We Need to Talk About "Compassion Fatigue"—Here's How to Recognize the Symptoms

2020 was a challenging year, to say the least. An unprecedented pandemic, racial injustices, political polarization, and natural disasters left many of us feeling exhausted. Compassion fatigue is a condition that many are at risk for, yet most people don’t even know there’s a name for what they’re going through. We reached out to a few psychologists to shed light on what it is, signs and symptoms to look out for, and how to manage and treat it—so that we can keep compassion alive for the long haul.

What Is Compassion Fatigue?

“Compassion fatigue is the emotional, mental, and physical exhaustion that can occur in people who care for individuals suffering from significantly challenging emotional or physical conditions,” says Dr. Carla Marie Manly, practicing clinical psychologist, author, and speaker. It also tends to impact those who have high ideals for making a difference and people with the personality traits of compassion and empathy, says Liz Kelly, LICSW, a therapist with Talkspace.

Additionally, this condition is referred to as second-hand shock or secondary traumatic stress disorder, points out Dr. Yvonne Thomas, a Los Angeles-based psychologist specializing in self-esteem and anxiety. “People who are around others that are suffering—emotionally or physically (or both)—may absorb this emotional wear and tear and can have their own trauma reactions," she explains. Individuals working as caregivers, healthcare or medical providers, mental health professionals, and frankly anyone dealing with situations that involve intense levels of emotions are at risk of experiencing this type of fatigue.

It’s important to highlight that people outside these professions can be affected, too. Compassion fatigue is becoming a broader issue as we’ve all been exposed to significant upheaval and repeated stress. It's almost as if we’ve become so accustomed to bad things happening around us that it’s dwindled our ability to feel genuine empathy.

The Causes

At its crux, compassion fatigue can take hold when an individual continually gives to others without having sufficient opportunity to rest and recharge. It can worsen when a person is overtaxed, working with large numbers of people suffering, does not have adequate training on the impact of trauma, and lacks self-care behaviors, according to our experts.

To that point, healthcare professionals around the world have been on the frontlines of the COVID-19 crisis for a while now. They’ve worked tirelessly around the clock with a huge amount of chronic stress, and even trauma, on a daily basis. There has undoubtedly be so much suffering and Dr. Chloe Carmichael, clinical psychologist and author of Nervous Energy, advises to take any feelings of your own depletion seriously. "With this uncharted pandemic, many people are afraid to take their own challenges too seriously when there has been so much derailment to others’ lives, and while it is certainly necessary to keep our challenges in perspective, it’s important to not devalue them to the point where we don’t take care of ourselves."

Personality Types and Compassion Fatigue

People with certain personality types or traits may be more at risk of experiencing compassion fatigue than others, so we asked our experts if they could elaborate. “Those who are more empathic—particularly if they don’t have strong boundaries—are certainly more likely to struggle with compassion fatigue as these individuals tend to absorb the stress and suffering of others,” explains Manly.

Optimists can be blindsided by compassion fatigue, too, because they're likely less able to notice becoming rundown. Compassionate perfectionists—those who try to do it all in a kindhearted way—are also susceptible to falling prey to the mental, emotional, and physical exhaustion that underscores compassion fatigue. It's just not possible to keep up with such a high standard of care without recharging.   

The Signs and Symptoms

The signs of compassionate fatigue are quite broad and can impact an individual psychologically, behaviorally, and physically. Dr. Thomas gave us a rundown on several potential signs and symptoms below:

Psychological

• Sense of numbness: Someone dealing with compassion fatigue may start to feel “numb” or disconnected, in turn leading the individual to withdraw socially because they simply can’t take any further stimulation.
• Hypersensitivity: On the other hand, people experiencing compassion fatigue might react with hypersensitivity (excessive sensitivity) to emotionally charged stimuli.
• Self-contempt: "People may even start blaming themselves and thinking, 'Why can’t I keep up?'" says Dr. Thomas, adding that these individuals often don’t have compassion for themselves and can't recognize that the level and standard of care they’re trying to keep up with is impossible.

Behavioral

• Avoidance of clients: Sometimes, compassion fatigue can cause a person to start dreading patients they have to look after in a caregiving capacity and simply avoid going to work.
• Blaming others: There may be an increase in irritability and even a tendency to blame others for their suffering when someone is experiencing the exhaustion marked by compassion fatigue.
• Trouble making decisions: The individual may realize they’re having trouble making decisions or can’t focus—this is because the person is essentially so depleted that it has affected their cognitive functioning.

Physical

• Continuing to give and give: If the individual doesn't address any feelings of depletion, this can result in physical issues like trouble sleeping, tension headaches, gastrointestinal issues, and even chest pains.

How to Prevent and Manage Compassion Fatigue

What can we do to protect ourselves from compassion fatigue while still caring for others? Well, the first step is to engage in regular self-care. "Far from being selfish, self-care is absolutely essential on a personal and professional basis; a lack of self-care can contribute to a wide variety of problems that can affect one’s ability to properly care for others as well as the self,” explains Manly. Carmichael adds that many times, people struggling with compassionate fatigue do not acknowledge their own needs. She suggests pretending you are your own caregiver. “You deserve the things you might do for someone else, like drawing a relaxing bath, making a bed, or preparing a beautiful meal, so nix the idea that it’s too self-indulgent and take time to replenish yourself.”

Kelly further points out that it’s important to prioritize your physical health and make sure that you’re drinking enough water, getting adequate sleep, eating regular healthy meals, incorporating physical activity, and avoiding or minimizing the use of alcohol and other mood-altering substances.

Another key step in preventing or managing compassion fatigue is to set limits and recognize that it’s OK to say no. It doesn’t make you a bad person to set boundaries. In fact, it makes you a healthier person. Manly says setting boundaries is crucial, as well as seeking out an adequate support system—whether that’s leaning on specific family or friends in your life, creating an understanding network of coworkers, or seeking personal psychotherapy for support and release.

The Treatments

The treatment for compassion fatigue involves many of the same steps as the prevention of compassion fatigue, notes Manly—this incorporates having regular self-care, a strong support network, ensuring plenty of rest and relaxation time, and perhaps obtaining individual psychological support where you can be in a safe, nonjudgmental space to process what you’re thinking and feeling. 

All our experts also highlighted other mindfulness techniques to help when struggling with exhaustion and depleted levels of empathy like taking regular breaks from screen time, journaling your feelings, meditating, and generally finding activities that are like balm to your soul. 

After a long year and with a number of societal issues that require our continued attention, recognize that it’s normal to feel depleted and reflect on what truly brings you comfort at this point in time. It also doesn’t have to be all or nothing—it’s important to be a caring and compassionate person, but finding a middle ground is key. As Thomas thoughtfully puts it, “Give yourself what you need to be able to keep giving to others."