Video Materials on Depression and a Breakdown of Expenditures for Japanese Living Alone in Relative Poverty

In the previous article, I explained that since September 1, 2016, the mentally disabled living alone in Japan are hit with the “double whammy.”

  1. Their own mental illness (existing difficulty)
  2. Relative Poverty (due to cutoff of disability pensions)

On September 1, 2016, the disability pension system for the mentally disabled was revised for the worse. Since then, it has become impossible for the mentally disabled living alone to receive disability pension benefits.

Economic damage worse than the worst

The amount of disability pension benefits (monthly) in US dollars

Reference: the Ministry of Health, Labour and Welfare, 2014 "Survey of Pension Systems"

The economic loss from the cutoff is “at least” 600,000 Japanese yen (about $5,800) to 720,000 Japanese yen (about $7,000) per year. On a monthly basis, it amounts to 50,000 Japanese yen (about $480) to 60,000 Japanese yen (about $580).

Even in the “Great Depression of the Century” caused by COVID-19, the average drop in Japanese annual income is said to be around 380,000 Japanese yen (about $3,700).

But we have suffered financial losses of more than 1.5 times that amount annually for the past several years.

Agonies that can't be visualized

The sentences so far are almost the same as those explained in the other articles.

I've explained these things repeatedly, but I don't think I've conveyed well how severe the “double whammy” is. This is because both of these sufferings are difficult to visualize. They are hard to explain visually and simply.

Indistinguishable disability

Among the physically, mentally, and intellectually disabled, the mentally disabled are the most difficult to distinguish from healthy people.

In fact, there are not so many people in the hospital waiting room who are instantly recognizable as mentally ill. Most of the patients look and behave much the same as healthy people.

Case of a patient with Self-Harm. The patient is played by an actor.

If you have a chance, take a look inside the psychosomatic medicine. People like the one in the video above are actually few and far between. The patients really look and feel much the same as normal people.

So, they struggle with mental disorders unnoticed by anyone. In that sense, they are all somewhat isolated.

For most of the people, the image of the person in the video above matches their image of the mentally disabled.

But it's different.

  • Schizophrenia
  • Depression
  • Anxiety
  • PTSD
  • Panic disorder
  • Eating disorder
  • Developmental disabilities
  • Asperger Syndrome
  • Postpartum depression, etc.

There are so many different types of mental disorders. Like physical disabilities, there is a great deal of diversity. It is incorrect to have only one stereotype regardless of this reality. And this leads to discrimination, prejudice and stigma.

Ms. Greta Thunberg, an environmental activist, is known to have Asperger's syndrome. Learning about the disease, we can be a little more tolerant of her peculiar behaviors.

I don't agree with her. But I sometimes sense the loneliness unique to those who struggle with disabilities in her as well.

Appearance and behavior of the mentally disabled

The reality is that there are more people with mental disabilities who are dressed normally and respond to questions in a calm manner, as shown in the following video.

Case of a patient with Anxiety. The patient is also played by an actor. The woman on the thumbnail is a doctor.

How depressed people look and behave

There are re-enactment videos of depressed patients, too.

Case of a patient with Depression. It is a very valuable video material.

A case of mild depression

There is also a video of a mildly depressed patient.

Case of a patient with Mild Depression.

People with mild depression are almost indistinguishable from healthy people, especially those who are distressed.

In each case, you wouldn't have thought that they looked or acted so strange or obviously abnormal, even if they were mentally disabled.

We are mentally disabled, but we are not psychotic or insane. Mental disorder is an inner suffering. Therefore, it doesn't always involve a noticeable change in appearance and behavior.

This makes it difficult for people to recognize the onset of mental disorders.

Visualize the mental state

Depression is a mental illness, an inner suffering. But it is impossible to visualize the inner world. If it's an injury or physical illness, you can directly record your suffering, such as a wound or hospitalization scene, as images.

Screenshot from gofundme

Screenshot from GoFundMe: #1 Fundraising Platform for Crowdfunding. Their eyes were blurred for privacy protection.

On the other hand, mental states and inner suffering cannot be converted into image data.

If we could, our agonies and difficulties could be easily shared with many people. Posts on image and video sharing sites will increase understanding and empathy for our difficulties.

