loading gif icon


Nurse Depression and Anxiety: Stopping the Mental Health Crisis

Nurses are the backbone of the healthcare system, providing essential care and support to patients and their families. They are also exposed to high levels of stress, trauma, and burnout, which can take a toll on their mental health. According to a recent American Nurses Association survey, 30% of nurses — nearly one-third — said they are “not emotionally healthy” or “not at all emotionally healthy,” with an increasing number of nurses struggling with depression or anxiety. In this article, we’ll look at what causes elevated levels of nurse depression and anxiety, how nurses can help themselves and each other, and how healthcare leaders can support their nurses’ mental health.

Nurse depression and anxiety can have serious consequences for both the individual and the organization. These conditions can impair the quality and safety of care, increase the risk of errors and adverse events, reduce patient satisfaction, and contribute to staff turnover and absenteeism. They can also affect the personal well-being and relationships of nurses, leading to chronic health problems, substance abuse, and even suicide. It is imperative that healthcare leaders recognize and address the mental health needs of their nursing staff and create a culture of support and compassion.

Because of the stigma associated with mental illness, nurses may avoid seeking the mental health care and support they need. But healthcare organizations need to be aware of their nurses’ mental health conditions so they can provide support. Not only does providing adequate support for mental health improve the lives of nurses — it also translates to better quality of care for patients.

Nurses conversing on a break — nurse depression and anxiety can worsen if they are not allowed to take sufficient breaks and have social support.
Nurses on a break talking and walking together.

What causes nurse depression and anxiety?

The nursing profession has many factors that can negatively impact mental health — high stress, heavy workload, long hours, inconsistent sleep schedules, exposure to trauma, emotional labor, and lack of support. Nurses often experience these and other mental health impacts more frequently than individuals working outside the healthcare industry. Here are some specific causes of nurse depression and anxiety:

High-stress situations

From a nurse’s first day on the job to their last, no two shifts are identical. Nurses experience new situations daily and must make quick decisions that could mean the difference between a good or adverse outcome. For new nurses, the anxiety induced by high-stress situations can be even more pronounced, especially if they have insufficient support.

Fear of causing patient harm

Nearly all healthcare professionals, regardless of rank, fear making a medical error. Unfortunately, many nurses are unable to leave this stress when their shift is over, and it becomes a central part of their lives, even when they are away from work.

Lack of work-life balance

Having insufficient time to relax and recover is a significant cause of nurse depression and anxiety. Due to the nature of nurses’ shift schedules, which often prevent them from doing much more than eating and sleeping during their off hours, finding time to 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 they need to succeed. It also heightens tensions within an already high-stress environment.

Compassion fatigue and burnout

When individuals repeatedly experience excessive overwork and stress with little opportunity to recover, they may have difficulty performing their jobs to the extent they once did. Burnout is characterized by feelings of exhaustion, increased mental distancing from one’s work, cynicism about work, and reduced professional efficacy.

Relias Vitals+Vision Podcast

Listen as we chat with Rola Aamar, PhD, an experienced marriage and family therapist and Partner for Behavioral Health Solutions at Relias. We discuss why psychological safety is critical for healthcare organizations and why it should apply to everyone.

How to identify nurse depression and anxiety

It can be difficult to identify mental health conditions in nurses. Anxiety and depression manifest differently depending on the individual, and many symptoms can be easily overlooked in nurses because they are constantly busy and have little time to self-reflect.

To identify nurse depression and anxiety, nurse leaders should watch for changes — even subtle ones — in their nurses’ behavior. Although these symptoms should not be used as a diagnosis, they can help open the door to conversations between employers and employees that help a nurse get appropriate care and treatment. Symptoms to watch for include:

  • Difficulty with time management, memory, or concentration
  • Slow responses during a crisis or impaired decision-making
  • Frequent accidents or medical errors
  • Limited ability to perform mental tasks, like calculating doses
  • Absenteeism, social withdrawal, or poor interpersonal or communication skills
  • Anger issues that may lead to outbursts toward coworkers, family, or patients
  • Fatigue, cynicism, negative moods, or lack of empathy

How can nurses manage their anxiety and depression?

