Thu Feb 27

What’s the difference between burnout and depression?

Written by Gordon Parker, Scientia Professor of Psychiatry, UNSW Sydney

If your summer holiday already feels like a distant memory, you’re not alone. Burnout – a state of emotional, physical and mental exhaustion following prolonged stress – has been described in workplaces since a 5th century monastery in Egypt ^[1].

Burnout and depression can look similar and are relatively common conditions. It’s estimated that 30% of the Australian workforce is feeling some level of burnout ^[2], while almost 20%^[3] of Australians are diagnosed with depression at some point in their lives.

So what’s the difference between burnout and depression?

Depression is marked by helplessness and burnout by hopelessness. They can have different causes and should also be managed differently.

What is burnout?

The World Health Organization defines burnout as an “occupational phenomenon ^[4]” resulting from excessively demanding workload pressures. While it is typically associated with the workplace, carers of children or elderly parents with demanding needs are also at risk.

Our research ^[5] created a set of burnout symptoms we captured in the Sydney Burnout Measure to assist self-diagnosis and clinicians undertaking assessments. They include:

exhaustion as the primary symptom
brain fog (poor concentration and memory)
difficulty finding pleasure in anything
social withdrawal
an unsettled mood (feeling anxious and irritable)
impaired work performance (this may be result of other symptoms such as fatigue).

People can develop a “burning out” phase after intense work demands over only a week or two. A “burnout” stage usually follows years of unrelenting work pressure.

What is depression?

A depressive episode involves a drop in self-worth, increase in self-criticism and feelings of wanting to give up. Not everyone with these symptoms will have clinical depression, which requires a diagnosis and has an additional set of symptoms.

Clinically diagnosed depression can vary by mood, how long it lasts and whether it comes back. There are two types ^[6] of clinical depression:

melancholic depression has genetic causes, with episodes largely coming “out of the blue”
non-melancholic depression is caused by environmental factors, often triggered by significant life events which cause a drop in self-worth.

When we created our burnout measure, we compared burnout symptoms with these two types of depression ^[7].

Burnout shares some features with melancholic depression, but they tend to be general symptoms, such as feeling a loss of pleasure, energy and concentration skills.

We found there were more similarities between burnout and non-melancholic (environmental) depression. This included a lack of motivation and difficulties sleeping or being cheered up, perhaps reflecting the fact both have environmental causes.

Looking for the root cause

The differences between burnout and depression become clearer when we look at why they happen.

Personality comes into play. Our work ^[8] suggests a trait like perfectionism puts people at a much higher risk of burnout. But they may be less likely to become depressed as they tend to avoid stressful events and keep things under control.

A mother feeling overwhelmed with a toddler.

Excessive workloads can contribute to burnout. tartanparty/Shutterstock ^[9]

Those with burnout generally feel overwhelmed by demands or deadlines they can’t meet, creating a sense of helplessness.

On the other hand, those with depression report lowered self-esteem. So rather than helpless they feel that they and their future is hopeless.

However it is not uncommon for someone to experience both burnout and depression at once. For example, a boss may place excessive work demands on an employee, putting them at risk of burnout. At the same time, the employer may also humiliate that employee and contribute to an episode of non-melancholic depression.

What can you do?

A principal strategy in managing burnout is identifying the contributing stressors. For many people, this is the workplace. Taking a break, even a short one, or scheduling some time off can help.

Australians now have the right to disconnect ^[10], meaning they don’t have to answer work phone calls or emails after hours. Setting boundaries can help separate home and work life.

Burnout can be also be caused by compromised work roles, work insecurity or inequity. More broadly, a dictatorial organisational structure can make employees feel devalued. In the workplace, environmental factors, such as excessive noise, can be a contributor. Addressing these factors can help prevent burnout ^[12].

As for managing symptoms, the monks had the right idea. Strenuous exercise, meditation and mindfulness ^[13] are effective ways to deal with everyday stress.

Regular exercise can help manage symptoms of burnout. alexei_tm/Shutterstock ^[14]

Deeper contributing factors, including traits such as perfectionism, should be managed by a skilled clinical psychologist.

For melancholic depression, clinicians will often recommend antidepressant medication ^[15].

For non-melancholic depression, clinicians will help address and manage triggers that are the root cause. Others will benefit from antidepressants or formal psychotherapy.

While misdiagnosis between depression and burnout can occur, burnout can mimic other medical conditions such as anemia ^[16] or hypothyroidism ^[17].

For the right diagnosis, it’s best to speak to your doctor or clinician who should seek to obtain a sense of “the whole picture”. Only then, once a burnout diagnsois has been affirmed and other possible causes ruled out, should effective support strategies be put in place.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline ^[18] on 13 11 14.