Burnout is Indistinguishable from Depression, Researchers Find

Despite burnout being officially recognized as a syndrome, research suggests it overlaps considerably with current understandings of depression.

Jessica Janze
23
1221

In the eleventh revision of The International Classification of Diseases (ICD-11), which will go into effect in 2022, a new definition for burnout has been added which labels it a “syndrome” resulting from “chronic workplace stress that has not been successfully managed.” However, new research, published in the Journal of Occupational Health Psychology, finds that tools for assessing burnout and depression seem to be measuring the same thing.

“Burnout, which has been conceived of both dimensionally and categorically, is thought to constitute a public health problem. The interest surrounding burnout, however, has coexisted with marked difficulties in characterizing the syndrome. One of the difficulties concern the overlap of burnout with depression,” the researchers, led by Irvan Schonfeld, at the City University of New York, write.

Photo Credit: Pixabay

Recent attention has been brought to the growing problem of work-related stress in the United States. According to the World Health Organization, burnout is not considered a medical condition, but an “occupational phenomenon.”

To deal with this “syndrome of work stress,” research recommends healthy boundaries, seeking support, mindfulness, and psychoanalysis. However, researchers have begun to question the difference between burnout and depression, and have asked if such a distinction exists at all. Because research on depression and burnout were conceived and developed in separate fields, it’s not unlikely the concepts may be indistinguishable.

“Although burnout is thought to be work-related…depression is common in the workplace. Research on burnout has largely developed independently of the research conducted in psychiatry, behavioral psychology, and neurobiology on stress-induced conditions such as depression. Consequently, the question of the overlap of burnout symptoms with depressive symptoms has largely been neglected by the pioneers of burnout research,” Schonfeld and colleagues write.

“Depression is best conceived of as a dimensional variable, with clinical depression only representing a section—the high end—of the depressive continuum. When adopting a dimensional approach to depression, no theoretical space is left to the notion that burnout is a phase in the development of depression. When examining burnout and depression consistently by adopting a dimensional approach to both entities, the continuum of burnout appears to parallel the continuum of depression.”

The article examines three studies, including over 3,000 individuals in two countries, conducted in two languages to explore the correlation between burnout and depression. “We investigated the discriminant validity of burnout scales by evaluating the magnitude of the correlation between (latent) burnout and (latent) depression. In each study, we examined the burnout–depression association based on confirmatory factor analysis (CFA), controlling for item-level content overlap.”

After conducting multiple CFAs and deliberately removing items with the potential for content-level overlap, researchers observed high correlations between latent exhaustion (burnout) and latent depression as well as a high correlation between latent exhaustion (burnout) and anxiety. “In the three studies, latent exhaustion, the core of burnout, and latent depression were highly correlated (correlations ranging from .83 to .88). These results cast serious doubt on the discriminant validity of burnout scales.”

“The balance of evidence from the research presented here undermines the view that the discriminant validity of burnout scales is satisfactory. notably, because our results were obtained controlling for item-level content overlap.” The researchers write, “The replication of our findings in three different samples, combined with research that shows that the nomological networks (e.g., relationship to job adversity, stressful life events, social support, work-nonwork interference, attentional, interpretative, and memory biases in the processing of emotional information) for burnout and depression scales are highly parallel. reinforces that view.”

With a growing understanding that depression and burnout may be the same latent variable, researchers suggest moving away from research using the burnout construct. “Nosologically speaking, burnout is undefined; despite more than 40 years of sustained research, the syndrome cannot be diagnosed. This prevents burnout researchers from getting a clear view of workers’ health status. Conclusions from burnout assessments are typically vague and clinically foundationless.”

The authors conclude:

“Depression can be approached from both an individual and a social standpoint, and methods for assessing the weight of occupational factors in the development of depression are available. On these bases, we recommend that occupational health specialists focus on depression rather than burnout to more effectively identify and help suffering workers.”

 

****

Schonfeld, I. S., Verkuilen, J., & Bianchi, R. (2019). Inquiry into the correlation between burnout and depression. Journal of occupational health psychology. (Link)

23 COMMENTS

    • Exactly. The only possible difference is “depression” has a pill that can be pushed to “cure” it, whereas “burnout” likely doesn’t.

      So our “mental health workers “recommend that occupational health specialists focus on depression rather than burnout to more effectively identify and help suffering workers.”

      Of course, that recommendation will result in harming suffering workers, rather than helping them. Since, of course, antidepressants don’t “cure” bad working environments. Fixing the problems within the bad working environment is how you “cure” such problems.

