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Why Japan's hikikomori isolate themselves from others for years
These modern-day hermits can sometimes spend decades without ever leaving their apartments.
- A hikikomori is a type of person in Japan who locks themselves away in their bedrooms, sometimes for years.
- This is a relatively new phenomenon in Japan, likely due to rigid social customs and high expectations for academic and business success.
- Many believe hikikomori to be a result of how Japan interprets and handles mental health issues.
There's a particular type of person in Japan. They are about 32 years old, mainly male, and typically come from middle-class families. They avoid social situations. You might be able to empathize — some people get anxious around others. But this particular type of person lives a lifestyle most cannot imagine for themselves.
They're called hikikomori, and their self-imposed isolation is so profound that they do not leave their apartments for a minimum of six months. Reportedly, some have even tethered themselves to their bedrooms for decades.
But this kind of isolation must be a rare thing, right? Who could stand to constantly avoid other people for years? Well, apparently about 700,000 Japanese people have adopted this lifestyle.
What causes someone to become hikikomori?
Some argue that Japan's rigorous and demanding education system helps to cause people to become hikikomori.
(KAZUHIRO NOGI/AFP/Getty Images)
Like most behavioral issues, it's difficult to pin down exactly what mechanism lies behind it. However, there are some common features.
Japan is a very rigid, structured society, and the pressure starts early. Students are expected to study constantly, the school year lasts six weeks longer than in the U.S., and, when the Ministry of Education reduced the school week from six days a week, many parents began enrolling their children in juku, or "cram schools," to fill in the extra hours with as much education as possible. Because of the emphasis on exams in Japan, about half of all junior high students in Japan attend juku.
Combined with the fact that the period from 1990 to 2010 saw very little economic growth in Japan, many students questioned the purpose of their high-intensity education when there was little guarantee of work at the end of it.
Social life in Japan, too, is highly structured and etiquette practices can quickly become complex depending on the situation and the others involved. For example, Japanese has many grammatical structures that vary depending on the exact nature of the person being addressed, whether they're a superior, an employee, a customer, an older woman or man, a younger woman or man, and many others. Giving gifts is common, but certain items are considered impolite. Giving a kitchen knife to a newlywed couple is a no-no, since this implies separation.
What's more significant than the specific rituals and rules in Japanese culture, the general, pervasive sense of propriety and correct behavior can be stifling. It is impossible to go through life without embarrassing yourself socially at least once, but in a culture where correct behavior is highly valued, slipping up in this regard can be traumatizing.
Often, a triggering academic or social failure prompts young men and women to withdraw from society and become hikikomori. It's also been speculated that this social phenomenon is due, in part, to a culture of shame surrounding mental health issues. Depression wasn't even recognized as a real condition until the late 1990s in Japan, and it is sometimes still seen as an excuse to take time off of work. Rather than be labelled as depressed or anxious, the term hikikomori paints people with a broader brush.
How do they survive?
Many hikikomori support themselves through remote work.
(Photo by Tomohiro Ohsumi/Getty Images)
Most hikikomori come from middle-class families that can provide support for them. A large number of them continue to depend upon their parents for food and shelter. Considering how long some hikikomori maintain their hermit-like lifestyle, this can be both crippling to the parents and extremely dangerous for the hikikomori themselves.
The "2030 problem" refers to the fact that by 2030, the first observed generation of hikikomori will turn 65, and their parents will likely have died. In 2017, the bodies of an elderly couple were found in their apartment, along with that of their 43-year-old son. His body showed signs of starvation.
However, other hikikomori support themselves, all while never leaving their apartments. This lifestyle is relatively new, partly because the internet makes it possible. Some hikikomori support themselves with remote work, like software development. Food can regularly delivered, or, if necessary, they can make late-night runs to nearby, 24-hour supermarkets when they're least likely to run into anybody. In addition, Amazon enables the delivery of basically any necessity.
Can they recover?
Fortunately, some hikikomori do recover. Because the condition is social in nature, much of the treatment is based on normalizing social interactions. Support groups for hikikomori exist as well as publications run by and produced by current or recovering hikikomori. Jogging therapy has been used before. Reportedly, some hikikomori have claimed that playing Pokémon Go — it requires players to walk around outside and use their smartphone cameras to capture virtual Pokémon — has significantly helped their social anxiety. In a more unusual treatment method, a Japanese media company released a series of videos of Japanese people simply staring at a camera, the idea being that hikikomori can slowly acclimatize themselves to social contact virtually and in the safety of their own home.
Although the disease originates in Japan, hikikomori can be found across the world. It's a kind of modern hermitism. And, just as in Japan, the global hikikomori community (admittedly an ironic term) has shown that this condition can be recovered from.
Scientists are using bioelectronic medicine to treat inflammatory diseases, an approach that capitalizes on the ancient "hardwiring" of the nervous system.
- Bioelectronic medicine is an emerging field that focuses on manipulating the nervous system to treat diseases.
