Burnout Might Really Be Depression; How Do Doctors Cope?

Leigh Page

Disclosures

January 17, 2018

In This Article

Burnout Might Actually Be a Form of Depression

By now, most physicians are keenly aware that burnout is rampant in the medical profession.

Medscape's 2018 National Physician Burnout & Depression Report shows that it's not just burnout that's plaguing physicians; depression is a component, too—both colloquial depression (feeling "down") and clinical depression. More than 15,000 physicians in 29 specialties responded.

The report figures show that 42% of physicians overall reported burnout, and 15% reported depression of some kind. Twelve percent of physicians said they suffered from the colloquial form of depression, or "feeling down"; a small percentage (3%) said they suffered from clinical depression.

Some experts see a connection between burnout and depression. Often, clinically depressed physicians describe themselves as burned out rather than depressed, says Michael F. Myers, MD, a psychiatrist in Brooklyn, New York, who has been exclusively treating doctors and their families for 20 years. "It can be easier to admit to burnout because a lot of doctors have it," Dr Myers explains. "Burnout is almost a badge of honor."

Note: In addition to the Burnout & Depression Report, Medscape has just published its 2018 Physician Lifestyle & Happiness Report, covering such issues as happiness outside of work, spiritual and religious beliefs, marriage and divorce, exercise and weight, and alcohol consumption. Also included: what makes of cars physicians prefer to drive and how much vacation time they take. Those findings are reported at the end of this article.

Burnout and Depression

Among physicians, the highest rates of burnout were found among intensivists, neurologists, family physicians, obstetricians/gynecologists (ob/gyns), and internists. The lowest rates of burnout were reported by plastic surgeons, dermatologists, pathologists, and ophthalmologists.

Fourteen percent of respondents reported experiencing both burnout and depression. The highest rates of physicians having both burnout and depression were found among ob/gyns (20%), public health physicians (18%), and urologists and neurologists (17%).

While burnout is a serious problem, it is not as well studied as depression and is still not regarded as a full-fledged condition with clear treatment guidelines, says Dr Myers. For example, he says that burnout is not listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the standard reference for mental health diagnoses.

Dr Myers says that burnout is often categorized as one of the adjustment disorders—symptoms that are not full-fledged illnesses, such as exhibiting signs of stress, sadness, and hopelessness while undergoing a stressful life event.

Some researchers even see burnout as simply part of the continuum of depression. "The current state of science suggests that burnout is a form of depression rather than a differentiated type of pathology," according to a 2015 analysis.[1]

"Burnout is partly the result of very trying working conditions, but it is basically a depressive syndrome caused by chronic stressors," says a coauthor of that study, Irvin Sam Schonfeld, PhD, a professor of psychology at the City University of New York.

This is good news for physicians seeking treatment, he says. "Viewing burnout as a depressive syndrome can motivate people to get treatment," Dr Schonfeld tells Medscape. "There are treatments for depression, while treatment research for burnout is not at the same level of quality."

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