Ellie works as a nurse in a big hospital for over 20 years now. She loves her job and is committed to her patients with heart and soul. But when the reorganization started and the hospital merged with another hospital, this had major consequences for Ellie’s work. There were more patients to take care of and less nurses available per patient. There was also an increasing administrative pressure. Everything that Ellie did had to be reported. Ellie sometimes worked for 11 days in a row and received little appreciation for her unbridled efforts. Sounds depressing, right? And that is what happened, Ellie got depressed.

But is Ellie her story representative? How often does misery at work actually lead to a depression? What is the difference between depression and a burn-out? And, if you find yourself depressed, what can you do?

Depression in numbers

Before we dive into these questions, first some information. Did you know that 1 in 5 people in the Netherlands has to deal or dealt with a depression? That is twenty percent! Therefore depression had the dubious honor of being among the top 5 of disorders with the highest burden of disease, medical expenses and absenteeism. When you feel low for the majority of the day or you experience loss of pleasure in activities which would normally interest a person, you meet the diagnosis of a depression. This must coincide with some of the following symptoms:

•  concentration, attention and memory problems,
• too much or too little appetite and insomnia,
• feelings of guilt
• sometimes thoughts about self-harm and suicide

Is your work the cause of your depression?

Depression can be caused by stressful working conditions: research shows that work-related situations certainly play a role in the development of depressive symptoms. Working pressure (27%); uncertainty about the future(19%); lack of support or bullying / conflicts (26%) are the most reported factors causing sensitivity for a depression. Mainly the combination of a demanding job combined with a lack of decision-making power are big risk factors. However, a noisy or dark work environment does not seem to play a role in the development of depressive symptoms.

Are you vulnerable for a depression?

Is everyone who deals with these burdensome working conditions depressed? No, definitely not. As with many psychiatric disorders, “nature” and “nurture”, or genetic predisposition and environmental factors, play a role.

Genetic vulnerability

Research shows that children with a depressive parent are three times more likely to get depressed. Also, you are also more vulnerable to depression when you are inclined to react negatively to stressful events, believe that these events are your own “stupid” fault and when you do not feel power over the situation. This is also called “cognitive vulnerability”.

Your home situation

Translated into everyday life, these insights mean that genes, your character in combination with your working conditions, can make you vulnerable to the development of depressive symptoms. This vulnerability can be increased even more if you experience problems in other areas of your life. In Ellie’s case, besides feeling overloaded at work, there was also a very stressful home situation with her partner who regularly grabbed the bottle and got aggressive. Ellie, who described herself as a perfectionist with a great sense of responsibility having an unsafe home situation, broke after the reorganization. It was the last straw that broke the camel’s back. Ellie got depressed.

Burnout or depression?

She became depressed. However, this work-related problem could also have led to a burn-out. The distinction between both disorders is quite difficult as there are big similarities in the symptoms of both disorders, such as fatigue and concentration problems. Yet experts also mention very important differences between a burn-out and a depression. In short, someone with a burnout still wants to work, but can not do it anymore, while someone with depression lost his or her drive to work. This seemingly small difference has major consequences for the treatment. In the case of depression it is important that people get out again, that they gradually start doing things again. For people with a burnout complaints, on the contrary, it is important that they take a step back.

What can you do?

As always: to prevent is better than to cure. This means that it makes sense to seek support as quickly as possible and to investigate what you need to feel better. Your supervisor or your employer can play a role in this. Structure your working hours and ensure sufficient sleep, exercise and relaxation. If you find that difficult, it is wise to seek help from a professional counselor. Together you can investigate how to find balance and how you can learn to deal with vulnerable characteristics, such as; learning to say “no”, setting limits and being more gentle with yourself.

And Ellie?

Ellie learned not to ask too much of herself and eventually chose to leave her violent partner. At her work she is carefully rebuilding under the supervision of her employer and she tries to get to know her limits and to monitor them. What we learn from Ellie’s story? That we can manage to get out of that valley and be happy again. And that is important to know: good help is available. You do not have to do it alone.