Japan's Princess Aiko (C), accompanied by her parents Crown Prince Naruhito (L) and Crown Princess Masako, pose for photos as they attend her graduation ceremony at the Gakushuin Primary School in Tokyo March 18, 2014.
Japan's Princess Aiko (C), accompanied by her parents Crown Prince Naruhito (L) and Crown Princess Masako, pose for photos as they attend her graduation ceremony at the Gakushuin Primary School in Tokyo March 18, 2014. REUTERS/Toru Hanai

For the first time after a decade, Japan's Crown Princess Masako and Crown Prince Naruhito attended a welcoming function for King Willem Alexander and Queen Maxima of Netherlands at the Imperial Palace in Tokyo on Oct. 29. It was her first welcome ceremony appearance in five years, and first attendance at the Imperial Palace after 11 years. The event was hosted by Emperor Akihito and Empress Michiko.

The national anthems of both countries were played out, and the Dutch royal couple, state guests for the Japanese, were also given an honorary salute. The two royal families met for 20 minutes. King Willem-Alexander told Akihito that Netherlands values Japan as a country of special importance, according to the Imperial Household Agency. Masako wore an orange suit to pay homage to the Netherlands, according to asahi.com.

The 50-year-old princess had been suffering from a stress-related illness after she got married in 1993. After her daughter was born in 2001, she came in public sometimes, but most of the time she stayed away from royal responsibilities. After a lot of pressure to produce a male heir, she gave birth to a daughter, Aiko, in 2001.

Before she married, she had been a successful diplomat who "spoke several languages and travelled extensively," according to BBC.com.

But once she married the eldest son of the Japanese royal family, observers speculate that her lifestyle had undergone a change, and she had to follow a rigid set of rules. She had a lot of emotional problems, exhibiting symptoms of depression and anxiety. It is suspected that her problem was due to the pressure to produce a male heir to the Japanese throne. The royal family was going through a lot of crises.

In July 2004, the Imperial Household Agency announced that she was undergoing an adjustment disorder because of the "hardship of assuming a weighty responsibility as a crown princess" and a "hectic life in which there is no distinction between private and public activities," according to asahi.com. She made only 30 forays into Tokyo in 2012 to attend to official responsibilites.

Last year, in April 2013, she was unsure whether she should attend King Willem-Alexander's inauguration. But Queen Maxima rang her up to try and convince her, which boosted her self-esteem, according to hellomagazine.

While undergoing treatment, her doctors confirmed that it was most important to bring down the stressors by amending her environment. Through counseling and medication, they tried to help her to heal and come back to official duties. They also wanted her to go beyond her "life's work" and "private activities," according to asahi.com. One solution was provided by the next son, Prince Akishino and his wife, who had a boy in 2006.