mental health

[Two Pronged] Depression, anxiety, and burnout

Margarita Holmes

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[Two Pronged] Depression, anxiety, and burnout
'[H]indi ka nagiisa sa burnout, Alan, especially during this pandemic and our never-ending lockdown'

Rappler’s Life and Style section runs an advice column by couple Jeremy Baer and clinical psychologist Dr Margarita Holmes.

Jeremy has a master’s degree in law from Oxford University. A banker of 37 years who worked in 3 continents, he has been training with Dr Holmes for the last 10 years as co-lecturer and, occasionally, as co-therapist, especially with clients whose financial concerns intrude into their daily lives

Together, they have written two books: Love Triangles: Understanding the Macho-Mistress Mentality and Imported Love: Filipino-Foreign Liaisons.


Dear Dr. Holmes and Mr. Baer,

If a person is depressed, has anxiety and burnout, and no enthusiasm for work, what can he do to gain back his energy and confidence? I am asking for myself and wish to consult with you in person, but if you are busy, I will understand.

Thanks po,


Dear Alan,

Thank you for your email.

It is sometimes, but not always, the case that the issues you raise are connected. Each however can be a standalone condition. You say that your issues are depression, anxiety, burnout, and job dissatisfaction, so let’s start with your diagnosis.

Is this your personal opinion, your conclusion after a session at the keyboard with Dr. Google, or the considered opinion of a mental health professional ? 

Unless it is the last, you should get a professional diagnosis to ensure that your treatment is appropriate for your condition.

Having said that, it is not unusual for depression and anxiety to be linked and for lack of job satisfaction to follow (burnout however can be due to a number of other causes, and without some background to your condition, it is difficult to say more).

Regarding your depression, it is important to distinguish between situational depression and clinical depression.

If your case is situational, you need to consider what has triggered it, and that will give you an insight into how to deal with it and how long it may last. If however you suspect it is clinical depression, you should seek the help of a mental health professional, since therapy and/or medication may be required.

Anxiety is a different condition but is often associated with depression.

“Job dissatisfaction is probably something that everyone has experienced at some stage in their careers. Plenty of people have jobs for which they have little or no enthusiasm, but the need for a paycheck is generally greater than the attraction of quitting, unless of course something better comes along. Lack of enthusiasm does not however necessarily lead to depression, anxiety, and burnout. It is important therefore to establish if lack of enthusiasm is the cause or the effect of the depression, etc.”

In summary, you need to analyze your situation carefully and decide whether this is something you can handle alone i.e. something that will go away with time and personal adjustment, e.g. exercise, diet etc., or something where you need outside help.

Please write again if you have further questions.

Best wishes,
JAF Baer

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Dear Alan:

Thank you very much for your letter. 

Anxiety. Depression. Lack of enthusiasm. Burnout. Wow. WOW!! 

You brought up our worst nightmares. What could be considered the four apocalypses of modern life, issues that affect us all. 

Admittedly, we hardly think about them when the going is good. But it might be a good idea to do so, since it involves at least two realms that make us truly human: our everyday, occasionally mundane reality, but also our existential reasons for being.

Mr. Baer dealt with your questions about anxiety and depression and gave you a springboard from which you can learn more and delve more deeply into these two mental conditions. He discriminates between what you can get when you (merely) Google and when you consult a psychiatrist/psychologist.  

Mr. Baer also showed you how lack of enthusiasm and burnout can be exacerbated by these two mental conditions, but also how they can spark the start of anxiety and depression.

Realizing how Mr. Baer did the heavy lifting for this column, I thank him with all my heart for thus allowing me to concentrate on what else I feel important:

What should come first? Knowing what you actually have (accurate diagnosis) or doing something about it (treatment)? Many people feel you cannot treat a person effectively without the proper diagnosis. Alas, people who share this view are usually the ones who stand to gain financially from this – yup, psychologists like myself (though, admittedly, I hope I am an exception where this is concerned).

As in most “shoulds” in our life, this belief is all BS. You do both — finding a scientifically accurate term for what you’re feeling (as this can help you get the best (medical) treatment available AND start doing things that make you feel better.

No, I don’t mean binge-watching on Netflix or staying in bed all day. What I mean is, making the effort to do things you know from the past have really helped when you felt lousy: exercise, adequate sleep, eating healthily, being grateful for the blessings you have, caring for others, etc.

In the immortal words of Nike: Just do it! (Yes, yes, even if you doubt it will work this time and even if it seems to be getting harder and harder every day.)

Every day, without exception, do what you can. Face some of your demons – it’s okay to choose not to face the most overwhelming ones first; baby steps are a really good start. If you’re in the mood to read a really helpful book, please try: Alloy, L.B and Risking, J.H.’s Cognitive Vulnerability to Emotional Disorders (2006)

Burnout is no longer considered a (mere) feeling you have that signals you need a break. The best “proof” of this is that it is now officially categorized as a condition by the World Health Organization’s International Disease Classification (ICD-11) — the official compendium of diseases. WHO defines burnout as a “syndrome” that results from “chronic workplace stress that has not been successfully managed.”

In other words, hindi ka nagiisa (you are not alone) sa burnout, Alan, especially during this pandemic and our never-ending lockdown. 

There is so, so much more to say regarding the issues you brought up, dearest Alan. Should you want to follow up on any of them, or include some new problems, please write us again?  

All the best,
MG Holmes


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