The art often turns fantastical to portray the mental states.

Portraying insanity and despair in a believable way is hard. Most often manga and anime resort to pushing it as far as they can to an extreme where all plausibility flies out the window. That approach often has very entertaining results as we saw in Mirai Nikki for example. In Shi ni Itaru Yamai however the author Asada Hikari decided to pull it back to a level where the psychological conditions would remain believable. It’s one of the most successful attempts I’ve seen in manga at exploring extreme psychological disorders without going so far as to make it unbelievable.

Kazuma is studying to become a clinical psychologist. During his studies he takes on a case to see if he has what it takes to become successful in his field. The patient turns out to have bigger problems than he ever imagined possible. Her name is Emiru and is suffering from utter despair. It’s to the point where she is decaying physically and has heart problems. Kazuma has to determine the cause of her despair, and try to cure it before she fades away and dies.

The manga successfully kept me guessing whether I seeing supernatural phenomena or hallucinations

With a setup like this the entire story hinges on several story beats being believable, the biggest one being the cause of the despair. The story unfolds as a puzzle where it all starts clicking together in your mind over time as you understand everything going on. There were a few times where I raised an eyebrow at what was going on, but it always managed to work out any issues I had with the premise. The ability of it to make me believe in the story and characters no matter the extremes it went to impressed me. When it was all over and I could look back at everything that had happened it all made perfect sense to me.

The tone of the series is dead serious without a trace of humor. It’s trying to tell a story about severe mental problems where life and death are involved and the tone it struck worked for me. Kazuma and Emiru fall in love over the series and develop a serious relationship. Their love isn’t enough to heal her issues however and when Kazuma finds out the cause of the despair it becomes a problem that he’s so close to her. It’s definitely a bit melodramatic and has plenty of fantastical artwork to portray the mental conditions of the characters. On the whole it all worked for me and I didn’t feel like it was straying too far in any direction where it would go off the deep end. All the elements were in enough balance that it felt well written and planned.

Love blooms, and with it strong motivation to save Emiru

At only two volumes Shi ni Itaru Yamai isn’t a particularly long read, and nor did it need to be either. The story fits perfectly within the space given and never loses focus of what is most important. I liked the artwork by Seguchi Takahiro who also did the art for My Balls, a series about as far removed in tone and style from this as you can get.

For anyone wanting to read a serious and well thought out story about psychological disorders I’d recommend this. I’m sure someone who actually knows about these disorders it might be a bit too melodramatic and unrealistic, but for the rest of us who just read it to be entertained it has enough authenticity to sell the ideas in it. It’s a tragic love story that goes to some dark places, and I loved it.

The biggest success of the manga was making the despair believable once you learned the cause

NOTE: Shi ni Itaru Yamai has not been licensed and is only available as translated scans.