Role ambiguity
Role Clarity
Organizational factors associated with anxiety included: work overload, time pressures causing teachers to work during their free time, and role conflict. There were significant correlations between the reported anxiety and those stressors relating to pupils and parents [ 45 ]. In addition, interpersonal conflict, organizational constraints and workload were reported to result in depression through increasing job burnout [ 73 ]. Furthermore, depressive symptoms correlated with teaching special needs students and had a significant and robust relationship with the general burnout factor [ 50 ]. Self-perceived accomplishment was also positively associated with autonomy and negatively associated with low student motivation [ 18 ]. Personal accomplishment had a significant positive relationship with the number of teaching hours per week [ 40 ]. On the contrary, a cross-sectional study by Baka reported that increased work hours are usually accompanied by job demands, job burnout, and depression [ 73 ]. Job strain, job demand and job insecurity all showed positive associations with depressive symptoms [ 80 , 94 ]. Work-related factors, such as workload, were also correlated with stress, burnout, depression, and anxiety [ 42 , 73 ].
Furthermore, the educational level and teaching experience also predict depression. Depression was highest among teachers with a lower education followed by teachers with the most teaching experience [ 42 ]. Teacher stress was reported to be significantly associated with psychological distress, and social support could moderate the influence of stress; hence, the high-stress and the low-support group were most vulnerable to anxiety [ 74 ]. Studies have also reported that 55% of teachers without spousal support had depression [ 42 ]. In addition, stress was reported to be associated with missed work days, high anxiety and high role conflict [ 43 , 89 ] and 53.2% of teachers identified work as a source of long-term stress, leading to burnout [ 55 ]. According to Fei Liu et al. resilience significantly correlated with job burnout and turnover intention, and low resilience could result in a high job burnout [ 86 ]. The research also showed that personality trait neuroticism was the best predictor of burnout (28–34%) [ 67 ].
A significant overlap was reported between stress, burnout, anxiety and depression. Eighteen articles reported a correlation between burnout and depression, with differences in depressive symptomatology depending on the prevalence of burnout [ 3 , 18 , 25 , 41 , 42 , 48 , 50 , 52 , 54 , 60 , 64 , 69 , 84 , 86 , 92 , 95 ]. Three articles reported a correlation between burnout and anxiety symptoms [ 52 , 64 ]. Seven articles reported a correlation between stress and anxiety [ 28 , 58 , 65 , 71 ]. Six articles reported a correlation between stress and depression [ 28 , 31 , 43 , 61 , 68 , 71 ]. A correlation exists between moderate depressive disorder and anxiety disorder as well as stress [ 31 , 96 ]. Negative affectivity (a tendency to feel depression, anxiety, or stress) plays a role in the development of burnout among teachers. Teachers who developed a more markedly negative affectivity also felt more burnt out, and the opposite was true [ 41 ]. This may be related to rumination. According to Nolen-Hoeksema, rumination is a pain response which entails a recurrent and passive focus on the symptoms of pain and their likely causes and outcomes [ 97 ]. Ruminative responses may prolong depression by overly focusing on negative thinking and may affect one’s behaviour and problem-solving [ 97 ]. Liu et al. reported that rumination moderated the association between job burnout and depression and that burnout was a stronger predictor of depression in teachers who experienced low rumination rather than high rumination [ 98 ]. This was explained by the importance of rumination for depression; with an improvement in the rumination level, job burnout had less ability to predict depression for those with high rumination levels.
There is a strong association between burnout and depression, as reported in several studies. High frequencies of burnout symptoms were identified among clinically depressed teachers [ 92 ], with 86% to 90% of the teachers identified as burnt out meeting the diagnostic criteria for a depressive disorder [ 60 , 64 ], mainly for major depression (85%) [ 60 ]. In 25% to 85% of teachers with no burnout, depression ranged from 1% to 15% of the study sample. Specifically, only 1% to 3% of the participants in the no-burnout group were identified as having minor depression or depression not otherwise specified (2%) [ 60 , 64 ]. A history of depression was reported by about 63% of the teachers with burnout and 15% of the burnout-free teachers [ 60 ]. The high overlap between depression and burnout was emphasized in one study, which categorized depression as “low burnout-depression” (30%), “medium burnout-depression” (45%), and “high burnout-depression” (25%) [ 92 ]. Notably, the report suggests that although teacher burnout leads to subsequent depressive symptoms, it is not true vice versa [ 95 ]. Furthermore, burnout symptoms at ‘time one’ did not necessarily predict depressive symptoms at ‘time two’ [ 99 ]. Another study reported a positive relationship between burnout and depression [ 84 ]. This was confirmed by a study which suggested that depressive symptoms had a significant and robust association with the general burnout factor [ 50 ].
Anxiety disorder is also associated with higher perceived stress and major depression [ 65 ]. In one study, higher ongoing stressors were positively associated with higher anxiety levels. Continuous and episodic stressors were significantly and positively associated with anxiety and depression. They accounted for 28% (adjusted 25%) of the variability in anxiety and 27% (adjusted 24%) of the variability in depression. [ 71 ]. In contrast, higher levels of co-worker support were related to lower levels of anxiety and depression [ 71 ]. Teachers reported a high prevalence of depressive symptomatology relating to subjective and school-related stress [ 43 ].
This scoping review included 70 articles. The prevalences of stress, burnout, anxiety and depression reported in this scoping review are similar to those reported in two systematic reviews and meta-analysis conducted among teachers during the pandemic. For example, the prevalence of stress reported by Ma et al., from a meta-analysis of 54 studies was 62.6%, whereas the prevalence of anxiety was 36.3% and depression was 59.9% among teachers during the pandemic [ 100 ]. In another meta-analysis, the prevalence range of anxiety was 10% to 49.4%; depression was 15.9% to 28.9%; and stress was 12.6% to 50.6% [ 101 ], which all fall within the range reported in this scoping review for stress [ 28 , 40 ], anxiety [ 42 , 56 ], and depression [ 48 , 59 ]. However, the minimum in all cases was higher during the pandemic, suggesting an increase in psychological problems during the pandemic.
The varying prevalence for stress, burnout, anxiety and depression reported by different studies in this review may be attributable to heterogeneous study designs, including the sample size, location, period of data collection, diversity in the standardized scales used for the assessment, and other factors such as the class size and grade taught [ 102 , 103 ]. In this scoping review, the studies used combinations of terminologies such as “none,” “slightly,” “significant,” “much,” “extremely,” “considerably”, “almost unbearable”, “quite a bit” or “a great deal” to describe the level of stress experienced by teachers according to the measures utilized,, such as the Teachers Stress Inventory [ 44 , 77 ] or the Bruno Teachers Inventory [ 43 ]. The prevalence rates also varied with population, for example, in the case of Fimian, the teachers were teaching special needs students, and this may explain the relatively high prevalence (87.1%) recorded [ 44 ]. More recent studies which used other scales, such as the Perceived Stress Scale (PSS), and the Depression Anxiety Stress Scales (DASS), used terminologies such as “symptoms of stress”, ranging from “mild,” “moderate,” “mild to moderate” or “extremely severe”, to describe the stress levels. For burnout, although most studies used a combination of the three interrelated components of burnout reported by Maslach et al. [ 6 , 7 , 11 , 16 ], some studies focused on reporting the sub-dimensions of burnout, whilst others reported general burnout. Varying expressions such as “low burnout”, “high burnout, “severe burnout”, and moderate were used to describe burnout, making it difficult to make an effective comparison. It was also not clear whether the stress and burnout experienced by the participants were everyday existential life experiences that everyone faces or chronic ones that needed intervention, as these were not specifically stated in the studies. It is essential that future research clarifies this to estimate their prevalence rates more accurately. Secondly, as indicated in the review, the studies applied various scales to measure the prevalence of psychological disorders; however, there was a lack of consensus. This scoping review provides a comprehensive picture of the prevalence of the target outcomes and sets up a foundation for future systematic reviews and meta-analysis to accurately estimate the prevalence of these outcomes among teachers.
The essential correlates of stress, burnout, anxiety, and depression identified in this review include socio-demographic factors such as sex, age, gender, marital status, school (organizational) factors and work-related factors (years of teaching, class size, job satisfaction, subject taught and absenteeism). Most studies were published in the last fifteen years (2007–2022), indicating a recent increase in interest in this area of research.
Socio-demographic factors such as sex, age and marital status significantly influence teacher stress [ 54 ]. Sex correlates with stress although there are some conflicting reports [ 42 , 53 , 76 ], especially between the levels of stress experienced by males and females. Some studies suggest that female teachers experience more stress than their male counterparts [ 28 , 75 , 77 ]. Working women often have additional demands at home, and trying to accomplish both roles may increase their stress levels [ 104 ] compared to males who may have less demand from home. However, this may be context-dependent, as no sex difference in occupational stress was reported among police officers [ 105 ], for example. The demand from female teachers’ personal lives, including marital issues and home, may be a source of increased stress levels [ 104 ]. Among the general workforce, work–family conflict has been reported to be significantly associated with work stress [ 106 ], and this is not confined only to females. This argument is confirmed in three separate studies, which reported that gender, per se, was not a significant predictor of perceived stress [ 39 , 85 , 89 ]; thus, it is possible that these differences may, rather, be due to differences in the scales used or the effect of organizational factors. For example, the organisational effect experienced by female teachers in a female only elementary or high school may differ from that experienced in a male only or mixed sex teaching environment; however, further research is needed in this area of gender influencing stress factors. Findings from the Canadian Community Health Survey data nonetheless endorsed a difference between males and females regarding work stress, in particular supervisor support. Higher levels of supervisor support seemed to lower work stress amongst women but not men [ 107 ]. Among the general population, social support at work could be more strongly related to a stress reduction in women than in their male counterparts [ 108 ] Sex difference was also observed in relation to student behaviour, with women experiencing increased stress [ 42 , 77 ]. In particular, female teachers’ collective efficacy and beliefs about their school staff group capabilities may lower their stress from student behaviour. Findings from the study by Klassen support the hypothesis that teachers’ collective efficacy serves as a job resource that mediates the effect of stress from student behaviour [ 77 ]. Interventions addressing gender/sex differences may also be considered in supporting female educators’ mental health and work productivity.
A study among refugee teachers also endorsed sex differences in stress [ 42 , 57 ]; however this was in relation to self-care and the association was moderated by age [ 57 ]. Higher occupational stress scores were observed among teachers over 40 years [ 28 ]; nonetheless, among the general population, the published literature reports that the ageing process can worsen or counter the effects of stress [ 109 ], indicating that age does not necessarily increase stress. The cause of increased stress, hence, shifts to other factors such as the poor academic performance of students, or a lack of assistance [ 78 ], which may be influencing an increase in stress.
The class size, grade level taught, workload, poor student performance or lack of progress and other work and school-related factors contribute to teachers’ stress. According to Fimian et al., when stressful events or the perception of them are not ultimately resolved or improved, this may result in several physiological manifestations [ 44 ]. There is clear data indicating that teacher stress was intensified among primary school teachers, special needs teachers, and teachers in private schools who provided more support and input to students than other teachers [ 28 , 78 , 85 , 110 ]. The additional time and energy teachers may invest in primary school kids, who are usually much younger and may require more support, may explain the increased stress among primary school teachers. Again, teaching special needs students may require significant teacher input and assistance, depending on the nature and degree of the disabilities. There is also an increased expectation from teachers in private schools regarding the students’ performances, leading to increased stress [ 28 ]. A study conducted among primary and secondary school teachers in Pakistan concluded that government school teachers were more satisfied with their working conditions than private school teachers [ 110 ], and thus, may experience less stress. In addition, the school location (rural vs. urban), teacher role ambiguity and coherence further exacerbated teacher stress [ 3 , 75 , 89 , 111 ]. An excessive use of technological devices, such as mobile phones, has also been associated with social disruption [ 112 ] and may result in a lack of concentration or poor student performance at school [ 112 , 113 ], leading to teacher stress. Teachers experiencing more significant stress were also burnt out [ 68 ]. For example, during the pandemic, teachers had to adopt and adjust to teaching online, and virtual instruction teachers had the most increased anxiety [ 58 ]. Nonetheless, a rapid systematic review with a meta-analysis reported that teacher stress during the pandemic was still comparatively lower in school teachers with a prevalence of 13% ([95% CI: 7–22%]) in comparison to studies with university teachers as the participants of 35% ([95% CI: 12–66%]) [ 114 ].
