Burnout, compassion fatigue, depression—what’s the difference?

Burnout, compassion fatigue, depression—what’s the difference?

Understanding the signs, symptoms and causes of mental health issues may help to identify problems in yourself and your veterinary colleagues.
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May 01, 2015

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. 

Compassion Fatigue

Older DVM --- midland USA
How about just fatigue? How about just real love?
1. DVM's have a working knowledge of many disciplines. Not so with other medical professions. General practitioners in Veterinary Medicine are expected to answer many questions in various elements of internal medicine, dermatology, cardiology, GI, urinary, endocrine, behavior, etc.
This alone is stressful; it does have an effect on our composure, especially in difficult cases and all the diagnostics / decisions to be made.
2. Long hours.
3. For smaller practices, the demands for running the business: advertising; operating hours, convenience, learning new computer programs, updates in many areas, etc.
4. Interaction with staff
5. Interaction with every form of behavior known to humans contained within our clients.
6. High sense of dedication to animal health.
7. Declining moral and financial base is some areas of America.
8. Demand, real or perceived, for equipment upgrades.
9. Consumer Price Index which show veterinarians, in most cases, taking it on the chin.
10. Practitioners, with only one income, while the spouse attempts to raise children with values by being present in formative years. This compared to the financial aspects of multi-income veterinary families, and combined withing the realm of the aforementioned CPI...
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Folks, if you are going to dance you have to pay the fiddler.
That is one [1] of two [2] items that made America great.
So, if people want good veterinary medicine, the have to pay for it, not only the DVM's training and judgment, but for ALL THE TURNKEY EXPENSES IT REQUIRES TO OPEN THE DOOR EACH, DAY WHETHER ANYONE VISITS OR NOT. THIS COST IS NOT UNDERSTOOD BY THE MAJORITY OF AMERICANS....!
Number 2: Love.
Love is a voluntary gift. It cannot be coerced.
Too often clients seek the latter by establishing a sense of guilt in the DVM. This is wrong. Guilt is not love! But this is difficult to fend off if you are a person who has a conscience.
This is the battle line: How much love can one person muster for family, friends, enemies, animal patients, unscrupulous or indigent clients?
I suppose it varies within each doctor. There is still a heavy weight when asked to to this the number of times we have to do it for complete strangers.
Personally I try to asses the background of the recipient of my 'love'. Will they learn anything from my actions? This for any future pets the person might entertain.
Of course, is impossible to know, but often one can estimate. At this point, it is decision time--help or not help...?
That is the crux of compassion fatigue. I often rely on this:
"Give a man a meal and you feed him for a day; teach a man to work and you feed him for a lifetime."
Perhaps a tough lesson with appropriate words about life, suffering, responsibility is in order with those who ask for compassion. Then assess the giving of alms with or without a proper response. If you feel grain is being tossed on infertile ground, you should consider declining. The creature we are trained to treat, is caught in the middle, and that is also a factor and a turning point. Why a turning point? Because one has to think of the present lesson for and and all future 'creatures'.
The recipient of such questioning and guidance could make a difference for ALL pets the recipient choses in the future. That is feeding the client for a lifetime, not just the moment.