Hikikomori (prolonged social withdrawal): what helps

Hikikomori, a Japanese word, describes a state in which a person avoids taking part in society, such as school, work or socialising outside the home, and stays mostly at home for a long time. The 2010 guidelines of Japan’s Ministry of Health, Labour and Welfare defined it as staying mostly at home, in principle for 6 months or more, and counted people who still go out as long as they do not interact with others (Ministry of Health, Labour and Welfare, 2010). The concept was proposed in a 1998 book by the Japanese psychiatrist Tamaki Saito (Kato et al., 2024).

It is not a diagnosis. The same guidelines say the word is not the name of an illness but a rough description of one phenomenon in a person’s relationship with society (Ministry of Health, Labour and Welfare, 2010). The World Health Organization’s classification (ICD-11) has no such diagnosis and lists “social withdrawal” only as a symptom of various mental disorders (WHO, 2024). The American Psychiatric Association’s DSM-5-TR (2022) is reported to describe it in its section on culture and psychiatric diagnosis, not as a disorder with criteria (Kato et al., 2024).

Researchers have proposed three criteria: marked social isolation at home, isolation lasting at least 6 months, and significant impairment or distress because of it. People who go out 4 or more days a week do not meet them; going out 2 or 3 days a week is graded mild, 1 day or less moderate, and rarely leaving one room severe. Isolation that has lasted at least 3 but not 6 months is called pre-hikikomori (Kato et al., 2020). These are researchers’ proposals, not official diagnostic criteria.

The kind of outing matters too. Going to a convenience store or taking a walk every night does not count as a meaningful outing (Kato et al., 2024). Some people point to brief outings without contact, such as putting out the rubbish, as proof that they go out, and some deny distress or impairment while their family is very worried, so the researchers count other people’s concern as evidence of distress or impairment (Teo et al., 2023).

Six months is a research and survey convention, not a condition for getting help. In Japan the 2010 guidelines’ “in principle 6 months or more” was applied strictly in some places, and some people lost trust in help desks after being told to come back once 6 months had passed. The ministry’s 2025 handbook therefore states that the length of time does not matter for support (Ministry of Health, Labour and Welfare, 2025). Korea’s youth survey asks only how often people go out, with no time limit (Office for Government Policy Coordination, 2023), and the Korean act speaks only of “a considerable time” (Act on Support for Children and Young People in Crisis, 2025).

Staying at home for a long time is not an illness in itself. Researchers see the need for prompt mental health support when the isolation comes with impairment and distress, not because of the isolation alone (Kato et al., 2024). The Japanese guidelines also note that not every child or young person in a hikikomori state needs support or treatment (Ministry of Health, Labour and Welfare, 2010).

Korea’s government speaks of “isolated and reclusive young people”. The Act on Support for Children and Young People in Crisis, in force since March 2026, defines them as people aged 34 or under who have almost no contact with others, or have lived only in a confined space for a considerable time, so that daily life has become markedly difficult (Act on Support for Children and Young People in Crisis, 2025). mind.io does not offer a hikikomori test, and this guide is not a diagnosis. It sets out, from research and official sources, what the condition is, how common it is and why it happens, what helps families and the person, and where to get help.

In Korea, measured with the same question about how often people go out, young people aged 19 to 34 who stay home almost all the time, excluding reasons such as pregnancy, childbirth or disability, were 2.4% in 2022 (about 244,000 people) and 5.2% in 2024, and in 2024 those who did not leave home at all were 0.9% of all young people. The 2024 figures are provisional (Office for Government Policy Coordination, 2023; 2025). Among specific reasons in 2024, difficulty finding work was the most common (32.8%), followed by difficulty with relationships (11.1%) and dropping out of education (9.7%) (Office for Government Policy Coordination, 2025).

The numbers change a lot with the definition. Using the same 2022 survey data, counting only people withdrawn for 6 months or more who were distressed or impaired by it gave 1.4% (Baek & Yoon, 2025). An analysis pooling 19 studies also found a large gap: 3.1% in surveys with probability samples and 12.5% in non-probability samples such as online recruitment (Zhang et al., 2025).

