Ryuta Idogawa traces the onset of his battle with mental illness to a moment not long after his parents had been relocated to Saitama from their hometown of Futaba, Fukushima Prefecture, in the spring of 2011.

Idogawa recalls with almost claustrophobic clarity how, as he boarded a train to travel to Tokyo, a sense of panic set in when the carriage walls seemed to close in and fellow passengers in the rush-hour squash started to stare — piercing, even accusatory stares, he thought.

“I was sweating, but I felt really cold and my heart was racing, faster and faster,” says Idogawa, 33. “I could hardly breathe. I thought, ‘Oh My God! I’m going to die.'”

Today, Idogawa continues to suffer from such panic attacks, although their frequency has decreased. To mitigate the problem, he has found a job near to his apartment and avoids trains whenever possible. On occasions when rail travel is unavoidable, he steers clear of express trains, as there are fewer opportunities to “escape” should panic set in, he explains. Medication, too, has sometimes helped.

One likely cause of this continuing condition, he believes, is guilt — guilt that in the aftermath of the March 11, 2011, disasters that struck northeastern Japan and claimed 18,455 lives (including 2,561 still listed as missing), he was powerless to prevent the accident that occurred at his place of work, the Fukushima No. 1 nuclear power plant.

“At the beginning I wasn’t even aware of my condition, or I felt somehow separate from it and from what was happening,” says Idogawa, a former employee at plant operator Tokyo Electric Power Co. “Looking back, maybe I was hiding it or hiding from it.”

Such mental afflictions are not unusual among Tepco’s Fukushima plant workers, especially in the aftermath of the disasters, experts say. According to a study of some 1,500 workers compiled by Jun Shigemura and others, all had experienced a variety of stressors (see table below) relating to their direct experiences of the disasters, losses of loved ones and the backlash from a disgruntled public, in particular the 160,000 Fukushima residents who were evacuated due to the contamination of their homes and land that resulted from the multiple reactor meltdowns at Fukushima No. 1.

According to lead researcher Shigemura, 29.5 percent of workers at the plant subsequently displayed symptoms of high post-traumatic stress responses (PTSR), including flashbacks and avoidance of reminders of the terrifying events they went through.

Around 1 in 5 Tepco workers at neighboring Fukushima No. 2 plant also showed similarly high levels of PSTR, even though there was no serious damage to the four reactors there.

Jun Shigemura, an associate professor at the National Defense Medical College’s department of psychiatry, sits at his office in Tokorozawa, Saitama Prefecture, on Aug. 15. | ROB GILHOOLY

Continued surveys of the workers by Shigemura, an associate professor at the National Defense Medical University’s Department of Psychiatry, and other experts say that while the overall influence of disaster-related experiences on PTSR of workers had decreased since 2011, it remains high.

“For some workers, this is going to continue for a long time, probably years and decades,” says Shigemura, who specializes in the mental health of disaster workers.

This is consistent with previous findings following the Chernobyl nuclear accident in 1986, he says. While scientists then had assumed that cancers and other malignant disorders would be the biggest health risk, mental health issues turned out to be far more prevalent, he says.

Indeed, studies have shown that mental health problems, including post-traumatic stress disorder (PTSD), depression and suicide ideation, were still high and remained the most prevalent problem for the Chernobyl cleanup workers even 20 years after the disaster, Shigemura says. “So I think we can say with some confidence that the Fukushima workers also carry a very high risk of developing long-term mental health issues.”

Furthermore, while PTSD is often thought of as the main persisting illness in such disasters, Shigemura says factors such as depression, anxiety and alcohol abuse are also likely to linger for some time.

More than 6½ years on from the Fukushima disasters, former Tepco employee Idogawa knows all about these problems, although how he got there was a gradual, but nonetheless alarming, process.

A graduate of Toden Gakuen, Tepco’s now-defunct training academy, Idogawa had lived and breathed the utility’s doctrine since he was just 15 years old. It centered as much around technical excellence as it did corporate group identity and loyalty, and those who followed it were rewarded with the kind of mouthwatering salaries that placed them very much among the elite of their communities.

Ryuta Idogawa believes that guilt over the nuclear accident that occurred at the Fukushima No. 1 power plant on March 11, 2011, has been a contributor to his continuing struggles with mental illness. | ROB GILHOOLY

On the day of the disasters, Idogawa was on leave, having worked a night shift the previous day. Even before the Earth’s violent convulsions had subsided, however, he was heading toward the plant from his nearby home, arriving there just before the black waves of the 15-meter mega-tsunami engulfed the facility.

As one of the plant’s operators, his day-to-day duties took place inside the central control room for reactors 1 and 2, where he was charged with scrutinizing the instruments that monitored the plant’s oldest reactor, the outmoded unit 1. By the time he joined the on-duty team of 14 operators, the tsunami had extinguished all available power sources, plunging the control room into complete darkness and disarray.

With monitoring apparatus also dependent on power, there was no way of knowing for certain if coolants were still reaching the reactor cores. Believing that this was unlikely, by midnight Idogawa calculated that the first reactor, and probably the second, were already in meltdown.