We are now in the “Era of Images” as represented by Instagram and YouTube. If we explain that “the battle against mental disorder is a series of hardships” without eye- catching images, how many people will be interested and sympathetic?

The “Donation to Support the Mentally Disabled Living Alone in Japan” campaign started in October 2020.

Struggling with mental disorders is a hardship in itself. Nevertheless, just simply because we live alone, our disability pension benefits was cut off. And we fell into relative poverty, a double blow. As for relative poverty, donations will solve the problem. One of the two difficulties can be removed with the love of donation. This is how I am asking for your help.

But it's quite difficult to gather effective images to draw people's attention to the suffering of the mentally disabled. This is because it is an inner torment, an invisible anguish. For this reason, I am now struggling with publicity activities.

It's a battle against overly visual communication or the “Era of Images.”

Typical symptoms of depression

We can't find any more visual materials about mental disorders. They were educational video materials for clinical psychology. Universities and other educational institutions should have more.

Anyway, I believe you could get a glimpse of the true state of the mentally disabled through those videos.

Now let me post the video of the depressed patient again. But this time with closed captions.

What are we struggling with?

The closed captions allow you to read what she is struggling with in addition to hearing it.

Please “watch and listen” to the first 8 minutes. It's set to stop at 8:02. The rest of the video is for researchers and students, so you need not watch any of it.

Watch and listen intently to her words. Then, in just 8 minutes, the blurred picture of depression and its suffering will become visible.
  • Feeling down, fed up, and miserable
  • Low or No energy
  • Spending the day on the sofa
  • Sleep problems (difficulty falling asleep and early-morning awakening)
  • Severe exhaustion
  • Feel heavy-headed (in the video she said her brain was turned off)
  • Decreased appetite
  • Diminished ability to concentrate
  • Self-denying and lack of self-esteem
  • Feeling powerless
  • Lowering of motivation
  • Obsessed with the idea of how she should be, what she should do

These are her chief complaints. I also added a few symptoms that did not appear in the doctor's final recap. Almost all of these symptoms are very common in depressed people.

This video is the best material to learn about depression because it is a fairly typical case.

What's the most difficult?

Depression is a mental illness or a hormonal imbalance in the brain. However, it is also accompanied by physical symptoms.

The mind and body are inseparable.

  • Low or No energy
  • Sleep problems
  • Severe exhaustion
  • Feel heavy-headed

It's just my personal opinion, but I think the most serious symptom of depression is “Severe Exhaustion.” It makes us completely down-and-out.

It's impossible to get up and go to school or work, clad in so many layers of lead that can't be easily peeled off.

We also lack the energy to carry them out. Lack of sleep adds to the fatigue. Especially the brain fatigue is terrible. We feel so heavy-headed that we don't even know whether we are exhausted or in pain. It's really torturous.

No images or even words can fully express this torture. For most of the day, we are stuck in bed or on the couch in a constant state of agony. It lasts until the fatigue wears off and we are able to move. We might suffer from some psychological symptoms such as strong anxiety. However, “Severe Exhaustion” is millions of times more painful.

Unless it is fully controlled, I think it will be quite difficult to return to work or return to society. I have failed at this challenge for years. I think my life would have been completely different if there had been some kind of one-shot-medicine to cure the “Severe Exhaustion.”

Now that the effectiveness of antidepressants has improved dramatically, I suppose that what depressed patients have the most trouble with is not the psychological symptoms, but the “Severe Exhaustion.” Of course, the most “dangerous” thing is the suicidal urge, though.

Is there (or was there) anyone at school or work who takes irregular days off several times a month? I think there are many people who do the same things as healthy people but actually struggle with depression and “Severe Exhaustion” or easy fatigability.

Handicaps need to be visible, and if they are not “liked” and “shared,” they will not be paid attention to. If that is true, the mentally disabled are the least likely to be cared for. It's because our suffering lies inside our minds. And no one can capture our sufferings as images from outside and “share” them with others.

In addition, there are privacy concerns when making a live-action video of our struggles. Visual communication and mental disabilities are very incompatible; it's really hard to live.

Visualize relative poverty

There are two types of poverty.