Many healthcare professionals view emotional and psychological distress as a reflection of unsuitability for the profession, when in fact, it is a normal reaction to the stress they experience. Nurses might not realize — or avoid acknowledging — that they may be experiencing anxiety or depression. Fear of losing their jobs may cause nurses to suffer in silence.

Ignoring the problem can make it even harder for nurses to perform their duties and compromise the quality of care they provide. Worse, it can lead to distress and suffering for all affected. Nurses can continue to work with depression and anxiety, but they must take steps to address their mental health conditions. Nurses can do this by:

  • Becoming aware — The first step to managing anxiety or depression is awareness. Understanding that mental health conditions do not determine an individual’s worth and that they are common can empower nurses to seek the support they need.
  • Asking for help — Asking for help in specific, stressful situations or informing trusted individuals that they are experiencing depression or anxiety can help nurses ensure that they have a network of supportive 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 and contribute to anxiety and depression. Eating regular, healthy meals and sleeping well helps people refuel and regain a sense of balance. Relaxation practices such as 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 can empower nurses with coping techniques that help them maintain their mental health and minimize its impact on their work.

How to support nurses suffering from anxiety or depression

Nurse leaders can support nurses suffering from depression and anxiety in many ways, such as:

  • Educating staff — Education can help both new and veteran nurses recognize that they may be suffering from mental health issues and encourage talking about mental health and asking for help.
  • Providing recognition — Healthcare leaders who express gratitude and acknowledge the achievements and contributions of their nurses through awards, incentives, or other forms of recognition can help them feel valued and appreciated and provide confidence that can help them get through personal challenges.
  • Creating support systems — Reliable support systems are critical for helping nurses navigate mental health challenges. Leaders should help develop mentoring programs, peer relationships, and social opportunities that create space to discuss mental health concerns. These efforts allow nurses realize they are not alone, validating their experiences and helping them get the support they need.
  • Offering flexible work arrangements — Long hours, heavy workloads, and conflicting demands can interfere with work-life balance and cause stress and fatigue. Support nurses by providing flexible scheduling, adequate staffing, reasonable workloads, and opportunities for rest whenever possible.
  • Promoting self-care — Self-care is critical for managing anxiety and depression. Encourage nurses to give themselves the same attention they typically reserve for others. Nursing leaders can promote self-care by modeling work-life balance and encouraging nurses to take breaks when needed.
  • Sharing resources — Improving access to behavioral health resources, such as contact information and referrals for mental health counselors, crisis hotlines, mental health screenings, and employee assistance programs can motivate nurses to seek help before their conditions intensify. Leaders should work with HR to share appropriate resources.
  • Promoting a culture of compassion — Create a culture of openness and compassion by encouraging honest and respectful communication and showing empathy and understanding. Make it clear that your organization does not condone judgment, discrimination, or retaliation.

Destigmatize mental health issues across your organization

Nursing jobs can cause anxiety and depression in even the most resilient of individuals, yet the stigma surrounding mental health persists. Nurses may feel ashamed, isolated, or afraid to talk about their mental health issues. Instead of seeking help, they may hide their suffering for fear of judgment or penalty. But silence doesn’t benefit anyone.

It is up to healthcare leaders to reduce stigma and bias surrounding mental health, help create a positive and healthy work environment, and ensure their teams are supported. By doing so, they can improve the quality and safety of care, enhance patient satisfaction, and retain and attract their nurses over the long term.

Are you experiencing mental health difficulties?

If you or someone you know is experiencing a mental health emergency, you or they can call the national Suicide and Crisis Lifeline at 988 or 988lifeline.org. Also, For the Frontlines is a free crisis counseling text line for healthcare professionals.

If it is not an emergency, seek out resources in your community or in your workplace. Know that help may be just a phone call or conversation away. Being proactive about protecting nurse mental health isn’t a weakness — it’s the best thing to do.


Reducing Mental Health’s Stigma in Healthcare

Despite the number of individuals affected by mental health disorders, the stigma around mental health remains. Healthcare workers may be less likely to seek treatment, leading to unnecessary complications.

Download research brief →

Connect with Us

to find out more about our training and resources

Request Demo