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.

 

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

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