In later stages of burnout it seems common for GP and OH to simply "sign a person off sick" - with or without antidepressants. There is a problem with this on several fronts.

Firstly - antidepressants ( or some of them at least) can make a person's depression symptoms worse in the first few weeks.

Secondly work itself - whilst at the core of burnout - can be a limiting factor to the depression in that despite the person suffering at work - removing work can exacerbate several aspects of containment.

Thirdly - the depression may be a dysfunctional coping mechanism for the burnout. What this means is that treating the depression ( much like removing alcohol or dependency forming self medications) allows the burnout to escalate.

Finally - depression and burnout are thought of as two different issues by some researchers but also thought of as the same issue by others. But research is research and does not always translate helpfully ( or at all) to the real world.

What I mean by all this is that an antidepressant and some time off work for burnout complicated by depression is in fact potentially dangerous. There is anecdotal evidence that taking such a simplistic approach to burnout management can push those at stage 11 to stage 12 - a complete mental and or physical collapse with a risk of suicide.

This is a fascinating topic because the real cost is not immediately apparent - particularly the sometimes heavy cost of NOT seeking it. 

Whatever way you do it - there are ways to reprioritise the use of funds. Yet sometimes after years of career misery or frustration people just can't get their minds around spending on their career happiness... even though they may be very unhappy indeed.


This may be due to
* not believing there is any way things could get better
* not feeling enough energy to pursue career exploring (?burnout)
* feeling that getting work into a good place is not the top expense priority
* never having experienced independent career guidance support before
* not prioritising career happiness and wellbeing high enough
* genuine lack of funds

The number of times I hear that people describe taking days to wind down and for their holiday to begin in earnest only to start winding back up sometimes in dread of returning - a few days before coming home. That is half of a 2 week holiday wasted - every single holiday and means that one week holidays are almost pointless.

Could it be too that doctors are good at putting themselves second but not that good at putting themselves first?
Could it be that because we are not trained in finances - that our focus is not at all on "opportunity cost" but more on the list of things in front of us.

So - let me challenge you and ask two questions....
"are you worth it?"
"what is the cost of NOT taking action on your career if it's not where you'd like it to be?"


​Opportunity cost = the loss of other alternatives when one alternative is chosen.