Beyond Screening Clients: Depression and Burnout in Mental Health Providers

October’s National Depression and Mental Health Screening Month isn’t only about public awareness—it’s also a reminder for us to reflect on our own well-being and that of others. 

As mental health practitioners, we’re trained to screen, diagnose, and treat depression in others on a regular basis. Most clinicians may not be surprised to know that the Anxiety & Depression Association of America (ADAA) reports depression as being the third leading cause of death among people aged 15-29 and that approximately 5.7% of all US adults had at least one major depressive episode with severe impairment in 2021.

Seasoned therapists may agree that assessment is not always as straightforward as referencing a standard list of symptoms as set by the American Psychiatric Association (APA) or utilizing the Beck Depression Inventory assessment. As the ADAA points out, depression often presents differently across age and gender. For example, depression is more prevalent in women and typically exhibits as sadness, worthlessness, and guilt, whereas it tends to show up as tiredness, irritability, and anger in men. In older clients who may not be as open with their feelings, an occasional check-in may reveal subtle symptoms of grief and sadness. For teens, more obvious issues—substance abuse, eating disorders, and anxiety—may be the reason parents seek therapy, but even they may not realize that their teens’ sullen angst, irritability, and behavioral issues, along with those co-morbidities, are symptomatic of depression. For our youngest clients, separation anxiety and concern with parental death, leading to school refusal, can be signals that depression is an issue.
 

Regardless of who is sitting across from us, the Hope for Depression Research Foundation (HDRF) reminds us of what we already know and strive to do daily: depression is a treatable illness that is best approached through developing a secure alliance and providing a safe space where root causes can be explored and negative thinking can be compassionately challenged. 

Just as symptoms vary across age and gender, the very act of holding space for others’ pain can lead to depression-related symptoms specific to therapists. Emotional and physical exhaustion and a negative self-concept, along with telltale signs of burnout—negative attitude regarding professional life and a depersonalization of clients—are likely indicators of depression (Rosenburg & Pace, 2006). While one can have depression without experiencing burnout, they are often experienced together. 

Depression, directly linked with a deficit in one’s sense of self, may find us when we’re not meeting our own standards (Kopala-Sibley & Zuroff, 2018). Rosenburg and Pace (2006) explain that if we have unrealistic goals and expectations for therapeutic outcomes, struggle to accept ‘failures,’ and/or base our self-worth in performance, we may be inclined to keep pushing ourselves to prove our professional legitimacy, which ultimately results in both depression and burnout (Chen et al., 2023). 

Physical and emotional isolation, lack of supervision, and reduced resources may be more problematic for those in private practice, whereas a higher workload, safety issues, and time pressures may be more of an issue for those in community agencies (Delgadillo et al., 2018). Regardless of work environment, continuous exposure to severely distressed clients and/or those who present with chronic and complex mental illness creates vulnerability for all (Rokach & Boulazreg, 2022). 

Supervisors and therapists alike should set and maintain boundaries, monitor workload, and stay attuned to the impact of emotional work. Burnout generally presents as short-lived “attacks” that can develop into longer phases, so bouts of depression and emotional exhaustion should not be dismissed (Rosenburg & Pace, 2006). In fact, October can serve as an annual reminder for industry leaders to promote screening, services, and preventative measures for mental health professionals. 

To prevent depression and burnout, self-care and mindfulness are our best defenses. Adequate sleep, nutrition and hydration, exercise, social support, and work/life boundaries are the gold standard for self-care, but practicing such discipline is no easy feat with daily competing priorities (Rokach & Boulazreg, 2022). Here are just some ways to turn vague direction into actionable practices: 

