If you think your 40-hour work week is brutal, then wait until you get a load of some the hours worked by Japanese employees. In a country where job competition is fierce, many young workers are facing more and more pressure when it comes to putting in an insane amount of overtime. Unsurprisingly, this had lead to a startling number of health effects including depression, exhaustion, heart attacks, and strokes. In fact, the Japanese even have a word to describe the worst case scenario. “Karoshi” literally means death due to overwork. With the number of deaths on the rise, more and more people are calling on the Japanese government to intervene in what’s becoming a national crisis.

The overtime culture

According to BBC News, nearly a quarter of the companies in Japan expect their workers to put in over 80 hours of overtime each month, often without any extra pay. Around 12% of those companies expect even more from their workforce, with employees working up to 100 hours of overtime each month. With suicides, stress, and substance abuse on the rise, some Japanese citizens have even set up helplines for overworked employees who just can’t take the unrealistic expectations that are being heaped upon workers across the country.

Makoto Iwahashi, a representative from one such helpline called Posse, says that many employees just don’t feel that they have a choice in the matter. “It’s sad because young workers think they don’t have any other choice,” Iwahashi told BBC. “If you don’t quit you have to work 100 hours. If you quit you just can’t live.”

Why the long hours?

Though the problem of karoshi has recently been thrust into the spotlight due to a series of high-profile tragedies, it’s hardly a new phenomenon. In fact, it was born from a post World War II initiative gone horribly wrong. Back in the 1950s, Japanese Prime Minister Shigeru Yoshida decided that it was time to get down to business and rebuild the country’s economy in a huge way. So the Prime Minister got together the heads of a large number of Japanese corporations and asked them to please start offering lifetime job security to their workers, asking for only loyalty in return. Well, in a way the plan worked. Japan’s economy is now not only booming but also ranks among the top three in the world. The problem, however, soon came in the form of many peoples’ assumptions about what exactly “loyalty” entails.

It wasn’t long before deaths and medical conditions began to crop up as the result of many employees’ efforts to prove their loyalty to the companies that issued their paychecks. After all, for many Japanese workers, the hope of promotion is only garnered through a Spartan level workload. The only other option? Quit and try to find another job where you’ll have to start at the bottom of the ladder all over again.

Karoshi begins making more headlines

The call for the Japanese government’s help in ending karoshi has been prompted by a series of tragic deaths directly related to overwork in the past few years. The mother of 27-year-old Naoya Nishigak recently spoke to the BBC about her son’s work schedule after his death was officially ruled a case of karoshi. “He usually worked until the last train, but if he missed it he slept at his desk,” she said, “In the worst case he had to work overnight through to 10 PM the next evening, working 37 hours in total.”

But the crisis isn’t just limited to male employees, as a number of female karoshi deaths have demonstrated. Back in 2013, a 31-year-old journalist named Miwa Sado died from heart failure after working 159 hours of overtime in one month alone.

Another young woman named Matsuri Takahashi, who worked for the Japanese advertising agency Dentsu, committed suicide after working over 100 hours of overtime during the month before her death. In hindsight, the warnings signs couldn’t have been more obvious. Before her death, she wrote a number of chilling twitter posts. “It’s 4 AM. My body’s trembling,” Takahashi wrote in one such post. “I’m going to die. I’m so tired.” On Christmas Day of 2015, she jumped to her death from the top of her employer’s building. The company’s president and CEO ended up resigning a month later over the incident.

The street sleeping businessman

So rampant is exhaustion in the country of Japan that a photographer named Pawel Jaszczuk was able to compile a whole book of photos featuring Japanese businessmen sleeping on the streets at night. In his description of the book, which is called “High Fashion” Jaszcazuk imagines the lives of the slumbering subjects he photographs each night. “These men and those they speak for in offices of money and power are everywhere,” he says in his blog, “…They call him lazy and indulgent and remind him that they alone know what it is to be a man and force upon him nightmares of penury to keep him from the peace they enjoy.”

Japan begins seeking solutions

In response to the growing crisis, many Japanese companies are attempting to initiate creative ideas to help protect their employees. Some companies are turning off their lights at 10 PM to help encourage employees to leave the office, while others are restricting overtime to mornings alone. Another company instituted a measure in which their workers wear purple capes on which their clock-out times are displayed. Japanese Prime Minister Shinzo Abe also launched a “work style reform” panel a few years ago in an effort to help cut down on unreasonable work hours. Whether such efforts at reform will help cut down on overwork will be revealed as the country attempts to reset its culture in the coming years.