Hikikomori: How to identify and deal with the symptoms of extreme social withdrawal

Earlier this month, a research article published in the peer-reviewed journal  World Psychology  pointed out (again) that hikikomori, a form of severe social withdrawal, is not limited to Japan and is quickly taking root among the young population of the world today, turning people into recluses. In the article, Dr Takahiro A. Kato — a lecturer at the department of neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, and lead author of the study — wrote that the increasing prevalence of hikikomori across the world has led scientists to believe that it is no longer a cultural condition limited to Japan - cases have been reported from the US, Korea, Hong Kong and India along with Australia and some other countries in Asia and Europe. [caption id=“attachment_7793551” align=“alignleft” width=“380”]  Representational image. Image by Free-Photos from Pixabay.[/caption] Additionally, Dr Takahiro wrote, hikikomori may have several health implications. Hence, there was a need for new diagnostic criteria to identify it. The first step to dealing with hikikomori, of course, is to understand it. Read on to know what is hikikomori, and tips on how to prevent it from affecting you or your loved ones.

What is hikikomori

Hikikomori is an extreme form of social withdrawal where the person isolates themselves in their own home and completely avoids going out. The term hikikomori is used to define both the condition and the person who has it. It mainly affects young adults or those in the 20-27 age group. Though, it may occur in older adults too.   Doctors diagnose the severity of the condition depending on how often the person gets out of the house. Those who go out once, twice or three times a week are said to have severe, moderate or mild hikikomori. Those who go out over four or more days a week do not fall under the hikikomori criteria. The social withdrawal duration may last for three months to six months or more. People with this condition don’t really avoid social interactions, though they don’t really have many. And although anxiety and distress are usually associated with social withdrawal, those with hikikomori find themselves at peace with the isolation, at least in the beginning. After a while, the person starts to feel lonely and distressed. The condition usually affects men more than women, the male to female ratio is 4:1, and is more commonly seen in the oldest sons of families with a good socioeconomic status. Most people with this condition live with their families; people who live alone represent only 11% of cases. Hikikomori often overlaps and co-occurs with some other mental health disorders such as anxiety, depression and personality disorder.  

What causes hikikomori

Several factors are thought to be responsible for the growing prevalence of this condition. They include globalisation, increasing use of social media and developments in technology. As a result, unlike older times, children now spend more time indoors, glued to screens. They often lack the skills required for direct social interactions, which are, in a way important for forging better connections. A lot of socially withdrawn people don’t even talk to friends much on social media or have less demanding relationships.   Scientists have also found specific blood markers that are believed to be present in all people with hikikomori. Men who have this condition have lower uric acid levels and women have low high-density (HDL) cholesterol. How to help someone with hikikomori In his 2019 article, “Hikikomori : Multidimensional understanding, assessment, and future international perspectives”, Dr Takahiro had listed the following steps for the management of hikikomori:

• Family support: Since most people with hikikomori like to be alone at first, it is highly unlikely that they might seek support. So, if you see signs of the condition in your loved ones, it is important that you intervene. However, it won’t be easy and you will have to be patient. Some people, especially teens may be a bit aggressive if you try to bring them out of isolation. Teach yourself on what exactly the condition is, so you don’t confuse it with some other psychiatric disorder. Listen to the person without judgement and encourage them to take support from experts.
• Individual support: This includes support from doctors and other healthcare practitioners who can help the person deal with the condition.
• Assessment of triggers and therapy: This may include individual and/or group therapy.
• Animal therapy or using robotic pets

Read our section on   Types of Anxiety_, to know more about social anxiety and withdrawal._ Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.