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When compassion fatigue hits

A heart-shaped stone.

It’s two in the afternoon. Sarah, a social worker who specializes in mental health and substance abuse, knocks on a client’s door for a scheduled at-home visit.

The patient, a 32-year-old mother of five struggling with opioid addiction, takes almost 10 full minutes to answer the door. When she finally does, she appears lethargic and disoriented.

The home itself looks like something straight out of the reality show “Hoarders.” There are clothes, toys, and garbage everywhere. An awful stench fills the air.

Sarah has been working with this client for over a year now. But since the pandemic hit, things have progressively gotten worse with her behavior. The neighbors are complaining about the kids being neglected. The police are called at least once a week. And now the landlord is threatening eviction because of property damage.

Sarah knows she’s supposed to treat addiction as a disease and feel compassion for her clients, but when she looks at this woman, she feels nothing. Sometimes all she wants to do is scream at her to stop doing drugs.

She would never say that out loud, of course, and she continues to treat all her clients—including this woman—with respect and professionalism. But on the inside, she feels numb and frustrated. It feels so heavy that sometimes she wonders if she should consider switching careers.

What is compassion fatigue?

Compassion fatigue happens when we become exhausted from caring for others. This can happen to someone in a helping profession or someone who acts as a caregiver for children, elderly parents, or ill loved ones.

Teachers, nonprofit staff, medical professionals, childcare workers, mental health clinicians, and many others can experience compassion fatigue. So can parents, grandparents, siblings, and friends.

As someone who has experienced compassion fatigue from being a therapist, a parent, and a volunteer, I understand what it feels like to find yourself questioning and doubting whether you’re still a good person.

Signs and symptoms of compassion fatigue

Compassion fatigue can be tricky to identify because it shows up over time. Here are some signs and symptoms to look out for: 

  • Reduced or nonexistent feelings of sympathy or empathy
  • Feelings of anger, sadness, hopelessness, irritability, and frustration
  • Chronic exhaustion—emotional, physical or both
  • Hypersensitivity or complete insensitivity to emotional or traumatic material
  • Difficulty maintaining and enjoying personal relationships
  • Reduced sense of career fulfillment

I specialize in both career counseling and mental health, so clients often come to me with compassion fatigue. Above all other symptoms, they tell me, is the fact that they struggle with overwhelming guilt for losing their ability to care. 

Compassion fatigue vs. burnout

Some people mistake compassion fatigue for burnout, but the two are actually quite different—with some overlapping characteristics.

Compassion fatigue can hit suddenly and come as a shock to someone’s system. Many people find themselves asking “How did this happen?” or feeling like they should be able to handle the physical and emotional burden of caretaking easily.

Burnout can happen to the broader population, not only caregivers. Like compassion fatigue, it develops over time and for a variety of reasons. It can resemble compassion fatigue because exhaustion, inefficiency, and cynicism are common to both.  

However, people experiencing burnout feel unable to change their situation, no matter how hard they try. Burnout can also cause you to feel like you don’t believe you can make an impact on something or someone. 

Compassion fatigue, on the other hand, involves giving everything you have emotionally to the people you’re trying to help—but feeling like nothing positive is coming from your efforts.

How to prevent compassion fatigue

If you’re suffering from compassion fatigue, there are actions you can take to prevent it from swallowing up your daily life.

Practice self-care

We often hear about the importance of self-care. For preventing compassion fatigue, it’s at the top of the list. 

A good self-care routine varies from person to person, but typically it includes a balance of work and leisure, regular exercise, nutritious eating, time with loved ones, a strong support system, and paying attention to your own emotional needs.

Pursue interests and hobbies

When we take care of others, it can be easy to forget about our own lives and what we enjoy doing. One of the most impactful ways to refresh ourselves emotionally and physically is by putting in the effort to engage in interests and hobbies we love.

Anything that feels authentically fun and enjoyable can be considered an interest or a hobby. If you do something for pure enjoyment, instead of to fill a workout quota or to earn income, then you’re on the right track.

Banish guilt and shame

For many people, compassion fatigue is an ongoing struggle because they feel shame and guilt about losing their sense of caring. They may also be battling the feeling that they should be doing more. 

The best way to minimize shame and guilt is to find and maintain a sense of self-worth. When someone truly cares about their own feelings, they often recognize that guilt and shame are not productive.

Set emotional and physical boundaries

Boundaries and self-care go hand in hands. If boundaries get blurred, then a self-care routine usually goes out the window. 

How do you know if you have weak boundaries? If you’re skipping meals or sleep, canceling activities you enjoy, not paying attention to your feelings, and not taking enough downtime, then you may be making sacrifices to overfill your caregiver role.

Remember that in order to show compassion and support for others, you must be compassionate and supportive toward yourself first. If you establish firm boundaries, you may find the opportunity to develop a real self-care routine.

Use positive coping strategies

Being a caregiver in any capacity can be stressful. Even if you aren’t experiencing compassion fatigue at the moment, it’s important to have good coping strategies in place in case you need them. 

When you find yourself trying to reduce stress and emotional burdens by engaging in addictive behaviors—such as drinking, drugs, shopping, or overeating—isolating yourself from loved ones, overreacting by yelling and screaming, or being overly critical of yourself, these behaviors can have a negative impact on your mental health and potentially lead to anxiety or depression.

Positive coping strategies like meditating, walking outside, talking with a friend, engaging in a hobby, or playing with a pet can alleviate stress and emotional burdens. These strategies can also help you build resilience.

Build and maintain a strong support system

A strong support system looks different for each of us, but it’s important to have one in place. It could include joining a hiking group or a book club, staying connected with friends and family, and getting help with time-consuming tasks (housekeeping, accounting, childcare, etc.).

Some caregivers seek out a place to connect with others who are experiencing compassion fatigue or other caregiver stress. A specialized in-person or virtual support group that addresses compassion fatigue for caregivers or medical professionals can really help.

Get help now

If compassion fatigue seems to be spilling over and impacting your daily life, you may want to consider working with a mental health professional. Browse our therapist directory to find support now. 

About the author

Suzi Sena, EdS, LPC, is a licensed professional counselor with over 20 years of experience in human resources, education, integrative mental health, career counseling, and private practice settings. She earned her master’s degree in industrial organizational psychology from Fairleigh Dickinson University, her master’s in counselor education from Kean University, and her EdS degree in family and marriage therapy from The College of New Jersey. She holds numerous certifications and credentials in integrative mental health, career counseling, and human resources. She is currently in private practice, where she provides integrative mental health services to individuals and couples and consulting services to employers.

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