As 'chronic grind' causes more burnout some experts worry it's really depression

For many, burnout masks depression. That's why some want to change the conversation about burnout and mental health.

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/ Source: TODAY
By Meghan Holohan

With emails, texts, push notifications and calendar reminders, it feels like work never stops. For many, this frenzied pace causes burnout. Talk of it creeps in everyday life as people claim mommy burnout, millennial burnout, social burnout and work burnout.

And the World Health Organization (WHO) has noticed. This week, the group updated how it defines burnout: Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.

According to WHO, it is characterized by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and 3) reduced professional efficacy.

Some experts believe people may be confusing depression and burnout.

“If someone thinks he or she is suffering from high levels of burnout, I would suspect depression,” Irvin Schonfeld, a professor of psychology at the Colin Powell School for Civic and Global Leadership at the City College of the City University of New York, told TODAY.

Schonfeld and his colleagues have been studying occupational burnout for years. It first rose to prominence in the 1980s when Christina Maslach developed the Maslach Burnout Inventory (MBI), which evaluates burnout based on three criteria.

Based on that research, Schonfeld says the criteria for burnout are:

  • Emotional exhaustion, such as feeling fatigued when you wake up in the morning or emotionally drained from work.
  • Depersonalization. In other words, being indifferent to other people's feelings or not caring what happens to them.
  • Feeling less of a sense of personal accomplishment on the job.

Psychologist Lily Brown said early research looked at people in high-stress industries, such as nursing, but as employment has become so demanding, she suspects burnout affects people regardless of the industry.

“It tends to develop from a lot of expectations from having a very busy schedule, assignment after assignment without protecting with self-care,” Brown, the assistant professor of psychology in psychiatry at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania, told TODAY. “It rises from the chronic grind we find ourselves in.”

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Changing the thinking about burnout and depression

People think of burnout and depression and anxiety separately, but Schonfeld believes it might be more useful to think of them on a continuum.

Maybe burnout is more closely linked to depression and anxiety than realized.

“It can be more helpful in seeing burnout, anxiety and depression falling along a segment,” she said. “If you are not doing enough things to help burnout, you tip toward depression.”

But even if someone is feeling burnout, there's not a clear fix.

If someone is experiencing a high level of exhaustion and feels like they’re not treated well at work, some might encourage a vacation or a massage. But that’s not remedying the underlying problem.

“The half-life of a vacation is about two weeks,” Schonfeld said. “There really aren’t treatments.”

Treatments for depression, such as cognitive behavioral therapy or dialectical behavioral therapy, could help people deal with burnout before it evolves. In dialectical behavioral therapy, for example, Brown teaches patients to be assertive, which helps them lead less demanding lives.

“It is an important step to figure out a way to express needs and healthy boundaries,” Brown said.

Saying “no” when appropriate can help people cope before stress becomes overwhelming. What’s more, Brown said she encourages patients to engage in social activities or exercise to soothe negative emotions. She thinks this could also be useful for helping with burnout.

“Take a lunch break. Go for a walk or to the gym. It tends to be the anxiety in the moment that drives us to neglect self-care,” she said. “Break that cycle of engaging in mood drive behavior.”

Hard to admit depression

For some, claiming burnout feels safer than admitting to having depression or anxiety.

“The literature suggests physician burnout may very well be depression. Doctors’ careers could be hurt if it gets out that they are suffering from depression,” Schonfeld explained. “I understand why they might not want to say it.”

Brown believes that the stigma impacts people throughout their lives, not just at work.

“The language we use to communicate how we are feeling says a lot about stigma and what is culturally acceptable,” Brown said. “I think it is better to report feeling burnt out instead of saying depression or anxiety.”

This fear of admitting to mental health challenges can be preventing people from seeking treatment. If people fall back on burnout instead of depression or anxiety, they can be at a greater risk.

“With depression, there are all kinds of problems,” Schonfeld said. “That’s where the profundity lies. If this is depression, we have to really take it quite seriously.”