⚫︎Disrupted Lifestyle Habits Become the Gateway to Mental Illness
—What can we do in everyday life to prevent mental decline?
Kabasawa: I take pride in being probably the psychiatrist in Japan who talks the most about "improving lifestyle habits." Many mental illnesses arise from disrupted lifestyle habits. Genetic factors play a part too, I think, but what matters first is sleep, exercise, and a "morning walk." The morning walk also carries the meaning of living a regular, well-ordered life—not staying up late, going to bed at the same time and waking at the same time.
—That sounds difficult for modern people.
Kabasawa: These days there are so many temptations—unlimited video-streaming sites, games, social media—so young people in particular stay up until the middle of the night. When that kind of disrupted lifestyle is compounded by work stress and relationship problems, the combination leads to mental illness. Mental illness is said never to arise from a single cause; multiple causes are always intertwined. And among them, I believe the most important is lifestyle habits.
—Put the other way around, if your lifestyle habits are in order, you can withstand it.
Kabasawa: If you sleep properly and exercise, you can let even considerable stress roll off you. With good lifestyle habits, you can process the day's stress within the day. But people who sleep six hours or less can't clear away that day's fatigue. As the term "sleep debt" suggests, the fatigue keeps piling up until one day it explodes—sometimes as the onset of a mental illness, and sometimes manifesting in the body as a heart attack or stroke.
—Many people try to relieve stress with alcohol, though.
Kabasawa: Recent research has made it clear that alcohol actually "increases" stress. The nerves are temporarily excited, but afterward they crash and the brain's neural activity is impaired. When someone whose mind is already tired drinks to blow off steam, their condition worsens. For someone who feels unwell, the best thing is to go home early and sleep.
⚫︎Loneliness Corners the Mind — The Pitfall of Remote Work
—You also emphasize the impact of loneliness on mental health.
Kabasawa: When you look at people who develop mental illness, the overwhelming majority have no friends—or even if they do, they're poor at communication and can't confide in anyone. Just being able to say a single line to someone—"Work's been so busy lately, I'm worn out"—releases a great deal of stress. Simply having someone to turn to when you're in trouble reduces stress dramatically.
—Does remote work pose a risk in that regard?
Kabasawa: Remote work is quite bad for mental health. You don't meet people in person; you sit at home facing a computer in isolation. Since COVID, a great deal of data has emerged showing that remote work is bad for mental health. What's more, we now know that video meetings provide almost none of the "soothing" effect the human brain craves.
—What is different from meeting in person?
Kabasawa: A substance called oxytocin is involved. Oxytocin is secreted during communication that involves eye contact, but in a video call the position of the camera and the position of the eyes on the screen don't align, so your gazes never actually meet. Information can be conveyed, but the communicative effects of soothing and reassurance are almost entirely lost. Even bigger is the loss of small talk. Before COVID, casual chat arose naturally before and after meetings, but the moment work went remote, meetings began abruptly with the agenda. Many studies show that losing this small talk is very bad for mental health.
⚫︎Putting Things into Words Protects the Mind
—Within connection, you say that "putting things into words" is important.
Kabasawa: Putting things into words is extremely important. Many people won't even say "work is busy and it's tough." If they did, their manager could respond—"Let's cut back a little," or "I'll get you some support"—but unless they say it, no one even knows they're struggling. There's a culture in Japan that sees admitting weakness as shameful, but being able to say casually, "This is a bit hard for me—could you show me how?" becomes a great force for protecting the mind.
—But once mental health has declined, it becomes even harder to speak up.
Kabasawa: Exactly. That's why it's important to build, in ordinary times, "a relationship where you can talk about even trivial things." You can't expect someone to confide in a manager they never consult only when their mental health worsens. If you have a relationship where you can routinely mention small work troubles, you'll naturally be able to talk about mental issues too. If you suddenly start engaging with "You seem off—how are you doing?" without a relationship of trust, it ends with "I'm fine."
—How should one-on-one meetings be used?
Kabasawa: One-on-ones often don't work well when conducted by the person's direct supervisor. Without psychological safety, people can't tell the truth. If they say "I've been feeling off lately," they might be sent to the occupational physician and have their duties changed. Once they think that, they can't say anything. Rather, it's important to weave in everyday small talk, not just work topics. Even in a psychiatric consultation, it's in the middle of ordinary chat—"Anything fun happen lately?"—that the patient's mental state becomes visible through their expressions and reactions.
⚫︎The Daily Life That Lets You Stop Before the Cliff
Order your sleep, maintain your connections with others, and put your own condition into words. The preventive measures Dr. Kabasawa describes are nothing special—they lie within everyday life. That said, "a relationship where you can talk about trivial things" cannot be built overnight. The accumulation of ordinary days becomes the breakwater when the crisis comes. In the next and final installment, we ask about a methodology for actively building a rich inner life—the three happiness substances, and the positive feedback that transforms organizations.
Profile
Shion Kabasawa (Psychiatrist, Author, Film Critic)
Born in Sapporo in 1965. Graduated from the School of Medicine at Sapporo Medical University in 1991 and joined the university's Department of Neuropsychiatry. From 2004, he studied for three years at the psychiatry department of the University of Illinois in Chicago. After returning to Japan, he founded the Kabasawa Psychology Institute in Tokyo. Under the vision of "preventing mental illness through the dissemination of information," he shares knowledge of psychiatry, psychology, and neuroscience in accessible terms through internet media. With more than twenty years of communication experience, he has built a combined following of over one million across multiple online platforms, including his email newsletter, X, Facebook, YouTube, and Instagram. Known as "Japan's most prolific output psychiatrist," he has written 55 books (as of 2026), including The Power of Output and The Power of Input (Sanctuary Publishing), a series that has sold more than 2.7 million copies in total.
