Burnout or Depression?

By Dr. Faisal Alzahrani

At some point in our lives, we may feel stressed, overwhelmed and exhausted. Surely, some situations are less stressful than others. However, whether we study, work or care for someone, every thing we do comes with a variable dose of stress that we need to cope with. In fact, due to differences such as relationship status, financial situation and individual coping mechanisms, some of us can cope with stress better than others. Nevertheless, the majority, if not all of us, are vulnerable to experiencing the “I’m over it” or “I give up” moment. The question is; at that point, are we burnt out, depressed or both?[1]

‘Burn out’ is a state of exhaustion that can be mental, physical or emotional in response to high levels or moderate but sustained levels of stress. Initially, the symptoms may be subtle. However, if not recognised, they can progress rapidly to burnout and ultimately affect what we do. These include negative thoughts, pessimistic attitude, lack of energy, ongoing or progressive exhaustion, and carelessness when it comes to performing tasks. Interestingly, these symptoms can also appear in depression, and make it difficult for us to differentiate.[2]

Depression can initially present as burnout, however, it can be far more damaging and much more serious. If not detected and dealt with early, it can lead to tragic outcomes, one of which is suicide. Similar to burnout, depression can be linked to demanding jobs and overwhelming tasks. On the other hand, it is not often caused by high or sustained levels of stress. More commonly, depression can be caused by biological, psychological or environmental factors that make some of us more susceptible to it than others. In addition to the symptoms mentioned above, the depressed person may also experience withdrawal, change in eating habit, weigh changes, disturbed sleep or insomnia, poor concentration, low self-esteem and anhedonia. Clearly, there is an overlap in symptoms between burnout and depression, but is there also a relationship between the two?

Theoretically, depression can accelerate the process of burnout while burnout alone can lead to depression. A recent systematic review that was done in March 2019 by the University of Macedonia in Greece concluded that there was a significant association between depression and burnout. However, the actual relationship between the two was not made clear by the studies that were included in the analysis. Therefore, it was suggested that more studies are needed to further clarify that relationship and better identify the cause and effect.[3]

In conclusion, we now know that burnout and depression are two distinct conditions that can be difficult to distinguish due to the overlapping symptoms and strong association. Depending on the severity, medical treatment and professional intervention might be required. However, in most and non-severe cases, early recognition may enable us to deal with depression and or burn out better and make a faster recovery.

About the author

Dr. Faisal Alzahrani is a registered medical officer at Redcliffe Hospital (QLD) and Associate Lecturer at the University of Queensland. He graduated from Bond University with multiple degrees - Bachelor in Medicine, Bachelor of Surgery (MBBS) and Bachelor of Health Sciences.