A review of nursing discussion groups indicates that depression within the nursing community is a major problem. Every year, approximately 18.8 million Americans and three million Canadians suffer from clinical depression. Females have higher rates of depression than males by a ratio of 2:1. During their lifetime, about five to 12% of men and 10% to 25% of women will suffer from major depressive episode at least once.
But do nurses have special circumstances that contribute to depression? While there is a wealth of anecdotal information, no definitive study has looked at all of the factors. Here is the run-down on a few studies that uncover some of the possibilities. You can draw your own conclusions.
The Stress Connection
According to a study that used the Maslach Burnout Inventory Tool, nurses consistently scored higher on burnout than any other group of healthcare professionals. Burnout is indeed an official term – it is defined as a psychological state of physical and emotional exhaustion, which is thought to be a stress reaction to a reduced ability to meet the demands of one’s occupation. For many, the line between being burned out and being clinically depressed is a fine one. Martin et al studied French healthcare workers and found that while many were burned out and exhausted, it was when these factors combined with conflict at work and a high level of job dissatisfaction that they were more likely to become depressed.
On the subject of dissatisfaction, a study by the American Nurses Association found that 30% of nurses feel powerless to improve patient safety and care, and a whopping 40% report job dissatisfaction.
Major life events, such as divorce, death, and changing work conditions are stressful for anyone. Aside from the chance that nurses may be experiencing these events on a personal level, they are likely to experience them vicariously through their patients on a daily basis.
Round-the-clock Care Giving, Exhaustion, and Depression
Nurses often complain of sleep deprivation, and recent studies indicate that lack of sleep can result in heightened levels of cortisol (the stress hormone) in the blood. A study by Dr. Patricia Carter of theUniversity of Texas Austin, School of Nursing and Betty Chang at UCLA School of Nursing measured sleep quality and depression indices in caregivers of terminally ill people and found that lack of sleep resulted in a higher incidence of depression.
Peri-menopause and Depression
Statistics show that the average age of a nurse is 45 years old in the US and 44 years old in Canada. Many of the female nurses are in the peri-menopause age range, which may contribute to higher rates of depression. While the precise link between depression and fluctuations in hormones is unknown, there is ample anecdotal evidence that these fluctuations contribute to feeling sad. A study byHarvard University on moods and cycles found that women who undergo menopause before age 48 are twice as likely to self-report a history of depression. The researchers hypothesized that stress and depression may in fact influence endocrine function and lead to early ovarian failure. This early exposure to peri-menopause can result in a longer period of transition to menopause and longer bouts of depression as the woman’s hormones undulate.
Depression Awareness
This theory is a simple but logical one: nurses, because of their training, are much more likely to be aware of the symptoms to watch for when it comes to their mental and physical health. As a result, perhaps nurses (as a group) are better able to recognize the signs of depression in themselves, report those symptoms, and seek treatment.
Is it Because of a Nurse’s Personality?
Some researchers believe that temperament may be more important than environmental factors in predicting who might become depressed. A psychological study by Japanese researchers found that people who score high in novelty seeking, harm avoidance, reward dependence, and persistence are more prone to depression. People who score high in reward dependence are those who like to help others, are sympathetic, and are sensitive to social cues – certainly, nurses share these characteristics. Could nurses’ innate personality predispose them to depression?
Let us know what you think.
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