Following on from my previous post on burnout and the signs of it, I thought it was fitting to write a post on how it is different to depression. I feel like the two are so similar, and as doctors we can become familiar with one or even both. Sometimes, in the depth of our exhaustion we can start to wonder if we are developing depression. Or sometimes we can keep pushing through our burnout and find ourselves in the midst of a depressive episode, without realising we even got there. So what is the actual difference between burnout and depression?
I just did 3 night shifts in the emergency department, and was looking forward to my long weekend. I finished Saturday 8.30am, and am back at work on Wednesday. A great amount of time off, and I was excited for it. However, I have spent the whole weekend basically asleep. I slept for 17 hours straight my first night, then 10 hours the second night. I’m not sure how long I’ll sleep tonight…but I strangely still feel exhausted.
I know I am burnt-out, and I am sure this intense level of exhaustion is a symptom of that, but it made me think about what the real difference is between burnout and depression.
Burnout is defined as work related stress, while depression is feeling down or miserable most of the time for more than 2 weeks.
What are the symptoms?
|Symptoms of burnout||Symptoms of depression|
|Cynicism||Change in sleep habit|
|Job dissatisfaction||Activities that used to bring you pleasure do not anymore|
|Feeling of incompetence||Withdrawing from friends and family|
|Sleep difficulty||Feelings of guilt|
|Physical ailments – stomach pain, hypertension,||Sadness most of the time|
|Substance misuse to cope||Fatigue|
|Loss or change in appetite, weight loss or gain|
|Muscle aches, headaches or stomach pain|
|Thinking life is not worth living|
There is a lot of overlap. After a while you may start to wonder where you fall in the two groups. Is all your unhappiness directly related to work stress? Or is it starting to seep into every aspect of your life?
What is the difference?
El Camino Health states one of the main differences is that burnout does not usually come with feelings of hopelessness, low self-esteem or suicidal thoughts.
Some state the key difference is that burnout is directly related to work, and that outside of work you are capable of enjoying yourself. If you were suffering from depression, it may be difficult to find pleasure in any aspect of life, let alone work.
As medics this can become increasingly hard to differentiate, as we spend most of our waking moments at work or studying for work. If you are unhappy with your job, you start to feel like you don’t enjoy anything, because all you really do is work or sleep!
Are they more linked than we realise?
‘Comparative symptomatology of burnout and depression’, goes so far as to say they do not think there is any difference, and question the entire construct of burnout. This study looked at 46 burnout individuals, and 46 individuals with depression and found similar severe levels of depressive symptoms.
Have we labelled another facet of depression as burnout to not deal with the stigma?
Maybe the source of burnout is all the same, a challenging work environment, but maybe it leads down the same road…ultimately to depression?
Another study ‘Burnout and Depression: Two Entities or One?’ believes that burnout is simply a form of depression, and that people with burnout would benefit from treatments for depression.
Twist of events
Honestly, when I set out to write this post I was ready to show how different the two truly are. To help clarify if you need help for depression or if it is simply a case of burnout. From my research into it, and from experiencing burnout myself, I feel like the studies are true.
Burnout does seem like another form of depression. It does stem from an unhappy work environment, and usually you do enjoy other things in life. However, if the burnout becomes bigger you may be so tired, sad and exhausted that it begins to affect other aspects of your life.
If you spend your weekend sleeping, what happens to your hobbies, likes, relationships, exercise? I feel like I am finally feeling a bit rested, just in time for starting work again on Wednesday.
Maybe the many doctors lost to suicide started off with burnout. Shouldn’t we take it seriously?
Saving your limited energy and getting help
When you begin to feel so tired all the time you need to conserve your limited resources. It can feel quite miserable to have just enough energy to show up to work for your next shift, but nothing else left over.
Even calling in sick isn’t quite cutting it. One day is not going to solve years of exhaustion. I doubt one week will do it either.
In the end, you need to prioritise your health above anything else. That is all we truly have, our health and our loved ones.
If you feel like you are losing that for a job, it is time to reassess.
If you have burnout or depression, or both, get help. Tell someone. Let people know, it is so important for us to talk about it more.
Things that can help
Learn when to say ‘no’ to things that are too much for you to handle. Like helping your friend move house, driving around someone, running a marathon…
Recuperate your energy – relaxing is productive too
Take the time you need – hard in the hospital system, and if you’re on a training program I know…but try your best to have the time off you need. Don’t leave it too long
Get help – get a good psychologist or GP, sometimes you need an outsider’s perspective
Prioritise your wellbeing – emotional, physical and spiritual