What Is Compassion Fatigue? 9 Coping Tips For Caregivers

• The term compassion fatigue refers to a state of emotional and physical burnout brought on by prolonged exposure to the stressors and traumas of other people.

• Compassion fatigue is also sometimes referred to as ​“secondary traumatic stress disorder” or as ​“vicarious traumatization.”

• Compassion fatigue is most common in those who work in caregiving and healthcare professions and can negatively impact workers’ professional quality of life in addition to their health and personal life.

• Signs of compassion fatigue include a reduced ability to empathize, physical and emotional exhaustion, stomach upset, and more.

Compassion fatigue, sometimes referred to as secondary trauma or vicarious trauma, can happen to anyone. However, compassion fatigue is especially prevalent in those who work in healthcare and caregiving settings.

This article will discuss the basics of compassion fatigue and provide coping strategies and tips for caregivers who may be experiencing compassion fatigue themselves.

Compassion fatigue is a set of symptoms that most often occurs in people who are in caregiving and healthcare fields, especially those professionals involved in helping to heal other people’s trauma and emotional pain.

Research has shown that in helping professions, 7.3 to 40 percent of workers will experience compassion fatigue. Potential helping professions that could be impacted by compassion fatigue include:

• Social workers
• Therapists
• Doctors
• Nurses
• Caregivers
• Community service workers

There are a number of symptoms associated with compassion fatigue in regard to one’s physical and mental health.

Mental Health Symptoms

Mental health symptoms of compassion fatigue include:

• Emotional exhaustion
• Apathy
• Cynicism
• Rumination over other’s problems
• Self-blame
• Irritability and/​or anger
• Feelings of helplessness or sadness
• Numbness
• Negative changes in worldview

Physical Symptoms

Physical health symptoms of compassion fatigue include:

• Problems with sleep
• Appetite changes
• Upset stomach
• Nausea
• Exhaustion
• Dizziness

The main cause of compassion fatigue is prolonged exposure to secondary trauma and stress. Compassion fatigue most often occurs in a work environment that involves caring for others such as healthcare and caregiving.

Compassion Fatigue Risk Factors

Risk factors for developing compassion fatigue in addition to one’s work environment include:

• High stress
• Poor coping skills
• Insufficient social support
• Neglected self-care
• Trauma history

Left untreated, compassion fatigue and other caregiving stress can seriously impact health and overall wellness, in addition to one’s professional quality of life. Examples of such risks include:

• Reduced compassion satisfaction: ​“Compassion satisfaction” is a term used to describe the pleasure one is able to derive from one’s job and assisting other people. Risks linked to lower compassion satisfaction include:
  • Decreased engagement on the job
  • Impaired professional judgment
  • Poorer patient care
  • Less productivity
  • Higher employee turnover
• Increased risk of chronic health issues: For example, 45 percent of caregivers, or double the amount of non-caregivers, report having chronic health conditions such as heart attack, heart disease, cancer, diabetes, and arthritis.
• Accelerated aging: Experiencing chronic stress is linked to quicker aging (weaker muscles, skin wrinkles, and potentially organ failure).

Research has shown that compassion fatigue primarily happens in four stages:

• Stage 1, Empathetic ability: The first stage of compassion fatigue is being able to sense others’ pain. 
• Stage 2, Empathetic response: The next stage of compassion fatigue is responding to another’s pain upon noticing it and attempting to find ways to soothe and help the matter at hand. 
• Stage 3, Compassion stress: The third stage of compassion fatigue is known as compassion stress which basically means that the caregiver begins to experience stress as a result of their compassion. 
• Stage 4, Compassion fatigue: Finally, the fourth stage is compassion fatigue, at which point the person providing support for someone else will experience the symptoms associated with compassion fatigue (i.e. emotional exhaustion, self-blame, sleep issues, etc.).

There are various effective coping strategies one can put in place as a caregiver to both prevent and navigate compassion fatigue including managing stress, getting regular exercise, eating a healthy diet, practicing good sleep hygiene, and more. Treating compassion fatigue is imperative for improving one’s personal and professional life.

#1: Reduce & Manage Stress

Because stress is one of the primary causes of compassion fatigue, learning how to effectively manage and reduce stress levels is absolutely essential for preventing compassion fatigue as well as coping when it arises.

Ideas for stress management strategies can include:

• Journal
• Practice yoga
• Talk it out with trusted friends and family
• Perform deep breathing exercises
• See a therapist
• Practice self-care
• Taking regular breaks

#2: Exercise Regularly

Getting regular exercise is beneficial for a myriad of reasons such as:

• Improved brain health and function
• Weight management
• A reduced risk of disease
• Stronger bones and muscles
• A better quality of life
• Lowered depression and anxiety
• Higher quality sleep

Since being a caregiver can be a physically-demanding role in addition to the emotional strain, staying in shape and tending to your physical health is imperative to preventing compassion fatigue. Physical activity is also a great way to relieve stress and boost endorphins.

There are various options for staying active such as:

• Aerobic exercise (i.e. walks, jogs, runs, elliptical machines, water aerobics, etc.)
• Strength training (i.e. free weights, weight machines, resistance bands, etc.)
• Flexibility training (i.e. yoga, tai chi, static stretching, etc.)
• Balance training (i.e. wobble boards, standing on one foot, balance boards, etc.)

The CDC recommends at least 150 minutes of physical activity for adults per week. Put another way, 30 minutes of exercise daily, five days per week. Usually a combination of aerobic and resistance training is best.

Note: Learn more about the importance of physical activity at this resource.

