Compassion Fatigue: Causes, Signs, & Ways to Cope

What Is Compassion Fatigue?

Compassion fatigue, sometimes called empathy fatigue, emerges when people internalize the pain they experience through others. For example, those in caregiving, healthcare, or first-responding positions encounter life-threatening and crisis-oriented situations that can lead to secondary trauma. Over time, this trauma takes an emotional and physical toll, leading to feelings of helplessness, hopelessness, social isolation, and a growing inability to be empathic.

Compassion Fatigue Vs. Burnout

While some may refer to compassion fatigue as “compassion burnout,” the two experiences differ in many ways. Burnout develops over time, but compassion fatigue can occur after a single case of trauma.¹ Additionally, people typically experience burnout because of overwhelming stress or responsibilities, not repeated exposure to trauma or crisis.

Compassion Fatigue Vs. Vicarious Trauma

Compassion fatigue and vicarious trauma both result from close encounters with trauma and suffering. However, while related, they are two different experiences. Compassion fatigue results in a reduced ability to feel empathy or compassion, while vicarious trauma can result in PTSD symptoms like intrusive thoughts, heightened anxiety, and flashbacks.

Compassion Fatigue Symptoms

Compassion fatigue causes various symptoms, including exhaustion, hopelessness, and emotional volatility. Over time, managing these experiences can become difficult, leading a person to become desensitized to the suffering of others. Some may also seem more irritable or angry and lash out at loved ones. Others may retreat inward and struggle with low mood and depression.

Common symptoms of compassion fatigue include:

• Physical, spiritual, emotional, and mental exhaustion
• Irritability
• Hopelessness and helplessness
• Feeling overwhelmed by the pain and suffering of others
• Self-isolation
• Anger
• Sadness
• Reduced empathy
• Inability to tolerate stress
• Overly sensitive or insensitive to the emotional experiences of others

Signs of Compassion Fatigue

Compassion fatigue can manifest as emotional, mental, and physical behavior. Individuals may experience changes in mood, emotional detachment, apathy, sleep problems, or substance use. All of these signs can indicate internal overwhelm and chronic stress that can lead to more severe concerns down the road.

Mood Swings

Compassion fatigue leads to emotional exhaustion, which can cause a person to swing between periods of worry and indifference. The stress of feeling unable to help others can lead to powerlessness and overwhelm, and individuals may struggle to separate themselves from and manage their emotions.

Emotional or Mental Detachment

One of the hallmark symptoms of compassion fatigue is detachment, desensitization, or distance. This separation happens when a person becomes emotionally overwhelmed and starts to withdraw, often resulting in negativity, apathy, and cynicism.

Trouble Focusing

Compassion fatigue can negatively impact focus in several ways. The emotional strain of being in a caregiving role can increase worry and stress, distracting from other cognitive functions. Additionally, chronic stress increases cortisol and adrenaline, which impact the ability to think clearly. These factors, combined with difficulty sleeping, can make staying focused challenging.

Sleep Disturbances

The stress and emotional roller coaster associated with compassion fatigue can lead to trouble falling or staying asleep. These problems can intensify other symptoms of compassion fatigue, like mood swings, making coping with stress more difficult.

Substance Use

People experiencing compassion fatigue may turn to alcohol, nicotine, or drugs to cope with stress, overwhelm, and sleepless nights. They may use substances to numb their emotions, relax and unwind, or deal with the physical effects of chronic pain or headaches.

Who Experiences Compassion Fatigue?

Healthcare, emergency, and community service workers are most at risk for compassion fatigue.² The nature of their roles means they devote themselves to caring, healing, and protecting the people to whom they provide support. Additionally, compassion fatigue is more common in women because they gravitate toward professions in the caring field.

Below are the populations most at risk of compassion fatigue:

• Healthcare providers
• Military personnel
• Mental health professionals
• Emergency medical technicians/paramedics
• Fireman
• Law enforcement
• Clergy
• Hospice workers
• Lawyers
• Veterinarians

What Causes Compassion Fatigue?

Compassion fatigue is caused by working with or providing care for people experiencing significant trauma, suffering, or distress. Prolonged exposure to traumatic stories and events can ultimately result in emotional exhaustion, especially in stressful work environments with high stress or inadequate support.

Common triggers of compassion fatigue include:

• Supporting someone through grief
• Responding to car accident scenes
• Witnessing or hearing about domestic violence or abuse
• Identifying with a client or patient who has a shared background or experience
• Working with difficult cases with no clear solution or resources
• Hearing about the injury or death of children
• Helping someone severely injured or ill

Compassion Fatigue Examples

Although compassion fatigue can look different for each individual, specific behaviors may appear similar across various professions or situations. Those experiencing compassion fatigue may appear detached, anxious, or hopeless when interacting with others at and outside work.

Below are examples of compassion fatigue:

• Compassion fatigue in nursing: Nurses may become irritable with patients or spend less time asking about symptoms, performing examinations, or administering medications. Their ability to feel empathy for patients or their families may also decrease.
• Compassion fatigue in hospice care: Those providing hospice care may feel exhausted or angry toward patients. They may also experience anxiety or panic before work shifts, which may result in more absences or asking colleagues to cover shifts.
• Compassion fatigue for caregivers: Compassion fatigue may manifest as neglect of patient care, including feeding or bathing. Caregivers may feel hopeless about their condition or indifferent toward their symptoms or pain. In severe cases, compassion fatigue may result in physical or emotional abuse toward a patient.

Is Compassion Fatigue Preventable?

