Can nurses have depression?

Posted April 27, 2022

Nurses are often working on the frontline with a kind of mythical superhuman quality about them. But nurses are human too, and subject to the same vulnerabilities as the rest of us. A common question people may ask is, can nurses have depression?

In this article we will answer this question. We cover what depression is and how common it is in nursing. We pay particular reference to the increase in depression as a result of COVID.

What is depression?

In brief, depression is a psychological disorder in which the person experiences a range of psychological, physical and cognitive symptoms. 

The primary symptoms of the condition are persistent low or depressed mood and a feeling of lethargy and reduced interest in your normal day-to-day activities.

Depression differs between person to person and between different cultural contexts. So, your depression may look and feel very different to your colleague or friend’s.

Importantly, these symptoms aren’t just like being “down in the dumps” or “a bit sad or negative” about life. Depression is serious and goes beyond the transient woes and downturns we all experience from time-to-time.

Read our article “What is depression and do I have it?” for further information about the diagnosis of depression and how to spot it in yourself or one of your nursing colleagues.

What causes depression?

Depression is a complex, multifaceted psychological disorder which varies significantly from one person to another. In general, we know that there are a few key factors which increase or decrease someone’s risk for developing depression. It’s important to consider:

Biology – genetics (family history makes it more likely to develop it), poor diet with high sugar/high processed foods, reduced or too much sleep, lack of regular physical activity and exercise, other ongoing physical illnesses (e.g. hypothyroidism, cancer, chronic pain).

Social factors – upbringing and exposure to maltreatment, lack of social support, lower income, living in densely populated area vs countryside, being single and not married, having a child with a disability or chronic condition, exposure to stressful events, nature of your job.

Psychological factors – personality characteristics, coping styles, resilience, stress vulnerability. 

Gender  – depression is approximately 1.7 times more likely in women than men, a robust finding in the literature which is thought to be due to biological differences rather than socioeconomic factors.

So, can nurses have depression? Yes. Nurses are vulnerable to these same risk factors as any other person. As we explore below, depression is actually more common in nurses than the general population.

Nurses are vulnerable to these same risk factors as any other person. As we explore below, depression is actually more common in nurses than the general population.

How many nurses are depressed?

As nursing is a diverse profession with many different settings and specialties, it is not straightforward to answer this question. 

However, one leading review on this topic estimated that Registered Nurses are around twice more likely to develop depression than other types of workers (Brandford and Reed, 2016). 

Moreover, data summarised in a recent review in the UK titled, “The mental health and wellbeing of nurses and midwives in the UK” similarly suggests that rates of depression may be around 30% in nurses for some nurses.

This represents a significant problem both for the individuals’ affected, the patients they treat, the organisations they work for and society as a whole.

Has COVID increased levels of depression in nurses?

The current context of COVID has meant that many nurses have been faced with additional stress in the working environment. 

Working in ICU and emergency settings is well known to increase nurses’ risk of developing psychological disorders. 

Therefore, with many nurses having been redeployed to work in frontline roles during the pandemic, it might be expected that rates of depression have increased. 

The literature paints exactly this picture. 

Olaya et al (2021) conducted a systematic review and meta-analysis of studies evaluating mental health complaints in healthcare workers. This basically means they took the data from previously published studies (57 studies, to be precise) and used statistical procedures to look at the picture as a whole.

The data were quite varied, coming from 17 different countries. They found the pooled prevalence of depression was 25% for nurses (vs 24% for doctors) but 43% for frontline professionals. 

Take that in for a second. Almost half of all frontline workers had developed depression in this huge sample of thousands of nurses. This conclusively answers the question, can nurses have depression?

And how does the prevalence of 25% for nurses in general compare with the rest of the population? According to a study by Bueno-Notival et al (2020) the pooled prevalence of depression in the community was also 25%. 

This means that overall, nurses did not fare worse than the population at large during COVID, however frontline nurses were almost twice as likely to be depressed.

Alarmingly, this 25% rate is still very high. Pre-pandemic, the prevalence of depression in adults was estimated to be just 3.44% in 2017. 

The takeaway here then is that the pandemic has led to a seven fold increase in the rate of depression in both nurses and others in general. For frontline workers, this figure is over ten times higher.

Nurses have historically been more likely to experience depression than other people. The impact COVID has had makes it more likely they will continue to experience this condition. 

It is therefore imperative that adequate support is provided for nurses and midwives to recover from the current pandemic, and prepare for ongoing stressful work.

Nurse Wellbeing Mission are committed to providing nurses with tools and techniques to help enhance wellbeing and reduce the chances of developing conditions like depression.

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    Support for depression

    If you think you are depressed, we have provided some guidance and resources for you below.

    If you are feeling suicidal and feel imminently unsafe, contact 999 immediately. The operator will be able to link you in with immediate support to help you through this difficult time. You can also call one of the numbers below to receive support from trained professionals:

    National Suicide Prevention Line (UK) – 0800 689 5652

    Support Line: 01708 765200

    The NHS Practitioner Health Service is a designated service for NHS staff. You can find their website here – https://www.practitionerhealth.nhs.uk/support-services-access-to-therapy.

    GPs and Improving Access to Psychological Therapies

    If you think you are depressed, we recommend you go to your local GP who will refer you to your local psychology service. They will be able to quickly allocate you to a worker who can assist with advice and treatment options.

    You can also check out the following website, which provides lots of links to mental health resources for healthcare workers:

    Healthcare Worker’s Foundation – https://healthcareworkersfoundation.org/nhs-workers/counselling

    Article written by Nathan Illman. Nathan is a Clinical Psychologist. His mission is to give nurses access to high-quality psychological education and training to help them prepare for and heal from emotionally challenging work.

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