When people become clinically depressed, it's not just they who suffer. Families of the depressed are deeply affected -- riding an emotional roller coaster -- and when a breadwinner is afflicted, as is often the case, financial struggles inevitably ensue. Worst of all, many families must live with the creeping fear that, any day, they might come home to find that their loved ones have hanged themselves or jumped to their death.

That's what Hiromi Tanaka has had to go through. Her husband became depressed due to stress from overwork seven years ago, while working as a systems engineer for a subsidiary of a major PC manufacturer. His deadline-driven job often required him to work all night and continue working the following day.

Then, one working day after New Year, he found himself incapable of getting out of bed. On his doctor's advice, Tanaka's husband stayed home and rested for three months, got better and returned to work. But then he fell ill again. He repeated the cycle twice more before he was nudged into resigning around three years ago.

Meanwhile, Tanaka, who has a teenage daughter, started juggling several part-time jobs to support the family. Feeling exasperated and isolated, she turned to the Internet for emotional support. But back then, there were no support groups for the families of the depressed, she said.

"There were some Web sites run by depression sufferers," Tanaka, 42, said. "I once posted a message [saying it's tough for family members as well], but I got a reply that basically said: 'You can't possibly understand what I'm going through.' "

Need for support

Families of the depressed have long been ignored here in Japan, where, until only recently, depression was regarded as a sign of weakness or laziness, rather than as an illness.

But a support network is slowly growing for the families of victims of depression. In 2002, public health nurse Ritsuko Yamaguchi founded MDA-Japan, modeled on the Mood Disorders Association of British Columbia, Canada, where she went through a one-year residency training in the mid-1990s. She now organizes several programs for depression patients and what she calls "caregivers" -- family members, friends and coworkers.

In these workshops, families can learn about the illness and how to cope with what sometimes looks like irrational behavior. They can also get updated on the latest treatments by leading depression experts, as well as getting tips on family finance. But more than anything, the families can share their pain and get advice on how to stay supportive to the troubled spouses, siblings and children while keeping themselves from becoming depressed.

During a recent workshop for depression patients' families, Yamaguchi briefed participants on the different feelings they can experience over time. Families' initial reactions to the discovery of the illness are panic and shock, which are followed by feelings of denial and anger, Yamaguchi says. They also blame themselves for the calamity -- and at the same time are troubled by sudden changes in the patients' character, from "caring husbands" and "great moms and wives" to melancholic, lethargic and negative-minded people. Then, in the next phase, the families begin to feel isolated and depressed themselves, and ultimately come to feel indifference, mental exhaustion and lethargy.

"Depression is an illness that, by nature, destroys human relationships," Yamaguchi told the crowd of 40 or so at the workshop. "Depression patients act nicely to outsiders, but they show their innermost feelings only to their family members. Especially in the recovery stage, the patients often turn violent and say harsh things. This is a step in their recovery, and the families need to handle them well and be especially supportive at that point. Otherwise, the patients will get hurt and won't be able to go out again."

Pachinko-playing sprees

Tanaka, for one, saw a light at the end of the tunnel in spring 2004, when she found a members-only online message board for the wives of men who are depressed. Along with the owner of the site, Tanaka set up a group of wives of depression patients, named Utsu-sapo Seikatsu Kojo Iinkai last August. With the help of a psychiatric social worker, they have been meeting once every two months since then.

During a recent session in Tokyo, wives talked about their husbands threatening a divorce, secretly reading books on how to commit suicide and frequenting consumer lenders for pachinko-playing sprees. Some also talked about bad experiences with doctors who, they said, ignored the needs of patients or would only see them for five minutes after a two-hour wait.

Families definitely need help in riding out the hard times, Yamaguchi says, adding that you should pamper yourself at times.

"When you are feeling down, treat yourself to something," Yamaguchi said. "Ditch your usual Ito-Yokdado store and go for a little more upscale retailer for your necklace. Choose Yebisu brand beer over your regular beer, a 500 yen-per-piece cake in a depa-chika [the basement food floor of department stores] instead of a 100 yen slice. . . . If you don't have that special something for yourself, you can't possibly hang on."