Burnout, compassion fatigue, depressionwhats the difference?

2015-05-01
Julie Scheidegger

Understanding the signs, symptoms and causes of mental health issues may help to identify problems in yourself and your veterinary colleagues.

It might be tempting to dismiss feelings of stress, fatigue, alienation, dissatisfaction, negative self-esteem and numbness as just another bad day, but these feelings can be signs of a serious problem. Issues that begin as manageable, if left unaddressed, can develop into emotional and mental strain.

Burnout

Burnout results from the stresses in the work environment, says Jennifer Brandt, PhD, LISW, veterinary social worker at the College of Veterinary Medicine at Ohio State University. If you're experiencing problems with coworkers, loss of economic security or position or diminished control, burnout can start to set in. Here are three primary characteristics:

>Emotional exhaustion. You may feel drained, exhausted, overloaded, tired, low and lacking adequate energy. Physical problems include stomach pains and digestion problems. 

>Alienation from job-related activities. You may find your job increasingly negative and frustrating and develop a cynical attitude toward your work and your colleagues. At the same time, you may distance yourself emotionally from your work. 

>Reduced performance. Burnout mainly affects everyday tasks at work, at home or when caring for family members. People with burnout tend to be negative about their activities, find it hard to concentrate, are listless and lack creativity.1

Brandt says situational burnout may often be “treated” by changing your environment-solving a persistent problem or getting a fresh start in a new work environment.

Compassion fatigue

Compassion fatigue is an emotional and physical burden created by the trauma of helping others in distress, which leads to a reduced capacity for empathy toward suffering in the future.2 It evolves from the relationship between veterinarians and their patients or clients, Brandt says.

What distinguishes compassion fatigue from burnout is that while burnout springs from where you work, compassion fatigue is associated with the work you do. “Compassion fatigue is going to go where you are-a job switch is not going to fix that,” Brandt says. 

That long overdue vacation isn't going to fix it either. The symptoms-intrusive negative thoughts, physical problems (gastrointestinal issues, headaches and lethargy), loss of hope, questioning one's contribution, skepticism and guilt-will follow you and be waiting for you when you return.

Depression

Experts agree that burnout and compassion fatigue are not forms of depression, but they can lead to and coexist with it. Here are the characteristics of true major depression, according to the Mayo Clinic:

> Feelings of sadness or emptiness

> Angry outbursts, irritability or frustration, even over small matters

> Loss of interest or pleasure in normal activities

> Sleep disturbances, including insomnia or sleeping too much

> Tiredness and lack of energy; even small tasks require extra effort

> Changes in appetite-often reduced but increased in some people

> Anxiety, agitation or restlessness-for example, excessive worrying or an inability to sit still

> Slowed thinking, speaking or body movements

> Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that are not your responsibility

> Trouble thinking, concentrating, making decisions and remembering

> Frequent thoughts of death, suicidal thoughts, suicide attempts or suicide.

Laurie Fonken, PhD, psychological counselor at the Colorado State University College of Veterinary Medicine and Biomedical Sciences, says compassion fatigue is more accepted within the veterinary profession than depression because it can be externalized. “If I have depression, that's an internal thing-that's a stigma,” Fonken says. “If I say I have depression, there's something wrong with me,” Fonken says.