- Clinical studies show that using electronic devices to stimulate the vagus nerve is effective at treating inflammatory diseases like rheumatoid arthritis.
- Although it's not yet approved by the US Food and Drug Administration, vagus nerve stimulation may also prove effective at treating other diseases like cancer, diabetes and depression.
The nervous system’s ancient reflexes<p>You accidentally place your hand on a hot stove. Almost instantaneously, your hand withdraws.</p><p>What triggered your hand to move? The answer is <em>not</em> that you consciously decided the stove was hot and you should move your hand. Rather, it was a reflex: Skin receptors on your hand sent nerve impulses to the spinal cord, which ultimately sent back motor neurons that caused your hand to move away. This all occurred before your "conscious brain" realized what happened.</p><p>Similarly, the nervous system has reflexes that protect individual cells in the body.</p><p>"The nervous system evolved because we need to respond to stimuli in the environment," said Dr. Tracey. "Neural signals don't come from the brain down first. Instead, when something happens in the environment, our peripheral nervous system senses it and sends a signal to the central nervous system, which comprises the brain and spinal cord. And then the nervous system responds to correct the problem."</p><p>So, what if scientists could "hack" into the nervous system, manipulating the electrical activity in the nervous system to control molecular processes and produce desirable outcomes? That's the chief goal of bioelectronic medicine.</p><p>"There are billions of neurons in the body that interact with almost every cell in the body, and at each of those nerve endings, molecular signals control molecular mechanisms that can be defined and mapped, and potentially put under control," Dr. Tracey said in a <a href="https://www.youtube.com/watch?v=AJH9KsMKi5M" target="_blank">TED Talk</a>.</p><p>"Many of these mechanisms are also involved in important diseases, like cancer, Alzheimer's, diabetes, hypertension and shock. It's very plausible that finding neural signals to control those mechanisms will hold promises for devices replacing some of today's medication for those diseases."</p><p>How can scientists hack the nervous system? For years, researchers in the field of bioelectronic medicine have zeroed in on the longest cranial nerve in the body: the vagus nerve.</p>
The vagus nerve<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYyOTM5OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NTIwNzk0NX0.UCy-3UNpomb3DQZMhyOw_SQG4ThwACXW_rMnc9mLAe8/img.jpg?width=1245&coordinates=0%2C0%2C0%2C0&height=700" id="09add" class="rm-shortcode" data-rm-shortcode-id="f38dbfbbfe470ad85a3b023dd5083557" data-rm-shortcode-name="rebelmouse-image" data-width="1245" data-height="700" />
Electrical signals, seen here in a synapse, travel along the vagus nerve to trigger an inflammatory response.
Credit: Adobe Stock via solvod<p>The vagus nerve ("vagus" meaning "wandering" in Latin) comprises two nerve branches that stretch from the brainstem down to the chest and abdomen, where nerve fibers connect to organs. Electrical signals constantly travel up and down the vagus nerve, facilitating communication between the brain and other parts of the body.</p><p>One aspect of this back-and-forth communication is inflammation. When the immune system detects injury or attack, it automatically triggers an inflammatory response, which helps heal injuries and fend off invaders. But when not deployed properly, inflammation can become excessive, exacerbating the original problem and potentially contributing to diseases.</p><p>In 2002, Dr. Tracey and his colleagues discovered that the nervous system plays a key role in monitoring and modifying inflammation. This occurs through a process called the <a href="https://www.nature.com/articles/nature01321" target="_blank" rel="noopener noreferrer">inflammatory reflex</a>. In simple terms, it works like this: When the nervous system detects inflammatory stimuli, it reflexively (and subconsciously) deploys electrical signals through the vagus nerve that trigger anti-inflammatory molecular processes.</p><p>In rodent experiments, Dr. Tracey and his colleagues observed that electrical signals traveling through the vagus nerve control TNF, a protein that, in excess, causes inflammation. These electrical signals travel through the vagus nerve to the spleen. There, electrical signals are converted to chemical signals, triggering a molecular process that ultimately makes TNF, which exacerbates conditions like rheumatoid arthritis.</p><p>The incredible chain reaction of the inflammatory reflex was observed by Dr. Tracey and his colleagues in greater detail through rodent experiments. When inflammatory stimuli are detected, the nervous system sends electrical signals that travel through the vagus nerve to the spleen. There, the electrical signals are converted to chemical signals, which trigger the spleen to create a white blood cell called a T cell, which then creates a neurotransmitter called acetylcholine. The acetylcholine interacts with macrophages, which are a specific type of white blood cell that creates TNF, a protein that, in excess, causes inflammation. At that point, the acetylcholine triggers the macrophages to stop overproducing TNF – or inflammation.</p><p>Experiments showed that when a specific part of the body is inflamed, specific fibers within the vagus nerve start firing. Dr. Tracey and his colleagues were able to map these relationships. More importantly, they were able to stimulate specific parts of the vagus nerve to "shut off" inflammation.</p><p>What's more, clinical trials show that vagus nerve stimulation not only "shuts off" inflammation, but also triggers the production of cells that promote healing.</p><p>"In animal experiments, we understand how this works," Dr. Tracey said. "And now we have clinical trials showing that the human response is what's predicted by the lab experiments. Many scientific thresholds have been crossed in the clinic and the lab. We're literally at the point of regulatory steps and stages, and then marketing and distribution before this idea takes off."<br></p>
The future of bioelectronic medicine<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYxMDYxMy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjQwOTExNH0.uBY1TnEs_kv9Dal7zmA_i9L7T0wnIuf9gGtdRXcNNxo/img.jpg?width=980" id="8b5b2" class="rm-shortcode" data-rm-shortcode-id="c005e615e5f23c2817483862354d2cc4" data-rm-shortcode-name="rebelmouse-image" data-width="2000" data-height="1125" />
Vagus nerve stimulation can already treat Crohn's disease and other inflammatory diseases. In the future, it may also be used to treat cancer, diabetes, and depression.
