Rising Numbers, Deeper Issues
A recent survey from the Japan Institute for Health Security has raised fresh concerns over the mental and physical health of young Japanese women in the workforce. According to the report, women in their twenties are twice as likely to take extended sick leave (over 30 days) compared to men of the same age group. The leading causes? A mix of mental health issues — such as depression and anxiety — and pregnancy-related conditions like hyperemesis gravidarum (severe morning sickness).
This trend has sparked a new wave of discussion around the gendered impact of workplace stress in Japan, a country still grappling with karoshi, or death from overwork. While the term traditionally evokes images of overburdened middle-aged male employees, today’s data tells a more nuanced story — one that increasingly includes young women facing intense emotional and physical stress, often in silence.
By the Numbers: What the Research Shows
The survey analyzed sick leave data from 2012 to 2021, tracking around 100,000 employees from companies based in east-central Japan. Here are some of the most revealing statistics:
6,518 male employees took long-term sick leave 1,866 female employees took the same — a lower absolute number, but When calculated per 10,000 workers, women showed an incidence rate of 115.5, compared to 89.2 for men
This means that young women were more prone to extended leave than men, despite making up a smaller portion of the sample.
Mental Health: The Hidden Epidemic
One of the most alarming findings was the high incidence of mental health conditions among female employees. Depression, anxiety disorders, and stress-related burnout were the most cited reasons for leave.
This reflects a broader societal issue. In Japan, mental illness is still heavily stigmatized, particularly among young women who are expected to juggle work, family responsibilities, and societal expectations around appearance and behavior. Many report symptoms like:
Chronic fatigue Panic attacks Sleep disturbances Lack of motivation Social withdrawal
Despite the burden, many women do not seek treatment until the situation becomes unmanageable — largely due to fear of being seen as “weak” or unreliable at work.
Pregnancy-Related Leave: A Biological Reality, A Corporate Blind Spot
In addition to mental health, pregnancy complications accounted for a significant portion of long-term sick leave among women. Conditions like:
Severe morning sickness (hyperemesis gravidarum) Pregnancy-induced hypertension Pre-term labor risks
…are rarely accounted for in company wellness programs or HR planning.
Even in a progressive economy like Japan’s, pregnancy is often seen as an inconvenience in the corporate world. Some women report subtle discrimination, such as being passed over for promotions or excluded from key projects once their pregnancy becomes known.
Karoshi Culture: A Legacy That Refuses to Die
Japan’s infamous karoshi culture, or death from overwork, has long cast a shadow over its labor environment. According to a government white paper:
In 2023, 173 workers died due to overwork 79 of these cases were suicides or attempted suicides 216 workers developed work-related brain or heart conditions, surpassing 200 for the first time in four years
These figures are stark reminders that work-related stress remains a life-threatening issue — and young women are increasingly caught in the crosshairs.
Young Workers Are Beginning to Push Back
There is some hope, though. In recent years, younger Japanese employees — both men and women — have started rejecting the culture of overwork. According to the Recruit Works Institute:
Annual working hours have dropped from 1,839 in 2000 to 1,626 in 2022 That’s an 11.6% decrease over two decades
This shows a slow but steady shift in mindset. Younger generations are more open about mental health, more likely to demand work-life balance, and less willing to sacrifice well-being for corporate loyalty.
Cultural Pressures Specific to Women
While change is in motion, Japanese women still face unique cultural pressures that their male peers often don’t:
Expectation to Leave the Workforce After Marriage or Childbirth Many women are expected to either quit or significantly scale back after becoming mothers — a cultural norm that pressures them to “prove” their loyalty before they even start a family. Workplace Gender Bias Despite Japan’s modern image, women in the workplace often face outdated attitudes, including: Being asked about marital plans during job interviews Assumptions they will be less ambitious Subtle discouragement from leadership tracks Emotional Labor Women are expected to manage office harmony, care for sick relatives, and balance household responsibilities — all while maintaining their performance at work.
This triple burden leaves them mentally and physically exhausted, often with no formal support system to fall back on.
The Way Forward: What Needs to Change
This health crisis is not just about individuals — it’s a structural issue. Here’s what experts and health advocates recommend:
Gender-Specific Mental Health Programs Government and corporate health systems need to design mental wellness programs that address women’s needs, including hormonal factors, family pressure, and role-related anxiety. Inclusive Workplace Policies Companies must adopt flexible work hours, paid mental health days, and clear maternity support policies. HR teams need training to support — not penalize — women dealing with health issues. De-stigmatizing Mental Health Public campaigns should normalize therapy, counseling, and open conversation. Mental health should be treated just like physical health — without shame. Data-Driven Interventions This study by the Japan Institute for Health Security should be a wake-up call for policymakers. By regularly collecting and publishing sex- and age-specific health data, interventions can be more precise and impactful.
Final Words: Time to Listen to Japan’s Women
Japanese women in their twenties are speaking with their actions — and their sick leave is a cry for help. Behind every extended leave request is a story of burnout, unacknowledged pain, or silent pregnancy complications.
For a country as technologically and economically advanced as Japan, it’s time to match progress with empathy. Because no nation can truly prosper if half its workforce is breaking down in silence.
The future of Japan’s work culture lies not in productivity alone, but in protecting the minds and bodies of those who build it — especially its women.