While there are complex interactions among several factors which contribute to teacher stress, there have been limited evidence-based interventions to help teachers alleviate these stress sources despite some self-reported coping strategies. This research gap started to receive attention during the COVID-19 pandemic through the application of mindfulness-based interventions [ 115 ], warranting more advanced research on how to best address these challenges in education.
Burnout continues to pose problems within the teaching profession, and factors such as gender, sex, age, marital status and the number of years teaching correlated with the degree of burnout [ 40 , 47 , 51 , 52 , 53 , 54 , 55 , 63 , 67 , 68 , 72 , 73 ], although conflicting results were reported with potentially different explanations. Differences in the study design, particularly the scales used to assess burnout as well as geographical and organizational factors, may account for some of the conflicting results. In addition, there could be an interplay between some personal and professional factors. For example, younger teachers are more likely to be enthusiastic about their new teaching careers, whilst older teachers may experience boredom leading to increased exhaustion. Consistent with this hypothesis, one study reported that teachers who had taught for the fewest (0–5) years experienced the lowest burnout prevalence [ 54 ]. On the contrary, more experienced teachers were likely to have gained exposure, learnt students’ characteristics and classroom management skills and the necessary tools to help them prevent and address burnout. Additionally, teachers who lacked self-fulfilment may have been mostly younger and lacked personal accomplishments [ 47 ], leading to more burnout.
Significantly higher burnout scores, including for emotional exhaustion, depersonalization, and intellectual burnout were found among female teachers than among male teachers in some studies [ 51 , 52 , 53 ], whilst other studies reported that burnout was higher among male teachers. These results are contrary to findings reported among police officers, which indicated no significant difference in the levels of occupational burnout reported by male and female police officers [ 105 ]. Further studies are needed to investigate the contradictory gender differences in teachers’ burnout by different studies. In addition, research is needed on innovative gender-neutral ways of addressing burnout in teachers. Other structural factors, such as the number of children teachers have and class sizes which are associated with increased teacher burnout, require an increased investment in teachers and schools to address them. Governments providing teachers with affordable childcare and other supports for their own children, and building more schools to reduce the class sizes, may lead to a reduced burnout among teachers.
There is also a relationship between burnout and school or work-related factors. The subjects and grades taught and the medium of instruction all contribute to teachers’ burnout [ 7 , 51 ]. Teachers’ perceptions of the difficulty of a subject taught appears to determine their degree of burnout experienced; however, no particular subject seems to be the leading cause of burnout. High school teachers may perceive an increased workload in terms of the amount of time attributed to class preparation due to the difficulty of a subject taught. A cross-sectional study among nurses also found that role overload contributed to higher levels of emotional exhaustion [ 116 ] and this was also endorsed among healthcare managers where prolonged job strain resulted in burnout and an increased turnover intention [ 117 ]. This suggests there is a complex interaction between self-perception and burnout, which makes burnout in teachers a complex problem to address. Differences were also noted in the prevalence of burnout among teachers working in different countries [ 84 ]. For example, 58% of the variance in burnout in Cyprus could be explained by job satisfaction and anxiety, whereas 57.5% of the variance in burnout in Germany was explained by job satisfaction alone [ 84 ]. Different countries have different working conditions which may explain the differences in job satisfaction and associated burnout prevalence among teachers in different countries.
Resilience involves adapting well in the face of stress, difficulty, trauma, disaster, and threats. Resilient people use positive emotions to rebound and find positive meaning even in stressful circumstances [ 118 ]. Resilience had a significantinverse correlation with job burnout and turnover intention, and resilience could negatively predict job burnout [ 86 ]. Resilience was also reported to have an inverse association with burnout symptoms [ 119 ]; thus, increased resilience is linked to decreased burnout and, hence, the tendency for a teacher to remain in their job and thrive no matter what they encounter. Job burnout had a significant positive predictive effect and correlation with turnover intention, which suggests that the more severe the job burnout is, the higher the turnover intention [ 86 ]. Teachers require positive emotions and an increased resilience to remain in the profession and succeed without quitting. Conversely, among physicians, a survey indicated that the burnout prevalence was still significant even among the most resilient physicians; however, West et al. suggested that physicians exhibited higher levels of resilience than the general working population [ 119 ], including teachers. Additionally, resilience was also a significant predictor of depression and anxiety [ 88 ]; thus, the higher the resilience, the less likely teachers will experience depression or anxiety.
Socio-demographic, school and work-related factors are all associated with both anxiety and depression [ 42 , 50 , 51 , 80 ]. This association is consistent with what was reported in a systematic review and meta-analysis by Ma et al., which suggested that teachers’ experiences of psychological issues were associated with various socio-demographic factors such as gender, institutional factors, teaching experience, and workload volume [ 100 ]. In this scoping review, conflicting results were found in relation to the association between teacher gender and depression. Whilst some studies reported that female teachers have higher depression levels than male teachers [ 42 , 51 , 70 , 79 , 81 , 82 ], other studies have reported no gender differences in teacher depression levels [ 53 ]. Contradictory results were also reported for the association between the age of teachers and depression, with some studies reporting higher depression levels in younger teachers [ 42 ] and others reporting higher depression in older teachers [ 51 ]. As discussed previously, it is likely that the use of different scales, coupled with organizational factors, contributed to these contradictory findings among the different studies. The findings also indicated that most female teachers who suffered from depression had been working for about 11 to 15 years [ 120 ].
A poor workplace environment has also been associated with increased anxiety and depressive symptoms [ 121 ] and school-related stress may transition to depressive symptoms among teachers [ 80 , 94 ]. As teachers’ workloads increase, their working hours will invariably increase, resulting in a rise in job demand and ultimately a surge in stress, leading to anxiety and depression. A systematic review reported similar findings where the main risk factors associated with anxiety and depression included job overload and job demands. [ 122 ]. The research also shows that teachers are not the only exception regarding experiencing a poor workplace environment which may lead to increased anxiety and depression [ 122 , 123 ]. Improving teachers’ workplace environments may, therefore, reduce the prevalence of anxiety and depression among teachers. Anxiety has also been linked to stressors relating to pupils and parents. For example, the possibility of a parental complaint increased anxiety scores [ 45 ]. Generally, parents want their children to succeed academically, which sometimes creates friction between teachers and parents. The underperformance of students or failure may be blamed on teachers or construed as the responsibility of schools and teachers [ 124 ], which may result in increased stress and subsequently anxiety and depression for teachers.
Social support was also reported to predict anxiety and depression symptoms, with high support levels indicating fewer symptoms related to anxiety and severe depression [ 121 , 125 ]; thus, teachers who perceived social support at school (e.g., the personnel relation dimension) expressed a lower stress level than those who did not [ 75 ]. According to Peele and Wolf 2020, anxiety and depressive symptoms increase for all teachers over the school year, and poor social support plays a significant role in the development of anxiety and depression symptoms [ 121 ]. Organizational policies that include the provision of adequate social support for teachers may, therefore, be a useful strategy to prevent and mitigate anxiety and depressive symptoms among teachers.
The scoping review is not without limitations. This scoping review searched for articles in the English language only. Though every effort was made to identify all relevant studies for this review considering our eligibility criteria, we may have left out some relevant studies, particularly those published in other languages. Our search included six databases, yet the overall search strategy may have been biased toward health and sciences. Searching other bibliographic databases may have yielded additional published articles. Furthermore, different studies included in this scoping review used various screening tools and worldwide diagnostic classifications to determine stress, burnout, anxiety, and depression, leading to variations in the prevalence estimates. The scoping review included studies from 1974 till date; therefore, it is possible that the theoretical approaches to the concept of burnout may have changed. Notwithstanding these potential changes in the theoretical approaches to the concept of burnout, the burnout prevalence among teachers has appeared to have remained stable over the years. There was also no evaluation of the risk of bias for the included studies. Despite these limitations, this scoping review provides an excellent perspective on the prevalence and correlates of stress, burnout, anxiety and depression among teachers.
Teachers’ psychological and mental health is of utmost importance as it indirectly affects the students they teach. The stress associated with the teaching profession can be linked to three major overlapping issues: burnout, anxiety, and depression, which have a myriad of effects, including an impact on teachers’ health, well-being, and productivity. A wide range of prevalences and correlates were reported for stress, burnout, anxiety, and depression. Differences in the severity were observed in different articles resulting in the diverse prevalence reported among the various studies. The differences in the measurement instruments creates critical knowledge gaps, making it difficult for researchers to make effective comparisons between the different studies. Future research should focus on addressing these research gaps arising from methodological issues, especially the use of different scales to allow for a meaningful comparison. Researchers, educators, and policy makers could benefit from an international consensus meeting and agree on common scales to be used when assessing stress, burnout, anxiety, and depression in teachers. Such an international consensus meeting can also help to streamline the definition of stress and can be used as a forum for addressing other methodological issues related to research and innovations involving elementary and high school teachers. Future research can also focus on exploring the gender differences in these psychological issues further, especially, defining the various subsets of gender being referred to and the specific prevalence in each case. In addition, the high prevalence of stress, burnout, anxiety, and depression reported particularly by several high-quality studies suggests that these psychological problems are widespread among teachers and deserves special attention both at the level of policy and practice.
This scoping review also highlights the risk factors associated with stress, burnout, anxiety, and depression. Identifying these risk factors is a significant step toward addressing these issues among teachers. Schools need to prioritize and promote interventions aimed at teachers’ personal wellbeing. Testing and implementing the interventions aiming to improve teachers’ well-being and ability to cope are important to address stress and burnout, with the expectation that this will prevent or reduce anxiety and depression. This may include school-based awareness and intervention programs to detect the early signs of teacher stress and burnout, or programs that incorporate meditation techniques or text-based support. Meditation techniques have been proposed to be effective in improving psychological distress, fatigue and burnout [ 126 ]. For example, mindfulness practice has been suggested as beneficial in coping with job-related stress, improving the sense of efficacy and reducing burnout in the teaching profession [ 127 ]. Interventions such as mobile text technology are an evidence-based, unique, and innovative way that offers a convenient, low cost and easily accessible form of delivering psychological interventions to the public with mental health problems [ 128 , 129 , 130 ]. Mobile text-based programs can be easily implemented at the school level to support teachers’ psychological needs. Future studies need to explore the development, implementation, monitoring, and evaluation of intervention programs for improving mental health outcomes among teachers. For instance, the Wellness4Teachers program which is planned for implementation in Alberta and Nova Scotia, Canada [ 34 ], is expected to provide evidence of effectiveness for the use of daily supportive text messaging to combat stress, burnout, anxiety, and depression among teachers. Finally, governments, school boards and policymakers need to collaborate with researchers on the design and implementation of measures to enhance teachers’ mental health, productivity (teaching) and quality of life.
Summary of studies with prevalence and correlates of Burnout/Stress.
