Is It Burnout or Depression, and Does the Solution Differ?

Shelly Reese


November 27, 2018

In This Article

Is It Stress, Depression, or Burnout?

One might think that identifying burnout is obvious, but the topic itself has become controversial. There's a lot of heated debate swirling around the question of what burnout is, how it should be measured, and what's causing it. And different experts and physicians have different answers.

Some people are using the terms "depression," "stress," and "burnout" interchangeably; others insist that there needs to be more precision in identifying stress, depression, or burnout in order to treat them effectively.

A recent analysis in JAMA of more than 180 studies of physician burnout conducted in 45 countries over the past 27 years highlights just how complex the topic has become. The analysis found estimates of physician burnout that range from 0% to 80.5%, based on arbitrary and inconsistent criteria for labeling individuals "burned out."[1] The varying definitions and thresholds for measuring burnout and a lack of prospective studies mean that researchers can't even establish whether burnout is a growing problem, says Douglas Mata, MD, MPH, a pathologist at Brigham and Women's Hospital and one of the authors of the study.

When it comes to burnout, the conversation is "almost reaching a frenzy, but I don't know what we're frenzied about," says Jodie Eckleberry-Hunt, PhD, director of health psychology, executive health, and wellness for Beaumont Health System in Royal Oak, Michigan. "We've got to start with knowing what we're measuring."

Is There a Precise Definition of Burnout?

The concept of burnout as a "psychological syndrome resulting from prolonged response to chronic interpersonal stressors on the job" arose in the mid-1970s.[2] Christina Maslach, PhD, one of the early researchers in the field, developed the Maslach Burnout Inventory (MBI), a frequently used tool to measure what she determined to be the three dimensions of burnout: emotional exhaustion, depersonalization, and a low sense of personal accomplishment.

But as the JAMA study found, the definition of burnout is far from cut-and-dried.

Not everyone uses the MBI to determine burnout, and those who do may apply it differently and not agree on the threshold at which a person becomes "burned out." Because of these inconsistencies, "burnout" is often used colloquially rather than scientifically.

Some have come to use the term as a synonym for stress, but burnout goes deeper than stress, insists Michael Privitera, MD, director of the Medical Faculty and Clinician Wellness Program at the University of Rochester Medical Center and chair of the Medical Society of the State of New York's task force on physician stress and burnout. Not only is it a specific type of stress—chronic workplace stress—but it probably has specific triggers, he says.


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