  • Absolute poverty
  • Relative poverty

Absolute poverty is a condition where the living standard is so low that it is difficult for people to survive. For example, it can be seen in the sub-Saharan Africa regions and in the refugee life.

On the other hand, roughly speaking, relative poverty in Japan is a condition: food and shelter are the only things they can afford. We can't pay for other expenses such as clothing, socializing, medical care, and for entering further education.

The poverty that the mentally disabled people living alone in Japan have fallen into since September 1, 2016 is, of course, relative poverty.

But we are not living on the streets, nor are we terribly skinny.

Therefore, relative poverty is hard to distinguish by appearance. In addition, if the hardship is not explained and visualized very carefully, there is a risk of bullying, banter, and slander.

Explain it by the numbers

So I would like to explain it with numbers instead of images.

In October 2019, I received a loan from the prefecture called “General Support Fund” to help me make ends meet for the time being.

I was working as a non-regular employee, disguising myself as a healthy person, until December 2018. However, I was forced to resign due to repeated health problems or the “Severe Exhaustion.”

After that, I received unemployment insurance benefits, but the benefit period ended in June 2019. Of course, during that period, I tried very hard to find a job, but I couldn't find any. By September, I was no longer able to afford near-term living expenses.

With no other recourse, I decided to take advantage of public financing.

Breakdown of expenditure for one month

In the beginning of October, I visited the Council of Social Welfare. Then, the discussion with the person in charge about the terms and conditions of the financing and the loan amount started.

We had very thorough discussions about the minimum required expenditure for each month and the amount that I would be able to repay without fail. I provided all necessary vouchers for payment, receipts, and credit card statements. I also presented all my passbooks for all my bank accounts. Financing is not easy.

Scrutiny of evidence materials

All evidence materials were always checked twice with a calculator. Source: Bookkeeping as a Service - Partners in Business

Based on those evidences, I made an exhibit called "Breakdown of Monthly Expenditures for Living Expenses," which shows the breakdown of incomes and expenses in a table. I rewrote it three times or more. She made fairly precise remarks in each meeting. However, I think three times rework is rather few.

Household income

On the exhibit, the first thing to do is to declare your household income.

Household income

The exchange rate is 104.75 yen to the dollar and 127.01 yen to the euro.

In the “Income from working” entry, you must calculate and fill in the average of the take-home pay of your most recent job by yourself. You also need to provide the pay stubs of that time as evidence. In addition, bank passbooks are required. These were checked to see if there were any other sources of income and if the amounts were correct.

Of course, “A. Current income” was zero. This was also checked on the bank statement to make sure there were no false declarations.

Household expenditure

It was quite difficult to complete the calculation of “household expenditure.” In the table below, there was actually another column called "Current Expenses." But I omitted it because it would be very confusing.

Household expenditure

The exchange rate is 104.75 yen to the dollar and 127.01 yen to the euro.

In the “Expenses while working” entry, report the breakdown of expenses for the month in which you had your last income. Of course, all receipts and other evidences at that time are required. You have to set items for your expenses (e.g., house rent, utilities, and food) and classify your spending all by yourself. Then, the person in charge corrects them.

Although I skipped the breakdown of “Current Expenses,” I reported the breakdown of expenses at that time, or October 2019 as well, with the required evidences. Its total amount was 151,075 Japanese yen (about $1443, €1200).

These written materials were compared and scrutinized, and the monthly loan amount was determined through detailed consultations.

By the way, the “Income from working” was 170,250 Japanese Yen (about $1626, €1340), and the “Expenses while working” was 167,767 Japanese Yen (about $1602, €1320). The margin was only 2,483 Japanese yen (about $24, €20). Even though I was working, all I could do was to pay food expenses and secure a place to live. That is the relative poverty in Japan.
  • Being hard up for cache on food, but barely survive
  • Barely secure a place to live

I know the house rent is relatively high. That is because I have been living in the same condo since before the onset of my depression. I have considered moving several times. However, I couldn't even afford the moving expenses. I really have barely enough to pay the rent and food expenses.

Housing Security Benefit

At the time of application, on October 21, 2019, the total balance in my bank accounts was 144,815 Japanese Yen (about $1383, €1140).

