Burnout versus depression – what is depression?

 

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. This post is a follow up about burnout, which you can find … to understand the key differences between the two diagnoses.

 

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Depression

 

What are the origins of depression?

The Ancient Greeks wrote about depression as ‘melancholia’. Melancholia (from Greek: µέλαινα χολή) is a concept from ancient or pre-modern medicine. Melancholy was one of the four temperaments matching the four humours. In the 19th century, “melancholia” could be physical as well as mental, and melancholic conditions were classified as such by their common cause rather than by their properties. It is the predecessor of the mental health diagnosis of clinical depression and still exists as a subtype for major depression known as melancholic depression [1].

Depression can be found in the DSM unlike burnout. Depression falls in the group of mood disorders and those form, accompanied by personality disorders, schizophrenia and to a lesser extend addictions and intellectual disabilities, the base of (modern) psychiatry.

Depression is a mood disorder with mental and physical changes in the body. If you want to know more, you are welcome to read Does depression have an effect on the body?

 

In what way do depression and burnout differ?

Depression comes with the loss of being able to feel pleasure or anhedonia.  You don’t feel pleasure in any setting, not at work, not at home and not when you’re on holiday.

Depersonalization occurs with depression but with depression there is so much going on, that depersonalization isn’t a key concept as it is with burnout.

Burnout is a reaction due to stress from your occupation. Depression doesn’t need something to (bad) happen to you to unfold itself. It can appear with no triggers visible.

Feelings of worthlessness are not only present in the work setting with depression but are generalized. In burnout you feel the source of your stress and exhaustion, it is work. Maybe you react emotionally when work is brought up in a conversation in your free (!) time or maybe Sunday evening you dread going back to work the following morning. Your self-esteem suffers in burnout in regards to your work but not outside the workplace.

 

What are the symptoms of depression?

You are depressed when you have 5 of the following symptoms. Note: you can’t diagnose yourself. You can have a gut feeling or a general idea, you may know yourself well but to be able to see what really is going on, you need to talk to a professional in the mental health field. Back to the symptoms of depression:

  1. Depressed mood
  2. Low or no interest, or motivation
  3. Appetite change
  4. Sleep change
  5. Agitated or slowed
  6. Low energy
  7. Worthlessness (not only to work, in general)
  8. Thinking problems
  9. Suicidality (active or passive)

 

In what way will treatment differ?

With depression antidepressants can be prescribed or medication to help to fall asleep or to stay asleep. Or medication to help you become more active and to curb your anxiety. Or medication to help you relax deeper. Or a combination of those things and of course your doctor will prescribe what is needed and a the best fit for you and your situation.

Therapy is recommended to lift depression but the focus will differ. Depression takes all and touches your whole being. I felt that burnout was difficult and a real struggle, a more active struggle than depression where you are basically helpless. Burnout left the core of me intact. My work sucked but I still loved listening to music, to cook and to dance. Depression came, saw and took what was left.

With depression you’ll need to talk to your doctor about going back to work. If you’re prescribed medication, they need time to work. Your doctor can help to see when you’re still too vulnerable to undertake great decisions and when the time has come to take (small) steps forward.

 

 

 

References.

[1] Article on Wikipedia on Melancholia.

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

Picture 1 click here.

Picture 2 click here.

15 thoughts on “Burnout versus depression – what is depression?

    1. I have no idea to be honest. I got time off work with the burnout that wasn’t a big deal.
      The big deal started when it didn’t stay a burnout.
      I would guess that burnout occurs due to chronic stress and an adjustment disorder would be more ‘acute’ but also not at the same time.
      I first thought that my psychiatrist filled in ‘relapse into depression’ as a justification for the insurance. I was like, ok, whatever. When he told me about the medication, that is when the penny dropped.
      I feel that it’s not easy as a ‘patient’ to follow the diagnosis and when it is stated otherwise than what reality is (for sick leave) than the patient should know about it.
      In my opinion there is a lack of transparency. (in my experience).

      Liked by 2 people

      1. They tried to set quotas here, for burnout you’ll get 2 months off, for breast cancer 4 months etc. So that would increase the obscurity I think. But the quotas are not in action (yet?).

        Liked by 1 person

      2. That seems rather silly. What, is someone going to say they need more time off because they’re cancer spread, and insurance will insist that no, the cancer couldn’t have possibly spread because that’s not on their timeline?

        Liked by 2 people

      3. And that is how I got kicked of benefits.
        The timeline of depression told them that between 6 to 8 months after starting the medication, I theoretically should be in remission. Practically no doctor saw me.
        So I guess they would like to see that kind of action for every disease. Rather silly it is. People who are really ill are dealt a bad hand and some bad apples get away with it and make it difficult for the rest.
        The thing to ‘do’ is to go along, go back to work for a week or so and then start the process at the beginning. They will be more strict but because it is technically a ‘new’ file, it is possible. It is all Kafka to me!!

        Liked by 1 person

  1. Wow. Thankfully we don’t have to deal with insurance for mental illness or burnout. Although here in the UK, Burnout would be a difficult one. I even tried to google it for the UK and all it came up with was stress. You can have time off due to stress but I think each employer is different. Fortunately, with the NHS, I was paid full pay for 6 months and half pay for the next six months.

    Liked by 1 person

  2. The first time I really thought about depression in the clinical sense was when I read Hyperbole and a Half by Allie Brosh. Her book collects several of the illustrated stories from her blog as well as unique material like her account of dealing with depression. Her description, which definitely ticks off all the boxes mentioned here, made me much more careful about how I use the term “depression.” It’s not a term to be used lightly or a passing mood . It’s a serious issue that generally requires outside help once it’s taken root.

    Liked by 1 person

    1. A clinical depression isn’t a bad day, a mood or a normal grieving process. It can be used lightly sometimes when people say ‘I’m depressed’ but I doubt they want to feel (or the non-feeling) of a clinical depression. There are different kinds of depression though.
      It is a serious illness, burnout too.
      You’ve worded it very beautifully and correct imo, once it’s taken root. It grows slowly, through the years and when you can’t counter it alone anymore, it comes out to show you what is really going on on the inside. It’s quite the journey I must say!

      Liked by 1 person

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