Dealing With Compassion Fatigue: 4 Stages of Fatigue and How To Manage

• Compassion fatigue is an experience of an individual caring for someone going through a traumatic experience, impacting the caregiver on a physical, emotional, and mental level.
• Compassion fatigue is different from caregiver burnout, which involves large amounts of stress and dissatisfaction not necessarily linked to secondary trauma.
• Compassion fatigue isn’t uncommon—up to 71.4% of caregivers experience symptoms of compassion fatigue.

Compassion fatigue is defined as the physical, emotional, and psychological impact of caring for others, particularly through times of stress or trauma. It was first defined by Charles Figley and other late 20^th century psychologists who studied physicians and those who work in nursing. A care provider who cares deeply is more likely to experience this fatigue, especially when working long hours or helping patients with difficult situations.

Over the course of many years, researchers have expanded the definition in order to recognize the fatigue of unpaid caregivers too, such as parents caring for children or individuals caring for aging family members.

Compassion fatigue may lead to secondary traumatic stress or vicarious trauma and most commonly occurs in individuals who deal with the physical and mental health of others, including:

• Psychiatrists
• Psychologists
• Frontline healthcare professionals
• Caregivers for loved ones who have experienced/​are experiencing immense trauma, including life-altering medical conditions/​illness, such as cancer or Alzheimer’s.

Difference Between Caregiver Burnout & Compassion Fatigue

The concept of compassion fatigue and caregiver burnout are sometimes mistaken for each other. However, burnout and compassion fatigue are different. Compassion fatigue is more distinctly linked to those who help and care for victims of traumatic circumstances, while burnout results from stress and overworking themselves (usually in a career/​caretaker role). However, burnout can be a symptom of compassion fatigue.

Compassion fatigue can happen for a few different reasons, such as constant empathy, lack of control, putting off self-care, and having a traumatic history.

• Endless empathy: when caring for a person who has/​is experiencing trauma, empathy is necessary to navigate the process. However, the demand for constant empathy for an individual with little to no relief can result in mental, physical, and emotional exhaustion.
• Secondary trauma: Depending on the reason why a loved one needs care, a caregiver may develop secondary traumatic stress disorder, which is when someone experiences emotional distress due to traumatic events that happened to someone else.
• Lack of control: particularly in circumstances brought on by caregiving, the overwhelming feeling of having no control over a person’s suffering or condition can increase the possibility of compassion fatigue.
• Lack of self-care: Similar to burnout, compassion fatigue can occur when an individual doesn’t care for themselves because they serve as a caregiver—often sacrificing their own needs to help a loved one. Over time, this can result in a decline in mental and physical health and higher levels of stress for the caretaker.
• Traumatic history: If a caretaker has a personal history of related trauma (such as illness or previously experiencing a loved one go through a debilitating medical condition), this could contribute to a higher likelihood of experiencing compassion fatigue.

Compassion fatigue isn’t something that happens overnight. In fact, it’s often broken down into four stages: empathetic ability, empathetic response, compassion stress, and compassion fatigue.

1. Empathetic Ability

Empathetic ability involves the initial realization of an individual becoming aware of another person’s pain. This ability is often what draws people into caregiving roles, including for aging parents or relatives. This stage is often paired with empathetic concern which is defined as the desire to alleviate other’s pain and suffering. However, stage one usually doesn’t show signs of distress or concern.

2. Empathetic Response

An empathic response is an action-oriented stage when a person witnesses or is exposed to a person experiencing pain or trauma. This stage usually involves a person taking tangible steps to help alleviate a person’s physical or emotional pain, which can include stepping into a caregiver role for family members who need it.

3. Compassion Stress

This stage is when an individual may start to become more aware and susceptible to full-fledged compassion fatigue. During this period, they may experience feelings of stress, anxiety, or burnout. It may also be more difficult for them to maintain a sense of hope or they may feel more anger about what is happening in the present moment. 

