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Depression and Anxiety in Nurses

While most nurses are eager to discuss their profession with friends, family, and colleagues, conversations surrounding depression and anxiety among nurses remain taboo, despite the prevalence of these mental health conditions within the field.

According to the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative, 18% of nurses exhibit symptoms of depression — double the rate within the general population. These numbers have increased significantly during the COVID-19 pandemic, with 50% of nurses treating patients with COVID-19 reporting signs of depression.

But as long as the stigma associated with mental health persists, many nurses, for fear of being viewed as weak or inferior, will continue to avoid seeking the mental health support they need. It falls on the shoulders of nursing leaders to support their staff and create spaces that encourage self-care over silent suffering. Mental health should be a priority for any healthcare facility, helping them improve their nurses’ overall well-being as well as the quality of care they provide their patients.

Why Are Nurses Prone to Depression and Anxiety?

Many of the factors that impact an individual’s mental health, including significant stress, an odd sleep schedule, and lack of support, are a normal part of a nurse’s profession. In fact, nurses often experience these challenges at a higher level than individuals working outside of the healthcare industry.

Some of the specific causes of anxiety and depression in nurses include:

High-Stress Situations

From a nurse’s first day on the job to their last, no two shifts are identical. Nurses are thrust into new situations daily, forced to take action and make quick decisions that could affect the difference between life and death for a patient. It’s a never-ending process of learning through experience. For individuals in a new nursing job, the anxiety induced by these high-stress situations can be even more pronounced, especially if they are exacerbated by insufficient peer or mentor support.

Fear of Causing Patient Harm

Even veteran nurses can find themselves feeling overwhelmed by their work. Nearly all healthcare professionals, regardless of their rank, are haunted by the fear of making a medical error. Unfortunately, many nurses are unable to leave this stress at the door when their shift is over, meaning it becomes a central part of their lives even when they are off the clock.

Finding Work/Life Balance

The difficulty of creating a clear division between work and home is a significant cause of anxiety and depression in nurses. Due to the nature of nurses’ shift schedules, which often prevent them from doing much more than eating and sleeping on their days off, finding the time to take a step back and focus on themselves and their families can be challenging.

Toxic Workplace Culture

Lateral violence among nurses is a major issue within the healthcare industry. A form of workplace bullying, lateral violence fosters feelings of failure and inadequacy in new nurses and can leave them without the support systems they need to thrive. It also heightens tensions within an already high-stress environment.

How Do Nurses Deal With Anxiety?

It is all too common for nurses to rarely acknowledge — either to themselves or to others — that they are experiencing anxiety or depression. This is largely out of fear of the prejudice and stigma often associated with mental health.

Many healthcare professionals continue to view emotional and psychological distress as a reflection of a nurse’s unsuitability for the industry, versus a reasonable reaction to the stressors they experience daily. Fearing they will be viewed as incompatible for their position, potentially leading to the loss of their job, nurses across the country choose to suffer in silence. This can make it harder for them to perform their duties well, compromising the quality of care they provide their patients.

The truth is that nurses can work with depression and anxiety, but they must take steps to address their mental health conditions if they want to succeed. Nurses can do this by:

  • Being Aware of the Issue: The first step to dealing with anxiety or depression is awareness. Understanding that mental health conditions do not impact an individual’s value and that they are not uncommon, especially in nursing, can empower nurses to seek the support they need.
  • Asking for Help: Asking for help means different things to different people. Some nurses may choose to ask for help in specific, stressful situations. Others will inform trusted individuals that they are dealing with depression or anxiety and that they may need assistance from time to time. Regardless of how a nurse asks for help, simply acknowledging that they need support helps ensure they are surrounded by a network of peers and mentors they can turn to at any given time.
  • Eating, Sleeping, and Relaxing: The long, grueling hours many nurses work can leave them feeling depleted, resulting in rising stress levels and burnout as well as anxiety and depression. Eating regular, healthy meals and sleeping well helps these professionals refuel and maintain a sense of balance. Relaxation practices, like deep breathing and meditation, can also help nurses lower their anxiety threshold.
  • Seeking Professional Support: Behavioral health professionals, including psychiatrists, psychologists, and mental health counselors, can help nurses manage their anxiety and depression. These skilled professionals will empower nurses with coping techniques that help them manage their mental health and minimize its impact on their work.

