Special articleThe relationship between job stress, burnout and clinical depression
Introduction
In recent years, the term ‘burnout’ has been used to denote a condition of emotional and mental exhaustion at work, and a phenomenon that significantly impacts modern culture, particularly in Western societies and in Japan. Work is not just a way to make a decent living, but is also considered a vital element of the social status of the person, and a source of meaning in one’s life, especially for those individuals who have rejected a religious answer to their existential quest. Although money is important, it is neither a cure nor a preventive factor for burnout, except when it is considered the only measure of success. An important feature of work as part of modern society, concerning work, is the very high level of commitment. Many people, usually high level professionals, identify with their work and organisation to the point of personalising every success or failure. In this concept, failure may be experienced as a traumatic event, a loss of meaning in the individual’s life, that leads to a depressive-like condition.
From very early historical times, language has linked work with burden, anxiety, pain, effort, slavery and punishment. In Ancient Greek, the word for work is ‘agos’ (άγος), which is synonymous with burden. The Greek word for anxiety (anchos, άγχος) comes from ‘agos’. Another Ancient Greek word for work was ‘ponos’ (πόνος) the Modern Greek word for pain. The English word ‘pain’, on the other hand, comes from the Greek word ποινή (poeni) which means punishment or sentence. The Modern Greek word for work is ‘doulia’ (δουλειά) which comes from ‘doulia’ (δουλεία), the Ancient and Modern word for slavery. However, there is another word ‘ergasia’ (εργασία) derived from ‘ergo’ (έργο), the word for ‘product through effort-full work’. All of these antecedents for with the Old Testament’s notion that work was the punishment God gave man for disobeying Him. Modern attitudes towards work are largely attributed to Martin Luther and the Reformation that considered work as holy, and a way to worship God. In contemporary times, work is considered one of the highest values of society. On the other hand, unemployment may produce severe distress and even depression, even though many other variables (e.g., age, gender, etc.) may complicate the picture (Bromberger and Matthews, 1994). Claussen et al. (1993), reported that the prevalence of depression, anxiety, and somatic illness may be from four to 10 times higher in unemployed than employed people and is related with less chance of obtaining a job. This paper will attempt to clarify the phenomenological features of burnout vis-à-vis other terms used to describe it (i.e., job stress) and well established clinical conditions as depression.
Section snippets
Job stress
It is clear that work is not only a source of satisfaction and socio-economic status, but also of stress. In sharp contrast with stress coming from one’s personal life or environment, coping with job stress is difficult, because usually there are not many things to do in order to modify the job environment. This is analogous to the concept of internal versus external control suggested to be a critical factor in the development of coping (Pearlin and Schooler, 1978, Rotter, 1966). In fact, no
Methodological issues
The study of occupational stress is hindered by methodological issues. Most important but complex aspects of studies in this area are job and organisational satisfaction, organisational security and commitment, resilience, worriedness, physical symptoms and exhaustion, pressure from workload, relationships, career development, managerial and personal responsibilities, home demands, daily hassles, drive, impatience, control, decision-making latitude, and the coping strategies of problem
Phenomenology and course
The term ‘burnout’ was introduced by Freudenberger (1974) to describe a picture of exhaustion of mental care professionals at the work place. He defined it as “to fail, wear out, or become exhausted by making excessive demands on energy, strength or resources”. The subject becomes rigid, stubborn and inflexible, blocking progress and constructive change, because change demands more adaptational efforts. He/she becomes the ‘house cynic’, and looks, acts and seems depressed. Freudenberger
Theoretical considerations
The nature of any given occupation acts as a screening tool, and attracts only people with specific personality features. Personality determines the way the person interprets events, and conceives the interaction between self and the environment (Cooper and Baglioni, 1988). At one extreme, some individuals interpret events as being substantially due to ‘chance’, with their actions being largely irrelevant to either the occurrence or outcome (external locus of control). At the other end of the
Conclusion
Burnout is a problem more common in modern times than generally believed. It has a large impact on both individual and society. Empirical research suggests that burnout and depression are separate entities, even though they may share several common characteristics. Especially in the more severe forms of burnout, and in individuals that have a vulnerability trait to develop burnout (because they receive low satisfaction from work, even in the absence of burnout), it seems that depressive and
Acknowledgements
The authors wish to thank the editor and the referees for their valuable help in the final formation of the manuscript.