#3: Eat Healthy

Eating a healthy diet can help mitigate symptoms of chronic stress for a number of reasons. For one, consuming a balanced diet supports immune system function as well as can help repair damaged cells and provide the energy needed to deal with stressful situations. Not only that, some early research suggests that certain foods such as polyunsaturated fats such as omega‑3 fats as well as vegetables may help to regulate cortisol, the hormone associated with stress.

Note: Learn more about healthy eating at this resource.

#4: Get Quality Rest

Getting enough sleep, and quality sleep at that, is essential for one’s overall health and well-being. For caregivers, good sleep helps mitigate stress and be energized for the job.

Some tips for improving your sleep hygiene and feeling more well-rested include:

• Go to bed and rise at the same time every single day (including on weekends)
• Make your bedroom as relaxing as possible ensuring it is dark, quiet, and a comfortable temperature
• Avoid electronic devices from your bedroom and avoid them prior to bedtime
• Skip the large meals, caffeine, and alcohol before bed
• Get enough exercise; this can help you fall asleep more easily

#5: Join a Caregiving Support Group

Support groups can be imperative to managing your stress and coping with compassion fatigue. Support groups can be peer-led or run by a trained facilitator such as a social worker or psychologist. Support groups are helpful because they provide a sense of community as well as connect you with valuable resources and education that can help you on your caregiving journey.

Note: Use ElderCare Locator to find a support group near you.

#6: Practice Self-Compassion

Self-compassion is critical for overcoming compassion fatigue. Research has illustrated that mindful self-compassion training for healthcare professionals specifically had various positive effects on workers including improved compassion satisfaction. As well, self-compassion is linked to an increase in resilience as well as lower anxiety, depression, and stress.

Examples of self-compassion exercises include:

• Practice mindfulness: Mindfulness is the act of observing your human experience through a non-judgmental lens. It is paying attention to what you are feeling, thinking, or doing. You can practice mindfulness at any time to help bring you back to your body and the present moment. One easy option for incorporating mindfulness into your day is when washing your hands. While you wash your hands, simply notice the sensations of the water, the temperature, the movement of your hands as you rub them together to clean them.
• Use self-kindness: Being kind to yourself is fundamental to self-compassion. Saying positive affirmations, validating your own feelings, etc. are great ways to be kind to yourself.
• Remember your common humanity: This is especially important when you feel overwhelmed while caring for others. When you notice stress or agitation, take a second to breathe in deeply, acknowledge and validate your feelings, and then use coping statements such as, ​“I am feeling stressed due to my patient’s suffering. While their hurt is beyond my control, I will do what I can to help.”

#7: Set Firm Emotional Boundaries

Emotional boundaries are essential for protecting your mental wellness and combating compassion fatigue.

Emotional boundaries may include but are not limited to:

• Saying ​“no” when it means putting yourself and needs first
• Set clear expectations about time commitments with your patients and loved ones to set the pace for your time spent together
• Be clear about when you’re available to communicate with your loved ones or patient (i.e. at certain times of day, you won’t be available by phone or text)

#8: Consider Resilience Training

Resilience training is a method of combating burnout and stress in healthcare settings among employees. Research has shown that programs providing guidance on fostering resilience in healthcare workers have positive benefits and can help with feelings of burnout and job-related stress.

Resilience training is a skills-based program that involves teaching workers about resilience, stress management, goal setting, cognitive reframing, and more.

#9: Schedule Respite Care

Respite care is a short-term care solution that relieves primary caregivers of their duties. Respite care can be scheduled for an afternoon, evening, or even several days or weeks.

Caregivers can find respite care workers in their community through the ARCH National Respite Locator Service. If you are a caregiver for a spouse, Well Spouse Association also offers support to you as well as provides a nationwide network of local support groups for people in similar situations.

Note: Learn more about self-care for caregivers at this resource.

Signs you may need to seek professional guidance include:

• Struggling with depression
• Onset of anxiety or anxious tendencies
• Suicidal thoughts

Remember, you cannot pour from an empty cup. Your health and well-being matters, too. And you can deliver better, more compassionate patient care if you take care of yourself first and make your own wellness a priority.

There are many mental health resources available that can help yourself, a family member, a friend, or someone else you may be worried about. Some resources include:

• National Alliance on Mental Health (NAMI)
• Substance Abuse and Mental Health Services Administration (SAMHSA)
• 988 Lifeline

To find a therapist in your area, visit:

• Good Therapy
• The Recovery Village
• Talkspace

For immediate assistance, call, text, or visit:

• 1–800–662-HELP (4357)
• 1–800–273‑8255 (TALK)
• Suicide Prevention Lifeline for Hearing Impaired: 1–800–799‑4889
• The Samaritans: (877) 870‑4673 (HOPE)
• Text HOME to 741741
• https://www.imalive.org/
• 988 Lifeline Chat

Are burnout and compassion fatigue the same thing?

No. While these present in similar ways, burnout and compassion fatigue are different. Burnout is when someone is exhausted from their job and experiences a lack of motivation and interest in their work as a result. Compassion fatigue is a specific type of burnout related to caregiving professions and is marked by a loss of empathy in addition to other negative emotions and physical symptoms. Learn about caregiver burnout at this resource.

How serious is compassion fatigue?

Compassion fatigue can become a serious problem if left untreated. Without proper intervention, compassion fatigue can lead to various mental and physical health problems. This is why addressing the signs of compassion fatigue is so important.

What is the compassion fatigue scale?

The compassion fatigue scaleis a means of measuring compassion fatigue in healthcare workers. Developed in 1995, the Compassion Fatigue Self Test (CFST) was designed to understand healthcare workers’ burnout level as well as compassion fatigue. The CFST consists of 40 items divided into two subscales: 23 items for compassion fatigue and 17 for burnout. The scale will score participants based on their answers to questions on the test.