Authors/Year | Country | Study Design | Sample/Population Size (Response Rate %) | Teachers/Age Range | Scales Used | Key Findings | |
---|---|---|---|---|---|---|---|
Correlates of Burnout/Stress | Prevalence of Burnout/Stress | ||||||
Okwaraji et al., 2015 | [ ] Nigeria | Cross-sectional | SS = 432 | Secondary 26–48 years | Maslach burnout inventory, The General health questionnaire (GHQ-12) and the Generic job satisfaction scale | DP: gender, marital status Reduced PA: age, gender, marital status. | 40% emotional exhaustion EE 39.4% for DP 36.8% for reduced PA. |
Kidger et al., 2016 [ ] | UK | Cross-sectional | 555/708/ (78.4%) | Secondary | Warwick Edinburgh Mental Wellbeing Scale-WEMWBS) | Stress at work: change in school governance. | Not Mentioned. |
Bianchi et al., 2015 [ ] | France | Survey | SS = 627 | Primary/Secondary | Maslach Burnout Inventory (MBI) | Burnout symptoms at time 1 (Tl) did not predict depressive symptoms at time 2 (T2). | Time 1 43%, mild burnout 49% moderate burnout, 8% severe burnout. |
Ramberg et al., 2021 [ ] | Sweden | Cross-sectional | Year 2014/16 3948/7147 (55.2%) SS Final = 2732 | Teachers | Stockholm Teacher Survey. The (Questionnaire) | Perceived stress: high job strain, high SOC. Stress: psychological demands at work. High SOC was linked with lower levels of stress and depressed mood. Variation of 4.8% for perceived stress and 2.1% for depressed mood. | Not mentioned. |
Shukla et al., 2008 [ ] | India | Survey | SS = 320 | Secondary | Maslach Burnout Inventory | Lack of PA: subject taught. Science teachers’ higher burnout than arts teachers. More burnout cases in English medium teachers than Hindi medium. Burnout: gender. | EE: 56.56% low burnout, 19.68% average, 23.75% high. DP: 20% high burnout, 16.56% average, and 63.43% low. Lack of PA: 28.43% high burnout. 13.43% average, and 58.12% low. Lack of PA: 28.43% 11.88% high burnout level in all 3 dimensions, 2.81% average burnout on all 3 sub-scales and 40% low burnout level in all dimensions. Burnout of SCIS teachers 26.26%, (AS, 13.76%. EE: 22.5% SCIS and 25% AS teachers’ high burnout category, 21.88% SCIS and 17.5% AS teachers’ average burnout level, 55.62% SCIS and 57.5% AS teachers’ low burnout. Approximately 56–64% in all dimensions of the sample is showing low burnout levels. |
Pohl et al., 2022 [ ] | Hungary | Cross-sectional | 1817/2500 (72.7%) | High school/18–65 | Maslach Burnout Inventory. | Severe burnout, EE and DP: Internet addiction Internet addiction was associated with severe burnout (10.5 vs. 2.7%, < 0.001), moderate (36.8 vs. 1.7%, < 0.001), and severe (6.3 vs. 0.1%, < 0.001). | 26.0% mild, 70.9% moderate, and 3.1% severe burnout. |
Papastylianou et al., 2009 [ ] | Greece | Cross-sectional | 562/985 (57.1%) | Primary/30–45 | Maslach and Jackson, MBI: Maslach Burnout Inventory. | EE: depressed affect, positive affect, degree of role clarity, role conflict and role ambiguity. | EE: 25.09%, PA 14.27% and DP: 8.65%. |
Hadi et al., 2009 [ ] | Malaysia | Cross-sectional | 565/580 (97.4%) | Female/male Mean age 40.5 | Depression, Anxiety and Stress Scale (DASS 21) and Job Content Questionnaire (JCQ). | Stress: age, duration of work and psychological job demands. | 34.0% stress, 17.4% of teachers experienced mild stress. |
Ratanasiripong et al., 2021 [ ] | Thailand | Cross-sectional | SS = 267 | Primary/secondary 44.4 | The Maslach Burnout Inventory for Educators Survey, Thai version (MBI-ES). | Stress: marital status negative relation with stress., Family economics status, gender, sleep and resilience. Burnout (EE): relationship quality and age. DD: relationship quality and drinking. PA: resilience and number of teaching hours. | 6.0% had severe to extremely severe stress. |
Szigeti et al., 2017 [ ] | Hungary | Cross-sectional | SS = 211 | Primary/secondary 42.8 | Hungarian version of the MBI–ES | General burnout/EE: overcommitment | General burnout 58%, 13% for EE 11% for DP, and 17% for PA. |
Hodge et al., 1974 [ ] | Wales, England | Cross-sectional | 107/145 (75%) | Secondary, 33 mean | Maslach Burnout Inventory (MBI) and General Health Questionnaire (GHQ-60). | EE: difficulty of subject taught and satisfaction, age. 58% of music teachers thought subject was the most difficult subject to teach, 29% of mathematics teachers. | Music teachers have significantly higher EE and DP (high burnt) scores than mathematics teachers. Music teachers. |
Baka 2015 [ ] | Poland | Cross-sectional | 316/400/ (79%) | Primary/secondary 22–60 | The Oldenburg Burnout Inventory. | Job burnout: age and job seniority, work hours, job demands. Job burnout decreases along with age and job seniority. Increased work hours were accompanied by job demands, general job burnout, depression and physical symptoms. | Not mentioned. |
Othman et al., 2019 [ ] | Malaysia | Cross-sectional | SS = 356 | Secondary <20->/= 50 | Malay Depression Anxiety Stress Scales (DASS). | Stress; gender, educational status, teaching experience, marital status. | 32.3% stress symptoms 25.3% were mild to moderate. 7.0% severe to the extremely severe stress. Female stress 32.7%, Indian/other ethnic 50.6%, lowest educational status 46.1%, longest teaching experience (34.6%), lowest income (33.9%), marriage duration 11–20 years (37.3%), 1–3 children (35.5%), |
Skaalvik et al., 2020 [ ] | Norway | Longitudinal | SS = 262 | High school | Maslach Burnout Inventory-Educators Survey. | EE: time pressure. Cynicism: low student motivation. Self-perceived accomplishment: autonomy and low student motivation. Burnout: motivation to quit, job satisfaction. | Not mentioned |
Li et al., 2020 [ ] | China | Cross-sectional | 1741/1795 (97%) | Kindergartens/preschool 18–48 | Chinese version Maslach Burnout Inventory and the Perceived Stress Scale-14. | Burnout rate: overweight/obesity, type of school, income satisfaction, depression. Burnout: age, higher perceived stress levels, shorter years of teaching. Perceived stress ( < 0.001, OR = 1.15, 95%CI: 1.13–1.18). | Burnout was 53.2%. 53.0% (851/1607) in female subjects and 56.0% (75/134) in male subjects. |
Gosnell et al., 2021 [ ] | Malaysia | Cross-sectional | 123/400(31%) | Primary/secondary | Depression Anxiety Stress Scales-21 self-care strategy questionnaire was adapted from a self-care scale in the Mental Health Handbook. | Stress: self-care. The association was moderated by age. Among refugee teachers, women were more stressed than men. Stress: negative correlation with age. Younger teachers experienced higher rates of stress than older teachers. | Refugee teachers 8.3% in the severe or extremely severe stress levels clinical ranges. |
Capone et al., 2020 [ ] | Italy | SS = 285 | High school 29–65 | Burnout Inventory- General Survey (MBI). | EE, and DP: flourishing participants languishing teachers. | 22.1% for EE and 9.5% for DP. | |
Chan et al., 2002 [ ] | China | Cross-sectional | SS = 83 | Secondary 22–42 | The shortened 20-item Teacher Stressor Scale (TSS). e 20-item Chinese shortened version of the General Health Questionnaire (GHQ-20). | Stress: psychological distress. Gender, age. Self-efficacy: psychological distress, social support. | Not mentioned. |
Zhang et al., 2014 [ ] | China | Survey | SS = 590 | Primary/secondary 34 ± 8.11 | Chinese Maslach Burnout Inventory. | Reduced PA and intellectual burnout: somatization EE, DP, and intellectual burnout: gender. Burnout: gender, level of mental health. EE, DP: best predictor anxiety. | EE accounted for 92.8% of the burnout cases, DP for 92.9%, reduced PA for 89.9%, and intellectual burnout for 95.0%). Burnout is more severe in female teachers than in male teachers. |
Vladut, et al., 2011 [ ] | Romania | Cross-sectional | SS = 177 | Primary/secondary/High 22–64 | Maslach Burnout Inventory (MBI). Teachers’ Sense of Efficacy Scale. | Burnout: rural or urban teaching, self-acceptance, classroom management, work-conditions and confidence. | 49.6% above moderate or severe EE 28.7% on DP 54.1% on inefficacy. |
Liu et al., 2021 [ ] | China | Cross-sectional | 449/500 (89.8%) | High 36.70 | Maslach Burnout Inventory (MBI). | Job burnout: turnover intention; resilience has negative correlation. EE was the most predictive factor for turnover intention with an explanatory variance of 29.2%, followed by DP with an explanatory variance of 1.9% Lest is low PA with 1.5%. | Not mentioned. |
Fimian et al., 1983 [ ] | US | Survey | 365/800(47%) | Special education | Teacher Stress Inventory (TSI) Survey. Sources of Stress (25 items); Emotional and Behavioral Manifestations of Stress (24 items); Physiological Manifestations of Stress (16 items). | Stress: lack of time to spend with individual pupils, teaching. Special needs, or mixed ability students. Increased workload, feeling isolated, and frustrated because of poor administration attitudes and behaviors. | 87.1% moderately-to-very stressful. (45.6%) much-to-very-much stress. 15.9% (58/365) identified as low-stress, (68.4% (250/365) as moderate-stress, and 15.6% (57/365) as high-stress teachers. |
Katsantonis 2020 [ ] | * 15 Countries. | Survey | SS = 51,782 | Primary | Self-efficacy is domain-specific and three scales reflect the self-efficacy. 5 items scale was designed by OECD (2019) to measure factors that cause workload stress. | Workload stress: self-efficacy in instruction, student-behavior, workplace well-being, work satisfaction. Stress: perceived disciplinary climate. School climate negative effect. Increase work satisfaction results in perceived less stress. 16% (organizational constraints as a predictor of depression). | Japanese participants had greater levels of workload stress than Korean participants. Participants from Belgium perceived greater workload stress. |
Ratanasiripong et al., 2020 [ ] | Japan | Cross-sectional | 174/200 (87%) | Primary/secondary 41.65 | Japanese version of depression, Anxiety, and Stress scale (DASS-42). Japanese version of the Connor–Davidson Resilience Scale (CD-RISC). Japanese version of the Rosenberg Self-Esteem Scale (RSE). | Stress: resiliency and self-esteem. Strength Higher self-esteem and resilience were significantly correlated to less stress. | Not mentioned. |
Jurado et al., 2005 [ ] | Spain | Cross-sectional | 496/602/ (82.7%) | Primary/secondary (women, 45.3 ± 9.8; men, 44.7 ± 9.7). | Spanish version of Epidemiologic Studies Depression scale (CES-D). | Job stress: negative correlation with job satisfaction, desire to change job and appraisal by others. Teachers wishing to change jobs (25%; significantly higher score on job stress but low on job satisfaction and appraisal by others. | |
Bianchi et al., 2021 [ ] | France Spain Switzerland | Survey | France ( = 4395), Spain ( = 611), and Switzerland ( = 514) | Schoolteachers | Maslach Burnout Inventory for Educators. Job strain was measured with a shortened version of the Effort-Reward Imbalance Questionnaire. | Burnout: neuroticism prediction (28–34%), job strain (10–12%), skill development, security in daily life, and work–non-work conflict (about 15–18%), sex, age, unreasonable work tasks, workhours, job autonomy, sentimental accomplishment, leisure activities, personal life support. | Not mentioned. |
Bianchi et al., 2014 [ ] | France | Analytical | SS = 5575 | School teachers 41 years; | Maslach Burnout Inventory. Depression was measured with the 9-item depression scale of the Patient Health Questionnaire (PHQ-9). | EE: Strongly associated with depression than with DP and reduced PA. | No-burnout 13% (750) participants. |
Hammen et al., 1982 [ ] | US | Cross-sectional | SS = 75 | Secondary | DASS-21scale. Bruno’s Teacher stress Inventory | Stress: depressive symptomatology, days off work, school-related factors. | 76% moderate or greater stress 20% level of stress was “almost unbearable.” |
Méndez et al., 2020 [ ] | Spain | Cross-sectional | 210/300 (70%) | 30 to 65 | Maslach burnout inventory. | Burnout: correlates with EE, PA and DP resulting in three burnout profiles (high burnout); (moderate burnout) and (low burnout). Burnout: depressive symptomatology. The higher the burnout the greater the depressive symptomatology | 33.3% high burnout 39.1% low burnout and 27.6% moderate burnout. |
Jepson et al., 2006 [ ] | UK | Cross-sectional | 95/159 (60%) | Primary/secondary | Perceived Stress Scale (PSS). 10 scale item, occupational commitment 6 scale item. | Work-related stress, strongest predictor and negative relationship, was occupational commitment, achievement striving experience, level taught. Educational level taught. Occupational commitment increases, perceived stress decreases. | Significantly higher levels of perceived stress were reported from primary school teachers than secondary school. Higher achievement striving experience have higher levels of perceived stress. |
