Smallscreen Reviews
Review: IFC presents 'Does Your Soul Have A Cold?'
By April MacIntyre
Oct 19, 2007, 17:30 GMT

Mike Mills' striking film, "Does Your Soul Have A Cold" is a fascinating glimpse of modern Tokyo and its younger inhabitants; it is a study of depression and how it is treated in modern Japan.

Taking notice of the American Pharmaceutical slogan, "Does Your Soul Have a Cold? (Kokoro no Kaze)," being advertised Japan, Mike Mills explores how the country deals with depression from the perspectives of Japanese people taking antidepressants.

A frequent visitor of Japan, Mills' quiet interviewing style and use of framing and tight editing takes you into the lives of five people taking antidepressants in Tokyo.  It is his meditation on the issues of globalism, pharmacology and Japanese social stigma and cultural shame towards mental illness of any stripe.

Mills commentary is understated, and his film is an unresolved examination of a very complex culture and society just coming to terms with admission and addressing of many mental illness afflictions.

Mills cites the quintupling of antidepressant sales in Japan from 1998 to 2003, Mills' documentary chronicles a nation still coming to terms with how depression is affecting its citizens and how American interests and influence are shaping this change.

The film was lensed beautifully and stops just short of laying blame on big U.S. Pharmaceuticals for the explosive growth of prescriptions with the Japanese populace in recent years.

Mills created a film that echoes a Japanese art aesthetic; it is a quiet, spare and pensive visual journey with five troubled young Japanese who live in cramped quarters and shades of grey, both literally and figuratively. 

Mills' subject's and their surroundings affected me as I watched and listened.

Mika is a medical supply courier.  She tells Mills for years her emptiness consumed her, and now takes daily vinegar and antidepressants to "fix" her deep depression.  Mika's mother's interview with Mills demonstrates an older generation of Japanese who lived with mental illness and mentally challenged family as virtual house arrest victims, hidden in shame.

Taketoshi is a 37 year-old "failure to launch" type.  Still living off his parents, he is depressed and feels he needs constant medical supervision.  He draws extensively and has never held a job.

Ken is a computer programmer that prefers his home environment - cramped, dirty and smoke filled - than with being out with other people.  He also appears in public in high heels and hot pants, yet hasn't had the courage to admit he is gay to his family.   Ken is full of shame and regularly visits a 'rope master" in a bondage exercise that hog-ties him up.  The effort makes him happy.

Kayoko harbors suicidal thoughts and is trying to maintain her weight, and find solace with her pet dog.  She is going through many different prescriptions to find the right combination to help her with her crushing depression.

Daisuke took to his bed for three weeks.  He takes an astounding combination of four different antidepressants daily to help.  He also drinks and smokes, and like the others lives a horribly cluttered life that has no organization.  His sole hobby seems to be smoking and growing cactus plants.

I shared my "Does Your Soul Have a Cold" screener with Michael Zielenziger, a research scholar at the Institute of International Studies, University of California - Berkeley who penned a fascinating book, "Shutting Out The Sun" LINK - his detailed account of the real people who make up modern Japan. 

Zielenziger has written extensively about social, economic and political trends in Japan, China, South Korea, India and Southeast Asia.

His book is a fascinating look at the intriguing Japanese culture.  He shared his initial impressions of the film with me.

"The film would probably have benefited from a deeper understanding of how 'primitive' by developed, (rich nation) standards, Japanese mental health really is."

Zielenziger continued. "Even today. Most of the advanced SRI drugs used in the West (like Prozac, for instance) were banned from Japan because Japanese would not accept efficacy tests done in foreign countries.

Partly this is a classic "trade" barrier question; partly this reaffirms Japanese beliefs that their anatomies differ significantly from those of Westerners. (Many Japanese still believe their "brains" or their "intestines" somehow differ from those of Westerners.)

In addition, mental health care has been a private industry, and mental patients warehoused. Most 'mental clinics' are private, profit making hospitals, where patients are encouraged to become resident...because this allows the clinics to make more money."

Zielenziger added: "Some real data also would have helped. Male suicide rates in Japan are the highest in the industrialized world, per capita with the US...and a 40 year old male is twice as likely to die by his own hands than in an auto accident.

The number of hospitalized mental patients in Japan is staggering, 3 times the world average. Female fertility rates in Japan are among the lowest in the world...another evidentiary point pointing to anomie and an unwillingness to 'connect' with others. Cross-national surveys do continue to show that young Japanese are the least-happy young people in the world."

I had an opportunity to interview filmmaker Mike Mills for this riveting film.

How did the subject of Japanese depression become your film project?

I have a lot of friends in Japan. On one trip I noticed a friend was taking antidepressants. I was surprised to see such a Western device, the pill, being adopted by this very different and much older culture.

It seemed like a new level of globalization, made more scary and impactful because this medicine attempts to effect the most mysterious and vulnerable parts of our innermost self - our sadness, our emotions.

I did some research and learned the story of the Glaxo and their 'does your soul have a cold' campaign and I felt like I had a story. I immediately new that I wanted to flop the usual strategy of newspaper reporting which relies on expert, expert, expert, and then one quote from a non-expert who is dealing with the issue - I decided to interview only people who were taking antidepressants and look at this big global issue in the smallest, most intimate and subjective way.