In the Japanese Cabinet Office’s 2022 survey, 2.05% of people aged 15 to 39 and 2.02% of those aged 40 to 64 were in a hikikomori state, about 1 in 50 in both age groups. This broad definition includes people who go out only for hobbies, and people who hardly ever left their own room were 0.06% of those aged 15 to 39 (Cabinet Office of Japan, 2023). The figure is sometimes converted to about 1.46 million people (Kato et al., 2024), but the ministry’s handbook notes that no estimated number was calculated from this survey, and that the share of women was over 40% in both age groups, higher than in earlier surveys (Ministry of Health, Labour and Welfare, 2025). In both age groups about half had been withdrawn for 3 years or more and over 20% for 7 years or more (Ministry of Health, Labour and Welfare, 2023).

In a Japanese community survey, 1.2% of people aged 20 to 49 had at some point in their lives completely withdrawn from society for 6 months or longer (Koyama et al., 2010). It is not only Japanese. In a telephone survey of young people in Hong Kong, withdrawal of more than 6 months was 1.9% (Wong et al., 2015), and in a national survey of people aged 15 and over in Italy, the risk of hikikomori was 1.7% (Amendola & Teo, 2025). Definitions and methods differ between surveys, so the numbers cannot be compared directly.

Hikikomori is rarely explained by a single cause. In Japan’s 2022 survey, people aged 15 to 39 most often named as the main trigger leaving a job (14.9%), relationships going badly (14.0%), COVID-19 (12.3%), illness (10.5%) and not attending school in junior high (9.6%), and among those aged 40 to 69, leaving a job was by far the most common (42.2%) (Cabinet Office of Japan, 2023). In a Korean online survey that isolated and reclusive young people chose to answer, the reasons were work-related difficulties (24.1%), relationships (23.5%), family relationships (12.4%) and health (12.4%), and those who withdrew in their teens most often named relationships (27.1%), family relationships (18.4%) and violence or bullying (15.4%) (Ministry of Health and Welfare, 2023).

Hard experiences at school also play a part. In an online survey of 4,000 Japanese adults aged 20 to 34, only adversity at school, among childhood adversities, was linked with hikikomori, and each one-point rise in the bullying-related score went with a 37% higher risk (Wakuta et al., 2023). People referred to a Spanish treatment team for social withdrawal often had difficult family dynamics (61.5%) or a family psychiatric history (59.3%) (Malagón-Amor et al., 2020), but studies like these show links, not causes. Japan’s health ministry stresses that hikikomori can happen to anyone and to any family (Ministry of Health, Labour and Welfare, 2025).

Withdrawal can also keep itself going. Many people feel relief at first at escaping the painful realities outside, but as the withdrawal goes on, most begin to feel distress such as loneliness (Kato et al., 2020). In a study that surveyed 497 people aged 20 to 64 who met hikikomori criteria three times over a year, depressive symptoms predicted more withdrawal later, and the relief of avoiding people seemed to keep the cycle going (Nonaka et al., 2026a). Gaming cuts both ways. In young gamers in Hong Kong, gaming disorder symptoms were only marginally linked with later hikikomori symptoms (Ye et al., 2026), and gaming can also be a way of coping, so it is worth looking not only at how many hours it takes but also at what role it plays (Kato, 2026). Gaming problems are covered in gaming disorder, and phone use in general in Smartphone overuse.

Withdrawal also happens in middle age. In Japan the rate among those aged 40 to 64 was similar to that among those aged 15 to 39 (Cabinet Office of Japan, 2023), and the problem of households where elderly parents live with an unmarried, non-working child in their 50s is called the “8050 problem” (Ministry of Health, Labour and Welfare, 2023). As people who have been withdrawn for a long time reach their 40s and 50s and their parents age, the person and the family can become isolated together and struggle to make ends meet (Yong et al., 2022).

It is wrong to see people in withdrawal as lazy or dangerous. Japan’s health ministry calls remarks such as “it is just laziness” or “the parents spoiled them” misunderstanding and prejudice (Ministry of Health, Labour and Welfare, n.d.). Korea’s Ministry of Health and Welfare has also said that isolated and reclusive young people tend to blame themselves rather than others, and that seeing them as at risk of random violent crime is a mistaken social prejudice (Ministry of Health and Welfare, 2023).