  1. This is one of the hidden secrets of the MH industry. There is burnout and high turnover with poor working conditions and the benefits in some states meager.
    In one agency they had graphs of employees billable hours on the hallways. If you did not fill monthly requirements you were at risk for losing your job. Three months of not meeting the deadline and poof you are gone- no matter how good you were as a helper and support professional.
    Many staff take the same medications so it is literally so to speak the blind leading the blind.
    It was traumatic to work in many agencies due to one’s own stuff and then secondary and tererary trauma.
    How many clinical folks lost a client to suicide? That is a whole book in and of itself.
    Paperwork perfection was all that mattered to the administrators -many who never wanted or cared to work with humans in need.
    High turnover better financially.
    Draconian demands and poor everything else. So all the bad behavior and inhumanity could be from the dysfunctional system and those who decided to stay without awokeness.
    Double and triple whammy.
    If one thinks about it, the MH system a separate mirror and the client system a separate mirror reflecting back on and rerefecting all the shadowed dysfunctions to infinity and ad nausuem.
    One needs to step out or break the system of mirrors.

  2. Peter Breggin, in his Toxic Psychiatry (1991) has written that people are depressed because they are leading depressing lives.

    I take it that more often than not this will come down to career and marriage problems.

    Now I know a guy who was in such a state. He sort of lost it and ended up in a Psychiatric hold. They convinced him that he had a ~Brain Chemical Imbalance~ and that he needed to be on drugs. So his present addiction to alcohol merely advanced to psychiatric medications instead.

    And he did nothing to remedy his career or marriage problems. He just started sexually molesting his daughters. And he did this with what had to have been clear knowledge of the wife.

    It was because of mandatory reporting that when the youngest girl, 13yo, 8th grade said something to a youth center counseling intern, that an investigation started and he got arrested and charged.

    He confided to me about the pending case, assuming that I would be on his side, and on the side of all of his church members. He never said anything which directly indicated guilt. But I was blown away by the amount of energy he had invested in scapegoating his eldest daughter.

    Well, one does not ignore the Burning Bush. I got involved in the case right away. Circumstances gave me a much larger role than I ever could have imagined. These cases are highly political. Wouldn’t expect that, but they are. Most of the jury pool is completely unprepared to deal with such. And there is a whole cadre of lawyers who have made it their life’s work to use anti-feminist and anti-government prejudices to make it impossible to enforce any child protection laws.

    As it is though, this guy is now serving a long sentence in our state penitentiary.

    Very good book. She explains how important child protection and mandatory reporting are. She also explains that most of the time it is impossible to catch and prosecute people who have money. The exception though is child sexual molestation. But the upshot is that only with child sexual molestation will there often be highly capable and aggressive defense attorneys.

    https://www.amazon.com/Childism-Confronting-Prejudice-Against-Children/dp/0300192401

      • Really it was his Pentecostal Church which was standing behind him the whole time. That, and just the fact that there were all sorts of unresolved problems in his life. Rather than trying to deal with them, he listened to the white coats and learned to tune out to his feelings. So he took it out on his children, the girls for sexual molestation, and one son being feed into the mental health system. The other son sided with the parents, and he brought his college girlfriend with him and they sat on the defense side, and he testified against the eldest daughter. He did this in a really stupid way too.

        The other son, being feed into the mental health system, he had a hard life. But he definitely did not side with the parents. He has since taken his own life, shot himself in the head.

        The wife, she is still calling the girls liars.

        The psych drugs did not cause any of this, but they did encourage people afraid to feel their feelings, and this makes people really strange.

        I attended the entire trial. I couldn’t form any conclusive opinions about the case just based on the police report, though it was very well written. You wouldn’t believe how this guy just about lost it in the court house hallway when I showed up for jury selection.

        I did notice how when they gave a written survey to the batch of 80 perspective jurors and asked about familial sexual molestation, none of them said they had known of any of this within their own families. Either people don’t want to be honest or they are in denial. Based on statistics, it will be in most families.

        Remember, after the Menendez Brothers trial, they surveyed jurors and they said that no father would do that to his own sons.

        Our whole society is in denial, and the defense attorney appealed to anti-feminist and anti-government prejudices.

        • I actually explained in writing to the DA that it really was just a case of mid-life crisis. That was what got him into the psychiatric system, and he believed what they told him. And that convinced him that his life depended upon drugs and on not feeling his feelings.

          It was that and his Christian Fundamentalism, because such a person is not supposed to be having any mid-life crisis, they are supposed to already have all the answers which they need.

          I showed the DA clips of “The Arrangement” 1969.

          https://www.youtube.com/watch?v=ZSj7sYOUKUY

          Flying an airplane in circles around a high rise.
          https://www.youtube.com/watch?v=-2hasmMlm3c

          My Pentecostal Molester did do crazy things with cars, things which effected the rest of the family.

          • Rick’s Hope4MentalHealth circle is disingenuous.

            The five Scriptures have nothing to do with psychiatry. Ignorant or dishonest.

            The Five “Truths” of the circle should read:

            1. I’m upset. vs You’re sick and crazy.
            2. I need hope. vs You need a counselor to tell you to give up on life.
            3. I need love. vs You need to be segregated.
            4. I need help with obvious life problems. (Poverty, physical issues, abuse.) vs You need drugs and probably shocks too.
            5. I’m unhappy. vs You are a disease.

