Sexes differ in reactions to burnout, depression

Burnout worse in women; depression worse in men

Men and women sometimes approach their jobs differently, and recent findings published by the American Psychological Association (APA) indicate they may burn out in those jobs differently, too.

Work-related burnout can lead to inflammatory processes that play key roles in the initiation and progression of cardiovascular disease and other diseases related to inflammation, but furthermore, according to the study's authors, men and women differ in their inflammatory reactions to work-related burnout and depression

Writing in the Journal of Occupational and Health Psychology, an APA journal, Sharon Toker, PhD, of Tel Aviv University, describes the first large-scale study showing a physiological difference in how men and women react to emotional states. Toker and her colleagues examined micro-inflammation blood markers and levels of burnout, depression, and anxiety in 630 otherwise healthy, employed women and 933 otherwise healthy, employed men. According to Toker, the study aimed to determine which emotions are more likely to present more problems for each sex.

Women hit by burnout, men by depression

Blood levels of C-reactive protein (CRP) and fibrinogen concentrations were used to measure levels of micro-inflammation. Fibrinogen is a blood-clotting factor that responds to vascular and tissue injury, and CRP is a complex set of proteins produced when the body is dealing with a major infection or trauma. Women who experience job burnout and men who experience depression were found to have increased levels of fibrinogen and CRP. Both of these biomarkers have been associated in numerous studies with an increased risk of future cardiovascular disease and stroke over and above the conventional risk factors such as blood lipids and glucose.

Depression in the study is defined as a generalized distress encompassing all life domains and burnout is defined as a depletion of an individual's energetic resources at work. Anxiety is defined as a person experiencing "negatively toned arousal."

The women in the study who scored higher on burnout scores had a 1.6-fold risk of having an elevated level of CRP (>3) and elevated levels of fibrinogen compared with their non-burned-out counterparts (after controlling for their levels of depression and anxiety). The men in the study who scored higher on depression scores (controlling for their levels of burnout and anxiety) had a 3.15-fold risk of having an elevated level of CRP (>3) and elevated levels of fibrinogen compared to the non-depressed men.

These results suggest that the burned-out women and depressed men are at a greater risk for future inflammation-related diseases such as diabetes, heart disease, and stroke compared with their non-burned-out and non-depressed counterparts. All these links were obtained after taking into account a host of physiological factors known to be associated with CRP and fibrinogen levels.

Even though burnout and depression affect men and women differently, the health consequences end up being the same, according to Toker, who suggests that gender difference be included when comparing certain emotions and health risks.

"The findings also confirm that emotional states do indeed affect a person's risk for developing cardiovascular disease," says Toker. "This information can be used to help medical and mental health professionals design more appropriate stress management interventions for each sex and hopefully prevent long-lasting health consequences."

Toker and her colleagues discuss the complete results of their study in: Toker S, Shirom A, Sharpira I, et al. The association between burnout, depression, anxiety, and inflammation biomarkers: C-reactive protein and fibrinogen in men and women. J Occ Health Psychol 2005; 10. The article is also available on-line at www.apa.org/releases/TokerEtAl.pdf.