Burnout and depression

I liken the relationship between burnout and depression to "chicken and egg" as it is far from clear which happens first.

The truth is I believe that there are multiple associations between them that can manifest in different ways.

I think depression can pre-exist with burnout coming on later, co-exist with burnout purely coincidentally or causally - or at the advanced stages of burnout (stage 11 Freudenberger model) depression is said to be a feature or stage in the burnout process.

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.