            That’s what Psychiatry is really about. Rick doesn’t mention this. Perhaps he wants to offer real help, but why not just give it instead of promoting drugs and segregation?

            Psychiatry did NOT save your son Rick. Why push it as the magic cure to everybody else?

      • His incarceration will definitely be miserable, too. Child molesters are on the bottom of the inmate hierarchy, exaggerated by the number of other convicts molested when they were small children, who are now large and dangerous violent adults.
        That’s one reason why child molesting individuals from the professional classes aren’t imprisoned- because they’ll be eaten alive in the “joint”, which is hardly a reason to let them wander about, free.

  3. What a crazy world – work places are the cause of stress and burnout of broken marriages, families, broken bodies, boredom and essentially turning people into robots set to repeat the same old tasks over and over again for the best years of our lives – but hey lets not diagnose the work place as being ill and disordered and seek to change the work place or work ethic…NO let us always and forever pathologise the individual and make it his or her responsibility to change through the magic of ‘research recommends healthy boundaries, seeking support, mindfulness, and psychoanalysis’.

    We even have mental (ill) health services causing massive harm to staff – anyone worked in secondary (anti) care in the UK? many staff are hanging by a thread quite often functional substance dependent riddled with anxiety and low mood – or perhaps in the UK governments ‘flag ship’ IAPT service? again a service that is nationally burning its staff out on mass with its relentless drive to service targets targets targets – targets by the way that are meaningless and freakish distortions of what ‘recovery’ is meant to be – score ‘below clinical’ on the phq9 and we have a winner – congratulations you are now in recovery

    At the same time as its causing direct suffering to its staff on mass IAPT management is also tightening its sickness policies so now people are on final stage warnings for having minor issues like heart attacks, bereavements, major accidents and of course for burn out BUT you can always go have some of your own CBT to change your pesky NATS, unhelpful beliefs attitudes and behaviors and get with the program.

    a sick system doing little to help those its tasked to help and causing great suffering to its staff – in a word MENTAL.

  4. I am impressed at how complex and confusing they have made a very simple correlation. Burnout and depression “overlap” because they are both descriptions of how people feel and act when they are overwhelmed, stuck,hopeless, and/or disconnected or unsupported by their communities. Making it seem like they are somehow different things that “overlap” is just a sleazy way to continue to legitimize their medicalization of “depression.” I found it particularly amusing that they assert that “burnout” is a syndrome that can’t be clearly defined, as if “depression” were somehow different.

    Anyway, you can tell when someone’s explanation doesn’t hold water if it continues to make the situation seem more and more complicated instead of simpler.

    • Remember, Steve, that both “depression” and “burnout” are also likely to be the results of depletion of nutrients. In fact, in the most mentioned obvious dietary deficiency diseases- scurvy, beriberi and pellagra- depressed mood is common to all of them. Although constant job stress isn’t going to make you a scurvy knave with all your teeth falling out, it will affect your internal resouces and stress you as a consequence.

  5. Steve, supposedly you have been around as long as I have. Burnout was big in the early eighties and was trending toward its the system stupid but all of the stupids realized with the help of others that anytype of victim was trouble so in came the meds, incarceration, gerrymandering, redlining, and massive amnesia.
    Literally all agency meetings became explanations for how to play the cat and mouse game admin folks were playing with both state and federal agencies.
    It completely stopped being about the old term here you may have heard person in society.
    Any sense of social justice perspective or advocacy for others was out the door. It was all about money.
    Reg folk from the actual agency watchdog and other source of funding governmental and nongovernmental sources would go through record notes, yes folks your records were always seen on a random basis for compliance if the correct vocabulary were used and correct time spent ect ect the billable hour would be paid. If not the offending staff would be eventually through various ways and means be shown the door.
    Some MH agencies had a pharmacy tied to county or state. Many people were non compliant and I have never figured out how that system worked or didn’t work.
    Big Pharma came but not like in medicine. A lunch here a lunch there and if you were 50,000 in debt from college a free lunch is a free lunch.
    Funny how Big Pharma never was intelligent to use theirgrand expense accounts to offer a free meal to the community MH clients.
    There were some ground breaking programs but rife and fraught. And again good ideas and people were always beaten down- always.
    There should be a list of crimes committed and crimes for those actions that were deliberately and willfully not done that caused harm.
    Staff and former staff need to take on this. They know and many if not dead by vocation are retired.
    And the administrators off all systems and ilks- they bear the responsibility for committing and creating these crimes.

  6. I have been through “crappy boss.” This wasn’t my disorder, but a workplace disorder. I never figured out why they made that woman a supervisor.

    There was nothing “inner” I could have done to fix the situation except to quit. No matter how good my nutrition was, no matter how much I exercised, it wasn’t going to fix the crappy boss situation. I could have decided it was all due to my own mental illness and then, therapized the problem away, still wondering why I hated my job, why every day there sucked, why the therapy hadn’t exactly solved anything. What then? Time for pills? Oh I know! Shock treatments…..