Other mental health problems often come with withdrawal. In a Japanese community survey, 54.5% of people who had ever been in hikikomori had also had a mental disorder such as depression or anxiety, while nearly half had been withdrawn with no other disorder (Koyama et al., 2010). Conditions that often co-occur include avoidant personality disorder, social anxiety disorder, depression, autism spectrum disorder and schizophrenia (Kato et al., 2024). In Korea’s 2022 survey data, young people withdrawn for 6 months or more with distress or impairment (1.4%) also had more depressive symptoms (20.9% vs 5.9%) and suicidal ideation (11.0% vs 2.3%) than other young people, though a survey at one point in time cannot show which came first (Baek & Yoon, 2025). If you have thoughts of harming yourself, please do not carry them alone. Reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere.

The early stage of schizophrenia also needs to be considered. Weeks or months before its symptoms become clear, there is often a phase of losing interest in work or people, neglecting one’s appearance and turning night into day (WHO, 2024). The Japanese guidelines note that the chance of undiagnosed schizophrenia among people in withdrawal is not low (Ministry of Health, Labour and Welfare, 2010), and among 66 withdrawn young people seen by a French psychiatric outreach team, 37% were diagnosed with schizophrenia and 23% with a mood disorder (Chauliac et al., 2017). If someone hears voices others do not hear or holds beliefs that those around them find hard to understand, see a psychiatrist soon. More is in Schizophrenia.

It overlaps with social anxiety but is not the same. At the core of social anxiety is avoiding people for fear of embarrassment (Kato et al., 2024), whereas many people in withdrawal say they have little contact with others yet deny avoiding them (Kato et al., 2020). A study that grouped 200 people in withdrawal found a socially avoidant group of 37%, while 52% had marked impairment without high social anxiety (Nonaka et al., 2026b). If fear of people keeps you at home, see Social anxiety; if fear of criticism and rejection has kept you out of relationships, see Avoidant personality disorder.

It is also different from loneliness, introversion and lack of motivation. Withdrawal and loneliness are strongly linked (a correlation of 0.68), but which comes first is not yet known (Hajek & König, 2026). Liking to be alone is not pathological withdrawal if it causes no distress or impairment (Kato et al., 2024). Loneliness is covered in Loneliness, a preference for solitude in Introverts and extroverts, and having no energy for anything in Lack of motivation. A young child who refuses daycare or school out of fear of being apart from a parent may have separation anxiety.

People in withdrawal often do not seek help themselves, so family members tend to be the first point of contact. A stepped approach is therefore recommended: start with education and consultation for the family, then gradually engage the person (Kato, 2026). The Japanese guidelines likewise say that when only the family can come for advice, support starts with the family and moves step by step to support centred on the person (Ministry of Health, Labour and Welfare, 2010). In a Spanish study, families were the ones who noticed the isolation and called for help in 73.7% of cases (Malagón-Amor et al., 2020). It helps to keep up the family’s own consultations even while the person refuses, and help desks are not there to blame the family for how it has coped so far (Ministry of Health, Labour and Welfare, 2025).

Many of the family programmes studied for hikikomori are based on Community Reinforcement and Family Training (CRAFT), which came from addiction treatment. Families look at how criticism, scolding or vague words lead to conflict and practise replacing those words with calm ones (Kubo et al., 2020). The core elements an expert lists are reducing stigma about mental health, reducing heated exchanges, setting achievable goals, learning to handle crises and building regular routines (Kato, 2026).

The evidence for family programmes in hikikomori is still weak, though. In a Japanese study where 7 parents learned CRAFT, parents reported that 42.9% of their children improved or began attending services regularly, but it was a small study comparing groups of 7 without random assignment (Sakai et al., 2015). A randomised trial was stopped at 29 parents because of COVID-19 and could not judge effectiveness. In that trial, aggressive behaviour increased in the children of parents in the programme (with no serious domestic violence), and the researchers called for safer ways for families to approach (Kubo et al., 2022). What CRAFT has shown for alcohol and drug problems is covered in Alcohol use disorder.

Do not try to drag them out. Japan’s health ministry writes that scolding and forcing someone out of the house in a hurry does not improve things, while making the home a comfortable, safe place for them can change how they feel and how they relate to the family. Support workers also visit only after checking that the person does not refuse (Ministry of Health, Labour and Welfare, 2025). Unless it is an emergency, do not search their diary or drawers behind their back (Ministry of Health, Labour and Welfare, 2010).

