Finding the Way in Japan

Panoramic photo of large group of students sitting on track.
Melissa (Missy) MacDonald, a woman with ADHD, has found community while pursuing an English teaching career and a childhood dream to learn about Japanese culture.

Missy first discovered her interest in Japan in elementary school. Her best friend was always wanting to show her the latest manga and anime that she had discovered, but Missy wasn't interested and would always say that she would try to look at it later. That "later" came when she was 13 years old and she read her first piece of manga. That led to her watching an anime show. Between the Japanese language, storyline and school uniforms, Missy was hooked.

I said to myself, 'one day I'm going to watch this live action and understand everything'. It was a real turning point and I started learning about what foods people ate in Japan, what holidays they practiced, the history, etc.

Missy quickly started studying the basics of Japanese writing and self-introductions, and at the age of 16 she got her first break, spending a semester at a Japanese high school with Youth for Understanding (YFU). Despite challenges studying the Japanese language, Missy had discovered her interest that would motivate her through what was about to come next.

At the age of 18, she entered her first semester of college at Portland State University, and found herself struggling a great deal with motivation. It seemed like she and her classmates were aimlessly going through the motions of college life without a clear direction. She visited a therapist, who recommended that she get tested for ADHD. That same year, she got an official diagnosis and began a regimen of Adderall. She also made the decision to stay with her parents while spending some time at community college to find that direction that she felt was lacking. Having the support of people who cared about her success and the flexibility to study a variety of subjects helped her get back on track.

My interests always pointed back to Japanese language, culture, and history, so I just followed what I liked and focused my degree on liberal arts and foreign language with a focus on Asia.

She ultimately decided that she needed to get her Bachelor of Arts degree, since she knew that it would be necessary in order to teach English in Japan. She began preparing an application to transfer to Tokyo International University where she thought she might like to finish that BA.

Meanwhile she applied to spend a semester at Kwansei Gakuin University studying Japanese in Hyogo Prefecture through University Studies Abroad Consortium (USAC) in affiliation with University of Nevada Reno. Since Adderall is prohibited in Japan, even when legally obtained elsewhere, it was necessary to change to a permitted medication before setting out for her adventure. As of 2018, the only legal medications in Japan were Strattera and Concerta, and after consulting with her doctor, Missy chose the latter.

She discontinued her Adderall a couple weeks before departure to Japan and started up on Concerta after getting in touch with a local therapist who could prescribe it. She located the Japan specialist with the help of USAC staff. After answering some questions over the phone, she took her Japanese insurance card and a letter from her American Doctor to her first appointment, where an English-speaking specialist wrote her Concerta prescription. "I tried to make the switch to Concerta before flying over, but my insurance provider wouldn't cover it."

She spent the first month of Concerta on the lowest dose possible, before she and her therapist agreed on the amount that worked best. She meets with her therapist each month when she comes for a refill to check in and discuss any adjustments to the dose. "They're really great at making sure you're doing okay and ask for your input on if you think your dosage is too high or low for your lifestyle (like if you're on a summer holiday and not taking the Concerta, you can delay filling it or if you lower your class load you can lower your Concerta dose."

During her semester with USAC, she focused on getting the dose right and adjusting to the Japanese education system. She asked around and identified an easier class load. Her Japanese teachers were understanding, and available if she needed any extra assistance. It also helped that she was making the transition at the beginning of the semester.

The timing was lucky because I didn't have to worry about homework until I already had my routine down and my Concerta. That wasn't the case for all of my classes though, but it helped that every teacher I met had office hours and there was always school tutoring available because they really wanted to help every student do well and pass.

After finishing the USAC program, Missy found out that her Tokyo International University application was accepted. So the following semester she enrolled as a full-time student planning to finish her BA in Saitama Prefecture just outside of Tokyo.

Since she was now a full-time international student no longer affiliated with her American University, Missy had to find a specialist on her own, but even without the assistance of an American exchange program, all she needed to do was ask a nurse with her new school for a referral. For her first appointment with the ADHD specialist, she brought her medical records from Hyogo Prefecture as proof that she had been receiving treatment from a Japanese position the previous semester.

Currently her specialist speaks only Japanese. In order to get treatment in English, she would have to go to Tokyo, and she prefers to practice her Japanese and not have to travel as far for her appointments. There is a lot of paperwork in Kanji. She uses an app that pronounces the words in Japanese, getting help from her Japanese boyfriend if there is something in Kanji that she does not understand.

She checks in monthly with her doctor, and receives her Concerta prescription at the pharmacy next door. She is enrolled in the Japanese national health plan, which covers 70% of her medical costs. She pays a small monthly premium, or tax to support her enrollment on the insurance plan.

I've had an easy time finding clinics and people to help, and I feel that I'm given quality treatment with psychiatrists that ask plenty of questions and that really care about how I'm doing.

While there is not as much knowledge about ADHD, Missy has found her communities to be welcoming. She has made Japanese friends. After she finishes her BA, she hopes to stay in Japan and become an English teacher.

You can keep up with Missy's studies in Japan on her YouTube channel under the related links. Also be sure and review our tipsheet for applying for a Yakkan Shoumi, certificate to bring your medication with you.