Ethan Watter Crazy Like Us

It is true that in today’s world, it can be difficult to say exactly what a health system is as a singular definition. In the twenty first century the marketing industry, mainly Pharmaceutical companies help define what health and illness are to each separate country or society. Depending on the country, culture, religious values, traditions, economic status, or influence from the pharmaceutical companies the definition of health and illness varies. In 2005 the World Heath Organization survey showed seven out of ten Americans died because of chronic illnesses, while three years earlier the Japanese mortality rate for chronic disease was at eighty percent. Countries like Japan and the United States, have different ways of defining health and illness . This directly relates to the written work by Ethan Watter titled Crazy Like Us, in which Watters discusses the “most devastating consequence” of bringing the American culture to the rest of the country. In the excerpt “The Mega-Marketing of Depression in Japan” Watters discusses the effects of the spread of American

health beliefs and how they differed from the Japanese’s health system. In it he describes how each culture has particular expressions, descriptions, and understandings for each behavior response to mental health. This book aims to demonstrate how, regrettably, over the last twenty years or so, typically American conceptions of mental illness have been exported successfully to the rest of the world. In the final chapter he talks about the effects of the Americans in Japan. It details the successful efforts of GlaxoSmithKline, the producers of Paxil, to introduce new conceptions of sadness and depression to Japan.
Watters also discusses the traits self awareness of health and illness based on cultural beliefs. He mentions the importance of knowing each culture’s beliefs directly relating to it’s influence over the people. He clarifies the statement made by a GlaxoSmithKline representative by stating “In other words, cultural beliefs about depression and the self are malleable and responsive to that can be exported from one culture to another.” Each person’s response to an illness differentiates according to their cultural practices. In Watters text he retells how an academic named Kirmayer
“… told the assembled scholars and drug company representatives of how a Nigerian man might experience a culturally distinct form of depression by describing a peppery feeling in his head. A rural chinese farmer might speak only of shoulder or stomach aches. A man in India might talk of semen loss or a sinking heart or feeling hot. A korean might tell you of ‘fire illness,’ which is experienced as a burning in the gut… an American Indian might describe the experience of depression as something akin to loneliness. (Watters, 517)”
Thus proving the hypothesis that depression is not the exact same feeling for everyone. Assuming illness, especially mental illness is felt similarly, therefore treated similarly is shortsighted. This stems from Examples of this can be found in countries like America and Japan. Though the size and populations are different, there are similarities in the economy.
Health in the United States is quite overstated. Countless organizations, businesses, laws, and even departments within the government are dedicated to the cause of illness prevention and treatment. American health is defined as being of sound mind, physically fit, having a steady income, and participation in social activities. Being of sound mind is best described as not having any mental disabilities or handicaps. For some mental illnesses there are treatments and medicines that remove or suppress the abnormalities pertaining to the illness. In this way illness is not only physical but also mental. A recent WaPo article states
“half a world away from the U.S. health-care debate, Japan has a system that costs half as much and often achieves better medical outcomes than its American counterpart. It does so by banning insurance company profits, limiting doctor fees and accepting shortcomings in care that many well-insured Americans would find intolerable.”
Health in America is extremely superficial.

The tan toned physique is preferred to someone who has a healthy diet and flabby muscles. Another form of American health is having a steady income from a respectable job. Another idea of health in America is the involvement in social activities. This is similar to the concept of mental health in that it is socially unacceptable or seen as strange when people are not social. American advertisements about healing drugs is different from any other country. There are commercial, advertisement, and all other types of media surrounding health and curing illnesses. In this way Americans are accustomed to self diagnosis, which leads to a spike in sales for the pharmaceutical companies. Americans also have to register for healthcare. In the past, healthcare was not the government’s job to provide. Thankfully, Obamacare helps those that are in need of medical

attention.
Health in foreign countries such as Japan are very different in their belief of health except for in economical health. The concept of hazukashii or shame, is associated with all aspects of Japanese life including family, business and especially health. An article on healthcare beliefs of the Japanese by Lynn Blanch of Demand Media says
“[Japanese] importance is placed on achieving success and maintaining health and close family ties. Poor health can be a very shameful experience for the Japanese and great care is taken to approach a patient and the patient's family about illness in a blameless, indirect way. For example, the concept of shikata ga nai which means ‘it cannot be helped’ is often used to explain a case of terminal illness.”
It is clear there is stigma of physical illness in the Japanese culture. Japan also has mandatory healthcare for each of its citizens. They are required by law to have healthcare that is provided by the state. Although this costs more money Japan insures that each of its citizens are covered when it comes to health and illness. Watters details the way in which pharmaceutical giant GlaxoSmithKline literally set out to market antidepressants to the Japanese. Japan is one of the most highly populated countries on the planet so naturally the pharmaceutical companies took advantage of the situation. Kirmayer observed GlaxoSmithKline’s method of marketing
“ It was very explicit. What I was witnessing was a multinational pharmaceutical corporation working hard to redefine narratives about mental health. (Watters, 519)”
Before GlaxoSmithKline. there was virtually no depression in Japan. Japan has had for a long time now a diagnosis of what is translated as endogenous depression but that was considered extremely severe and a rather rare mental illness. They were much more concerned about dealing with the severely mentally ill patients. Though there are many different means to the words health and illness, it is agreed upon for the most part that health is preferred to illness. Universally health is the opposite of illness.