Japan reportedly has double the suicides than the US. Is your premise that the pharmaceutical companies marketing tactics are to blame for the increase in reported depression and subsequent prescriptions – or feel they have perhaps lifted the lid and educated the Japanese that there is no shame in diagnoses of depression?

It's not that Japan has double the suicides - Japan has about 33,000 suicides a year, which is roughly the same as US but we have twice the population. No one is to 'blame' for increases in reported depression, and yes there is no shame in a diagnosis of depression.

I believe that depression is a very real issue - very hard to describe, treat and understand, but totally real. It has been widely reported that since pharmaceutical companies began advertising and "educational" campaigns, there has been a huge rise in people discussing depression, writing about it in magazine and books, websites dedicated to depression and people visiting doctors because they think they have the symptoms they heard about. 

AD perscriptions from the year 2000 have shot up. It's not that these companies invented depression, it was already there, and most the people I interviewed would say that their campaigns were positive in that the outed something that was historically too taboo to talk about in the mainstream.

What is curious is that the people who are educating Japan about depression have a market interest in selling their medication. Glaxo has the biggest depression web-site called " Utsu.net" - if you google depression it's the first thing to come up. Two of the people I interviewed diagnosed themselves off of this site, the site lead them to doctors, the doctors perscribed Paxil (Glaxo's brand). But the website does not have any Glaxo logos or branding on it.

Japanese culture has sublimated suffering historically, often to the point of suicide for honor's sake.  Shouldn't they try a new approach to their mental illness and depression problems?

Is it our place to judge a whole culture like that? I think the most Japanese people I talked to are very concerned and even ashamed about the suicide rate. I'm sure they'd love to change their approach, especially the people who feel so lost that they do commit suicide - but maybe it's not that easy to try a new approach.

Your five subjects were deeply depressed and took copious amounts of pills, even drinking with it.  They seemed to have layers of heavy psychological issues they were grappling with.  Most people assume depression is a normal, transitory human condition, but your five subjects, three in particular, seemed really far gone - even on the medications.  Did they feel better that they were actually on the pills, versus regular talk therapy?

I don't agree with your generalization. I think Ken, Taketoshi, Mika are people who were depressed (Taketoshi very depressed) and have found a more stable place. So that's three of my subjects and they are not very different than a lot of people I know. I agree they take a lot of pills, that is part of Japanese culture, they rely heavily on medication for all illness. Kayoko and Daisuke, were deeper in a depressive state when we interviewed them.

Daisuke in particular, took a scary amount of pills and drank a lot and seemed to have the least support. But they would all answer your question differently about the effect of the pills. I feel like your questions are asking me to state my thesis and give you generalized answers for the whole group, but my film approach is not thesis based, nor is it interested in answers or conclusions. It's is a more observational and subjective approach that is not interested in resolution.

How big was your crew for this shoot?

I was shooting and interviewing, we had translator, two person sound crew, Jim Fronah and DJ Harder would trade off the other camera, 1 producer, 2 production assistants. We didn't use lights, we traveled on the subway.

Your artistic background shows in your spare cinematography and shot framing.  Was this intentional to emphasize the overall Japanese aesthetic?

I think this is just part of my aesthetic. I was not trying to be 'Japanese' because I was shooting in Japan.  That said, the films of Ozu have had a huge impact on me for many years, so maybe I've been influenced by a Japanese sensibility long before this project began.

Japan has the highest suicide rate and lowest birthrate of all industrialized countries and a rising incidence of untreated cases of depression. Even more troubling are the more than one million young men who shut themselves in their rooms, called "hikikomori", withdrawing from society, and the growing numbers of "parasite singles," the name given to single women who refuse to leave home, marry, or bear children.  Do you feel depression really truly is their modern day "plague?"

Again, I'm not really interested in these bigger questions, nor do I think I am such a Japanese depression aficionado that my answer would mean very much. I was very interested that Taketoshi thought of depression as the new plague (not just in Japan, but in the world). 

When he's talking about that, you get a palpable sense of how much he's thought about depression, that he's not just a victim of it, that he's very alive while he has these problems. This film is really interested in how these people think, their struggles, what the world is like inside their heads.

What were some of the challenges you faced with doing a documentary as opposed to your narrative feature, 'Thumbsucker"?

Well, talking to people about their depression can be depressing. It was heavier, but that's partly why I wanted to do it.

The classic definition of a documentary is that it is a factual movie or TV program- - presenting facts and information, especially about a political, historical, or social issue.  What facts or perspective were you aiming for in making this documentary?

Again, I don't really believe in the idea of solid facts. To me everything is subjective, all meaning is culturally/historically contingent. And the idea that film can be objective is a delusion. I don't believe in cinema verite, or the ideas of "direct cinema".

I do believe in intimacy between the filmmaker and the person being filmed, and believe that intimacy can be felt by the audience. I believe that sharing these unexplained experiences can engender empathy, sympathy and greater understanding.

I am trying to make a portrait of 5 different people at a certain moment in time. I'm trying to show how they live, what they think, what they feel. The rest is up to the viewer.

Despite the open-endedness of the subject matter for a "documentary" -"Does Your Soul Have A Cold" is Highly Recommended

"Does Your Soul Have A Cold" premieres October 22 at 9 PM ET/ 10 PM PT on IFC - The Independent Film Channel.