References (95)
- et al.
Personality dimensions in chronic fatigue syndrome and depression
J. Psychosom. Res.
(1999) - et al.
Relations of work stress to alcohol use and drinking problems in male and female employees of a computer factory in Japan
Environ. Res
(1993) - et al.
Burnout, depression, life and job satisfaction among Canadian emergency physicians
J. Emerg. Med.
(1994) CSF 5-HIAA correlates with neuroticism in depressed patients
J. Affect. Disord.
(1999)- et al.
Stress among factory workers in a developing country
J. Psychosom. Res.
(1991) - et al.
Clinical and personality correlates of outcome in depressive disorders in a Turkish sample
J. Affect. Disord.
(1997) - et al.
Work-related stress and depression among practicing emergency physicians: an international study
Ann. Emerg. Med.
(1994) - et al.
Work-related stress and depression among physicians pursuing postgraduate training in emergency medicine: an international study
Ann. Emerg. Med.
(1991) Psychosis and depression
Practitioner
(1990)Negative affectivity: moderator or confound in emotional dissonance-outcome relationships?
J. Psychol.
(1999)
Relation between socioeconomic status, employment, and health during economic change, 1973–93
Br. Med. J.
Burnout and related factors among HIV/AIDS health care workers
AIDS Care
Personality and clinical predictors of recurrence of depression
Psychiatr. Serv.
Work and depression in the Federal Republic of Germany
Women Health
Patient burnout behavior of young adults undergoing orthodontic treatment
Stress Med.
Relationships between work environments, psychological environments and psychological well-being
Occup. Med. (London)
Employment status and depressive symptoms in middle-aged women: a longitudinal investigation
Am. J. Public Health
A longitudinal test of Karasek’s Job Strain Model among office workers
Work Stress
Socioeconomic determinants of rates of consultation in general practice based on fourth national morbidity survey of general practices
Br. Med. J.
The minor events approach to stress: support for the use of daily hassles
Br. J. Psychol.
Sickness absence at the French National Electric and Gas Company
Br. J. Ind. Med.
Health and re-employment in a two year follow up of long term unemployed
J. Epidemiol. Community Health
Psychological distress and burnout among buddies: demographic, situational and motivational factors
AIDS Care
A structural model approach toward the development of a theory of the link between stress and mental health
Br. J. Med. Psychol.
Mental health, job satisfaction and job stress among general practitioners
Br. Med. J.
Burnout and health status in Italian air traffic controllers
Aviat. Space Environ. Med
Mental health effects of job loss in women
Psychol. Med.
Head nurse leadership style with stuff nurse burnout and job satisfaction in neonatal intensive care units
Nursing Res.
Status congruency as a predictor of job satisfaction and life stress
J. Appl. Psychol.
A factor analytic study of the lie scale of the junior Eysenck personality inventory
Personality
The Questionnaire Measurement of Psychoticism
Psychol. Med.
An uncertain future. The health effects of threats to employment security in white-collar men and women
Am. J. Public Health
Health effects of anticipation of job change and non-employment: longitudinal data from the Whitehall II study
Br. Med. J.
The stressors and strains of health visiting: demands, supports, constraints and psychological health
J. Adv. Nurs.
Staff burnout
J. Soc. Issues
The Staff Burnout Syndrome in alternative institutions
Psychother. Theory Res. Pract.
Work stress and depressive symptoms among Japanese information systems managers
Ind. Health
Secretaries, depression and absenteeism
Women Health
Women’s work roles and their impact on health, well-being, and career: comparisons between the United States, Sweden, and The Netherlands
Women Health
Depression, burnout, and perceptions of control in hospital nurses
J. Consult. Clin. Psychol.
Stress in surgeons
Br. J. Surg.
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