Princesses and Anxiety at Home and School

Crown Princess Aiko Japanese Princess Aiko, 8, attended elementary school again March 8, the first time since she stopped going to school March 2 after complaining of being bullied by some boys at school. Princess Aiko is in the second grade at Gakushuin Primary School in Tokyo. Princess Aiko is the only child of Crown Prince Naruhito and Crown Princess Masako.

Princess Aiko has complained of an upset stomach and has showed deep anxiety since March 2.

The Imperial Household Agency said that Princess Aiko and several other students had been "treated harshly" by boys in another class. A school official said the incident may have been a misunderstanding.

Crown Princess Aiko attends Gakushuin Primary School Crown Princess Aiko with parents

 "She had decided to leave school, and just as she had returned from changing into her normal shoes from her school shoes, I hear it was two boys that approached very suddenly and nearly collided with her, which scared her," school director Motomasa Higashisono told reporters.

Crown Princess Masako accompanied Princess Aiko to the school to attend the fourth period of morning classes. They then left the school together.

Japan's Princess Masako, January 2010

The outing was a rare public appearance for Crown Princess Masako, 46, who was diagnosed with an adjustment disorder in July 2004. Her condition is attributed to the difficulties of adjusting to palace life and the pressure to bear a son. Crown Princess Masako hasn’t attended most official duties for several years.

Doctors monitoring the health of Crown Princess Masako said March 5 her condition has vastly improved but she needs more time to reach a level that will allow her to expand the scope of her official duties.

Princess Masako "has gotten better and is now in a state incomparable to" five and a half years ago when she started to receive treatment, the doctors said in a statement issued through the IHA.

"However, considering her long battle with the illness and the stress she has been under, it will take more time for her to expand the scope of her activities," the statement said, noting that she "has made surprisingly great efforts" to overcome the illness.

Japan's Princess Masako and husband Crown Prince Naruhito, January 2010

In the statement, the doctors noted that the support of people close to her, especially members of her family, has played a key role in helping her to recover. "Watching Princess Aiko growing up and her increasing exchanges with her friends is a joy as well as a remedy for the crown princess," it said.

The doctors mentioned the crown princess’ presence last year at events commemorating the 20th anniversary of Emperor Akihito’s ascension to the throne as well as at a ceremony last month to mark the 15th anniversary of the Great Hanshin Earthquake.

The visit to Kobe for the quake memorial ceremony was her first official trip outside Tokyo involving an overnight stay since January 2008.

The statement warned, however, that high expectations for more public appearances could hamper her recovery.

"Although expectations for her to perform more official duties are expected to grow as her recovery progresses, it is necessary to consider the workload that she would shoulder so that it would not impose a heavy burden," the doctors said.

Japan's Princess Masako, Crown Prince Naruhito, Aiko, and pet dog, official photo

Some medical experts outside of the imperial family are skeptical about the prospects for a full recovery being achieved quickly.

"Although the cause of her stress is not clearly shown in the report, I assume there may be a gap between the feelings of Crown Princess Masako, who is longing to live the way she wants to, and the Imperial Household Agency, which tends to put things in a mold," said Masaaki Noda, a professor at Kwansei Gakuin University. "It looks like her illness could last longer judging from the doctors’ opinions," he said.

(Above compiled from news reports)

Princess Masako’s condition could have an influence on her daughter. 

The reports about Princess Aiko’s experience at school seem to indicate nothing more than normal, temporary fears.

However, studies suggest that children or adolescents are more likely to have an anxiety disorder if they have a parent with anxiety disorder.

Japan's Princess Masako and husband Crown Prince Naruhito, January 2010The US National Mental Health Information Center says the studies do not prove whether the disorders are caused by biology, environment, or both. More data are needed to clarify whether anxiety disorders can be inherited.

Researchers suggest watching for signs of anxiety disorders when children are between the ages of 6 and 8. During this time, children generally grow less afraid of the dark and imaginary creatures and become more anxious about school performance and social relationships. An excessive amount of anxiety in children this age may be a warning sign for the development of anxiety disorders later in life.

Researchers are becoming increasingly aware that depression runs in families, according to WebMD The Magazine.

Experts say anxiety disorders displayed by children are often a precursor to depression.

“Depression is highly familial,” says Myrna Weissman, PhD, a professor of epidemiology and psychiatry at Columbia University. She began studying depression in families in 1982 and has now tracked three generations of family members with the disorder.

When a parent has depression, a child faces three times the risk of becoming depressed, compared to a child without a depressed parent, Weissman says. If the parent developed the mental illness before age 20, the child’s risk rises four- to fivefold.

“The sequence seems to be anxiety disorders, mostly phobias, before puberty. Then in adolescence you begin to see depression, and sometimes in late adolescence and early adulthood, especially in boys, you see substance abuse,” Weissman says. “If you have a child of a depressed parent and before puberty they start developing fears, that’s something to be cautious about.” While all small children have fears, those with anxiety disorders have unusually intense fears, experts say.

In a 2008 study published in The American Journal of Psychiatry, Weissman reports that when women were treated successfully for depression, their children’s psychiatric problems, such as anxiety and behavior disorders, also improved, compared to the offspring of women whose depression did not lift with treatment. The women who got better became more interested and involved with their children, Weissman says. “There’s a lot you can do about it,” she says of familial depression. “If you can get the mother better and you can also get the child better, that’s a big success.” She is now studying depressed fathers’ effects on their kids.

An article in esperanza magazine says researchers are giving extra attention to how mothers transfer anxiety disorders to their daughters.

“Parents in general, and mothers in particular, often have both anxiety and depression,” says Golda Ginsburg, PhD, a child psychologist at Johns Hopkins Children’s Center and associate professor at the Johns Hopkins School of Medicine.

Recent studies suggest that the transmission of depression and anxiety can be interrupted. One 2008 study, published in the American Journal of Psychiatry, found that children’s psychiatric symptoms decreased after their mothers were treated for depression.

additional sources Depression: When It’s All in the Family, By Katherine Kam, WebMD The Magazine; Like Mother, Like Daughter; American Academy of Child Adolescent Psychiatry Anxiety Disorders Resource Center photos Gakushuin Primary School (1); (2)

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