Credit: Adobe Stock via Maridav<p>Vagus nerve stimulation is currently awaiting approval by the US Food and Drug Administration, but so far, it's proven safe and effective in clinical trials on humans. Dr. Tracey said vagus nerve stimulation could become a common treatment for a wide range of diseases, including cancer, Alzheimer's, diabetes, hypertension, shock, depression and diabetes.</p><p>"To the extent that inflammation is the problem in the disease, then stopping inflammation or suppressing the inflammation with vagus nerve stimulation or bioelectronic approaches will be beneficial and therapeutic," he said.</p><p>Receiving vagus nerve stimulation would require having an electronic device, about the size of lima bean, surgically implanted in your neck during a 30-minute procedure. A couple of weeks later, you'd visit, say, your rheumatologist, who would activate the device and determine the right dosage. The stimulation would take a few minutes each day, and it'd likely be unnoticeable.</p><p>But the most revolutionary aspect of bioelectronic medicine, according to Dr. Tracey, is that approaches like vagus nerve stimulation wouldn't come with harmful and potentially deadly side effects, as many pharmaceutical drugs currently do.</p><p>"A device on a nerve is not going to have systemic side effects on the body like taking a steroid does," Dr. Tracey said. "It's a powerful concept that, frankly, scientists are quite accepting of—it's actually quite amazing. But the idea of adopting this into practice is going to take another 10 or 20 years, because it's hard for physicians, who've spent their lives writing prescriptions for pills or injections, that a computer chip can replace the drug."</p><p>But patients could also play a role in advancing bioelectronic medicine.</p><p>"There's a huge demand in this patient cohort for something better than they're taking now," Dr. Tracey said. "Patients don't want to take a drug with a black-box warning, costs $100,000 a year and works half the time."</p><p>Michael Dowling, president and CEO of Northwell Health, elaborated:</p><p>"Why would patients pursue a drug regimen when they could opt for a few electronic pulses? Is it possible that treatments like this, pulses through electronic devices, could replace some drugs in the coming years as preferred treatments? Tracey believes it is, and that is perhaps why the pharmaceutical industry closely follows his work."</p><p>Over the long term, bioelectronic approaches are unlikely to completely replace pharmaceutical drugs, but they could replace many, or at least be used as supplemental treatments.</p><p>Dr. Tracey is optimistic about the future of the field.</p><p>"It's going to spawn a huge new industry that will rival the pharmaceutical industry in the next 50 years," he said. "This is no longer just a startup industry. [...] It's going to be very interesting to see the explosive growth that's going to occur."</p>
The first rule of Vulture Club: stay out of Portugal.
So you're a vulture, riding the thermals that rise up over Iberia. Your way of life is ancient, ruled by needs and instincts that are way older than the human civilization that has overtaken the peninsula below, and the entire planet.
"The Expanse" is the best vision I've ever seen of a space-faring future that may be just a few generations away.
- Want three reasons why that headline is justified? Characters and acting, universe building, and science.
- For those who don't know, "The Expanse" is a series that's run on SyFy and Amazon Prime set about 200 years in the future in a mostly settled solar system with three waring factions: Earth, Mars, and Belters.
- No other show I know of manages to use real science so adeptly in the service of its story and its grand universe building.
Credit: "The Expanse" / Syfy<p>Now, I get it if you don't agree with me. I love "Star Trek" and I thought "Battlestar Galactica" (the new one) was amazing and I do adore "The Mandalorian". They are all fun and important and worth watching and thinking about. And maybe you love them more than anything else. But when you sum up the acting, the universe building, and the use of real science where it matters, I think nothing can beat "The Expanse". And with a <a href="https://www.rottentomatoes.com/tv/the_expanse" target="_blank">Rotten Tomato</a> average rating of 93%, I'm clearly not the only one who feels this way.</p><p>Best.</p><p>Show.</p><p>Ever. </p>
Contrary to what some might think, the brain is a very plastic organ.
As with many other physicians, recommending physical activity to patients was just a doctor chore for me – until a few years ago. That was because I myself was not very active.