Stress, Burnout or Depression: Telling Them Apart

In crisis or thinking about suicide? Call or text 988 now (in Colorado it reaches the 988 Colorado Mental Health Line). If you are in immediate danger, call 911.

When you are running on empty

You drag yourself through the week and spend the weekend recovering. You snap at people you love. Maybe you have started to wonder whether this is just a hard season at work, or something more.

Stress, burnout and depression can feel alike from the inside. They share some signs, like poor sleep, low energy and trouble concentrating, and one can feed into another. This guide explains how official health sources describe each one, where they overlap, and when it makes sense to get evaluated. It is not a quiz, and it cannot tell you which one you have.

Everyday stress

The National Institute of Mental Health (NIMH) describes stress as the physical or mental response to an outside cause, such as a heavy workload or an illness. It can be a one-time event or something that happens again and again over a long time. NIMH says stress generally goes away once the situation is resolved, and that it can be positive or negative: it may push you to meet a deadline, or cost you sleep.

NIMH says you may be at risk for an anxiety disorder if stress feels unmanageable and its symptoms interfere with your everyday life, cause you to avoid doing things, or seem to be always present.

For practical CBT tools for everyday stress, such as thought records and behavioral activation, see the site's guide to managing stress with CBT tools.

Burnout and job stress

This guide uses "burnout" as an everyday word for being worn down by job stress that does not let up. It is not used here as a diagnosis.

The National Institute for Occupational Safety and Health (NIOSH), part of the CDC, defines job stress as the harmful physical and emotional responses that happen when the requirements of a job do not match the capabilities, resources or needs of the worker. NIOSH says job stress is not the same as challenge. Challenge energizes you, and when it is met you feel relaxed and satisfied. Stress sets in when demands cannot be met and relaxation turns into exhaustion.

NIOSH lists job conditions that may lead to stress, including heavy workload, few breaks, long hours, little say in decisions, poor support from coworkers or supervisors, unclear or conflicting expectations, and job insecurity. It also lists early warning signs of job stress:

• Headache
• Sleep disturbances
• Difficulty concentrating
• Short temper
• Upset stomach
• Job dissatisfaction
• Low morale

Depression

The American Psychiatric Association calls depression a common and serious mental disorder that affects how you feel, think and act. NIMH says that to be diagnosed with depression, a person must have symptoms most of the day, nearly every day, for at least two weeks, and one of them must be a depressed mood or a loss of interest or pleasure in most activities. NIMH notes that children and teens may seem irritable rather than sad.

Other signs NIMH lists include hopelessness, feelings of guilt or worthlessness, fatigue, trouble concentrating or making decisions, sleeping too little or too much, changes in appetite, aches or digestive problems without a clear physical cause, and thoughts of death or suicide.

NIMH also notes that certain medications and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression, and a provider can check for these. The site's depression treatment page explains how the practice uses CBT, and its article on behavioral health vs. mental health explains how habits and emotional health connect.

Where they overlap, and what can help you tell

Poor sleep, low energy, irritability and trouble focusing show up on NIOSH's list of job stress warning signs and on NIMH's list of depression signs. So a symptom by itself does not say much. Patterns tell you more.

Some things to notice, without scoring yourself: Is it tied mostly to work, or has it spread into weekends, friendships and things you used to enjoy? Does a real break bring some relief, or does the low mood stay? Has it lasted most of the day, nearly every day, for two weeks or more? These questions are not a diagnosis. They are useful things to bring to a clinician.

The American Psychiatric Association says it is normal to have moments of sadness or feeling down. What sets depression apart is that symptoms last most of the day, nearly every day, along with a clear change in how you function at work or school, in relationships or in hobbies. If you notice that kind of change, it is worth getting checked rather than pushing through.

It is also possible to have more than one at once. Long-running stress can wear you down, and NIMH notes that anxiety that does not go away may raise the risk of developing depression or an anxiety disorder. If grief is part of the picture, the guide on grief or depression may help.

When to get evaluated, and what to do next

If you are thinking about suicide, call or text 988 now. If you are in immediate danger, call 911.

NIMH says that if signs of depression persist or do not go away, talk to a health care provider, such as a primary care doctor, psychologist or psychiatrist. It may help to jot down notes before the visit: when it started, how long it has lasted and how often it happens. NIMH's stress fact sheet says that if you are struggling to cope, or stress symptoms will not go away, it may be time to talk to a professional.

Therapy can help you build coping skills and look at patterns, but it cannot redesign your job. NIOSH's research focuses partly on how work is organized, so some changes may need to happen at work, too.

Mountainside offers CBT and DBT for teens and adults, in Greenwood Village and by telehealth across Colorado. If you are weighing therapy and medication, see the guide on therapy, medication or both. The guide to the free therapy consultation explains the free 15-minute call, and the depression treatment page explains how to start.

Frequently asked questions