With Hideko Takayama and Deborah Hodgson in Tokyo

In 1997 Haruo resigned from the gas company and stayed in his bedroom for three years. "I closed the rain shutters and listened to music," he says. "I didn't know if it was day or night." Another recluse, a chatty 29-year-old, passed the national bus driver's exam three times but can't muster the courage to sit for an interview. "How," he frets, "should I explain the five-year gap in my resume?"

Both men, patients at a pioneering psychiatric hospital outside Tokyo, share a uniquely Japanese malady. Called hikikomori, or social withdrawal, the ill-defined but debilitating syndrome afflicts as many as 1.2 million young people--seven in 10 of them male. Symptoms include agoraphobia, paranoia, aversion to sunlight and severe anxiety; sufferers become antisocial in their teens or 20s and spend months or years holed up in their bedrooms. "They see themselves as ugly. They think they smell," says Tamaki Saito, who runs the outpatient program at SasakiHospital in Chiba. "They fear that they're being watched by neighbors, so they cover windows with curtains or black paper."

Hikikomori is a baffling public-health problem, one that has grown to epidemic proportions in Japan. Many Japanese associate the disorder with pathological teenage criminals--an impression etched by a string of headline murders perpetrated by juvenile loners since the mid-1990s. That view fans public hysteria and masks hikikomori's true breadth. Scholars first noticed the condition in the 1970s, and many now believe that victims have accrued largely untreated since then. Published in May, the Mental HealthCenter for Young People found that most victims are in their 20s and 30s, and that a significant number (nearly 8 percent) have been hiding away for more than a decade. And if experts debate most aspects of hikikomori, they agree on an essential point: it's getting worse.

Japan's teen troubles first appeared inside the classroom when truancy skyrocketed in the 1970s. Scholars rushed to explain the "school refusal" phenomenon. One of them, a prominent psychiatrist named Hiroshi Inamura, claimed to have discerned a mental disorder he called "apathy syndrome." In 1981 he began committing teen dropouts to mental hospitals. They were locked away, force-fed tranquilizers and isolated from their parents for weeks at a stretch--all to "cure" truancy. Criticism from colleagues and the media ultimately forced him to halt his treatments, but not before almost 5,000 teenagers had been institutionalized for skipping school.

Saito studied under Inamura and still draws on his mentor's work. He theorizes that hikikomori begins with adolescent trauma that causes the afflicted to "stop growing up." Takemi Matsuda, an activist who publishes a magazine for societal dropouts, agrees that hikikomori is a social phenomenon, not a specific mental-health disorder. He blames the problem on Japan's "efficiency first" value system, which promotes conformity among budding workers: students who stick out in any way--fat kids, smart kids, slow kids--are often punished violently. As Japan Inc. continues to decline, this system seems increasingly meaningless to many young Japanese. "People who suffer from hikikomori are at the top of a mountain," says Matsuda, "and that mountain is all of Japan's other problems."

Health officials recommend therapy and support groups like that at SasakiHospital, where Saito's patients attend twice-weekly "day care" sessions aimed at honing atrophied communication skills. They also undergo family counseling and psychotherapy. Saito's cure rate (defined by re-entry into society) is about 30 percent.

Those who seek treatment often arrive sullen, uncommunicative and sometimes even violent. A relative newcomer in his early 20s explains how he "punched holes in all the walls" at home, then adds: "I used to walk with my hands in my pockets in public so I wouldn't hurt people." Another describes himself as a "typical otaku [geek]." His only mates are fellow outpatients, and he figures he'll never have a girlfriend. "I like manga [comics] and computer games," he says. "I'm the kind of guy every girl loves to hate."

Chat rooms for hikikomori have begun to appear on the Internet, and Matsuda's magazine is full of letters. "I have been hikikomori for an entire year now, and I am unable to escape my despair," wrote a 29-year-old Tokyo man in a recent issue. "The house I live in will soon be taken away to pay debts, and when that happens I will be ruined." Another contributor wants a friend to share "trendy television dramas" with. A third, a 50-year-old teacher in Mie prefecture, invites parents of sufferers to form a support group in his living room.

Communication is essential, says Matsuda. "If they are put in a place where they can share their experiences and do not have to make excuses for how they feel, they will," he says. "But there is no medicine to help people make friends." Getting out may be the only cure for the blues.

From Newsweek, August 20, 2001 and © 2001 Newsweek, Inc.
All rights reserved. Reprinted by permission.