Al-Gelban 2008 [ ] | Saudi Arabia | Cross-sectional | 195/189 (96.9%) | Male 28–57 | Depression, Anxiety and stress DASS-42 scale. | Depression, anxiety and stress were strongly positively and significantly correlated. | 31% had stress. |
Lee et al., 2020 [ ] | Malaysia | Cross-sectional | SS = 150 | Secondary/primary | DASS-21 inventory. | Stress: number of years working. Majority of teachers with stress: either severe and extremely severe level are those working for 11 to 15 years. | 10.7% stress. |
Bounds et al., 2018 [ ] | US | Survey | 108/117 (92%) | Primary/secondary 42 | Teacher Stress Inventory (TSI). | Stress: violence against, urban, suburban, and rural setting. | Urban teachers had the highest levels of stress from violence rather than suburban teachers. |
Pressley et al., 2021 [ ] | US | Survey | SS = 329 | Elementary | The COVID Anxiety Scale. A teacher burnout subscale of stress. | Stress: anxiety factors in pandemic situations. | Not mentioned. |
Yaman 2015 [ ] | Turkey | Survey | SS = 436 | Elementary/branch 35.2 | Mobbing Scale and the Stress subscale of the Depression Anxiety Stress Scale. Turkish version of the Stress Subscale of DASS. | Stress: predicted positively by humiliation, discrimination, communication barriers, and mobbing scores. | Increment in mobbing will increase stress. |
Cook et al., 2019 [ ] | US | Cross-sectional | 180/105/58.5% | Middle 22 ± 37 | Teacher Stress Inventory. The Daily Spiritual Experience Scale. | Stress: teacher spirituality. As teachers’ spirituality increases, their time-management stress and their work-related stress increase. | Not mentioned. |
Okebukolal 1992 [ ] | Nigeria | Survey | SS = 368 | Science | The Occupational Stress Inventory for Science Teachers (OSIST). | Stress: school villages (personnel relation dimension) curriculum, facilities, student characteristics, administrative, and professional growth and self-satisfaction, subject taught, science budget. Science teachers in the rural schools mean stress score of 47.25 (SD = 4.89), urban schools mean stress score of 51.29 (SD = 6.95). | Urban teachers were found to be more stressed than those in rural areas. Female science teachers were more stressed than their male counterparts. |
Klassen 2010 [ ] | Canada | Survey | 951/- (Approximately 75%) | Elementary/secondary | Teacher Stress Inventory. Collective Teacher Efficacy Belief Scale (CTEBS Job satisfaction was measured with a one-factor, three-item, 9-point Likert-type scale. | Stress: collective efficacy, student behavior, gender, workload, class size. | 21.3% females rated the stress from workload “quite a bit” or “a great deal” of stress from workload factors. 13.4% of male teachers rated stress from workload at a mean of 7 or higher. More women (18.6%) than men (12.8%) reported feeling “quite a bit” or “a great deal” of stress from student behavior. |
Proctor et al., 1992 [ ] | UK | Survey | 256 (93%) | Primary 39.68 | Zigmond and Snaith’s 6 Hospital Anxiety and Depression (HAD) Scale and Moos and Insel’s7 Work Environment Scale (WES). | Stress: anxiety, work overload, time pressures, stressors relating to pupils and parents. | 67% found teaching ‘considerably’ or ‘extremely’ stressful, 79 (32%) ‘slightly’ stressful and 2 (1%) ‘not at all’ stressful. |
Akin 2019 [ ] | Turkey | Mixed research method | 460/3478 (13%) | Teachers | Turkish version of the Maslach and Jackson inventory. | DP: marital status. Reduced PA: number of children. | Not mentioned. |
Chan 1998 [ ] | Hong Kong | Cross-sectional | SS = 415 | Secondary 21–61 | Teacher stressor scale and the General Health Questionnaire. | Stress: high support—less anxiety symptoms, psychological symptoms. | 37.3% psychiatry morbidity. |
Adeniyi et al., 2010 [ ] | Nigeria | Cross-sectional | SS = 50 | Special Needs | Job Stress Inventory. | Stress: marital status, teaching special needs, lack of pupils’ progress in class work/academic achievement, societal attitudes/respect heavy workload and lack of help/assistance, degree and nature of disabilities of the special need children. | Not mentioned. |
Beer et al., 1992 [ ] | US | Cross-sectional | 86/92(93%) | Grade and high school | Beck’s Depression Scale, the Coopersmith Self-esteem Inventory—Adult Form, Stress Profile for Teachers, and the Staff Burnout Scale. | Burnout and stress: gender, level taught-high/grade school. Grade school teachers experienced more burnout than high school teachers. | Burnout scores higher for female high school teachers than for both male and female grade school teachers. Scores on stress were higher for male high school teachers than for both female high school teachers and male grade school teachers. |
Liu et al., 2021 [ ] | China | Cross-sectional | 907/1004 (90.3%) | Primary and secondary 20 ≥ 50 | Generic Scale of Phubbing, the Maslach Burnout Inventory—General Survey, Ruminative Response Scale, and the Center for Epidemiological Studies Depression Scale. | Job burnout: phubbing significant positive effect on job burnout, depression. The relation between job burnout and depression were moderated by rumination. | Not mentioned. |
Shin et al., 2013 [ ] | Korea | Survey | SS = 499 | Middle and high school | Maslach Burnout Inventory–Educator Survey Center for Epidemiological Studies Depression Scale. | Burnout: depression; baseline status of depression. Teacher’s burnout leads to subsequent depression symptoms, not vice versa. | Not mentioned. |
Genoud et al., 2021 [ ] | Switzerland | Cross- sectional | SS = 470 | Secondary 24–63 | Maslach’s burnout scale version validated by Dion and Tessier twenty-seven items French; Depression Anxiety Stress Scales (DASS). | Burnout: negative affectivity (tendency to feel depression, anxiety, or stress), personal fulfillment. Greater tendency to feel depressed result in teachers experiencing a lower level of personal accomplishment. | Two-thirds of the sample (N = 308) 66% of teachers below average for the three dimensions (stress, depression, and anxiety). |
Steinhardt et al., 2011 [ ] | US | Cross-sectional | /267 (26%) | High/Elementary/middle Mean 45 | Maslach Burnout Inventory-Educators Survey (MBI-ES) Modified version of the Teacher Stress Inventory. | Burnout: gender, experienced. Stress: depressive symptoms. Females reported greater chronic work stress and emotional exhaustion. Total effect of stress on depressive symptoms, taking together the direct and indirect effects via burnout, accounted for 43% of the total variance. | Increased stress leads to increased burned out. |
Pressley 2021 [ ] | US | Survey | SS = 359 | Primary/secondary | Teacher burnout scales. | Burnout-stress: COVID-19 anxiety, current teaching anxiety, anxiety communicating with parents, and administrative support. | High level of average teacher burnout stress score of 24.85. |
Schonfeld et al., 2016 [ ] | US | Survey | SS + 1386 | School teachers mean = 43 | The Shirom-Melamed Burnout Measure, Depression module of the Patient Health Questionnaire. | Burnout and depressive symptoms were strongly correlated. Burnout and depressive symptoms: stressful life events, job adversity, and workplace support. Burnout: anxiety. 86% of the teachers identified as burned out met criteria for a provisional diagnosis of depression. Fewer than 1% in the no-burnout group. | Not mentioned |
Bianchi et al., 2016 [ ] | New Zealand | Cross-sectional | SS = 184 | School teachers Mean 43 | Shirom–Melamed Burnout Measure (SMBM) Depression was assessed with the PHQ-9. | Burnout: strongly correlation. Depressive symptoms, moderately correlated with dysfunctional attitudes, ruminative responses, and pessimistic attributions. | Depression “low burnout-depression”, ( = 56; 30%), “Medium burnout-depression” ( = 82; 45%), “High burnout-depression” ( = 46; 25%). (About 8%) reported burnout symptoms at high frequencies and were identified as clinically depressed. |
Desouky and Allam 2017 [ ] | Egypt | Cross-sectional | SS = 568 | High 39.4 ± 8.7 | Arabic version of the Occupational Stress Index (OSI), the Arabic validated versions of Taylor manifest anxiety scale and the Beck Depression Inventory. | OS: Anxiety and depression scores, age, gender, higher qualifications and higher workload. OS, anxiety and depression scores were significantly higher among teachers with an age more than 40 years, female teachers, primary school teachers, higher teaching experience. | OS, anxiety and depression, respectively. 100%, 67.5% and 23.2%, Private schools show a significantly higher prevalence of moderate and severe OS compared to governmental schools (31.6% and 68.4% vs. 22.4% and 67.1%). |
Jones-Rincon et al., 2019 [ ] | US | Cross-sectional | 3003/3361(89%) | Elementary, middle/junior high or high | Patient Health Questionnaire. Job satisfaction was measured with 10 items. | Perceived stress levels: anxiety disorder. Teachers with anxiety disorder reported having higher perceived stress levels. | Not mentioned. |
Kinnunen et al., 1994 [ ] | Finland | Survey | 1012/1308/ (77%) | High/vocational/special/Physical/secondary 45–59 | Maslach and Jackson’s inventory. | EE: gender. Poor work ability. Women exhibit higher scores for EE. | Not Mentioned |
Martínez et al., 2020 [ ] | Spain | Random Sampling | 215/300 (71.7%) | Primary 30 to 65 years = 44.89 | The Maslach Burnout Inventory (MBI), Zung Self-Rating Depression Scale (SDS), Coping with Stress Questionnaire. | Burnout: depressive symptomatology, and quality of interpersonal relationships. | 48.37% low levels of EE, 25.12% high levels of PA, (b) high levels of EE and DP, and (c) 26.51% low levels of DE and PA. |
Capone et al., 2019 [ ] | Italy | Cross-sectional | SS = 609 | High school, middle school, elementary and primary school. 27 to 65, mean = 48.35 | The Center for Epidemiologic Studies Depression Scale (Italian version. The Italian version of the Maslach Burnout Inventory-General Scale. The Teacher Self-Efficacy Scale. | Burnout: collective efficacy, school climate, and organizational justice and relationship. EE and cynicism functioned as significant mediators between the three predictors (opportunities, organizational relationships, and organizational justice) and depression. | Not mentioned. |
Aydogan 2009 [ ] | Turkey N = 83 Germany N = 78 Cyprus N = 74 | Cross-sectional | 255/306 (83%) | High M = 38 ± 6.96, 37.9 ± 6.74, 45.8 ± 10.42 | Shirom–Melamed Burnout Measure. Turkish version of Minnesota Job satisfaction scale. | Burnout: country working, job satisfaction, depression. Cyprus teachers 57% of the variance in burnout explained by depression. 58% of the variance in burnout explained by job satisfaction and anxiety. Germany 575% variance in burnout explained by job satisfaction. | Not mentioned. |
Belcastro et al., 1983 [ ] | US | Cross-sectional | 428/359 (84%) | Public | The Maslach Burnout Inventory and the Teacher Somatic Complaints and Illness Inventory. | burned-out: somatic complaints | More than 11% burned out. 246 (68.5%) not burned-out. |
Capel 1992 [ ] | UK | Cross-sectional | 640/405/63.3% | Middle, upper, high school | The Maslach Burnout Inventory. The Taylor Manifest. | Stress and burnout: role conflict, and role ambiguity, High anxiety. Highest stress level: high workload demands after-school time, lack of recognition for extra work, too much paperwork. Students’ behavior. Burnout: anxiety. | Not mentioned. |
Ptacek et al., 2019 [ ] | Czech Republic | Cross-sectional | SS = 2394 | Primary 18–72 | Questionnaire survey: anamnestic part and Standardized questionnaires: SVF 78, SMBM, ENRICHD SSI, BDI II, USE. | Burnout: length of teaching/employment, healthy lifestyle. Cognitive burnout: age and length of teaching employment. Those with healthy lifestyle (work–life balance) have significantly lower burnout rates. Males–higher emotional burnout, females–higher physical burnout rates). | 18.3% of participants felt definitely threatened by burnout syndrome, 34.9% may be, 9.9% definitely not threatened by burnout syndrome. Long-term stress 21.8%, compared to the (7.5%) do not experience long-term stress. |
* Katsantonis 2020 (15 countries)—Japan and Korea form the East-Asian model. France and Spain form the Latin model. Denmark and Sweden form the Northern model. Australia and the United Kingdom represent the Anglo-Saxon model and finally, Belgium and the Netherlands form the Germanic model. Sample Size: SS; Emotional Exhaustion: EE; Personal Accomplishment: PA; Depersonalization: DP; Occupational Stress: OS; Sense of Coherence: SOC; Science Stream: SCIS; Art Stream: AS.