While prevention is not always possible, you can take specific steps to reduce the likelihood of empathy or compassion fatigue. Maintaining a work-life balance is crucial to separating yourself from the daily trauma you experience. Additionally, self-awareness of your mental and emotional well-being, perhaps through therapy, will help you understand your limits when providing support.

How to Deal With Compassion Fatigue

Compassion fatigue is a treatable condition, and people can take action to help alleviate the symptoms. The primary goal is creating a healthy balance between your work and home life. Consider prioritizing healthy activities, such as self-care, gratitude practices, or goal-setting. Additionally, remember to take breaks when possible. Everyone needs rest, especially those who provide ongoing care and support.

Below are tips for coping with compassion fatigue:

Utilize Healthy Self-Care Strategies

Positive self-care strategies are more than just massages and bubble baths (these are helpful, too!). Examples could include setting boundaries, taking regular breaks, or relying on a support system. Any changes and actions that promote wellness and happiness are beneficial. Self-care is a necessary and critical part of caregiving.

Set Realistic Goals for Your Work

Take stock of your current workload, and talk to your manager or supervisor about setting realistic and achievable goals. Break larger tasks into small, manageable steps. Set daily priorities to address the most urgent needs, focus on moving toward long-term goals, and explore ways to delegate or let go of unnecessary tasks.

Make Your Surrounding Environment More Positive

Play your favorite song, buy yourself flowers, or place your favorite photos around your work environment. Do things that lift your mood and spirit. Experiencing constant trauma and distress takes a toll on your emotional and mental health, so prioritize creating a positive, safe space to decompress and recover.

Seek Professional Support

Seeking professional help is beneficial when an emotional or mental concern like compassion fatigue negatively impacts the ability to function at work, school, or home. A mental health professional can help a person heal from vicarious trauma and develop healthy coping skills.

Below are signs you should consider seeking professional support for compassion fatigue:

• Workaholism
• Symptoms of depression
• Dreading going to work
• An increase in cynicism or “gallows humor”
• Reduced productivity
• Problems with sleep
• Difficulty completing regular tasks at home

Focus on Gratitude

Intentionally recognizing the good things in life can help shift your experience from negative and stressful to more positive and hopeful. Doing so can increase resilience, allowing you to bounce back from stressors. However, practicing gratitude differs from toxic positivity or ignoring your feelings. Gratitude is about acknowledging your emotions while choosing to focus on the positives.

Take a Break if You Can

Taking a break is critical when separating yourself from the emotional and mental challenges associated with your work. Rest can help rejuvenate mental energy, reduce stress, and prevent burnout. Additionally, productivity and creativity can increase once you are back on your feet.

Set Boundaries Around Work

Setting boundaries at work is key when preventing compassion fatigue. Boundaries help you maintain a healthy work-life balance, protect your personal time, and allow space for loved ones, hobbies, and activities that you enjoy.

Know When to Separate Yourself From a Situation

Sometimes, the best way to address compassion fatigue is to separate yourself from a situation. An intense emotional reaction to your work indicates the need for some distance. Consider asking for a new assignment or shift, or re-evaluate your position at your current employer. No job is worth your emotional, mental, and physical well-being.

Lean on Your Loved Ones

Leaning on loved ones for support and understanding can be a helpful way to cope with compassion fatigue. Trusted friends and family can provide emotional support, perspective, and encouragement. Ask them if they are willing to provide comfort and support or solutions.

Compassion Fatigue Treatment

Many treatment options are available if you want additional support when coping with compassion fatigue. The longer you wait, the more overwhelming your symptoms can feel. Consider choosing a counselor with expertise in the nuances of trauma, caregiving, and mental exhaustion. These professionals can help you develop a healthy work-life balance and coping skills for difficult situations.

Below are treatment options for compassion fatigue:

• Support groups: Many people find support groups helpful because they can share and gain knowledge from others experiencing similar situations.
• Cognitive behavioral therapy (CBT): CBT helps individuals challenge and change automatic negative thoughts to focus less on the difficult aspects of their job and more on the positives.
• Family therapy: Family members may not realize what their loved one is going through, and their emotional detachment and mood swings can lead to hurt feelings and communication problems. Family therapy can help everyone provide mutual support and strengthen relationships.
• Eye movement desensitization and reprocessing (EMDR): EMDR can help reprocess traumatic events associated with compassion fatigue.
• Acceptance and commitment therapy (ACT): ACT helps individuals with compassion fatigue notice their thoughts and take action based on their deepest values.

Supporting a Loved One Experiencing Compassion Fatigue

When supporting a loved one in a caregiver role, watch for warning signs associated with compassion fatigue. Gently inquire if you have concerns about worrisome behaviors. You may need to take this first step to help them explore ways to overcome and deal with compassion fatigue.

Below are ways to support a loved one dealing with compassion fatigue:

• Get educated: Educate yourself about the signs and symptoms of compassion fatigue so you can better support your loved one
• Help them with responsibilities at home: A person with compassion fatigue may feel overwhelmed and exhausted. Consider taking additional responsibilities at home until they can take a break and regain their mental and physical energy.
• Offer them a safe space to talk: Ask them if they would like to talk, and offer a safe place to process their emotions.
• Encourage them to seek help: Compassion fatigue doesn’t always go away without professional help. Encourage your loved one to seek support from a mental health provider or group. Offer to give them a ride or go with them.
• Do fun activities together: Get out and do something fun with your loved one to help them take a break and remember they have a life outside their work.