The emotional weight of being a nurse

The COVID-19 pandemic ^[1] shined a spotlight on the critical importance of front-line workers — including nurses. But in the years since ^[1], nurses and other healthcare professionals have continued to grapple with their mental health. In a 2022 study ^[2], over 30% of nurses met the criteria for clinical depression. 

Nursing, like other helping professions, is a rewarding but difficult job. Caring for people during some of their most challenging moments can take a toll on a person’s physical and mental well-being. But in addition to the strain of caregiving, nurses are also navigating unique workplace stressors. Staffing shortages, rotating schedules, and long hours can make it difficult to provide the best care possible. The resulting burnout ^[3] that many nurses face is correlated with depression. 

Nurses dedicate their lives to serving others, and they deserve work environments that support their mental and physical health. In addition, they deserve access to depression treatment that reflects the systemic challenges they’re up against. 

Learning more about depression among nurses can help you recognize it in yourself and others and know when to ask for help.

Signs and symptoms of depression in nurses

Nurses deal with illness, injury, and loss of life as part of their jobs. But that doesn’t mean that they don’t feel the effects of trauma. Their ability to perform their duties amid crisis and chaos is a testament to their strength. However, those abilities can, at times, make it harder to tell when a nurse is struggling with depression.

The diagnostic criteria for depression are the same for everyone. But it might show up in nurses ^[4] in these distinct ways: 

• Feeling detached from friends, family, and/or fellow nurses

• Intense sadness over a patient’s prognosis or death

• Becoming easily annoyed or irritated

• A loss of purpose or hope for the future

• No longer feeling in control or that you can make a positive impact

• Using substances to avoid uncomfortable emotions or cope with stress

Why depression is so common among nurses

Researchers who study workplace mental health have identified some of the reasons why rates of depression ^[5] are so high in nurses. 

These reasons include:

• Compassion fatigue ^[6] and burnout

• Working long hours

• Large amount of physical and mental labor

• Constantly changing schedules and shifts

• Chronic exposure to human pain and suffering

• Greater risk of experiencing workplace violence (including verbal and physical abuse and sexual harassment)

• Difficult interactions with coworkers, patients, and patient families

• Staffing and supply shortages

• Stigma around healthcare professionals seeking mental healthcare

The cost of caring in nursing

When nurses don’t receive support to prioritize their well-being, everyone can be affected. The stress of the job can spill over into relationships and family life and make it more difficult to care for patients. Nurses may feel like they have to make a choice between taking care of themselves and doing work they love. Or they might find themselves experiencing moral injury ^[7] if they can’t support their patients in the ways they feel they deserve. 

Sadly, workplace stress and burnout are taking the lives of nurses at alarming rates. As of 2021, 

women nurses in the U.S. had twice the rate of death by suicide* ^[8] than the general population.

This mental health crisis isn’t something that individuals can solve on their own. Nurses aren’t responsible for overcoming exploitive policies or unsafe working conditions. Healthcare leaders and organizations must make systemic changes to support their workforce. Or, unfortunately, nurses, patients, and families will continue to pay the cost.

*A note on safety: If you’re having thoughts of harming yourself, don’t hesitate to ask for help. You can contact the National Suicide and Crisis Lifeline by dialing 988 from any phone. Their counselors will provide confidential support and resources to help keep you safe.

Support for nurses with depression

If you’re a nurse who’s struggling with depression, know that you’re not alone, and it’s OK to ask for help. 

Taking good care of yourself is essential when your job is to take care of others. Therapy and medication (if needed) can help you balance your mood, learn healthy coping skills, and build resilience against trauma. 

You can also explore these strategies to manage depression and maintain your mental health: 

• Challenge stigma. When your work involves navigating life-and-death scenarios, you might feel pressured to perform at your very best at all times. But the truth is that no one can be perfect all the time, and asking for help isn’t a sign of weakness. Having a mental health concern like depression doesn’t mean that you can’t offer quality care to your patients.

• Consider a change. For many nurses, helping others isn’t just a part of their job. It’s part of who they are. The idea of leaving the profession can feel like losing part of their identity. But remember that there’s nothing wrong with contemplating a change if your job is negatively impacting your mental or physical health. Whether it’s taking a break or leaving nursing forever, you get to decide what’s best for you. There are many ways to serve others besides being a nurse.

• Make time for yourself. Self-care doesn’t always mean taking a bubble bath or an expensive vacation. It’s about making time for healthy activities that reduce stress and support your mental and physical well-being. You may not be able to change your workplace’s norms or culture. But prioritizing yourself outside of work can be a way to set healthy boundaries and increase your work-life balance.

Clinician’s take

Emotional numbing can be an early sign of depression. A nurse may still show up and do their job well, but feel detached, irritable, or less connected to patients and coworkers. They may also lose interest in things that used to help them recharge outside of work. Catching this early can make a difference.

Brandy Chalmers, LPC

Clinical reviewer