• Plan and prioritize for work/life balance on a monthly, quarterly, and yearly basis.
• Make weekly healthy food planning and prep an enjoyable shared hobby.
• Turn on your favorite music and pull out the “Questions to Ask” and get to veggie cutting with your family/ friends or fly solo with a Netflix show.
• Explore the countless flavors of sugar-free water additives and healthy hydration alternatives.
• Find accountability partners who share your interests. Walk three times a week for 30 minutes, meet up at the tennis court or yoga studio once a week, and/ or complete a monthly fitness challenge.
• Plan vacations that are relaxing and enjoyable for everyone, including you.
• Make Self of the Therapist work a top priority by engaging in regular personal psychotherapy, clinical supervision, and consultation.
• Explore and set fair expectations and boundaries for yourself and others. Write them down and revisit them.
• Don’t work harder than your clients. This is their life. This is your career.
• Practice diaphragmatic breathing and a calming body scan at the beginning and end of each day or session.
• Join your local professional organization group and meet other therapists for social support.

References

Ackerman, C. E. (2017, January 18). 21 mindfulness exercises & activities for adults. PositivePsychology.com 

American Behavioral Clinics. (n.d.). October is National Depression and Mental Health Screening Month, & ADHD Awareness Month, & so much more!

October is National Depression and Health Screening Month  

American Psychiatric Association. (n.d.). Depression. https://www.psychiatry.org/patients-families/depression  

American Psychological Association. (n.d.). Depression assessment instruments. 

https://www.apa.org/depression-guideline/assessment 

Anxiety & Depression Association of America. (2025, October 3). What is depression? 

https://adaa.org/understanding-anxiety/depression  

Bader, E. (n.d.). Are you working harder than your clients? The Couples Institute. Are You Working Harder Than Your Clients? – Couples Institute

Chen, C., Yu-Li, L., Shau-Lun Chiou, & Yi-Ching, L. (2023). The effect of emotional labor on the physical and mental health of health professionals: Emotional exhaustion has

a mediating effect. Healthcare, 11(1), 104 The Effect of Emotional Labor on the Physical and Mental Health of Health Professionals: Emotional Exhaustion Has a Mediating Effect

Delgadillo, J., Saxon, D., & Barkham, M. (2018). Associations between therapists’ occupational burnout and their patients’ depression and anxiety treatment outcomes. Depression and Anxiety, 35(9), 844-850. Associations between therapists’ occupational burnout and their patients’ depression and anxiety treatment outcomes – Delgadillo – 2018 – Depression and Anxiety – Wiley Online Library 

DAREBEE. (n.d.). Challenges [Fitness challenges index]. https://darebee.com/challenges.html 

Kopala-Sibley, D. & Zuroff, D. (2018). The self and depression: Four psychological theories and their potential neural correlates. Journal of Personality. 2020; 88: 14 

30. https://doi.org/10.1111/jopy.12456

Kurtz, J. (2017, July 13). Eight steps to a happier vacation. Greater Good Magazine. 

https://greatergood.berkeley.edu/article/item/eight_steps_to_a_happier_vacation 

Leadership Success. (n.d.). Time management — How to plan and prioritise your workload. 

How to prioritise workload? | Prioritising your workload 

Liles, M. (2024, October 2). 250 funny questions to ask to get all the giggles. Parade. https://www.parade.com/1208435/marynliles/funny-questions-to-ask/ 

National Academy of Medicine. (2017, November 29). Valid and reliable survey instruments to measure burnout, well-being, and other work-related dimensions.  

Valid and Reliable Survey Instruments to Measure Burnout, Well-Being, and Other Work-Related Dimensions – NAM 

National Clinician Wellness Committee. (2025, April). Using burnout assessment tools: 

Executive summary (April 2025 ed.). Using Burnout Assessment Tools: Executive Summary

Rokach, A. & Boulazreg, S. (2022). The COVID-19 era: How therapists can diminish burnout symptoms through self-care. Current Psychology, 41, 5660–5677. 

https://doi.org/10.1007/s12144-020-01149-6 

Shireen, H., Siemers, N., Dor-Ziderman, Y., Knäuper, B., & Moodley, R. (2022). Treating others as we treat ourselves: A qualitative study of the influence of psychotherapists’ mindfulness meditation practice on their psychotherapeutic work.