This was supported by readings on portable monitoring devices that showed radiation levels inside the control room were climbing. Idogawa joined all the other operators on the reactor 2 side of the windowless room, only venturing over toward the opposite first reactor side, where radiation levels were considerably higher, to make occasional, but futile, checks of the lifeless instruments.

Over the next two days, he remained inside the control room, still in the dark about the safety of his family and friends as meltdowns and explosions began to take their toll.

On March 14, he was ordered aboard a company bus bound for the Fukushima No. 2 nuclear power plant, which had fared far better than its older neighbor and had been designated an off-duty recuperation and medical center for workers at Fukushima No. 1. It was during that 10-kilometer journey that his focus slowly shifted to the outside world, which had a distinctly fishbowl appearance through his full-face mask.

“At one point, just past the entrance to Fukushima No. 1 plant, I looked out of the window and saw a man walking his dog like it was just another ordinary day,” Idogawa says. The scene seemed all the more bizarre because while most workers aboard the bus were wearing masks, the man went about his morning stroll completely unprotected. “I wondered, ‘What is he doing out there’ and wanted to shout out to him to get inside away from the high radiation.”

At the Fukushima No. 2 plant there was a noticeably subdued air. There was little food, no cigarettes and no heat to stay warm amid the snowy, wintery cold.

Idogawa had originally tried to make the trip to the Fukushima No. 2 plant via his own car, which was parked near the newly built quake-proof center at Fukushima No. 1 and was highly contaminated, but he couldn’t get it started.

“I wanted to take the car to give me an escape should things get worse. That’s what I was expecting,” he says. “I actually think that’s what (plant chief Masao) Yoshida was thinking, too — that everyone, himself included, should get out of there and go to the Fukushima No. 2 plant.”

Over the following months, the cumulation of these events began to take their toll. Idogawa became part of a team that the foreign media nicknamed the “Fukushima 50,” groups of workers on rotating shifts that split their time between battling the reactor meltdowns and recuperating at the Fukushima No. 2 plant, or at residences to which they had been evacuated.

With his home now off limits inside the 20-kilometer no-go zone, Idogawa had evacuated to an apartment in Koriyama, where time proved to be anything but a healer. With nothing to do but await his next shift, his mind wandered, among other things, to the man walking his dog and the tens of thousands of residents like him who had been forced to flee their homes as invisible radioactive substances fell on their land.

He began to suffer stomach cramps, chronic insomnia and depression, and turned to the only thing he could think of that would help him sleep and wash away the unwelcome images in his head: whisky — and lots of it.

“I felt bad for those people, like it was my fault,” he says. “I couldn’t do anything (to prevent the accident) and as a member of Tepco, I thought I was to blame.”

Takeshi Tanigawa, a professor of public health at Jutendo University’s graduate school of medicine, has been involved in mental health surveys of Fukushima plant workers. | ROB GILHOOLY

Such self-criticism and guilt have been major contributors to enduring mental illnesses among plant workers, according to Takeshi Tanigawa, a professor of public health at Jutendo University’s graduate school of medicine, who has also been involved in the mental health surveys of Fukushima plant workers.

Another factor was the continuing bashing at the hands of residents, Tanigawa says, adding that the tension reflected a tendency in Japan to associate people, both CEOs and their foot soldiers alike, with the company they work for, making them collectively the perpetrators of the accident in the public’s eyes.

“We found that those who have experienced such criticism and discrimination have a high degree of psychological distress or PTSR, more than two times higher than control subjects,” he says, adding that with 80 percent of workers being local hires, the bashing, sometimes at the hands of friends and relatives, was even more difficult to take.

Of all the stressors — including the life-threatening experiences, the loss of loved ones and possessions, and so on — this was the “most influential” among those workers with persisting mental health issues, says Tanigawa, who also has worked as a part-time occupational physician at the nuclear plants in Fukushima Prefecture since 1991.

“One thing we can be grateful for is that nobody has committed suicide at the plant,” Tanigawa says. “However, alcohol abuse, increased smoking and obesity are prevalent, and can lead to life-threatening diseases and early mortality.”

However, both Tanigawa and Shigemura believe that the enduring impact of the various “complex stressors” is the main reason why other contract workers and early respondents to the disasters will not display similar long-term mental health problems. This includes personnel from Tepco’s various subcontracting companies and members of Tokyo Fire Department’s Hyper Rescue brigade, who entered the plant on March 17, 2011, in an attempt to pump water onto the overheating reactor 3.

Yukio Takayama, former deputy superintendent and chief of the 8th district Hyper Rescue battalion, revisits his former workplace in Tachikawa on July 13. | ROB GILHOOLY

One of the leaders of that Tokyo Fire Department team, Yukio Takayama, who was at the time deputy superintendent of the 8th district Hyper Rescue battalion based in the city of Tachikawa, says a number of firefighters had been deeply affected by the thought of entering such a highly irradiated part of the plant, which offered an invisible fear factor quite different from that to which they were accustomed.

Indeed, Takayama fell sick during the operations and while they left an indelible impression, the 48-hour encounter with the radiation-spewing plant was unlikely to leave any long-term mental scars, he says. “It was stressful, but there were others who were up there for much, much longer,” he says.

