More sick days: Stress reactions and adjustment disorders on the rise

German workers are experiencing a significant rise in mental health-related absences, with acute stress reactions and adjustment disorders driving an increase in sick days, data from the KKH health insurance fund reveals. The number of sick days attributed to these diagnoses has climbed steadily, reaching nearly 119 days per 100 insured individuals last year, up from approximately 112 days in 2024 and just 66 days in 2017.

These conditions have become a major concern in the workplace. In 2025, adjustment disorders and stress reactions were the most common psychological diagnoses among working individuals and the third most frequent reason for sick leave overall, trailing only respiratory infections and back pain. The KKH, one of Germany's larger health insurers with about 1.5 million members, recorded 33,425 cases related to these diagnoses last year, a substantial increase from 19,658 cases in 2017.

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I like to call it the invisible stress of uncertainty.

Experts point to a confluence of factors contributing to this escalating mental strain. Family or professional conflicts, financial difficulties, physical illnesses, and bereavement can all trigger adjustment disorders. Acute stress reactions stem from traumatic events, and prolonged stress can lead to depressive symptoms or full-blown depression, according to Dr. Aileen Könitz, a psychiatric expert.

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Modern work can be exhausting, even though it has become more flexible.

Dr. Könitz suggests that the modern work environment plays a significant role. Excessive workloads, constant overtime, low wages, existential anxieties, and conflicts with colleagues or superiors contribute to the pressure. Even flexible work arrangements, while offering autonomy, can create "invisible stress" due to ambiguity regarding responsibilities, expectations, and communication channels. "Modern work can be exhausting, even though it has become more flexible," she noted.

The persistent uncertainty and the blurring lines between work and personal life make it difficult for employees to disconnect and recover. Könitz recommends establishing clear work and break schedules to delineate job, family, and leisure time. She also advises consciously switching off digital devices after work and incorporating physical activity and relaxation techniques to mitigate stress and prevent mental exhaustion.

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Not only the work itself puts many people under pressure, but the permanent interpretation: Who is responsible? What is expected? What can I refuse? Do I have to be available non-stop? When is something enough? On which channel should I communicate?