The difference between burnout and depression "Burnout is just a fashionable term for depression," is a common accusation from the media and the skeptical population. What is there to the accusation?? Is burnout really a fad. Ultimately a hidden depression? In fact, burnout is a relatively new ailment, first discussed publicly in the 1970s.
Work environment and the fear of weakness
In fact, burnout is a relatively new complaint, first talked about publicly in the 1970s. The term appeared in connection with nursing professions. People in social work in particular seemed to be prone to "burning out," running out of steam and falling into deep exhaustion due to their extreme workloads. Today, burnout is also often called "manager's disease".
In fact, a depression can be hidden behind a burnout. Burnout simply sounds better and is more compatible with the self-image of those affected, according to some experts. Finally, the term suggests that one has previously accomplished a lot. In contrast, depression is associated by many people with weakness. But the risk factors for burnout and depression are very similar.
Burnout is not a disease in its own right
Burnout, however, is not an independent medical condition. In the diagnostic catalog of physicians. Psychotherapists do not see this "illness". It is only an additional diagnosis, which is often given in combination with a disease.
One can be written unfit for work due to an additional diagnosis, but one does not have an illness because of it. The official definition of burnout is "problems related to difficulties in coping with life, including being burned out [burnout].".
In a revision of the catalog, expected to be published in 2022, more precise characteristics of burnout have been described for the first time.
"Burnout is a syndrome conceptualized as the result of chronic stress in the workplace that has not been successfully managed. According to this definition, burnout refers specifically to phenomena in the occupational context. Should not be used to describe experiences in other areas of life.
Additional diagnosis and therapy
Other examples of additional diagnoses, under which burnout syndrome also falls, are "lovesickness" or "noise at work". However, life crises or extraordinary stress are not mental disorders. Only when a person develops depression as a result of these stresses, for example, does a diagnosis of illness and usually also therapy become necessary. For a person with impending burnout, a week's vacation can work wonders, while for someone in a depressive episode, a vacation can actually worsen symptoms.
Often the additional diagnosis of burnout is made in combination with depression. In this case, depression is the reason for therapeutic treatment. In other cases, the burnout syndrome is due to a so-called "adjustment disorder", which makes therapy necessary.
With burnout, the focus is on the causes
How can burnout be distinguished from pure depression?? Unlike burnout, the symptoms of depression are clearly defined. They are the same internationally. When diagnosing depression, a doctor or psychotherapist relies solely on the patient's symptoms. Causes for the disease become a topic in psychotherapy, but do not change the clinical picture of depression itself.
In burnout, the focus is on where the exhaustion comes from. While depression can be diagnosed without context, the context of burnout is central. Thus, the individual phases of increasing exhaustion can also be seen as an explanatory model for its development. If the causes of the deep exhaustion lie in permanent exhaustion and overload, some experts nowadays prefer to speak of burnout rather than depression.
Causes should not play a role in the diagnosis of diseases
However, relying on causes for diagnosis is problematic: The International Classification of Diseases (ICD) describes mental illnesses solely on the basis of measurable symptoms. Causes have an enormous significance in terms of prevention and avoiding relapses, but at the moment of diagnosis they serve no purpose and are often even a hindrance. They are not as objectively measurable as symptoms. In addition, it is often not possible to make clear statements about cause and effect. In addition, during psychotherapy, often only after. According to possible causes of the disease elaborated. An example from medicine may illustrate that causes have no significance in diagnosis: Doctors diagnose lung cancer based on symptoms, the disease can be measured objectively. Whether the tumor is caused by smoking or by other causes is irrelevant for the diagnosis itself.
Burnout is not imaginary
Although there is no such thing as a purely "disease-like" diagnosis of burnout, this by no means means means that sufferers are imagining their suffering. The complaints of burnout sufferers are very real. Show themselves in a recognizable pattern. But the main diagnosis has a different name – often depression. The term burnout can serve as a supplementary explanation of how the exhaustion arose.
A burnout is often diagnosed in combination with a depression. But the characteristics of burnout do not apply to every person with depression. In order to understand how the disease could develop, it is worth taking a look at these peculiarities. While depression can develop both slowly and suddenly and seemingly without cause, a burnout syndrome usually develops insidiously. A person affected by burnout often goes through typical phases that build on each other. Some researchers describe the course of exhaustion in three stages, while others distinguish six stages.
The stages of burnout: up to total exhaustion
The burnout process is usually triggered by a phase in which those affected expend an excessive amount of energy. The reason can be, but does not have to be, idealism: One "burns" for a cause and puts all his energy into it. Behind the increased energy input, however, there can also be fear and worry: Fear of being fired or fear of not being able to complete a project on time. In this first phase of excessive demands, the threat of burnout is rarely recognized. However, if someone finds it very difficult to switch off in their free time, this can be seen as a warning signal.
Effort is followed by powerlessness
Especially when rewards fail to materialize over a longer period of time, eagerness eventually turns into frustration. Commitment dwindles, expectations of the environment increase. Often, those affected develop a downright aversion to their tasks. This state is often equivalent to an "inner resignation" – one only works to rule and begins to resign. Work becomes routine. Seems pointless. Affected persons become emotionally dull, cynical and less sensitive toward others. A warning sign in social professions can be when nurses or teachers no longer let the problems of patients or students get to them.
Emotionally, burnout victims either react with aggression against the environment, or they look for the reasons within themselves. In the last case, the symptoms are similar to those of depression: one feels empty, depressed and pessimistic.
Despair follows listlessness and indifference
With the motivation, the willingness of the affected person to perform also decreases. They have difficulty concentrating, make more mistakes, are less creative and are often no longer able to cope with everyday life. Those affected can no longer make decisions. Become increasingly indifferent. Socially, too, emaciated people withdraw and neglect hobbies. Boredom and listlessness set in.
Physical complaints often go hand in hand with the psychological ones. Typical symptoms are backache or headache, also heart or digestive problems, sleep disorders, nightmares and sexual problems. In the final burnout stage, the powerlessness ultimately develops into a general hopelessness and despair. One feels "burned out" in the truest sense of the word.
At the end of burnout there is often depression
Those who reach the final stage of burnout have usually slipped into depression. The feeling of deep exhaustion is typical for depression. The three core symptoms of depression are dejection, loss of interest and lack of drive. These signs of illness can also be observed in advanced burnout. Additional symptoms of depression can also occur in burnout victims – for example, sleep disturbances, lack of concentration, suicidal thoughts, pessimism or reduced self-confidence.
Burnout syndrome can be helpful as an additional diagnosis
When the term burnout is overused, there is a danger of diluting the diagnosis of depression. At the same time, the additional diagnosis also brings advantages: It is often easier for people to admit to suffering a burnout than a depression. After all, this indicates a lot of work and dedication. For those affected, the additional diagnosis can be helpful and relieving. In addition, the high prevalence of burnout syndrome sends an unmistakable warning signal in the direction of the working world: excessive workload is an important cause of depression. Because burnout causes are often related to working life, many companies nowadays pay attention to a good work-life balance of employees.
There are ways out of despair
The additional diagnosis of burnout should not, however, drown out the symptoms of depression. For the future it would be rather desirable that a depression attains the same acceptance and justification as a Burnout. Because fashionable term or not – especially in the final burnout stage, the two types of complaints are hardly distinguishable from each other. Therefore, the signs should always be taken seriously – regardless of what they are called on paper. The complaints should be counteracted. Effective therapies are available to help those affected find ways out of despair. The main components of psychotherapy for burnout sufferers are conflict and stress management, self-management, relaxation training and the strengthening of self-confidence.