Summary of studies with prevalence and correlates of Depression/Anxiety.
Authors/Year | Country | Study Design | Sample Size/Population Size (Response Rate) | Teachers/Age Range | Scales Used | Key Findings | |
---|---|---|---|---|---|---|---|
Correlates of Depression/Anxiety | Prevalence of Depression/Anxiety | ||||||
Jurado et al., 2005 [ ] | Spain | Cross-sectional | 498/602/ (82.7%) | Primary/secondary (women, 45.3 ± 9.8; men, 44.7 ± 9.7). | Spanish version of Epidemiologic Studies Depression scale (CES-D). | Depressive symptoms: female gender, age, low job satisfaction, high job stress, desire to change jobs, working at a public school, personality dimensions of harm avoidance (high), novelty seeking (high) and verbal insults from pupils. | Depressive symptoms 35.3% of the teachers. |
Al-Gelban 2008 [ ] | Saudi Arabia. | Cross-sectional | 189/195 (96.9) | Male 28–57 | Depression, Anxiety and stress DASS-42 scale. | Depression, anxiety, and stress were strongly, positively, and significantly correlated. | 25% percent had depression 43% had anxiety. |
Fimian et al., 1983 [ ] | US | Survey | 365/800 (47%) | Special education | Emotional and Behavioral Manifestations of Stress (24 items); and Physiological Manifestations of Stress (16 items). | Depressed/anxious: teaching special needs. | Not mentioned. |
Lee et al., 2020 [ ] | Malaysia | Cross-sectional | SS = 150 | Female primary/secondary | DASS-21 inventory. | Depression: gender, years of work. Female teachers who suffered depression are those who have been working about 11–15 years. | 15.3% depression; 30.7% anxiety. |
Ratanasiripong et al., 2020 [ ] | Japan | Cross-sectional | 174/200 (87%) | Primary/secondary 41.65 | Japanese version of depression, Anxiety, and Stress scale (DASS-42. Japanese version of the Connor-Davidson Resilience Scale (CD-RISC). Japanese version of the Rosenberg Self-Esteem Scale (RSE). | Depression and anxiety: resiliency and self-esteem, grade taught. Strength significantly predicted anxiety. | Anxiety in secondary school teachers significantly lower than elementary school teachers. |
Schonfeld 1992 [ ] | New York, US | Longitudinal | SS = 255 | Women 27 | Center for Epidemiologic Studies– Depression Scale (CES-D). | Depressive symptoms: work-environment, job satisfaction. Whites but not among principally Black and Hispanic subsample, motivation has negative affectivity. | Not mentioned. |
Vladut, et al., 2011 [ ] | Romania | Cross-sectional | SS = 177 | Primary/secondary/high | The Depression, Anxiety and Stress Scale. | Anxiety/depression: burnout dimensions, demographic variables, mismatches between work-conditions gender, perception of reward and community. | Higher levels of emotional exhaustion. EE or DP and PA had significantly higher levels of depression, anxiety, and stress. |
Bianchi et al., 2014 [ ] | France | Analytical | SS = 5575 | Teacher, mean 41 | Depression was measured with the 9-item depression scale of the Patient Health Questionnaire (PHQ-9). | Depression: burnout: | 90% of the teachers identified as burned out met diagnostic criteria for depression, mainly major depression (85%). 3% ( = 19) of the no-burnout group were identified as depressed, mainly minor depression or depression not otherwise specified (2%). |
Hammen et al., 1982 [ ] | US | Cross-sectional | SS = 75 | Secondary | The Center for Epidemiological Studies-Depression (CES-D) scale. | Depressive symptomatology: stress, stress-related, cognitions regarding the consequences of the stressful circumstances, days off work. | 8% reported major depression. 12% teachers met criteria for possible minor depression. 20% debilitating array of symptoms approximating a clinically significant depression syndrome. |
Baka 2015 [ ] | Poland | Survey | 316/400 (79%) | Elementary/secondary 22–60 | Depression (the Beck Hopelessness Scale). | Depression: 16% high organizational constraints predict depression. Interpersonal conflict, organizational constraints and 2% workload predicts depression. | Not mentioned. |
Lee et al., 2020 [ ] | Malaysia | Cross-sectional | SS = 150 | female primary/secondary | DASS-21 inventory. | Depression: gender, years of work. Female teachers who suffered depression are those who have been working about 11 -15 years. | 15.3% depression; 30.7% anxiety. |
Pressley et al., 2021 [ ] | US | Survey | SS = 329 | Elementary | The COVID Anxiety Scale. A teacher burnout subscale of stress. | Anxiety: stress and communication within the school, and with parents, providing instruction in a virtual environment. Anxiety: COVID-19 pandemic. online teaching was positively related to anxiety in communications. | 56.2% no change in anxiety. 38.9% of participants reported reduced anxiety, 4.9% of teachers felt more anxiety than their baseline at the 1st week of school. Almost 40% had a decrease in anxiety during the 1st month of the 2020–2021 school year. |
Besse et al., 2015 [ ] | US | Survey single-stage sample cluster | 3003/3361 (89%) | Elementary, middle, or high school, mean = 43.9 years | Occupational health survey and Patient Health Questionnaire. | MDD: Hispanic, divorced, years of experience, taught at elementary level, low job satisfaction and higher absenteeism and increased likelihood of leaving the profession, perceived stress, anxiety. | Teachers with MDD had higher levels of perceived stress, anxiety. |
Peele et al., 2020 [ ] | Ghana | Randomized control trial | SS = 444 | Kindergarten | Goldberg Anxiety and Depression Questionnaire. | Anxiety and depressive symptoms: poor workplace environment, social support, lack of parental support was associated with more anxiety (b = 0.12, = 0.002), new to the local community. Depressive symptom: household food insecurity. | Poor workplace environment led to increased anxiety and depressive symptoms. |
Beer and Beer 1992 [ ] | US | Survey | 86/92 (93) | Grade and high school | Beck’s Depression Scale, the Coopersmith Self-esteem Inventory—Adult Form, Stress Profile for Teachers, and the Staff Burnout Scale. | Depression: self-esteem, negative association. Teachers in an institutional setting, there is no significant difference for teaching level or sex on depression. | Not mentioned. |
Proctor et al., 1992 [ ] | UK | Survey | 256 (93%) | Primary 39.68 | Zigmond and Snaith’s 6 Hospital Anxiety and Depression (HAD) Scale and Moos and Insel’s7 Work Environment Scale (WES). | Anxiety/depression: stressors intrinsic to teaching and related to organizational factors within schools, ensuring pupil progress, work overload, time pressures, role conflict. | 79% low or normal level of depression. 44 (17%) borderline scores and 10 (4%) clinical depression. Anxiety: 92 (36%) had normal scores and 67 (26%) borderline, 97 (38%) scored at a clinical level. |
Liu et al., 2021 [ ] | China. | Survey convenient sampling method | 907/1004 (90.3%) | Primary and secondary 20 ± 50 | Generic Scale of Phubbing, Ruminative Response Scale, and the Center for Epidemiological Studies Depression Scale. | Depression: phubbing. Combination of phubbing and rumination had no significant effect on depression. | Not mentioned. |
Shin et al., 2013 [ ] | Korea | Survey | SS = 499 | Middle and high school | Maslach Burnout Inventory–Educator Survey Center for Epidemiological Studies Depression Scale. | Depression: burnout. Positive relationship between baseline status of teacher burnout and depression. | Not mentioned. |
Genoud and Waroux 2021 [ ] | Switzerland | Cross-sectional | SS = 470 | Secondary 24–63 | French: Depression Anxiety Stress Scales (DASS). | Anxious profile: emotional exhaustion. Depressive profile: sense of personal accomplishment, no negative affective trait. | 66% (two-thirds) (N = 308) below average for the three dimensions (depression, anxiety, and stress). |
Pohl et al., 2022 [ ] | Hungary | Cross-sectional | 1817//2500 (72.7%) | High 18–65 | Beck Depression Inventory (BDI-SF). Problematic Internet Use Questionnaire. | Depression: internet addiction. | No depression 37.1% (673/1817), 58.9% (1070/1817) had mild, 3.5% (65/1817) had moderate and 0.6% (9/1817) had severe depression. |
Steinhardt et al., 2011 [ ] | US | Cross-sectional | /267 (26%) | High/elementary/middle, mean 45 | The Center for Epidemiological Studies Depression Scale (CES-D). | Depressive symptoms: EE. Positive relationships with DP and reduced PA. Chronic work stress, experienced. | High school teachers reported greater depressive symptoms. |
Pressley 2021 [ ] | US | Survey | 359 | Primary/secondary | COVID Anxiety Scale. | Anxiety: stress, COVID-19, communicating with parents, administrative support, providing instruction in a virtual environment. Anxiety about online teaching was positively related to anxiety in communications. | Virtual instruction teachers have the most increase in anxiety. |
Ratanasiripong et al., 2020 [ ] | Japan | Cross-sectional | 174/200 (87%) | Primary/secondary 41.65 | Japanese version of depression, Anxiety, and Stress scale (DASS-42). Japanese version of the Connor-Davidson Resilience Scale (CD-RISC). Japanese version of the Rosenberg Self-Esteem Scale (RSE). | Resilience and self-esteem significantly predicted depression and anxiety. | Not mentioned. |
Ptacek et al., 2019 [ ] | Czech Republic | Survey | SS = 2394 | Primary 18–72 | Beck Depression Inventory II (BDI II). | Depression: burnout. There is a strong and significant correlation between burnout and depressive symptomatology. | 15.2% mild to severe depression. |
Bianchi et al., 2016 [ ] | New Zealand | Cross-sectional | SS = 184 | School teacher, mean 43 | Depression was assessed with the PHQ-9. | Depressive symptoms: burnout, dysfunctional attitudes, ruminative responses, and pessimistic attributions. | Depression” low burnout-depression,” ( = 56; 30%), “medium burnout-depression” ( = 82; 45%), and “high burnout-depression” ( = 46; 25%). 14/184 (about 8%) reported. |
Mahan et al., 2010 [ ] | US | Cross-sectional | 168/756 (23.9%) | High, mean 42.6 | Ongoing Stressor Scale (OSS) and the Episodic Stressor Scale (ESS), the Co-worker and Supervisor Contents of Communication Scales (COCS), the State Anxiety inventory (S-Anxiety), and the Center for Epidemiological Studies Depression Scale (CES-D). | Anxiety and depression: ongoing and episodic stressors and support, 28% (adjusted 25%) of the variability in anxiety and 27% (adjusted 24%) of the variability in depression. Co-worker support had an inverse relationship to anxiety and depression, work environment stressor. | Higher levels of ongoing stressors, leads to higher levels of anxiety and depression, higher levels of co-worker support related to lower levels of anxiety and depression. |
Desouky et al., 2017 [ ] | Egypt | Cros-sectional | SS = 568 | High | Arabic version of the Occupational Stress Index (OSI), the Arabic validated versions of Taylor manifest anxiety scale and the Beck Depression Inventory. | Anxiety and depression: occupational stress, OS), age, female teachers, primary school teachers, higher teaching experience, higher qualifications and higher workload. | OS anxiety and depression (100%, 67.5% and 23.2%), respectively. Mild, moderate and severe depressive symptoms among teachers was (19.7%, 2.8% and 0.7%), respectively, and little, mild, severe and very severe anxiety was (17.6%, 23.2%, 7.0% and 19.7%), respectively. |
Jones-Rincon et al., 2019 [ ] | US | Cross-sectional | 3003/3361 (89.3%) | Elementary, middle/junior high or high | Patient Health Questionnaire. Job satisfaction was measured with 10 items. | Anxiety disorder: absenteeism, MDD, panic disorder, and somatization disorder and higher intent to quit, Hispanic, subject taught, job satisfaction and job control, years taught. teaching ( = 0.009). | 65.8% major depression in the anxiety group and 11.2% major depression in the no anxiety group. Other depressive disorder among anxiety disorder group 8.4% and no-anxiety group 7.2%. |
