DEPRESSION, BURNOUT, MISDIAGNOSIS and DEPRESSION MANAGEMENT

shutterstock_396727762

Depression, burnout and depression management

Since the end of the Halloween celebrations, the clock was turned one hour back, the sun sets an hour earlier and most of us are returning home in dark feeling tired and some of us complain of feeling depressed and fearing that we might be suffering from depression linked to a seasonal affective disorder. The fact that the days are getting shorter and that there is a lack of light could lead to seasonal affective disorder (SAD) which is a winter depression that starts in autumn and gets worst during the winter season in December, January, and February. Although SAD was not formerly included in the Diagnostic Statistical Manual of Mental Disorders IV-TR (APA, 2000), it was classified as a subtype ‘Seasonal Pattern Specifier in the Mood Disorders section that includes depression and depressive disorders. When assessing and gathering information about the symptoms and causes of depression in order to create a personalised treatment plan, depressed clients will usually complain of feeling fatigue or loss of energy, depressed mood, diminished interest in or pleasure in all activities, they will report insomnia issues and although these are the symptoms of the major depressive episode in the Diagnostic Statistical Manual of Mental Disorders IV-TR (APA, 2000), some of these symptoms are also found and could be confused with the burnout syndrome (BOS).

Owing to the time of the year, end of the year can be stressful as we are trying to hit our last 2016 targets and working under continuous pressure and with a heavy workload and with little breaks this could all lead to burnout and feelings of low mood and depression. As discussed before people who self-refer for cognitive behavioural therapy depression management with a supposed depression will complain among many other symptoms of fatigue, loss of energy, depressed mood and loss of interest in most activities and some of my clients already arrive medicated on anti-depressants and in some cases clients will complain that the anti-depressants have not been working. Some of these clients will also describe that they feel frustrated and confused about their low moods, lack of energy, motivation and depressive symptoms because they should be happy having beautiful and good partners and overall good home atmosphere and good jobs. It is at this point that I will focus on the assessment of the client’s professional life that could be contributing to their current depressive and low energy state. Although such clients will present with similar negative thoughts found typically in clients suffering from depression and who respond well to cognitive behavioural therapy depression treatment and management, the burnout clients will not respond well to the same treatment and will also not recover as quickly as the typical depressed client does.

The burnout syndrome is a result of working too much and resting too little. It is a concept that was developed in the early 1970s in professionals and it is a term that was coined by Herbert J. Freudenberger (Hyman et al., 2011). Burnout can occur regardless of the environment you work in and it is typically described as inability to cope with emotional stress at work or as excessive use of energy and resources leading to feelings of failure and exhaustion and decrease in overall wellbeing (Maslach, 1978; Freudenberger, 1986 and Iacovides, et al., 1999). Clinical symptoms of burnout syndrome are fatigue, headaches, problems with eating, problems with sleeping or insomnia, irritability and emotional instability and as you can see now these symptoms are found in mood disorders and more specifically in depressions so the burnout syndrome could be easily misdiagnosed for depression (Poncet et al., 2006). Burnout is included in the International Classification of Diseases (ICD 10) under life-management difficulty and that also leads onto what would involve personalized treatment plan of burnout at Westminster Psychotherapy Ltd. The personalized treatment plan for burnout at Westminster Psychotherapy Ltd would evolve as a result of a careful assessment of your lifestyle that would be reviewed and you would be highly recommended relevant lifestyle changes and stress management techniques derived from cognitive behavioral therapy and mindfulness.

This article described some similarities between symptoms of depression and burnout and the issues of misdiagnoses that could lead to a poor response to treatment. If you suspect that you might be suffering from depression or suffering from burnout and need some support please do not hesitate to contact lsears@westminsterpsychotherapy.co.uk or call 07 505 124 933 to enquire about a possible appointment.

REFERENCES:

Hyman, S.A., Michaels, D. R., Berry, J.M., Schildcrout, J.S., Mercaldo, N.D., and Weinger, M.B. (2011). The Risk of Burnout in Perioperative Clinicians. A Survey Study and Literature Review. Anaesthesiology, (V). 114. No 1.

Freudenberger, H.J. (1986). The issues of staff burnout in therapeutic communities. Journal of Psychoactive Drugs.(18): 247 – 251.

Iacovides, A., Fountoulakis, K.N., Moysidou, C., Ierodiakonou, C. (1999). Burnout in nursing staff: is there a relationship between depression and burnout? International Journal of Psychiatric Medicine. (29): 421 – 433.

Poncet, M. C., Toullic, P., Papazian, L., Kentish-Barnes, N., Timsit, J.F., Pochard, F., Chevret, S., Schlemmer, B., and Azoulay, E. (2006). Burnout syndrome and nurses. American Journal of Respiratory and Critical Care Medicine. (175): 698 – 704.

Share