On some things, I agree. I've handled the cockroach invasions, the stereotyping, the lack of central heating, insulation AND double glazing, the NHK guy constantly on my doorstep, and the politicians in loudspeaker vans.
But this is HEALTH we're talking about. "You made your hospital bed in this country, now lie in it while we misdiagnose you and hand out medicine that'll make things worse?" If you ask me, that's taking it a bit too far.
I know having the option (the time, the finances, the freedom, the support) to seek medical help and advice in my home country, with family nearby, is a massive privilege. It's an option - a right - that I have, and will probably end up using. And I don't think I should feel guilty about that.
People change, and are allowed to change their minds
I've never been the type of person who wanted to travel to lots of different countries. There aren't that many I even want to visit, let alone try living in.
I did, however, have my heart set on Japan for over a decade. I'd visited a few times, and then I made sure to nab a Working Holiday Visa before I was too old. Getting settled here - apartment, full time job, kotatsu, all that jazz - was a huge milestone. I made it!
Part of what made it so easy for me to fly out and make a life in Japan was how much I prize my independence. I've always placed a high value on self-reliance and being able to live not just alone, but comfortably and easily enough by myself.
And I managed that before I came to Japan - I lived alone in London for about 4 years.
Homesickness for 'home' hasn't registered at any point since I arrived in Osaka. I missed people, and foods (the words 'full English breakfast' are practically triggering to me now), but I didn't miss the UK. Whenever I visited, I'd look at places I used to spend time in like "why would I ever willingly come back to this?"
Turns out there are mitigating circumstances.
Ever since I got sick, the distance I've put between myself and my family has been harder to manage. I've never felt it this strongly in over 3 years of living in Japan. I'm prepared to go back for now if it means being closer to them.
My priorities and values have changed. That's okay. And they might change again when I start feeling better - either back to what they were, or something different. That's also okay.
What's going on in your head is entirely your business
Other people will mean well when they try giving you advice, but they don't know what you're thinking right now. They haven't been through it like you have, mentally or physically. They might not have all the info they need. They might say 'stay here' or 'come home' because they want you to do that, even though it's not the best option you have.
It's your choice and nobody else's. There's no shame in it, no giant red F stamped in your passport at the airport. That's why this isn't framed as an advice post, mainly it's just me venting.
Even so, I feel like I'm going to regret whatever I do. I said that back when I decided to leave London and save up to come to Japan. (I also said that I wasn't depressed at the time...)
The other thing I said back then is "Right now, I can't imagine living anywhere else [other than Japan]." And I still can't, which is making this situation harder to deal with.
Time's the great healer, right?
Ask me about it again when I've spent weeks and weeks in a tiny English town, with no conbini in sight. I'll kiss the ground outside the nearest Lawson when I get back.
Sometimes things feel final, but they aren't
I don't hate Japan after all this. I don't completely want to leave, and I'm doing so with the full intention of returning. But I'd rather weather this particular storm with family there to hold an umbrella over my head.
And then, when the sun's back out, I can work on picking my life back up where I left off. I'm trying to think of it like playing an RPG again after having to delete a corrupted save file partway through. I need to build my inventory and my funds back up, but I've got the XP already.