Borrelli et al., 2014 [ ] | Italy | Cross-sectional | 113/180 (63%) | Primary/middle | The Karasek Job Content Questionnaire, the Self-Rating Anxiety Scale (SAS) and the Center for Epidemiologic Studies Depression Scale (CES-D). | Depression and anxiety: Job demand and low social support. | About 50% scored above the threshold for depression and for anxiety on self-rating questionnaires. |
Kinnunen et al., 1994 [ ] | Finland | Survey | 1012/1308/ (77%) | High/vocational/special/physical/secondary 45–59 | Anxiety-contentment and depression-enthusiasm; six-item, six-point scales. | Job-related anxiety and depression: subject taught, age, job competence, and job aspiration, lack of PA. Physical education teachers, sex, poor work ability. | Not mentioned. |
Martínez et al., 2020 [ ] | Spain | Random Sampling | 215/300 (71.7%) | Primary 30 to 65 years, = 44.89 | Zung Self-Rating Depression Scale (SDS), Coping with Stress Questionnaire. | Depressive symptomatology: quality of interpersonal relationships at school, dimensions of burnout. | Not mentioned. |
Hadi et al., 2008 [ ] | Malaysia | Cross-sectional | 565/580 (97.4%) | Secondary M = 40.5 | Depression, Anxiety and Stress Scale (DASS 21) and Job Content Questionnaire (JCQ). | Depression: decision latitude, psychological job demand and job insecurity. | The prevalence of depression was 49.1% (45.0, 53.2). Mild level of depression (21.0%). |
Ali et al., 2021 [ ] | Fiji. | Cross-sectional | SS = 375 | Physical education 20 to 55 years | The Stress with COVID-19 Scale (SCS). The Coronavirus Anxiety Scale (CAS). | Anxiety: social support, and sexual satisfaction during the COVID-19 lockdown, marital status. Married physical education teachers experience more stress. | Married couples scored higher on stress. Anxiety and social support, single teachers scored high. |
Capone et al., 2019 [ ] | Italy | Cros-sectional | SS = 609 | High school, middle school, elementary and primary school. 27 to 65, mean = 48.35 | The Center for Epidemiologic Studies Depression Scale (Italian version. The Teacher Self-Efficacy Scale. | Depression: collective efficacy, all the dimensions of school climate were negatively related to depression, sex. | Women displayed higher depression and exhaustion than men. |
Aydogan 2009 [ ] | Turkey N = 83 Germany N = 78 Cyprus N = 74 | Cross-sectional | SS = 235 | High M = 38 ± 6.96, 37.9 ± 6.74, 45.8 ± 10.42 | Depression, Anxiety stressTurkish version scale DASS-42. | Depression: burnout, country of origin, job satisfaction. | Not mentioned. |
Kidger et al., 2016 [ ] | Bristol, England | Cross-sectional | 555/708/ (78.4%) | Secondary | Warwick Edinburgh Mental Wellbeing Scale-WEMWBS) Depressive symptoms (Patient Health Questionnaire-PHQ-9). Copenhagen Psychosocial Questionnaire and the Bristol Stress and Health at Work. | Depressive symptoms: sickness absence, student attendance, dissatisfaction with work and high presenteeism, gender, supporting a colleague. Teachers’ wellbeing. | 19.4% moderate to severe depressive symptoms. |
Bianchi et al., 2015 [ ] | France | Survey | SS=627 | Primary/secondary | Depression was assessed with the 9-item depression module. | Baseline depressive symptoms predicted cases of major depression. | T1 baseline MDD 14% T 2 MDD 7%. |
Soria-Saucedo et al., 2018 [ ] | Mexico | Cross-sectional | SS = 43,845 | Female 25–74 | Patient Health Questionnaire (PHQ9). | Severe depression: family and work stress, physical activity, alcohol consumption, and smoking, rural/urban residents. | 7026 teachers (16%) severe depression. |
Gluschkoff et al., 2016 [ ] | Finland | Randomized selection | SS = 76 | Primary/25–63 | PHQ9. | Depressive symptoms: positive associations with effort–reward imbalance and job strain showed with depressive symptoms. Non-restorative sleep. | Not mentioned. |
Ramberg et al., 2021 [ ] | Sweden | Cross-sectional | Year 2014/16 3948/7147 (55.2%) Final SS = 2732 | Teachers | Stockholm Teacher Survey. | Depressed mood: high SOC among colleagues and stress. High SOC was linked with lower levels of stress and depressed mood variation of 4.8% for perceived stress and 2.1% for depressed mood. | Not mentioned. |
Pohl et al., 2022 [ ] | Hungary | Cross-sectional | 1817/2500 (72.7%) | High school/18–65 | BDI. | Moderate and severe depression: internet addiction. | 37.1%: no depression, 58.9% mild, 3.5% moderate and 0.6% severe depression. |
Papastylianou et al., 2009 [ ] | Greece | Cross-sectional | 562/985 (57.1%) | Primary/30–45 | The Centre for Epidemiologic Studies Depression scales. | Depressed affect: (positive) correlation emotional exhaustion (EE). | Depressed affect: 17.86%. |
Ratanasiripong et al., 2021 [ ] | Thailand | Cross-sectional | SS = 267 | Primary/secondary | Depression, Anxiety and Stress Scale Thai Version (DASS). | Depression: family economics status, marital status, classroom size, relationship quality and resilience. Anxiety: family economics status, classroom size and resilience. | 3.2% of teachers had severe to extremely severe depression, 11.2% had severe to extremely severe anxiety. |
Szigeti et al., 2017 [ ] | Hungary | Cross-sectional | SS = 211 | Primary/secondary | Epidemiological Studies-Depression scale. | Depressive symptoms: teaching children with special needs, general burnout factor. | Not mentioned. |
Baka 2015 [ ] | Poland | Cross-sectional | 316/400 (79%) | Primary/secondary 22–60 | The Beck Hopelessness Scale. | Depression: work hours, job demands, general job burnout. High level of depression: interpersonal conflicts, organizational constraints and quantitative workload. | Not mentioned. |
Othman et al., 2019 [ ] | Malaysia | Cross-sectional | SS = 356 | Secondary | Malay Depression Anxiety Stress Scales (DASS). | Depression, anxiety, and stress: socio-demographic and work-related characteristics such as female, spousal help, educational status, having 1–3 children. | Depression (43.0%), anxiety (68.0%), severe to extremely severe depression 9.9%, anxiety 23.3%. 84.6% depression among those educated up to secondary or diploma level. 45% and 47.6% teachers with longest teaching experience and highest income, respectively. Lack of spousal help (55%) depressed. |
Skaalvik et al., 2020 [ ] | Norway | Longitudinal | SS = 262 | High school | Depressed mood was measured by means of a five-item scale. | Depressed mood: positively associated with emotional exhaustion. | Not mentioned. |
Li et al., 2020 [ ] | China | Cross-sectional | 1741/1795 (97%) | Preschool 18 to 48 | Epidemiologic Studies Depression Scale (CES-D) and the Perceived Stress Scale-14. | Depression: teacher weight. Depression ( < 0.001, OR = 3.08, 95% CI: 2.34–4.05) is significantly associated with burnout. | Depression was 39.9%. |
Gosnell et al., 2021 [ ] | Malaysia | Cross-sectional | 124/400 (31%) | Primary/secondary | Depression Anxiety Stress Scales-21 self-care strategy questionnaire. | Depression/anxiety—self-care, being a refugee. Depression and anxiety: negative correlation with age. Younger teachers experienced higher rates of depression and anxiety than older teachers. | 14.4% depression in the severe or extremely severe clinical ranges. 41.2% anxiety levels in the severe or extremely severe clinical ranges. 10.5% nonrefugees reported anxiety at this level. |
Capone et al., 2020 [ ] | Italy | Cross-sectional | SS = 285 | High school 29–65 | The Center for Epidemiologic Studies Depression Scale (CES-D; Italian version. | Depression: flourishing or languishing. | 23.9% depression “flourishing” group, 38.7% low depression and burnout, 85.7% “languishing” had severe rating of depression. |
Chan et al., 2002 [ ] | China | Survey | SS = 83 | Secondary 22–42 | The shortened 20-item Teacher Stressor Scale (TSS). Chinese shortened version of the General Health Questionnaire (GHQ-20). | Anxiety: support, stress. | New teachers’ highest levels of symptoms in anxiety. |
Zhang et al., 2014 [ ] | China | Survey | SS = 590 | Primary/secondary 34 ±8.11 | Self-reported mental health was measured by the Symptom Checklist-90 (SCL-90). | Anxiety: burnout (EE and DP). | Not mentioned. |
Nakada et al., 2016 [ ] | Japan | Cross-sectional | 1006 (66.7%) | School teachers 39.7 ± 11.6 | The Japanese version of Zung’s Self-Rating Depression Scale (SDS), Job Stress Questionnaire. | Depressive symptoms: role ambiguity, role conflict, high quantitative workload, and social support from family or friends. | (20.1%) in depressive group. (79.9%) in non-depressive group. |
Georgas et al., 1984 [ ] | Greece | Cross-sectional | SS = 129 | Elementary school teachers 28–46 | Greek adaptation of the Schedule of Recent Experiences (SRE) Life Events Scale. The Manifest Anxiety Scale. | Anxiety: women only; psychosocial stress, sex differences, high correlations between psychosocial stress and anxiety, were found only for females. | Females reported more symptoms and had higher manifest anxiety than males. |
Sample Size: SS; Major Depressive Disorder: MDD.
This study was supported by the Mental Health Foundation and the Douglas Harden Trust Fund.
Conceptualization, B.A; software, and validation, B.A., G.O.-D. and L.B.; methodology and formal analysis, B.A.; data curation, B.A. and G.O.-D.; investigation and resources, B.A. and Y.W.; writing—original draft preparation, B.A.; writing—review and editing, B.A, G.O.-D., L.B. and Y.W.; supervision, L.B. and Y.W. All authors have read and agreed to the published version of the manuscript.
Informed consent statement, data availability statement, conflicts of interest.
The authors declare no conflict of interest. The funder had no role in the design and conduct of the study; collection, management, analysis, the interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the results for publication.
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
mental health center / mental health a-z list / stress article
What causes stress, what are the symptoms of poorly managed stress, who is most vulnerable to stress what are the risk factors for stress, what is the healthy response to stress, how does the body respond to stress, what is the role of the hypothalamus-pituitary-adrenal (hpa) axis (grouping) in stress, what is the role of the locus coeruleus in stress, how do the connections in the brain work in stress, what do we know about using (activating) and overusing our internal systems that respond to stress, what are the effects of stress on medical and psychological conditions, how does stress impact overall health, what can people do for stress management what are home remedies to combat stress symptoms.
Stress is a normal part of life that can either help us learn and grow or can cause us significant problems. Stress releases powerful neurochemicals and hormones that prepare us for action (to fight or flee). If we don't take action, the stress response can create or worsen health problems. Prolonged, uninterrupted, unexpected, and unmanageable (uncontrollable) stresses are the most damaging. Stress can be managed by seeking support from loved ones, regular exercise , meditation, or other relaxation techniques, structured timeouts, and learning new coping strategies to create predictability in our lives.
Stress is a fact of nature in which forces from the inside or outside world affect the individual, either one's emotional or physical well-being, or both. The individual responds to stress in ways that affect the individual, as well as their environment. Due to the overabundance of stress in our modern lives, we usually think of stress as a negative experience, but from a biological point of view, stress can be a neutral, negative, or positive experience.
In general, stress is related to both external and internal factors. External factors include the
Internal factors determine your body's ability to respond to, and deal with, the external stress-inducing factors. Internal factors which influence your ability to handle stress include your
Stress has driven evolutionary change (the development and natural selection of species over time). Thus, the species that adapted best to the causes of stress (stressors) have survived and evolved into the plant and animal kingdoms we now observe.