A former subcontractor employee, who was working at the Fukushima No. 1 plant at the time of the 2011 disasters, says he had not heard of any mental health issues among subcontractor workers. However, as they made up almost 90 percent of the total plant workforce, he couldn’t discount the possibility.

“One thing that was different for us was that we were never forced, or obliged, to return to the plant,” the worker says in an interview, speaking on condition of anonymity. “Like many others, I evacuated from the plant and never went back, but if I had, I suppose it’s perfectly possible I may have succumbed to mental illness.”

One other group that reportedly has been afflicted by mental health problems comes from an unusual quarter, and one that has not been a factor in previous nuclear accidents. American sailors who were taking part in the U.S. military’s “Operation Tomodachi” relief mission at the time of the Tohoku disasters were inadvertently exposed to a plume of radiation that passed over their ships, which were anchored off the Pacific coast north of Fukushima.

Several hundred have since developed life-changing illnesses, including leukemia and other cancers — a result, they claim, of the radioactive plume. Many have also suffered persisting mental health issues, either due to concerns of physical illnesses that have resulted from the exposure or extreme stress brought about by concerns for potential future illnesses, including cancers.

Sailors aboard the aircraft carrier USS Ronald Reagan scrub the flight deck to decontaminate it while the ship is operating off the coast of Japan providing humanitarian assistance on March 23, 2011. | NICHOLAS A. GROESCH / U.S. NAVY

“Unlike the nuclear plant workers, these sailors had no protective clothing. In fact, some of them literally had no shirts on their backs because they had given all their clothing away to people they saved from the tsunami waves,” says Charles Bonner, a lawyer representing some 400 sailors who have filed a lawsuit against Tepco and U.S. nuclear reactor manufacturer General Electric. “And because they had given away all their bottled water to tsunami survivors, they were drinking desalinated water that had also been contaminated. I do not doubt the psychological impact of the disasters on the plant workers, but at least they had masks and other protective clothing, as required by law. The sailors, however, knew nothing of their exposure and were literally marinated in the radiation.”

Idogawa’s exposure levels were also in excess of acceptable levels by the time he quit Tepco in January 2012 to protest the utility’s poor treatment of workers — who were, in most cases, also victims — and the government’s announcement the previous month that the plant had been brought “under control,” which was completely at odds with what he saw.

“Whether you take the viewpoint of a Tepco employee or a local resident, the outcome was far from satisfactory,” Idogawa says. “As a plant operator we caused a huge accident — the worst kind. Technicians train over and over, and are charged with ensuring this kind of thing doesn’t happen. That the accident did happen makes us the lowest of the low. From the viewpoint of a resident, the disaster meant they couldn’t go home. That we destroyed entire communities was bad enough. However, they were our communities as well.”

Despite his disgruntlement, Idogawa is hopeful that his former employer will implement measures to monitor and treat mental health issues that he believes continue to persist among many workers.

When asked to comment on post-accident care of its workers for this article, Tepco says it was unable to provide details due to privacy issues. It did, however, continue to hand out “health check” questionnaires, the nationalized utility says. The utility also would not comment on its policy regarding on-site care, which came into question following rumors that an on-site psychiatrist fled the Fukushima No. 1 plant following the 2011 disasters.

An employee from Tepco apologizes to a Tomioka resident during a meeting in the city of Koriyama, Fukushima Prefecture, on Feb. 11, 2013. | ROB GILHOOLY

Shigemura, whose surveys and subsequent treatment of plant workers was brought to an abrupt halt by Tepco in 2015, believes continued “surveillance” of workers is imperative. One reason is due to the possibility of “delayed onset” mental illnesses, which sometimes occur among “survivors” following a variety of situations, from disasters and conflicts to car accidents and familial loss. Some Vietnam War veterans, for example, only developed mental illnesses following the start of the Gulf War 20 years later, he explains.

During his research, Shigemura came across one plant worker, who was also an evacuee, who had experienced such a phenomenon. Three years later, after the evacuation order had been lifted, he re-visited his hometown, which was overgrown and deserted.

“When he evacuated, he hadn’t fully accepted the burden of the disaster,” Shigemura says. “It was only when he returned home that he felt the gravity of the disaster and was forced to confront it. And that’s when he experienced late-onset PTSD.”

Shigemura also believes there is a need for a major reconsideration of disaster management measures, especially those that can mitigate the psychological havoc a nuclear accident can wreak.

“We need multiple layers of support in preparation for these disasters because when they happen people tend to act in ways they might not usually act, especially following a disaster you cannot easily perceive, such as a nuclear accident,” he said. “They might run away and you can’t blame them for that, because they also have roles as fathers, mothers and so on. There needs to be measures to respond effectively to such eventualities and to provide effective care for those most affected.”

Fukushima plant worker stressors

Work-related experience

Earthquakes and tsunami

Plant explosions

Radiation exposure

Extreme overwork

Worker shortage

Survivor experience

Mandatory evacuation

Property loss

Family dispersion

Grief — loss of:

Colleagues

Family members

Friends

Social backlash

Public criticism

Discrimination

Harassment

Guilt as “perpetrators” of a nuclear accident