Do not hand them over to businesses that take people away by force in the name of “independence support”. In Japan, private firms offering hikikomori support have charged high fees, or forcibly taken people from their homes into facilities without providing proper services (Ministry of Health, Labour and Welfare, 2025). In 2022 the Tokyo District Court ruled that such a firm acted unlawfully by placing a person in its facility against their will and making it very hard for them to leave, and the mother who had hired it was held jointly liable (Tokyo District Court, 2022).

Pushing for steady, uninterrupted progress can turn support into coercion (Ministry of Health, Labour and Welfare, 2025). If there is violence at home or a life is in danger, do not wait: contact your local emergency services. The Japanese guidelines also say that visits may have to go ahead without the person’s consent when there is a danger to life or of harm to self or others (Ministry of Health, Labour and Welfare, 2010).

There is still almost no treatment proven to work for withdrawal itself. A systematic review judged evidence-based practice to be almost non-existent (Li & Wong, 2015). Today, medication is used when another mental disorder is present, alongside various psychotherapies, social work and family approaches tailored to the person (Kato et al., 2024).

Treating what comes with it matters. Cognitive behavioural therapy is a reasonable first choice for avoidance, social anxiety and negative thoughts; trauma-focused therapy helps when the avoidance comes from trauma; and social skills training can help when neurodevelopmental traits stand out. Medicine may be needed for a co-occurring disorder, but medicine alone rarely improves the difficulties of withdrawal (Kato, 2026). As depressive symptoms predicted more withdrawal later, depression treatment such as behavioural activation may help break the cycle (Nonaka et al., 2026a). Ways to deal with depression are in What helps with depression.

The way back is climbed slowly, like a staircase. The Japanese guidelines describe moving from support for the family to individual support for the person, then to in-between groups with peers such as drop-in spaces, and then to full participation such as study or work, and they advise against artificially hurrying or skipping these steps (Ministry of Health, Labour and Welfare, 2010). An expert also notes that recovery lasts longer with participation that eases all-or-nothing pressure, such as supported education or employment, graded community activities, peer support and relapse prevention plans (Kato, 2026).

Korea’s Youth Future Centres run programmes by level of isolation: shared living that helps with sleep, hygiene and eating habits; daily-life recovery that widens contact with people; relationship recovery such as family counselling and self-help groups; and work experience such as basic job training and internships (Ministry of Health and Welfare, 2026a). The support is said to be flexible, following the person’s recovery rather than a fixed sequence of steps (Ministry of Health and Welfare, 2026b). There is also counselling at home. In a study that visited and treated 41 withdrawn young people around Seoul and Gyeonggi, functioning and social activity improved somewhat in 68.3%, but there was no comparison group (Lee et al., 2013). There is also a case report in which online treatment for social anxiety, received at home, was the first step (Sakai et al., 2024).

Falling back into isolation after improving is not rare. In the Korean online survey that people chose to answer, 45.6% had become isolated again after trying to return to daily life, often because they lacked the minimum money or time to go out (27.2%) or were exhausted (25.0%) (Ministry of Health and Welfare, 2023). So rather than making a job or social participation the only goal, it is important to see recovery as a process of the person making their own choices (Ministry of Health, Labour and Welfare, 2025).

In Korea, young people aged 19 to 34 can have their level of isolation assessed at a Youth Future Centre and receive support that leads from daily-life recovery to building relationships and taking part in society. They can apply online through the “Youth ON” service, and not only the person but also people around them, such as teachers or social welfare workers, can ask for support (Ministry of Health and Welfare, 2026a). A relative living with the person can also apply on their behalf (Act on Support for Children and Young People in Crisis, 2025).

Youth Future Centres opened as a pilot in 2024 in four regions, Incheon, Ulsan, North Chungcheong and North Jeolla (Ministry of Health and Welfare, 2024), and are to expand to 16 regions by the end of 2026, so they are not yet everywhere (Ministry of Health and Welfare, 2026b). If there is no centre nearby or you do not know where to ask, call the Health and Welfare Call Centre on 129 first (Ministry of Health and Welfare, 2026c). Some programmes may ask for part of the cost (Act on Support for Children and Young People in Crisis, 2025).

