Depression and Burnout

Depression and burnout are an alteration of the mood

Depression is a mood disturbance. It is an illness characterized by symptoms such as low mood, loss of interest and initiative, psychomotor slowness, pessimism, indeciviness, feelings of guilt and others.

Depression differs from normal sadness in that it is too intense, goes beyond what would be expected, and causes a marked weakening of physical and social functions and work capacity.

There are numerous clinical forms of the depressive illness and the causes are multiple. Up to 50 % of the depressions in adults can have as root a psychological wound of the childhood.

The diagnosis of depression is suspected by the persistence of a state of sad mood, like a low tide, for more than two weeks, or dark glasses that prevent to see.

It is accompanied by feelings of guilt, unwillingness to do anything, lack of appetite, weight loss, early awakening, etc.

Distinguishing sadness from depression

The following chart helps to distinguish normal sadness from depression, although there is no exact demarcation:

Normal sadness	Depression
There is a triggering stimulus	There is not always one
Stimulus-response ratio	Disproportionate response
Limited and proportionate duration	Duration greater than two weeks
Little impairment at work, family, etc.	Marked impairment
No or few physical symptoms	Significant physical symptoms

The most important depressions are called endogenous, in which the cause is mainly an alteration of brain functioning, with a dysregulation of chemicals or neurotransmitters, especially serotonin, noradrenaline and dopamine.

Endogenous depression in turn includes several forms, mainly unipolar, or depressive only, and bipolar, in which there are periods of pathological euphoria or mania.

Personality factors influencing depression

Some personality traits that may favor the onset and relapse of depressive symptoms are:

Exaggerated desire for order
Tendency to hyper-reflexivity and scrupulosity
Self-demanding and intolerant
Strong and inflexible sense of duty
Exaggerated perfectionism
Dependence on others, including for self-esteem
Highly variable mood and obsessiveness

Professional stress or Burnout

An ailment similar to depression, which sets in gradually, is burnout or professional stress.

Burnout is a type of chronic stress. In other times it has been known as surmenage, psychasthenia, neurasthenia or chronic asthenia syndrome. The first cases were described in nurses in the 1950s in England.

It affects people with high responsibility jobs, such as executives, politicians or businessmen; and those who work in service areas or with many people under their charge: doctors, nurses, teachers, policemen, pilots, priests and even housewives.

Personality traits that favor burnout

The people most prone to burnout tend to have traits similar to those mentioned for depression:

insecurity
perfectionism
willfulness
meticulousness
controlling attitude
high self-demandingness
psychological rigidity
low frustration tolerance
strong dependence on performance and success
competitiveness
hyperactivity
nonconformity
impatience
obsessiveness

The stages of burnout are:

Emotional exhaustion, with indifference to suffering and lack of compassion.
Depersonalization or cynicism, with mistrust, rejection and feelings of guilt.
Low self-fulfillment with frustration leading to apathy.

Coping with depression and burnout

How to help a person with mood disorder depends on the situation or stage they are in. It is important not to unnecessarily prolong personal suffering or the suffering of others.

If depression is suspected, it is best to see a health professional early.

If there are attempts at self-harm or suicidal ideation, or delirium, or an episode of mania or pathological euphoria, medical attention is more urgent.

In depressive phases, the help of a family member, a friend or spiritual accompaniment is useful because it provides valid support, but often medication is necessary.

Medications for depression

Modern antidepressants achieve a faster recovery. Between crises or in the period of convalescence, it is necessary to face, with the advice of experts, the character traits that predispose to the disorder, like the rocks that the low tide has brought to the surface.

The most commonly used type of antidepressants are selective serotonin reuptake inhibitors:

Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac: which was the first to be marketed)
Paroxetine (Paxil, Pexeva)
Sertraline (Zoloft)

Useful tips in depression

The spiritual life and its resources help the person throughout the healing process. The patient is better able to distance himself from his symptoms (not always achieved), and to accept the illness without identifying with his pathological state.

Depressive patients are not helped by encouraging generic advice or exhortations. It is not necessary to ask them to make an effort of good will or to tell them, for example, “Courage, there are others worse than you!”

From the spiritual point of view, anything that leads them to come out of themselves, to look to God and to others, will help. They should be encouraged to offer up their suffering, even afterwards, when the episode is over. For many, accepting illness is difficult, but in no way should they see it as a punishment. Nor should they see it as a humiliating label.

Sometimes, it is part of the manifestations of the disease not to believe what the doctors tell them. It helps to foster hope, confidence and patience.

The sadness produced by the very feeling of sadness adds an extra suffering that is best avoided. Many come to understand that the experience acquired with a depression is of great value, also to help others, and that it is good to look to the future with optimism.

Faced with this illness, the human being thinks more about the limitations and deficiencies of his finite psyche.

An anxious and constant search for the cause of the symptoms, a trauma that triggered them or a motive should be avoided, because it increases the tendency to counterproductive self-criticism and fosters additional feelings of guilt and inadequacy.

In general, except in severe cases, a patient with depression is able to continue his or her normal activities (it will be the doctor who will say what he or she can or cannot do), including the practices of Christian piety that perhaps he or she used to do. It is advisable, if possible, to keep the time occupied, even if he can sleep more (always bearing in mind that too much sleep is counterproductive) and rest at certain times of the day.

In the face of job dissatisfaction and stress, it is necessary to evaluate individual factors and those of the institution or company in which you work.

On a personal level, the dangerous traits mentioned above must be addressed. One should avoid extremes in expectations: either very low, close to zero (I will never do anything useful, I am not good for this…), or very high and unrealistic.

Expectations that are too high or unrealistic sooner or later lead to ruin. Low expectations, on the other hand, destroy initiative or paralyze action, resulting in diminished self-esteem.

As for the company or workplace, it is important that there are areas of growth and relaxation for everyone, that diverse activities are encouraged, that adequate preparation is given to each person and that good interpersonal support is provided.

A preventive factor of burnout and depression is a strong purpose or meaning of the existence, valued by oneself and by other people who help us to carry it out.

It is necessary to reduce stressful circumstances and improve the ability to control them, tolerate negative events, maintain a positive self-concept, emotional balance and satisfactory interpersonal relationships.

It is essential to foster hope, optimism, distance oneself from events, re-evaluate situations, engage in rewarding activities, think of others and ask for help.

Learn more about depression and burnout