Humans are the most adaptive creature on the planet because of the evolution of the human brain, especially the part called the neo-cortex. This adaptability is largely due to the changes and stressors that we have faced and mastered. Therefore, we, unlike other animals, can live in any climate or ecosystem, at various altitudes, and avoid the danger of predators. Moreover, we have learned to live in the air, under the sea, and even in space, where no living creatures have ever survived. So then, what is so bad about stress?
Excess stress can manifest itself in a variety of emotional, behavioral, and even physical symptoms, and the symptoms of stress vary enormously among different individuals.
Common somatic (physical) symptoms often reported by those experiencing excess stress include
Symptoms of many preexisting medical conditions can also worsen during times of stress. Emotional and behavioral symptoms that can accompany excess stress include
Of course, none of these signs or symptoms means for certain that there is an elevated stress level since all of these symptoms can be caused by other medical and/or psychological conditions.
It is also known that people under stress have a greater tendency to engage in unhealthy behaviors, such as excessive use of alcohol and drugs , cigarette smoking , and making poor exercise and nutritional choices, than their less-stressed counterparts. These unhealthy behaviors can further increase the severity of symptoms related to stress, often leading to a "vicious cycle" of symptoms and unhealthy behaviors.
The experience of stress is highly individualized. What constitutes overwhelming stress for one person may not be perceived as stress by another. Likewise, the symptoms and signs of poorly managed stress will be different for each person.
Stress comes in many forms and affects people of all ages and all walks of life. No external standards can be applied to predict stress levels in individuals -- one need not have a traditionally stressful job to experience workplace stress, just as a parent of one child may experience more parenting stress than a parent of several children. The degree of stress in our lives is highly dependent upon individual factors such as our
However, it is possible to make some generalizations. People with adequate or strong social support networks report less stress and overall improved mental health in comparison to those without adequate social support. People who are poorly nourished, who get inadequate sleep, or who are physically unwell also have a reduced capacity to handle pressures and stresses of everyday life and may report higher stress levels. Some stressors are particularly associated with certain age groups or life stages. Children, teens , the newly married, working parents, single parents, and seniors are examples of the groups who often face common stressors related to life transitions.
A key aspect of a healthy adaptational response to stress is the time course. Responses must be initiated rapidly, maintained for a proper amount of time, and then turned off to ensure an optimal result. An over-response to stress or the failure to shut off a stress response can have negative biological and mental-health consequences for an individual. Healthy human responses to stress involve three components:
The combined results of these three components of the stress response maintain the internal balance (homeostasis) and optimize energy production and utilization. They also gear up the organism for a quick reaction through the sympathetic nervous system (SNS). The SNS operates by increasing the heart rate, increasing blood pressure , redirecting blood flow to the heart, muscles, and brain and away from the gastrointestinal tract, and releasing fuel (glucose and fatty acids) to help fight or flee the danger.
While the complete story is not fully known, scientists understand much about how the response to stress works. The two main systems involved are the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). (These systems are described later.) Triggered (activated) primarily by an area in the brain stem (lowest part of brain) called the locus coeruleus, the SNS results in the secretion of epinephrine and norepinephrine. The following are the five most important concepts to remember about these two systems:
The HPA axis is a grouping of responses to stress by the brain and the pituitary and adrenal glands. First, the hypothalamus (a central part of the brain) releases a compound called corticotrophin releasing factor (CRF), which was discovered in 1981. The CRF then travels to the pituitary gland, where it triggers the release of a hormone, adrenocorticotrophic hormone (ACTH). ACTH is released into the bloodstream and causes the cortex of the adrenal gland to release the stress hormones, particularly cortisol, which is a corticosteroid hormone. Cortisol increases the availability of the body's fuel supply (carbohydrate, fat, and glucose), which is needed to respond to stress. However, if cortisol levels remain elevated for too long, then muscle breaks down, there is a decreased inflammatory response, and suppression of the immune (defense) system occurs.
Corticosteroids in measured doses are used to treat many illnesses that are characterized by inflammation or an overactive immune system, such as asthma and inflammatory bowel disease . For the same reason, they are used to help reduce the chances that our body will immunologically reject a transplanted organ. Corticosteroids also can cause fluid retention and high blood pressure . Therefore, it is critical that the response to corticosteroids be carefully controlled (modulated). This control usually is accomplished by a feedback mechanism in which increased cortisol levels feeding back to the hypothalamus and pituitary turn off production of ACTH. In addition, extremely high levels of cortisol can cause mental changes, including depression and psychosis, which disappear when the levels return to normal.
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The locus coeruleus has many connections to other parts of the brain, particularly areas that bring in and process sensory information (information from sight, hearing , smell, taste, and touch). The locus coeruleus secretes norepinephrine and stimulates other brain centers to do the same. It is like the pacemaker (meaning it controls the tempo) of the brain. Thus, it increases arousal (heightened awareness, alertness) and vigilance (watchfulness, carefulness) and adjusts (modulates) the action of the autonomic nervous system, which includes the SNS.
The autonomic nervous system regulates blood flow, heart rate, blood pressure, and breathing ( respiration ). It can also temporarily shut down the gastrointestinal (GI) and sexual systems until the crisis or stressful event is over. These initial reactions, to get our blood flowing, heart pumping, and muscles energized, occur very quickly and automatically.
The HPA axis and the locus coeruleus systems are linked through the hypothalamus and an area of the brain known as the limbic system. The limbic system is the control area for emotion and the processing area for memory. These linkages are critical. For example, if you see the bushes rustling, your locus coeruleus immediately gets the stress response rolling. However, when you see that it is not a mountain lion but a golden retriever in the bushes, your memory of the tameness of the dog will turn off the stress response. Similarly, if a person is nervous before a public-speaking engagement and the first minute or two goes well, this happy feeling will turn down the activity of the locus coeruleus.
The connections also include the endogenous (within the body) opiate (opium-like) system and the reward ( dopamine ) system. Thereby, during stress, pain is reduced and an extremely happy feeling (euphoria ) may result. These connections partially account for "runner's high" and have a great deal to do with why we like roller coasters and scary movies.
Here's how the connections work. The limbic system performs an emotional analysis and memory review of the information provided by the senses. Then, the multiplicity of connections allows us to determine whether the current stress is
All of this internal activity must occur in milliseconds, and it does.
Animal and human research has taught us much about our internal stress systems. When laboratory animals are exposed to a prolonged stress (usually food deprivation, mild electrical stimulation of the foot, or handling), they develop a stress syndrome. This syndrome consists of high blood pressure ( hypertension ), loss of appetite, weight loss , muscle wasting, gastrointestinal ulcers, loss of reproductive function, suppression of the imm une system, and depression. Researchers also noticed that stress of long duration (chronic stress) sensitizes the stress system (makes it more responsive to stress). That is, the system then overresponds to new stressors. They further noticed that the administration of certain drugs, such as amphetamines or cocaine , could also sensitize the stress response. Moreover, constant stress increases the self-administration of drugs in laboratory animals. So, a vicious cycle is induced. The more stress there is, the more mice seek the drugs, and the more the sensitivity (increased responsiveness) to stress is increased!
Early separation from the mother has also been seen as another potent stressor in animals. Such separation has been linked to increased levels of the stress hormones that cause the stress syndrome, which includes depression. Studies in humans are under way to evaluate how maternal stress, even early in the pregnancy , can affect the developing fetus.
Why might maternal stress affect the fetus? The answer is the communication of the blood circulations of the mother and the fetus. From the mother's blood, the fetus gets both the good (for example, nutrients and oxygen) and the bad. The bad components of the blood can include alcohol, nicotine, illicit drugs, some prescription medications, and stress chemicals such as cortisol and norepinephrine.
These animal and human studies seem to indicate that excessive stress leads to depression. In other words, chronic stress in the mother's womb (in utero) or early deprivation (separation from the mother) might even predispose a person to developing the psychiatric syndrome of clinical depression in later life. Furthermore, other experiments show that the administration of stress hormones can actually decrease brain connections and even the number of brain cells in crucial areas, such as the limbic system. This loss of brain connections and cells then can lead to further maladaptive (inadequate adjustment) responses to stress.
What's more, some particular kinds of stress seem to be even more detrimental than other types. That is, some types of stress can actually lead to diseases. For example, stresses that are unpredictable and uncontrollable seem to be the greatest culprits. On the other hand, stresses with which we can cope and master are not necessarily bad. In fact, we can learn from these stresses, predict their recurrence, and develop action plans to reduce or avoid them in the future. In this way, some stresses can actually trigger new personality growth and biologically induced adaptive (healthy adjustment) changes. Indeed, much of psychotherapy is empirically (guided by practical experience rather than theory) based upon this concept.
There is now evidence that points to abnormal stress responses as causing or contributing to various diseases or conditions. These include anxiety disorders, depression, and substance abuse . Stress can affect virtually any organ system, being associated with conditions as diverse as skin rashes or hives , high blood pressure, cardiovascular disease , certain gastrointestinal diseases, some cancers , and even the process of aging itself. Stress also seems to increase the frequency and severity of migraine headaches , episodes of asthma , and fluctuations of blood sugar in people with diabetes . There also is scientific evidence showing that people experiencing psychological stress are more prone to developing colds and other infections than their less-stressed peers. Overwhelming psychological stress (also called trauma ) can cause both temporary (transient) and long-lasting (chronic) symptoms of a serious psychiatric illness called posttraumatic stress disorder ( PTSD ).
Uncontrollable, unpredictable, and constant stress has far-reaching consequences on our physical and mental health. Stress can begin in the womb and recur throughout life. One of the potential pathological (abnormal) consequences of stress is a learned helplessness that leads to the hopelessness and helplessness of clinical depression, but in additi on, many illnesses, such as chronic anxiety states, high blood pressure, heart disease , and addictive disorders, to name a few, also seem to be influenced by chronic or overwhelming stress.
Nature, however, has provided us with efficient processes (mechanisms) to cope with stressors through the HPA axis and the locus coeruleus/sympathetic nervous system. Furthermore, research has shown us the biological processes that explain what we all intuitively know is true—which is, that too much stress, particularly when we cannot predict it or control its recurrence, is harmful to our health.
If we think about the causes of stress, the nature of the stress response, and the negative effects of some types of stress (prolonged, unexpected, or unmanageable stress), several healthy management strategies and home remedies to combat the effects of stress become clear.
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Columbia psychologist explains why poor sleep makes it more difficult to cope with stress and regulate emotions, share this page.
Americans were having trouble sleeping before COVID-19. Unfortunately, it only got worse when the pandemic isolated us from friends and family, closed our schools and offices, and sent shock waves through the economy.
According to a study of 22,330 adults from 13 countries published in Sleep Medicine in November 2021, one in three participants, had clinical insomnia symptoms and nearly 20 percent met the criteria for insomnia disorder—rates more than double what they were before the pandemic. Furthermore, sleep disturbances were linked to higher levels of psychological distress. Anxiety and depression rates were also considerably higher than pre-pandemic levels in the same survey.
“Just like our electronics need to be charged, sleep may recharge or reset the brain to optimize functioning,” says Elizabeth Blake Zakarin , an assistant professor of psychology (in Psychiatry) and a clinical psychologist at the Columbia University Clinic for Anxiety and Related Disorders.
Columbia Psychiatry News spoke with Zakarin about the psychological impact of sleep deprivation, challenges brought on by the pandemic, the influence of food on our sleep patterns, and effective treatments for sleep difficulties.
Many of us know that we feel better after “a good night’s sleep” and more grumpy or foggy if sleep deprived. And there is now robust evidence similarly supporting that sleep is critical to not only our physical health but also our mental health. Poor or insufficient sleep has been found to increase negative emotional responses to stressors and to decrease positive emotions.
While more research is needed to understand the mechanisms underlying the connection between sleep and mental health, we know that sleep is important to a number of brain and body functions engaged in processing daily events and regulating emotions and behaviors. Sleep helps maintain cognitive skills, such as attention, learning, and memory, such that poor sleep can make it much more difficult to cope with even relatively minor stressors and can even impact our ability to perceive the world accurately.
