Compassion Fatigue | Symptoms & Treatment

What is compassion fatigue? 

Compassion fatigue is the result of repeatedly being exposed to someone else’s pain. This could be people or animals who are in pain or distress.  

The condition (also referred to as ’empathy fatigue’) is a secondary trauma. This is a traumatic stress disorder that results from exposure to another person’s traumatic experiences. 

You can experience symptoms that put your physical and mental health at risk.  This can result in disinterest in someone else’s trauma even if it is your own loved one needing care at home. You may as a result be reluctant to care.

What causes compassion fatigue? 

A person’with an empathetic connection to someone else’s trauma can cause your body to react through a process called vicarious trauma or secondary stress. It is as if another person’s suffering has happened directly to you.   

The more you are exposed to another person’s pain, the more likely you are to have feelings of devastation. 

‘The dark side of caring’ 

Jayne Ellis, the chief executive of EF training, which gives compassion fatigue training courses to nurses, care workers etc, calls it “the dark side of caring”.  

“Until recently it has been ignored or rarely talked about.

I assure you that even though they don’t know what it’s called, everyone who works in a role that involves them being exposed to the suffering of others knows exactly the effect this has on them.”  

Who can experience it? 

Anyone can experience compassion fatigue. You are more likely to get this condition, if you regularly witness a person’s pain and suffering. For example the sights, sounds and smell of sickness.

Typically, those who get this condition include people who care for a loved one at home, first emergency responders, humanitarian aid workers, care workers, nurses, therapists, animal rescue.

The condition can be an occupational hazard for funeral directors, the military and journalists on the front lines of war/disaster.

If you dedicate extra hours, do not take days off or neglect your own self-care, you are susceptible to compassion fatigue. 

What are compassion fatigue symptoms?  

The signs of compassion fatigue can be psychological, physical, emotional and behavioural.

Compassion fatigue symptoms can mirror those of the person you are trying to support. It affects your work life and home life.    

You may experience these symptoms: 

• Feeling shaky.
• Breathlessness.
• Panic attacks.
• Anxiety.
• Feel overwhelmed, exhausted and drained.
• Feeling depressed.    
• Irritability, feeling agitated, short-tempered. Uncharacteristic behaviour like angry outbursts.
• Avoiding being around the person in pain/distress. You may daydream about not providing care for them.
• Being emotionally switched off, detached, numb, avoiding connection or rejecting others.  
• Apathy. Reduced empathy and sensitivity to people’s suffering.   
• Less patience and less tolerance. 
• Feeling helpless, powerless, a sense of hopelessness. 
• Cynicism. 
• Sadness, feelings of emptiness.  
• Feeling isolated and lonely. 
• Feeling rejected.  
• Difficulty sleeping.
• Lacking energy.
• Weakness, tiredness. 
• Frequently falling ill.
• Losing interest in usual activities.   
• Headaches.
• Gastrointestinal issues e.g.stomach upset.
• Impaired ability to make care decisions.

What impact can the condition have?   

If compassion fatigue develops, a person caring for a loved one at home can display indifference or insensitivity to someone they are caring for. 

Compassion fatigue can prevent you from carrying out caring responsibilities properly and a role that you were once passionate about.   

The person receiving care could be at risk of harm from verbal or physical abuse or neglect. 

If you are a family carer, compassion fatigue can display itself in extreme ways if not tackled. For example, you may shout, hit or neglect the person you are caring for. Under such circumstances it is better to take a break from giving care. 

If not addressed, compassion fatigue can lead to psychiatric conditions including hypochondria, dissociative disorders, mood disorders (e.g., anxiety and clinical depression) and personality disorders. It can also lead to addictions (smoking, alcohol, drugs and gambling) and eating disorders. 

Loss of compassion was highlighted in the Robert Francis report as one of the reasons that hundreds of patients died at Mid Staffordshire hospital. Some 85 per cent of emergency department nurses met the criteria for compassion fatigue. This is according to a study published in the Journal of Emergency Nursing (‘Compassion satisfaction, burnout and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties’).   

Is compassion fatigue the same as burnout?  

The symptoms of burnout are similar to compassion fatigue. Feeling drained from everyday stress like work and child rearing results in burnout.  

However, compassion fatigue is different because it is triggered by the stress of another person’s pain.

Can you prevent compassion fatigue?

A person can recover from this condition. It is possible to deal with the effects of the condition and “greatly reduce or reverse the symptoms of compassion fatigue”, says Jayne Ellis, the chief executive of training provider EF training.

Ms Ellis helps people understand the causes, risk factors and effects of the condition. She helps people create and sustain emotional resilience by teaching them self-care strategies. 

Suicide prevention charity Samaritans stated in a post on X (@Samaritans): ‘Compassion fatigue can occur for anyone and that includes therapists and mental health professionals. Self-care is important for those struggling and for those helping’.

20 Tips to tackle signs of compassion fatigue   

1. Familiarise yourself with compassion fatigue symptoms, their impact and symptom causes.  
2. Prioritise your needs. Identify what’s important in your life and you may need to take bold steps to live the life you want.
3. Set realistic expectations for yourself to find your life balance. 
4. Set emotional boundaries.  
5. Give yourself a mental and physical break from care. Commit to taking sufficient rest and regular time off. This may require you to organise immediate respite care for a loved one.  
6. If you are a family carer, you may wish to consider a temporary stay in a care home for your loved one. You may consider more frequent care visits from a home care provider. You may decide on a permanent move to a care home. 
7. Be kind to yourself. Forgive yourself for any feelings or actions you have taken
8. Ensure healthy eating to fuel your body and mind.
9. Regularly exercise to keep your body/ mind fit and relieve stress.
10. Write in a personal journal to express your personal feelings. 
11. Talk with your friend/s. Reach out to people in your support and social networks. Develop support systems.
12. Seek professional help from a healthcare professional. This can include therapy.  
13. Take resilience training. This educates people about compassion fatigue symptoms, risks and teaches them about self-care strategies.
14. Practice self-care. This could involve nurturing your physical, psychological, spiritual, intellectual self. For example take 10 minutes each day to dance, laugh or sing.
15. To help you relax, try mindfulness, meditation e.g. breath work. 
16. Spend time outdoors in nature. Studies reveal that being outdoors improves mood and reduces stress.
17. For a new focus and sense of calm, try yoga.  
18. For relaxation try massage sessions. 
19. You can also try to relax by listening to your favourite music.  
20. Consider taking up a hobby or pursuing other interests.