Psychiatrists weigh in on Princess Masako's health

January 30, 2013

THE ASAHI SHIMBUN

Although her public appearances have dwindled in number, Crown Princess Masako has consistently smiled for the cameras and waved to the crowds. But the princess’ emotional state in her private life remains largely a mystery--and has increasingly become the subject of speculation.

Since her elaborate wedding in 1993, Masako, 49, has spent nearly half of her married life undergoing treatment for what her doctors call a stress-induced “adjustment disorder.”

The Imperial Household Agency has released statements by Masako’s team of doctors about her condition each year around Dec. 9, her birthday. They said in previous statements that “she is steadily recovering” but “her conditions remain unstable.”

Last year’s statement, however, offered little information about her health.

The Asahi Shimbun asked Yutaka Ono, director at the National Center for Cognitive Behavior Therapy and Research, who heads the princess’ medical team, about Masako’s illness and recovery plans.

But Ono declined to comment, saying it would affect her treatment.

Some outside specialists are questioning the team’s diagnosis and treatment because the princess remains in a state of recovery and appears no closer to resuming her official duties.

“It would be misleading to call her illness an adjustment disorder, given that she has remained under treatment for years,” Akira Iwanami, a professor of psychiatry at the Showa University School of Medicine, said. “It would be natural to suspect depression.”

Rika Kayama, a psychiatrist and professor at Rikkyo University, said, “The diagnosis usually comes under a different name when one’s illness becomes chronic due to friction within a given environment, especially when one is not in good health both physically and psychologically.”

But another psychiatrist defended the diagnosis of Masako’s doctors, saying, “Some serious adjustment disorders can cause severe symptoms, while anxiety and depression may become chronic.”

Others preferred not to even touch on the sensitive topic, citing the paucity of information provided in the official statements.

“It is impossible to understand what condition she is in and what kind of treatment she will be receiving,” another psychiatrist said.

The princess in December 2003 took a rest from her official duties to recover from a case of shingles.

In July 2004, the Imperial Household Agency announced that Masako was suffering an adjustment disorder caused by stress from the “hardship of assuming a weighty responsibility as a crown princess” and a “hectic life in which there is no distinction between private and public activities.”

The princess had been under enormous pressure to give birth to an heir to the throne, and discussions were being held for possible legal revisions to allow a female emperor.

According to the Imperial Household Agency, Masako made only about 30 outings in Tokyo in 2012, mostly for official duties.

Her only official public appearances that year were attending a court music concert at the National Theater in Tokyo’s Chiyoda Ward and celebrating Emperor Akihito's 79th birthday at the Imperial Palace.

Before her treatment started, Masako made several official visits outside of Tokyo. 2012 was the first time in eight years for the princess not to travel outside the capital.

During a rare public appearance on Jan. 2 at the Imperial Palace, Masako showed up on the balcony with her husband, Crown Prince Naruhito, and other imperial family members five times to receive New Year’s greetings from well-wishers. She smiled and waved to the crowd.

Masako and Naruhito will celebrate their 20th wedding anniversary in June.

As for her treatment, doctors said in a previous statement: “It is most important to reduce the stressors by working on her environment.”

They said they will continue to provide counseling and medication so Masako can resume her official duties. They also told her to expand her scope of activities from “life’s work” and beyond “private activities.”

Last autumn, one of Masako’s private activities was attending a Halloween party held at a relative’s house in Tokyo.

Naruhito, Masako and their daughter, Aiko, went incognito and spent a few hours there. Masako appeared to be having fun, sources said.

According to a source close to the Imperial Household Agency, Masako carefully decides which official events to attend and which ones to skip. She has had to make last-minute changes on her decisions.

“Princess Masako is overeager. I hope she will relax more,” said another person related to the agency.

Kyoji Komachi, grand master of the Crown Prince’s Household, said: “The crown princess is getting better. I hope people will take a long view and watch her warmly.”

(This article was written by Yasuhiko Shima and Ryuichi Kitano.)

THE ASAHI SHIMBUN
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Crown Prince Naruhito and Crown Princess Masako pose for a photo at the Crown Prince's Residence on Dec. 3. (Provided by the Imperial Household Agency)

Crown Prince Naruhito and Crown Princess Masako pose for a photo at the Crown Prince's Residence on Dec. 3. (Provided by the Imperial Household Agency)

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  • Crown Prince Naruhito and Crown Princess Masako pose for a photo at the Crown Prince's Residence on Dec. 3. (Provided by the Imperial Household Agency)
  • Emperor Akihito, Empress Michiko, Crown Prince Naruhito and Crown Princess Masako arrive on the Imperial Palace veranda Jan. 2 to receive New Year's greetings from the public. (Jun Ueda)
  • Crown Princess Masako holds her newborn daughter, Aiko, in December 2001. (Pool)
  • Bride Masako Owada and groom Crown Prince Naruhito on their wedding day on June 9, 1993. (Asahi Shimbun file photo)

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