Absolutely. Not getting enough sleep or poor-quality sleep can increase risk for mental health disorders. While insomnia can be a symptom of psychiatric disorders, like anxiety and depression, it is now recognized that sleep problems can also contribute to the onset and worsening of different mental health problems, including depression, anxiety, and even suicidal ideation.
Sleep deprivation studies show that otherwise healthy people can experience increased anxiety and distress levels following poor sleep. Those with mental health disorders are even more likely to experience chronic sleep problems and, in turn, these sleep problems are likely to exacerbate psychiatric symptoms and even increase risk for suicide. The good news is that there are ways to improve sleep quality and quantity, so identifying and addressing sleep problems is critical to alleviating the severity of psychiatric disorders.
The amount of sleep individual’s need in part depends on their age. In general, children and teens need more sleep than adults. While there are certainly individual differences in the amount of sleep each adult needs, the American Academy of Sleep Medicine (AASM) recommends that adults sleep at least 7 hours on a regular basis to promote optimal health and functioning, with most adults needing somewhere between 7-9 hours. Teens typically need 8-10 hours and older adults (65 years and older) between 7-8 hours. Although the amount of sleep we get is important, good quality sleep is also essential.
In addition to the amount of sleep, there are individual differences in “chronotype” the natural inclination of your body to feel more alert at certain periods of the day and more tired at others. The two most well-known chronotypes are often referred to as “night owls” and early birds (or “morning larks”), though many people likely fall somewhere in between. Genetics, age, and other factors impact whether you are more likely an owl or a lark. As you can imagine, getting enough sleep with a typical work schedule may be easier to do for a lark than for a night owl.
Insomnia disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) , is characterized by difficulty falling asleep, staying asleep, or waking too early, resulting in daytime impairments. While insomnia symptoms and insufficient sleep were already a widespread problem pre-pandemic, people are reporting more sleep problems than ever before. The increase in insomnia and related sleep problems related to stress caused by the COVID-19 pandemic have been labeled “ Coronasomnia .”
We know that stress can interfere with sleep and understandably the global pandemic has significantly increased daily stress and uncertainty. Spending more time at home and changes to daily routine can also impact sleep patterns by limiting light-based cues for wakefulness that help keep your circadian rhythm on schedule. And more time in bed and less activity or exercise can also interfere with sleep by reducing sleep drive. In a survey by AASM, over half (56%) of Americans (and 70% among those 35-44 years old) say they have experienced sleep disturbances during the pandemic. Common sleep disturbances include problems falling or staying asleep, sleeping less, and experiencing worse quality sleep.
Reduced sleep has been linked with increased eating and higher risk for weight gain and obesity. Conversely, studies show that getting more sleep can lead to consuming fewer calories and improve weight loss.
While some foods, such as milk products, fish and fruit (for example, kiwis and tart cherries) have shown some sleep-promoting effects, research is too limited to draw definitive conclusions or recommendations about specific foods to help sleep. Growing research suggests that the quality of diet or having sufficient nutrients can impact the quantity and quality of sleep. Low fiber, high saturated fat, high sugar diets have been associated with poorer quality sleep. Another large study found that deficits in nutrients, like as calcium, magnesium, and vitamins A, C, D, E, and K, were associated with sleep problems. As such, it’s likely most important to focus on eating a balanced and consistent diet and creating healthy food-related sleep habits, such as limiting caffeine intake in the afternoon/evening and trying not to eat large meals too late.
Unfortunately, we know that pre-pandemic and especially over the course of the last two years, a large percentage of the population continues to experience insufficient sleep. Longer work hours, constant access to social commentary and entertainment, and increased stressors all contribute to people getting less sleep. The good news is that there is increasing awareness of the importance of sleep for daily functioning and health. In order to see a shift in sleep behaviors, ongoing work is needed to promote science-based policies that help improve sleep health, such as encouraging employers to help promote healthy sleep and introducing later school starting times. And we need to increase access to care for individuals with sleep difficulties.
For some sleep difficulties, adopting healthy sleep habits may help to improve sleep. However, those with more chronic insomnia should seek professional help, including cognitive behavioral therapy for insomnia (CBT-I), which is recognized as a first line treatment for insomnia. CBTI involves educating people about sleep and aims to change their sleep-related behaviors and thought processes by teaching strategies such as stimulus control, sleep restriction, relaxation techniques and cognitive therapy.
If sleep problems persist or you continue to experience daytime sleepiness even after getting enough sleep, then it might be time to see a sleep specialist who can help determine whether you need cognitive behavioral therapy, medication, or another treatment.
In this video Dr. Zakarin discusses the relationship between sleep, mental health, and suicide in adolescents and steps we can all take to improve the quality of our sleep, which include some of the following:
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What is anxiety, symptoms of anxiety disorders, what causes anxiety disorders, types of anxiety, diagnosing anxiety disorder, when to see a professional about anxiety, how to treat anxiety disorder, how to prevent anxiety, frequently asked questions (faqs).
Anxiety, or the anticipation of a future threat, isn’t always a negative. While occasional feelings of anxiety may be intense, they’re a sign the mind and body are working together to maintain safety.
For people with an anxiety disorder, however, feelings of nervousness, tension and worry are so common and can be so intense that they interfere with normal life. Depending on the type of anxiety disorder, a person’s worries may apply to many things over a period of time, or they may be concerned with a specific object or idea. Large studies suggest that as much as 33% of the world’s population is affected by an anxiety disorder at some point in their lives [1] Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders . Dialogues in Clinical Neuroscience. 2017;19:93-106. .
Online therapy platforms connect you with licensed providers, which can include psychiatrists , psychologists, licensed marriage and family therapists, licensed clinical social workers and licensed professional counselors. Discover our top picks and the best online therapy to fit your needs and preferences.
Here are some important facts about anxiety—and how you can find the right treatment.
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Cynthia Catchings, a licensed clinical social worker and therapist at Talkspace, says heavy workloads can also cause serious mental health problems in the long run, like anxiety and depression.
Their study found that too much homework is associated with: * Greater stress: 56 percent of the students considered homework a primary source of stress, according to the survey data. Forty-three ...
This list is hardly comprehensive. ADHD, autism spectrum disorder, social anxiety, generalized anxiety, panic disorder, depression, dysregulation, and a range of other neurodevelopmental and ...
"Homework has perennially acted as a source of stress for students, so that piece of it is not new," Galloway says. "But especially in upper-middle-class communities, where the focus is on getting ahead, I think the pressure on students has been ratcheted up." Yet homework can be a problem at the other end of the socioeconomic spectrum as well.
Homework over a certain time limit can cause stress, depression, anxiety, lack of sleep, and more. Homework distracts from extracurriculars and sports as well, something colleges often look for. Homework is ultimately leading students to resent school as a whole. According to a study done by Stanford University, 56 percent of students ...
Lack of sleep. One of the most prevalent adverse effects of schoolwork is lack of sleep. The average student only gets about 5 hours of sleep per night since they stay up late to complete their homework, even though the body needs at least 7 hours of sleep every day. Lack of sleep has an impact on both mental and physical health.
Homework was a leading cause of stress, with 24 percent of parents saying it's an issue. ... Chronic stress can cause a sense of panic and paralysis, Alvord says. The child feels stuck, which only ...
Stress has direct effects on mood. Early initial symptoms of lowered mood can include irritability, sleep disruption, and cognitive changes, such as impaired concentration. However, the indirect ...
problems in the long run, like anxiety and depression. 2/5. And for all the distress homework causes, it's not as useful as many may think, says Dr. Nicholas Kardaras, a psychologist and CEO of ...
Homework may actually give them anxiety. It's not always easy to know when kids have homework anxiety. Some kids may share what they're feeling when you ask. But others can't yet identify what they're feeling, or they're not willing to talk about it. Homework anxiety often starts in early grade school. It can affect any child.
1) Multiple Hours of Homework. Starting in high school, or sometimes even middle school, students begin to slowly receive more and more hours of homework. There are various reasons why multiple hours of homework per week might lead students to depression, with stress and procrastination being at the top. Certain subjects, such as mathematics or ...
In Mirza et al.'s study, 1/3 of students encounter stress and depression (a subjective mean occurrence of 30.6%) of all participant students, which suggests students have a 9% higher rate of experiencing depression than general people. Depression can destroy life; it greatly impacts living a balanced life.
While we have shown a link between time spent on homework/studying and depression symptoms, the potential clinical implications are unclear. Additional studies are needed to evaluate the relative impact of homework/studying on sleep habits and mental health in pediatric populations with depression or anxiety.
1. Potential Psychological Effects of Homework-Induced Stress: • Anxiety: The pressure to perform academically and meet homework expectations can lead to heightened levels of anxiety in students. Constant worry about completing assignments on time and achieving high grades can be overwhelming. • Sleep Disturbances: Homework-related stress ...
Stress is the body's natural defense against predators and danger. It causes the body to flood with hormones that prepare its systems to evade or confront danger. People commonly refer to this ...
This causes students to spend far too much time doing such assignments and can be detrimental. A 2013 study conducted at Stanford University found that students in top-performing school districts who spend too much time on homework experience more stress, physical health problems, a lack of balance in their lives and alienation from society.
HOMEWORK AND DEPRESSION: 1. The benefits of homework don't always outweigh the stress it causes. At the end of the day, homework is all about cementing the learning the students have done in class. However, a lot of students complete busy work that does not promote the active learning they need for a class to help them in the future.
Cynthia Catchings, a licensed clinical social worker and therapist at Talkspace, says heavy workloads can also cause serious mental health problems in the long run, like anxiety and depression ...
Positive thinking often starts with self-talk. Self-talk is the endless stream of unspoken thoughts that run through your head. These automatic thoughts can be positive or negative. Some of your self-talk comes from logic and reason. Other self-talk may arise from misconceptions that you create because of lack of information or expectations due ...
Summary. A large body of research suggests that working from home may cause or exacerbate depression for some people. The likelihood of experiencing depression while WFH appears to be higher for ...
Any physical or psychological stimuli that disrupt homeostasis result in a stress response. The stimuli are called stressors, and physiological and behavioral changes in response to exposure to stressors constitute the stress response. A stress response is mediated through a complex interplay of nervous, endocrine, and immune mechanisms, activating the sympathetic-adreno-medullar (SAM) axis ...
They share many similar symptoms, such as muscle tension, moodiness, and sleep, concentration, and digestive problems. In fact, overwhelming stress can even lead to anxiety and panic attacks. However, stress is often caused by a specific trigger or "stressor," such as work pressure, a break-up, or financial problems.
Whether homework can lead to or cause depression is an age-long question, and this article aims to explain the 'if' and 'how' too much homework can cause depression. ... study showed that homework affects students' physical and mental health because at least 56% of students attribute homework to be their primary source of stress ...
Chronic stress may also lead to inappropriate anger and increased alcohol and drug consumption [6,7], and it can cause an individual to experience excessive anxiety, mental fatigue, and burnout, ... Depression Anxiety Stress Scales-21 self-care strategy questionnaire. Depression/anxiety—self-care, being a refugee.
Exercising regularly. It can relieve stress, tension, anxiety and depression. Consider a nature walk, meditation or yoga. Making time for friends and family. It's important to maintain social connections and talk with people you trust. Getting enough sleep. Adults should aim for seven to nine hours a night.
Stress is a normal part of life that can either help us learn and grow or can cause us significant problems. Stress releases powerful neurochemicals and hormones that prepare us for action (to fight or flee). If we don't take action, the stress response can create or worsen health problems. Prolonged, uninterrupted, unexpected, and unmanageable ...
Sleep deprivation studies show that otherwise healthy people can experience increased anxiety and distress levels following poor sleep. Those with mental health disorders are even more likely to experience chronic sleep problems and, in turn, these sleep problems are likely to exacerbate psychiatric symptoms and even increase risk for suicide.
An anxiety disorder is an emotional state during which "anxiety, fear, tension and worry become so severe that they get in the way of a person living their life," says Grindrod. The term ...
Symptoms of ED include. being able to get an erection sometimes, but not every time you want to have sex. being able to get an erection, but not having it last long enough for sex. being unable to get an erection at any time. ED is often a symptom of another health problem or health-related factor. Erectile dysfunction (ED) is often a symptom ...