May Disease (Gogatsubyo): Common causes and how to prevent and cope with it

Feeling down, stressed, or demotivated after Golden Week? You are not alone. Also known as “May disease” or the “May Blues,” gogatsubyou (五月病) describes a common phenomenon in Japan where feelings of fatigue, demotivation, and anxiety increase following the Golden Week period in May. Although gogatsubyou is not an official medical term, it describes a common set of symptoms that many students and employees feel during this time of year that result from the stress of coping with change and may lead to depression or adjustment disorders.

How Does May Disease Develop?

In Japan, April marks the beginning of the academic year for schools and the fiscal year for businesses. This means that during this time, many people are starting new schools and new jobs – changes that for many also entail moving to new cities, having to make new friends, and enduring significant changes in their personal and professional routines. 

Then, about a month into these new experiences, the long vacation period of Golden Week occurs, which stretches from the end of April to the beginning of May. Following a return from vacation, some students and professionals begin to show the symptoms of gogatsubyou like:

  • fatigue
  • lack of motivation
  • negative thinking patterns
  • poor sleep
  • changes in appetite 
  • disinterest in hobbies that once interested in you
  • feeling persistent anxiety and discomfort

What Causes May Disease?

Though there is no one set cause, physicians and mental health professionals in Japan often attribute the symptoms associated with May disease to the stresses of coping with major life changes. If you’ve started a new job, moved, transferred to a new department, or started a new school, you might be under increased pressure to keep up with the demands and responsibilities of your new environment. Your usual rhythm of life may be disturbed and may need to be altered to fit your new situation. In addition, after a month of working at your new job or being at your new school, you may worry that your new environment is not a good fit, or doubt your abilities if you are running into obstacles. 

While May disease is sometimes caused by the difficulties of adapting to change, it also fits into a broader seasonal pattern of mood disorders that researchers and healthcare providers have observed. In Japan, suicide rates usually peak in March-May. Reports of mania among those with bipolar disorder also tend to peak during spring, which some research suggests may be due to shifts in circadian rhythm caused by the increased light exposure of springtime.

Concerned about someone with suicidal thoughts or having suicidal thoughts yourself?

If someone you know is exhibiting warning signs for suicide, don’t be afraid to ask if he or she is depressed or thinking about suicide. Listen without judging and if possible, encourage them to seek professional help.

If you have suicidal thoughts, know that you are not alone. Also, know that help is available 24/7. Call your healthcare provider, go to the emergency room, or call a suicide prevention lifeline. Several are available in Japan, both in Japanese and in English. Lifelines are also available in the United States and the United Kingdom.

Don't Leave May Disease Unaddressed

Though experiencing these concerns is common when adapting to change, if left unaddressed, the symptoms of May Disease may develop into other conditions, such as depression or an adjustment disorder. 

Adjustment disorders refer to a set of conditions that occur when you develop an unhealthy or excessive response to change or stress that socially, emotionally, or professionally interferes with your life. Those with adjustment disorders may vary in what symptoms they experience. Some experience primarily depression-related symptoms or anxiety-related symptoms, while others develop symptoms that cause destructive behaviors or symptoms that combine all three types. 

Usually the symptoms or reaction occurs within three months of the stressful occurence or change. Adjustment disorders can happen to anybody at any age who is struggling to cope with stress and change. Adjustment disorders differ from depression in that adjustment disorders occur as the result of an outside stressor and often resolve once you begin to successfully adjust the change. 

As a result, it is important to treat the symptoms of gogatsubyou before they develop into depression or an adjustment disorder.

Preventing and Coping with May Disease

While dealing with the stress of the major life changes associated with gogatsubyou can be difficult, there are several strategies you can use to help prevent and cope with May disease.

  • Maintain a regular sleep schedule. Keeping a consistent and healthy sleep schedule can be very helpful in combating stressful life events and changes. Sleep deprivation or irregular sleeping schedules may leave you at heightened risk of feeling irritable, overwhelmed, anxious, or demotivated, which may make the symptoms of May disease worse. 
  • Find what helps you cope with stress. Whether it is keeping a diary, practicing meditation, working on a hobby, or exercising, find activities that help you process or manage your stress. Participate in activities that you enjoy, find fulfilling, and help keep you connected to yourself. 
  • Establish new routines. May disease can occur when we are uprooted from the familiar routines that help us navigate our day and environments. Be intentional about creating routines for your new situation – it may help you feel more grounded, reduce uncertainty, and make time for activities that help you cope with stress. 
  • Seek out support. Experiencing May disease is not uncommon – your coworkers, friends, or family members may understand what you are going through (or may be going through it themselves). Share your concerns with those you trust so they can be there for you if you need additional support. 

Though the tips above may give you a good start to preventing or coping with gogatsubyou, dealing with life changes and stress can be difficult. Should you need support, do not hesitate to book a counseling or psychotherapy appointment with us at Tokyo Mental Health. Working with a counselor or psychologist can help you develop stress management strategies and address the symptoms associated with May disease before it develops into a condition like depression or an adjustment disorder.