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  • 13 May 2021
  • 3 years

Depression, Anxiety, and Burnout: Where to Begin?

James Sussex

Clinical Team Lead

“Despite knowing the signs, I thought that it was just a transitory thing—the ups and downs of everyday life. But then I crashed.”  (Anonymous, 2016).

Even if we don’t know what they mean, most of us have heard of anxiety, depression, and burnout. It might be that we have a sense of these and what they mean through relating our own experience to them—yes! I have felt depressed, burned out, anxious, stressed, exhausted…—but how do they relate to (and differ from) each other? Are there clear separations, or is it that when we recognize these in ourselves, we do in fact recognize them all?


Anxiety is all around us, occurring at different moments in our lives, sometimes very inconveniently. Relationships, work, school—all aspects of our lives can be affected. When we worry about things, we can feel scared or fearful about them, but anxiety goes further than this. It can impact everyday life in a way that interferes with daily functioning and handling of tasks. While there are a variety of diagnosable anxiety disorders, some pervading symptoms include the following:

  • Tension
  • Restlessness
  • Sleep disturbances
  • Irritability and agitation
  • Trouble concentrating
  • Trouble controlling worry and panic

Anxiety can come from many sources, and although biological risk factors are a part of this (e.g. underlying illnesses), environmental causes are vastly important. Events that happen in one’s life play a huge role as a source of anxiety across the lifespan. Changes bringing in losses of control, uncertainty, and even trauma can result in experiencing symptoms of anxiety. In this sense, anxiety can be a response to a perceived threat, risk, and danger. The manifestation of anxious symptoms alludes to a sense of hypervigilance: a physical feeling of needing to act, fight, fly, or freeze paired with intrusive, spiraling, or catastrophic thoughts. It can be helpful to think about anxiety on a scale—at one end, we might experience some intrusive thoughts and tension; at the other, we might experience nausea and hyperventilating that can be physically debilitating.


Depression is more than just feeling sad or low temporarily. Depression refers to a cyclic or recurring sense of hopelessness (and/or worthlessness), and for the purposes of diagnoses of various depressive disorders, can last for a few weeks or more. While diagnostic and psychometric tools can provide a framework of levels and types of depression, some key symptoms may include the following:

  • Fatigue and low motivation
  • A loss of hope and optimism
  • Irritability and agitation
  • A sense of worthlessness
  • A loss of interest in pleasurable activities
  • Sleep disturbances
  • Physical pains (e.g. headaches)
  • Suicidal thoughts or thought of self-harm

As with anxiety, a combination of biological, environmental, and psychological factors can be sources of depression. Life changes that leave us feeling stressed and unable to cope can lead to a loss of hopelessness. These changes can revolve around losses, uncertainty, and conflict in our lives across many areas, including work, school, relationships, and home.


Feelings of exhaustion, cynicism, hopelessness, and stress are common features of burnout. But what exactly is it? Is it anxiety, depression, or both?

Excessive and exhausting demands on our strengths and resources can lead to feeling burned out. Stress leading to a chronic or acute sense of fatigue can forge a path toward this, but more specifically, burnout is related to work or occupational demands. When resources, tools, and mechanisms of coping with excessive work-related stress are depleted, we can begin to experience symptoms of burnout. To put it simply, burnout relates to the workplace.

At first glance, burnout symptoms resemble those of anxiety and depression: impairments in concentration, sleep disturbances, energy depletion, and exhaustion. Despite the ICD-11 defining burnout, it is important to note that it is not conceptualized as a medical condition but instead as an occupational phenomenon in recent diagnostic manuals – e.g. in relation to workplace environmental stimuli (Berg, 2019; Brooks, 2019; FM News Network, 2019; WHO, 2018; DSM V, 2013).

Making Meanings

At first glance, it might be difficult to discern burnout from anxiety and depression. In fact, there are overlapping symptoms with burnout that often lead to feeling anxious and depressed. Burnout, however, is not currently a diagnosable medical condition in the same way depression and anxiety are (according to the ICD-11 it is a ‘problem associated with employment or unemployment’ (WHO, 2018)). There are also symptoms of depression, for example, which are not features of burnout, such as suicidal ideation. Anxiety can also be a feature of burnout, with intrusive thoughts about oneself stemming from worries and concerns about workplace self-efficacy where coping resources are scarce and diminishing fast.

In this busy modern world of ours, we commonly acknowledge our own and each other’s experiences by alluding to anxiety, depression, and burnout without necessarily being able to separate them. We might say or hear others say, “I feel so depressed today,” “I’m really anxious about next week,” or “you look so burned out.” When we talk about these phenomena, we’re probably talking less about diagnostics, statistics, and codes. Perhaps what we’re accessing for reference is our own tacit knowledge—our reserves of experience and wisdom—and using the language to convey our experience (along with sympathy and empathy to other’s experiences).

Imagine being in space and looking at Earth through a powerful telescope. When you zoom in, you find your country, your region, city, or town. You can even see your house. But as you zoom out, what you recognize disappears, until, eventually, Earth is just a tiny pinprick among the vastness. When we zoom in, we make meaning. Zoomed out, we struggle to do this, and when we can’t make meaning, we lose purpose. A process of moving toward burnout might be quite the same—the longer we feel fatigued, exhausted, and stressed, the greater the cost to self-efficacy (and risk of escalation).

Maybe then, looking after ourselves and each other begins with intuition. Knowing might not just mean visiting your general practitioner or physician for advice and diagnosis, but possibly also paying attention to your feelings. As the grip of stress begins to tighten and you begin to feel symptoms associated with burnout, depression, and anxiety, it might be time to listen to your intuition.

Now more than ever, listening to the signs and symptoms that might tell us about overload is crucial to self-care and self-service. During the COVID-19 pandemic, our ability to be able to cope and deal with the demands of everyday life may have lessened, and as time under lockdown has increased, stress and fatigue have become unwelcome partners in the day-to-day. Diagnostics might be able to tell us some things, but where experiencing depression, anxiety, and burnout are concerned, if we feel something is wrong, it probably is.

Workplace Options helps employees balance their work, family, and personal needs to become healthier, happier, and more productive, both personally and professionally. The company’s world-class employee support, effectiveness, and wellbeing services provide information, resources, referrals, and consultation on a variety of issues ranging from dependent care and stress management to clinical services and wellness programs. To learn more visit 

Disclaimer: This document is intended for general information only. It does not provide the reader with specific direction, advice, or recommendations. You may wish to contact an appropriate professional for questions concerning your particular situation.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Anonymous. (2016, February 9). The secret psychologist: I started to experience depression, while treating it in others. The Guardian. Retrieved April 23, 2021, from

Berg, S. (2019, July 23). WHO adds burnout to ICD-11. What it means for physicians. American Medical Association. Retrieved April 23, 2021, from

Brooks, M. (2019, June 7). Burnout Inclusion in ICD-11: Media Got it Wrong, WHO says. Medscape Medical News. Retrieved April 23, 2021, from

FM News Network (2019, May 30). WHO Removes ‘Burnout’ From New ICD-11 List. Future Medicine. Retrieved April 23, 2021, from

World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics (11th Revision). Retrieved April 23, 2021, from

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