Teenagers aged 9 to 18 can receive home counselling, recovery programmes and learning support through the Ministry of Gender Equality and Family’s one-stop support for isolated and reclusive teenagers, but it runs only in some regions. Ask Youth Counselling 1388 or the support centre for out-of-school youth that runs the programme locally (Ministry of Gender Equality and Family, n.d.). Young people aged 9 to 24 and their parents or carers can use Youth Counselling 1388, free and open 24 hours (Korea Policy Briefing, 2024).

In Japan, every prefecture and designated city has a hikikomori regional support centre. Support coordinators with qualifications such as social worker, psychiatric social worker or certified public psychologist advise the person and the family, and the family can consult on its own. Many consultations start with the family and later include the person (Ministry of Health, Labour and Welfare, n.d.). For contract trouble with a private business offering hikikomori support, the consumer hotline 188 can help (Consumer Affairs Agency, n.d.).

In other countries, start with your family doctor or local mental health service. In France and Spain, some psychiatric teams visit people in withdrawal at home (Chauliac et al., 2017; Malagón-Amor et al., 2020).

If you have thoughts of harming yourself, please do not carry them alone. Reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If you are in immediate danger, contact your local emergency services.

Q. Is there a hikikomori self-test? A. mind.io does not offer a hikikomori test. A research questionnaire exists (the HQ-25), but at its suggested cut-off only 17% of those scoring above it actually had hikikomori (Teo et al., 2018), and its authors warn against people trying to diagnose themselves with it, since it supports a clinical diagnosis rather than replacing one (Teo et al., 2023). We found no questionnaire for the hikikomori state that has been validated in Korean. The online service “Youth ON” of Korea’s Ministry of Health and Welfare offers young people a self-check for isolation and reclusion (Ministry of Health and Welfare, 2024). Depression, which often comes with it, can be checked with the PHQ-9 depression check-in.

Q. Is hikikomori the same as “social withdrawal” or being a recluse? A. Hikikomori and being a recluse describe much the same state, but “social withdrawal” is broader: it is also a symptom of many mental disorders (WHO, 2024). Hikikomori is a word from Japan (Kato et al., 2024), while Korea’s government surveys and laws speak of “isolated and reclusive young people” (Office for Government Policy Coordination, 2025; Act on Support for Children and Young People in Crisis, 2025).

Q. My son won’t leave his room. Should I make him come out, even by force? A. No. Forcing someone out does not improve things (Ministry of Health, Labour and Welfare, 2025). Start by getting advice as a family, make home a comfortable and safe place, and keep up the family’s consultations even while he refuses. A Japanese court has ruled that a business acted unlawfully by placing a person in its facility against their will and making it very hard to leave (Tokyo District Court, 2022).

Q. If I like staying at home, am I a hikikomori? A. Not in itself. Staying home is not seen as pathological withdrawal if it causes you no distress or impairment (Kato et al., 2024). In a Hong Kong survey, too, people who saw their withdrawal as no problem formed a distinct group (Wong et al., 2015).

Q. I have stayed home for a few months. Is it fine if it has not been 6 months? A. Impairment and distress matter more than the length of time. Six months is a research convention, and 3 to 6 months is called pre-hikikomori (Kato et al., 2020). The Japanese guidelines say that the most important way to keep withdrawal from becoming long-term is to start getting advice as early as possible (Ministry of Health, Labour and Welfare, 2010).

Q. All they do is play games. Did gaming cause the withdrawal? A. It is hard to say either way. One study found gaming disorder symptoms only marginally linked with later withdrawal (Ye et al., 2026), but gaming can also be a way of coping and a channel towards help (Kato, 2026). Rather than taking games away, look together at what role gaming plays.

Q. Can people in their 30s or 40s be hikikomori? A. Yes. In Japan’s survey, the rate among those aged 40 to 64 (2.02%) was similar to that among those aged 15 to 39 (2.05%) (Cabinet Office of Japan, 2023). Support under Korea’s act covers people aged 34 or under (Act on Support for Children and Young People in Crisis, 2025), so if you are older, call the Health and Welfare Call Centre on 129 first (Ministry of Health and Welfare, 2026c).

Q. Things are so hard that I want to disappear. A. Please do not carry this alone. Reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If you are in immediate danger, contact your local emergency services.

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