Special article
The relationship between job stress, burnout and clinical depression

https://doi.org/10.1016/S0165-0327(02)00101-5Get rights and content

Abstract

The definition and phenomenological features of ‘burnout’ and its eventual relationship with depression and other clinical conditions are reviewed. Work is an indispensable way to make a decent and meaningful way of living, but can also be a source of stress for a variety of reasons. Feelings of inadequate control over one’s work, frustrated hopes and expectations and the feeling of losing of life’s meaning, seem to be independent causes of burnout, a term that describes a condition of professional exhaustion. It is not synonymous with ‘job stress’, ‘fatigue’, ‘alienation’ or ‘depression’. Burnout is more common than generally believed and may affect every aspect of the individual’s functioning, have a deleterious effect on interpersonal and family relationships and lead to a negative attitude towards life in general. Empirical research suggests that burnout and depression are separate entities, although they may share several ‘qualitative’ characteristics, especially in the more severe forms of burnout, and in vulnerable individuals, low levels of satisfaction derived from their everyday work. These final issues need further clarification and should be the focus of future clinical research.

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.

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