As I experienced both burnout and depression I became curious about the difference between the two and decided, like I do, to do some research on my own and intertwine that with my personal experience.
What are the origins of burnout?
The term ‘burnout’ in psychology was coined in the ’70 by H. Freudenberger and C. Maslach. Burnout is not classified in the DSM (or the Diagnostical and Statistical Manual of Mental Disorders.)
The roots of a burnout are the result of too much stress in the workplace or your home-life. Because when you are a homemaker and/or a care-giver, that is an occupation too. A burnout is by definition work-related and the result of too much pressure.
What are the core symptoms of a burnout?
Burnout has physiological implications; when burned out you are physical and emotional exhausted. You can experience a great and overwhelming fatigue. I was not able to walk more than one street without having a rest. Going up the stairs a few times a day, was difficult and it was impossible to maintain daily chores like doing the dishes. I remember bursting in tears because I wasn’t able to do these dishes. The main difference was that while I couldn’t do things physically I wanted to do them. I had plans in my head but couldn’t execute them. I felt what was good for me but I had no energy due to lack of sleep quality and tension in my head.
In 1984 the MBI or Maslach Burnout Inventory was used to screen for burnout. This instrument focuses on the tree core symptoms of a burnout due to stress in relation to work.
- Emotional exhaustion. It was so difficult to feel other emotions than being or on the go, planning or being angry or exhausted. There was no room in my brain for my partner or television, it was all too much input.
- Cynicism, being cynical towards your work, workplace or colleagues. NOT towards the world in general or yourself. You can feel detached from yourself. You are going through the motion, you do the things that are expected from you but more in a robot like way. You don’t view the world negatively but I looked and critiqued every meeting and every staff member. I was even jealous when somebody fell ill for a week because I wanted to have some rest for a week! Depersonalization is a centre concept of burnout.
- Inefficacy. Due to bad sleep and crazy tension, I wasn’t the most efficient at work or at home. I made lists, lists and lists of lists trying to keep it all together. You try harder, your work is badly done, so you try even harder and become more exhausted. At a certain point you reach the point of no return. There is just no way back no matter where you look or run.
What is the big difference between burnout and depression?
Burnout is chronic fatigue due to stress. When you take the pressure off of a person with burnout, they can relax. It is recommended to ignite another fire, the fire of more pleasure in life and enjoying yourself. Not to be so goal orientated or perfect. Loosen up and have fun would be the message. And rest, take plenty of rest, will do you good. I only remember my legs hurting all the time. When I’m exhausted my legs hurt and the muscles can’t relax no more. I have two rocks for legs then and that hurts. Burnout hurts, it is painful. It doesn’t give you the time of day to rethink/revalue something because in active burnout the stress seems to prick you like the devil with his torch. That is how it felt to me. They say that when a person with burnout takes a holiday and the pressure of work is gone, the responsibilities are being taken care of or when you have no care in the world, you are able to recharge your battery. The more severe the burnout, the more time it will take for the battery to recharge. In the early stages it won’t charge at all because the battery is broken. The system of recharging needs to be healed.
With depression, for me, that was not the case. When the pressure was gone, I imploded and lost more and more. When a depressed person goes on a holiday, the depression just goes along. It’s like your shadow, it is there in the airport, in the bed and breakfast, in the restaurant and on the beach. You are on holiday but it doesn’t make a difference anymore. It’s all grey although you know that the sun is shining. Just not for you. You can’t take a break from depression.
What are other symptoms of burnout?
Digestive problems, problems concentrating, feelings of fainting, dizziness, memory loss, muscle aches, headaches, aggression, heart palpitations, panic attacks, sleep disturbances, mood swings, loss of motivation and fatigue. Feelings of hopelessness but in regards to your work. In depression everything is a big grey hopeless mountain.
With burnout you will be able to enjoy things, just on a very tiny scale. The possibility to feel pleasure isn’t gone as it is with depression.
Why is the differentiation between burnout and depression an important one?
The treatment will differ greatly. For instance, depression can be treated chemically with antidepressants. For burnout there is no medication available. Antidepressants do not work in a case of burnout. When I heard that, I thought, great, no help there and I already felt to helpless. Due to loss of efficiency you are not that sure that you can conquer this big mountain with no help. A Sherpa can be provided in the form of therapy. With your burnout coach you’ll rethink yourself and your workplace.
You learn how to set boundaries for example and it is recommended to go back to work quite soon, but gradually and during your therapy. You learn how to manage stress by prioritizing your happiness, your sleep becomes more important to avoid the inefficacy. You can prioritize exercise to manage stress or take break, practice meditation or mindfulness. You’ll need to take care of yourself, your energy levels and the practice some balance between personal and work life, between duties and relaxation. There is a shift in priorities and in the way we perceive them.
Burnout happens when there is no fit between the person and the culture or demands of the job. When you can’t fix the incongruence, you are left with no personal satisfaction (= protective factor from stress) from your job and an overactive mind that is actually out of order if we are being totally honest.
When you learn how to manage stress and you adapt to it, it is also needed to take a good look at the workplace. When adaptations are not possible, some people decide to change the workplace or opt for a career switch.
Do you have experience with burnout? Do you recognize my story or do you have different opinions on burnout? Tell me in the comments!
Everything I wrote is how burnout is perceived anno 2020. I’ve heard that some clinicians classify burnout as a form of depression because it changes mostly the same regions in the brain. We’ll need to wait and see how burnout evolves. For now it is not a mental illness.
This post is the start of a series on burnout which will be posted every Tuesday. If you have questions, let me know in the comments and with your permission I’ll answer them in the series.
References and online resources.
Maslach C, Schaufeli W, Leiter M. Job burnout. Ann Rev Psychol. 2001;52:397-422.
The Tired, Retired, and Recovered Physician: Professional Burnout Versus Major Depressive Disorder. Am J Psychiatry. 2018 Aug 1;175(8):716-719.
Bianchi R, Schonfeld IS, Laurent E: Is burnout separable from depression in cluster analysis? A longitudinal study. Soc Psychiatry movement Psychiatr Epidemiol 2015; 50:1005–1011
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