Can I Be a Nurse If I Have Anxiety?

Absolutely. Pre-existing mental health conditions do not preclude individuals from being a successful nurse. The most important thing for nurses with anxiety — whether it is something they developed independently from nursing or during the early stages of their career — is that they take steps to care for their psychological well-being. That includes practicing self-care, seeking professional support when necessary, and building strong support systems at home and at work.

It is also important for nurses with anxiety to remember that they are not alone. Nursing is an extremely difficult and stressful profession and what they are experiencing is not uncommon. Asking for help or sharing challenges is a sign of strength, not weakness, and will lead to greater nursing success than suffering in silence.

How To Identify Stress Among Nurses

It can be difficult to identify mental health conditions among nurses. Anxiety and depression manifest differently depending on the individual and many of the standard symptoms of these conditions are considered normal for nurses given the inherent stress of their jobs.

To help them identify anxiety or depression among their staff, nurse administrators must strive to identify any changes — even subtle ones — in each nurse’s behavior. Although these symptoms should never be used as a diagnosis, they can help open the door to constructive conversations between employers and employees. Symptoms to watch out for include:

  • Difficulty with time management and concentration
  • Slow responses during a crisis
  • Frequent accidents or medical errors
  • Limited ability to perform mental tasks, like calculating doses or care mapping
  • Reclusivity and/or poor interpersonal skills
  • Temper issues, including having a “short fuse” that leads to outbursts toward coworkers, family, or even patients
  • Symptoms normally associated with burnout, including emotional exhaustion, cynicism, and depersonalization

How To Support Nurses Suffering From Anxiety and Depression

Nurse administrators can support nurses suffering from anxiety and depression by mentoring and guiding them through difficult situations. Administrators that maintain a healthy, open attitude regarding mental health can also help nurses feel safe coming forward with their mental health challenges. Other ways leaders can support their staff include:

  • Educating Staff: Education is one of the best ways to support new and veteran nurses alike. Education can help nurses realize that they may be suffering from mental health issues while also destigmatizing anxiety and depression. Education is also a way to demonstrate to staff that talking about mental health is a good thing and that asking for help is not a sign of weakness.
  • Creating Support Systems: Having reliable support systems in place is critical when it comes to navigating mental health for nurses. Leaders should encourage and develop mentorship and peer relationships between nurses and create space for nurses to discuss their mental health concerns. These efforts allow nurses to realize they are not alone, validating their experiences and helping them get the support they need.
  • Promoting Self-Care: As discussed above, self-care is paramount when it comes to dealing with anxiety and depression. But taking care of our well-being is easier said than done — especially in a profession that values endless resilience. Nurses must be encouraged to offer themselves the same grace, compassion, and attention typically reserved for others. Nursing leaders can promote self-care by modeling appropriate work-life balance and encouraging nurses to take breaks during the workday.
  • Sharing Resources: Improving access to internal and external behavioral health resources, including contact information for mental health counselors and crisis hotlines, free mental health screenings, and more can inspire nurses to seek help early, before their conditions intensify. If possible, leaders should work with HR to collect and share appropriate resources as often as possible.

Destigmatize Mental Health Issues From the Top Down

Nursing jobs can cause anxiety and depression in even the most resilient of individuals, yet the stigma surrounding mental health persists. Instead of seeking help, many nurses try to suppress their suffering for fear of judgment or penalty. But that silence doesn’t benefit anyone. It is up to nurse administrators to reduce the stigma surrounding mental health and ensure their teams feel supported.


Reducing Mental Health’s Stigma in Healthcare

Despite the number of individuals affected by mental illness and mental health disorders, the stigma around mental health remains. With that current stigma, healthcare workers may be less likely to seek treatment, and even have difficulty doing so once they decide to.

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