One week later, at the end of the month, the rent of 70,000 Japanese yen (about $670, €550) and about 30,000 Japanese yen (about $290, €236) for utilities and communication expenses, or about 100,000 Japanese yen (about $955, €790) in total, were deducted from my account.

So the actual balance in my account was only around 40,000 Japanese yen (about $380, €315).

This made it difficult for me to pay the rent from November onward. Therefore, I also used the “Housing Security Benefit.” Its upper limit was 45,000 Japanese yen (about $430, €350). These are benefits and nee not to be repaid.

Actual loan amount

The loan amount was determined by subtracting the Housing Security Benefits from household expenditures.

In the end, the monthly loan amount was determined by deducting the “Housing Security Benefit.” I received a loan for three months.

No, we're not really cultured at all

Now, let me post the breakdown of “household expenditure” again.

Household expenditure

The exchange rate is 104.75 yen to the dollar and 127.01 yen to the euro.

Do you notice something important?
It's that my monthly expenditure breakdown does not include the following expense items:
  1. Hobbies and leisure
  2. Clothing
  3. Socializing
  4. Education and personal development
  5. Savings

We, the households in relative poverty, are not “actually” able to afford these “cultural expenditures” or the five minimum human expenditures. These expense items should be listed in a standard household account book. But they don't exist in ours.

There are only five differences. But how do you feel if you are no longer able to pay for all five items?

You feel it's too hard? Miserable? Hopeless? The truth is, it's a chaos of grief mixed with all those other emotions.

The root cause of the relative poverty of the mentally disabled living alone is the unfair reform of the disability pension system.

Since September 2016, our disability pension benefits have been cut off merely because we are living alone. And thus we have fallen into relative poverty.

How can a depressed person who is poor have a partner to live with? Will I be able to break free from the hell of living alone? Is there any chance that we can be eligible for the disability pension again? No, we die alone, suffering from relative poverty for the rest of our lives.

This is absolutely a violation of the “Right to Life.” It must not be allowed to happen. This is why I am raising my voice on behalf of people in the same boat.

Article 25 of the Constitution of Japan - Right to Life

All people shall have the right to maintain the minimum standards of wholesome and cultured living.
In all spheres of life, the State shall use its endeavors for the promotion and extension of social welfare and security, and of public health.

Further note on expenses

For the treatment of depression alone, 4,000 Japanese yen (about $38, €32) is enough to cover the cost.

But I also suffer from a severe fatty liver, dyslipidemia, and body weight gain, possibly due to depression or stress. The sudden weight increase led to the injury or shin splints. The expenses for medical care are very high because of the additional costs for those treatments.

The reason for the high cost of miscellaneous expenses was that it coincided with the time when I had to replace my disposable contact lenses. I kept the estimates and receipts, so it was accepted as a necessary expense. Its cost was roughly 13,000 Japanese yen (about $120, €100).

Accountability of fundraisers

Since my previous article, I have explained that since September 1, 2016, the mentally disabled living alone are suffering from two difficulties at the same time.

  • Their own mental illness
  • Relative Poverty

These two are intricately entwined with each other, creating new hardships one after another.

But as for relative poverty, donations are of great help and surely can solve it.

If one burden of the two is relieved, the other will also be relieved.

When I was about to return to society after a year and a half of recuperation at home, my doctor repeatedly instructed me as follows:

Be sure to start with part-time work and move to full-time work after you get used to it enough.

However, the lack of financial support from the disability pension forced me to work full-time from the start. In the end, such a way of returning to society has been continuously failing as the doctor pointed out.

As for me, I'm not requesting donations to alleviate poverty and make a better life. All I want to do is just one thing.

Follow the original instruction of my doctor and reintegrate myself into society in a proper way, work part-time first. Then, live on my own.

Sufferings of depression and relative poverty. In both cases, visual materials were so scarce that I had much difficulty in explaining them clearly.

However, I noticed that the fundraiser had a responsibility to explain the difficult situations properly. I also thought it was necessary to explain the purpose and use of the funds.

By the way, sharing the articles is also quite supportive because they are not fun or trending topics, not interesting to many people, and not searched for often.

Thank you for reading to the end.

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