A Japanese Killer

All work and no play makes Americans tense: More than 65 million suffer symptoms of stress, and overall, they spend more than $370 million a year on stress-busting fitness routines and stress-related pharmaceutical drugs and books. But compared to the Japanese, the U.S. workforce looks mellow.

A study conducted by the Ministry of Health and Welfare in Japan and presented to the media found that 59% of Japanese workers feel markedly "fatigued" from work, compared to only 15% to 30% of American workers. In fact, stress in Japan, called karoshi, has become a national killer, claiming the lives of 10,000 Japanese men a year. By contrast, the U.S. sees few deaths directly associated with labor.

"Americans and Japanese work the most in the world, but the work ethic is much more extreme in Japan because of the patriarchal legacy of loyalty between the samurai and feudal lord," says Reiko Homma True, Ph.D., a psychologist and consultant to many Japanese mental health organizations. And Japan's strained economy is only making the situation worse, she adds—anxiety, depression and suicide rates are skyrocketing among middle-aged men.

Compounding the problem is their refusal to seek help. In Japanese culture, work obsession is a virtue, and weariness is a sign of weakness. Stressed-out men would rather pay for massages, drink alcohol and ultimately risk their lives than admit that they need a break. And while worried wives regularly call the crisis hotlines for the overworked in search of ways to help their partners, their efforts are to little or no avail. "'Business samurais,' as they are called in Japan, will never submit to a mental health break," says True.