Princess Mako's mental well-being began to deteriorate in 2018-19, according to the Imperial Household Agency.
At a press conference Friday, the agency said Princess Mako had been diagnosed with complex post-traumatic stress disorder (PTSD).
"She said she doesn't think she can bear the situation if it continues, " said Takaharu Kachi, an aide to the family of Crown Prince Akishino.
Psychiatrist Tsuyoshi Akiyama of the NTT Medical Center in Tokyo who diagnosed Princess Mako, said complex PTSD, a term that emerged in 2018, can occur when an individual experiences certain kinds of trauma over a long period.
According to the Imperial Household Agency, Princess Mako began suffering from feelings of helplessness in 2018-2019 due to the repeated criticism and abuse regarding her planned marriage to Kei Komuro. The agency said she fears she will not be able to have a happy life after she gets married.
"People suffering from complex PTSD can feel worthless or have negative feelings," Akiyama said. Lack of concentration, agitation, and lethargy are among other symptoms.
However, Princess Mako has been carrying out official duties with no signs of the impact on her mental well-being.
"If the abuse stops, I think her condition will improve," Akiyama said.
"It has been extremely distressing. I regret that our support has not been enough," Kachi said.
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