Feeling overwhelmed, exhausted, or low in energy is very common in Singapore. In this article I hope to shed light on the important distinction between experiencing the overwhelming pressure to achieve (both from self and externally), being so exhausted that daily functioning becomes a chore, and when we might actually be clinically depressed.
By figuring out which category one may fall into, the necessary strategies can be adopted to alleviate those symptoms. It is important to know what’s
actually going on to guide the appropriate intervention.
What is the difference between ‘Stress’, ‘Burnout’ and ‘Depression’?
The answer, firstly, lies in delving into what drives the symptoms of fatigue, irritability and poor concentration, and the act of social withdrawal. Secondly, finding out how pervasive they are, and finally, whether they ameliorate when circumstances change.
Stress is typically tied to a specific stressor. For example, your nervous system responding to pressure from a looming deadline, an interpersonal conflict, or a difficult work transition period. It is uncomfortable, but it is reactive. Remove or resolve the stressor, and you generally start to recover.
Burnout is what happens when stress becomes chronic and unrelenting, particularly in work or caregiving contexts. It manifests as emotional exhaustion, a deep sense of detachment or cynicism, and a feeling that nothing you do makes a difference. Although Burnout is real and serious, it is largely tied to your environment and roles.
Hence, taking a sabbatical, an occupational role change, or even getting regular and good quality sleep (i.e. feeling rested and ready for the day) can bring some positive change but it may not be meaningful relief. Instead, meaningful relief may come from re-appraising your expectations of your own work performance i.e. consolidating your efforts by doing less yet still seeing positive gains, or even finding alignment between your values and your roles.
Depression is different in a fundamental way. It does not need an external trigger to persist, and it does not reliably become more tolerable when things get objectively better. Clinically, we are looking for a persistent low mood or loss of interest or pleasure in things that used to matter. If it occurs for at least two weeks, across most of the day, most days, and is often accompanied by changes in sleep, appetite, energy, concentration, and a pervasive sense of hopelessness or worthlessness, then it’s likely to be a bout of Depression.
Another distinction worth highlighting: Stress tends to make you hyperactive. Burnout tends to make you feel empty and depleted. Depression tends to make you feel that you are the problem, that things are hopeless, and the future is bleak.
Is it possible to experience all of them at once?
Yes, and more commonly than people realise. Burnout, for instance, is a well-established risk factor for developing Depression. If you have been running on empty for long enough, the neurobiological and psychological effects can tip into a depressive episode. Similarly, someone with an underlying depressive vulnerability may find that a stressful period at work triggers a full episode.
This overlap is also why people sometimes resist the idea that they might be depressed; because there is a clear external reason they feel terrible. The presence of a stressor does not entirely rule out depression. In clinical practice, we assess whether the symptoms are disproportionate to the situation, whether they persist after the stressor eases, and whether the full picture meets diagnostic criteria regardless of what triggered it.
The practical implication here: if you are managing what feels like Burnout or Stress, but you are not improving despite rest and reduced pressure, that is worth paying attention to. Depression can come on the back of Burnout and stay long after the Burnout resolves.
I feel like I’m just going through a tough period these last few months. Will it all be fine after I get through this project?
This is one of the most common things people tell themselves. Difficult periods do end, and resilience is real.
But there is a particular pattern to watch for. If you have been saying a version of this for several months or longer, if the goalpost for “when things will get better” keeps shifting, or if you find that even when you do get a break, you cannot actually feel relief or enjoyment, then that warrants honest reflection.
Depression, by its nature, tends to generate explanations for itself. It convinces you that your low mood is entirely circumstantial, that you just need to push through, that seeking help would be an overreaction. This is part of why it persists. The cognitive distortions of depression are not experienced as distortions, but they feel like accurate assessments of reality.
A useful question to ask yourself: If I described my last three months to someone I trusted (e.g. the quality of my sleep, my enjoyment of things, my energy, my thinking about the future), would they be concerned? Sometimes an outside perspective can help notice certain blind spots.
Where do I start if I suspect I have depression?
The first step is a proper assessment by someone qualified to give one, such as a general practitioner (GP), clinical psychologist, or a psychiatrist. In Singapore, you have several pathways to obtain this.
You can start with your GP, who can conduct an initial screening and refer you appropriately. Many GPs are well-versed in mental health presentations and can offer a first-line assessment under the Community Health Assist Scheme (CHAS) if you are eligible, which significantly subsidises costs.
You can also go directly to a clinical psychologist, like myself, who will conduct a comprehensive psychological assessment and provide the strongest evidence-based therapy for your profile.
A psychiatrist can additionally assess whether medication is appropriate and prescribe accordingly. For moderate to severe depression, a combination of therapy and medication is often the most effective approach.
If cost is a concern, the Institute of Mental Health (IMH) offers subsidised outpatient psychiatric care. Polyclinics also provide mental health services and referral pathways. For more immediate support or if you are not sure where to begin, the Samaritans of Singapore (SOS) can be reached at 1-767, and the National Care Hotline is available at 1800-202-6868.
The key thing is not to let uncertainty about where to start become a reason to do nothing. Any one of these entry points can get you to the right place.
I feel really alone in this and there is still a stigma around Depression. What should I do?
That feeling of isolation is real, and it deserves to be named honestly rather than immediately dismissed. Depression is, among other things, a profoundly isolating experience because it narrows your world and makes connection feel effortful or undeserved.
Here is something worth holding onto: Depression is extraordinarily common. The World Health Organisation estimates that over 280 million people worldwide live with depression. In Singapore, a 2016 Singapore Mental Health Study found that Major Depressive Disorder was the most common mental health condition locally, affecting around 1 in 17 people at some point in their lives. Further, more recent data suggests prevalence has risen since the pandemic. You are not an anomaly. You are not weak. You are experiencing something that affects people across every demographic, profession, and background.
As for stigma, yes, it is real, and it is worth being honest that it persists in Singapore, particularly across older generations and in certain workplace cultures. However, the landscape is shifting. Seeking help is increasingly understood, including in professional contexts, as a sign of self-awareness and agency, and not failure.
Moreover, from a purely clinical standpoint, the data is clear: people who seek treatment for Depression recover faster, more fully, and with lower rates of relapse than those who try to manage it alone. Getting help is not a concession. It is the most effective thing you can do.
If you have read this far, you are already doing something important because you are paying attention to yourself. Whether what you are experiencing turns out to be Stress, Burnout, Depression, or some combination of all three, the act of reflecting on your situation rather than pushing through on autopilot is the starting point for everything that follows.
None of these experiences should be dismissed. You do not have to feel better on your own, and you do not have to figure out the “right” threshold before reaching out. If something feels off, that is enough of a reason to talk to someone.
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Mark Rozario, Senior Clinical Psychologist