4. Compassion Fatigue

The final stage occurs if compassion stress isn’t effectively managed or is left unchecked. Stage four is more likely to occur if:

• A person is exposed to secondary trauma for an extended period of time
• They don’t have coping mechanisms to deal with compassion stress/​fatigue
• A person lacks community or loved ones to lean on
• They have a personal history of trauma

Signs and Symptoms of Compassion Fatigue

Compassion fatigue signs may vary from person to person, but there are some basic symptoms to look out for, including:

• Physical, mental, and emotional exhaustion
• Struggling to feel empathy
• Feelings of depression, irritability, or frustration
• Chronic exhaustion
• Chronic anxiety, specifically surrounding the well-being of your loved one
• Feeling detached and apathetic
• Feeling emotionally numb
• Feeling helpless
• Placing blame on yourself for not preventing or solving your loved one’s trauma

Finding ways to combat compassion fatigue is essential, for both you and your loved one. It’s important to remember you aren’t alone, and there are ways of overcoming and managing compassion fatigue if you believe you’re experiencing it. Some ways to help manage can include:

• Asking for support: trying to handle everything alone, especially in a caregiver role, can be overwhelming and isolating. Asking for support from other loved ones or finding a support group to connect with can help you navigate your feelings and help ease some of your responsibilities.
• Taking time for self-care: While you may feel a strong obligation to prioritize your loved one’s needs over your own, doing this long-term can only extend your feelings of compassion fatigue. Taking time to rest, caring for your personal needs, and taking breaks from caregiving can go a long way.
• Setting boundaries: This can be difficult in practice, but setting and keeping boundaries for yourself can help ease your compassion fatigue and make it maneagable. Some examples of boundaries you may set can include taking certain amounts of time away, keeping space between your caregiving role and the rest of your life, and taking care of yourself.
• Allowing self-compassion: Alongside other emotions, you may feel guilt or shame for experiencing compassion fatigue at times. However, developing compassion fatigue can happen to anyone. Remembering you are human and can only handle so much is important when navigating through this experience.

It’s not uncommon to feel compassion fatigue, especially if you are in a caregiving role long-term. However, there are some effective coping strategies to keep in mind that can help lessen the likelihood of experiencing it, including:

• Lean on support: This can be in the form of asking family members for help, finding and connecting with a caregiver support group, or even talking to a therapist about your feelings. Knowing you have support and a safe place to express your emotions can help alleviate some of your stress.
• Take care of yourself: Ensuring that all of your needs—physical, mental, and emotional—are consistently met is a great way to avoid compassion fatigue. Getting regular exercise and enough sleep, not repressing your emotions, and sticking to a consistent routine are all ways you can keep yourself in a good place.
• Know when to take breaks: Caregivers in particular can struggle with taking time away or taking regular breaks from caring for their loved one, but it is an effective and essential way to ensure compassion fatigue doesn’t overtake your life. Setting up other caregiving options, such as relying on other family members or hiring a home health aide, can allow your loved one to be cared for without sacrificing your well-being.
• Reduce stress levels: Developing a practice to reduce the mental and physical symptoms of stress can help. Ways to reduce stress include meditation, yoga, and breathwork. 
• Seek mental health care: Being a caregiver doesn’t mean you won’t also benefit from support. Working with a therapist or other mental healthcare professional can have positive effects on your personal life, work environment, and relationship with those you act as a caregiver for. 

While stress management and self care are important, another facet of overcoming compassion fatigue is developing the opposite: compassion satisfaction, or deriving emotional well being and emotional resilience from caring for others. Healthcare workers who experience compassion satisfaction often report lower levels of burnout, fewer sleep disturbances, and higher professional well being. The benefits may be similar for those caring for loved ones. 

Ways to cultivate compassion satisfaction include:

• Time for self reflection: Reflect on the emotions experienced during time spent caregiving, including what’s going well.
• Reduce stress: By reducing stress, you can provide excellent professional or social support, making the caregiving experience better for everyone.
• Develop a self care plan: Ideally, this plan should include how to identify warning signs that you need a break, a few individuals who can offer peer support or help with caregiving, and a few mental wellness habits to try.

Practice gratitude: Writing regular lists of what you’re thankful for in your professional and personal life can help caregivers feel overwhelmed or fatigued less often, especially if in a position where they experience prolonged exposure to other people’s trauma. 

If you feel you are struggling with compassion fatigue, there are resources that can help.

National Foundation for Cancer Research (NFCR)

The NFCR has resources for those caring for a family member diagnosed with cancer, including tips for caring for certain types of cancers, avoiding caregiver burnout, and finding support groups with others in similar situations.

To learn more, visit this source here.

National Institute on Aging

The National Institute on Aging includes resources aimed at caregivers of older relatives and loved ones. Resources include ways to find support groups, tips on care for aging parents or relatives, and how to share caregiving responsibilities with others.

To learn more, visit this source here.

Compassion Fatigue Awareness Project

The Compassion Fatigue Awareness Project was developed to ​“promote an awareness and understanding of compassion fatigue and its effect on caregivers.” Their website includes resources such as reading materials and lists of organizations to help caregivers receive support compassion fatigue.

To learn more, visit this source here.