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Compassion Fatigue

What Is It, Causes, Symptoms, and More

Author: Lily Guo

Editors: Alyssa Haag, Emily Miao, PharmD, Kelsey LaFayette, DNP

Illustrator: Jessica Reynolds, MS

Copyeditor: David G. Walker


What is compassion fatigue?

Compassion fatigue, also known as secondary traumatic stress (STS), is the emotional and physical exhaustion that hampers one's capacity to empathize and show compassion towards others. It is frequently referred to as the adverse toll of caring, resulting in diminished feelings of empathy and exhaustion over time. 

Frustrated and burnt out healthcare provider sitting at desk.

What causes compassion fatigue?

Compassion fatigue is caused by the overwhelming sensations of compassion and empathy one may feel when caring for individuals suffering from acute or chronic illness, disasters, or other traumatic events. It may also occur in response to vicarious trauma, which is the emotional toll experienced by a caregiver when caring for an individual who has experienced trauma. Compassion fatigue is particularly prevalent within the healthcare industry; however, individuals in various other professions may also carry the risk of experiencing compassion fatigue. The various professions include healthcare workers, child protection workers, veterinarians, clergy, teachers, social workers, palliative care workers, journalists, police officers, firefighters, paramedics, animal welfare workers, public librarians, and student affairs professionals. Additionally, non-professionals, including family members and informal caregivers of those with chronic illnesses, may also encounter compassion fatigue.

Several factors contribute to an individual's susceptibility for compassion fatigue, including insufficient support systems and an inclination to avoid one’s emotions. Organizational flaws within high-risk fields, such as healthcare, contribute to compassion fatigue among workers. For example, a "culture of silence," where distressing events such as deaths within intensive care units are not openly discussed, has been linked to compassion fatigue. Lack of awareness regarding symptoms and inadequate training regarding the risks associated with high-stress occupations also contribute to high rates of compassion fatigue. Rates increase with prolonged exposure to individuals in need. For example, homelessness can be more prevalent in large urban areas, resulting in more urban dwellers developing compassion fatigue.

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What are the signs and symptoms of compassion fatigue?

The signs and symptoms of compassion fatigue are non-specific and can differ between individuals. Affected individuals may experience reduced endurance and energy, diminished empathic ability, feelings of helplessness or hopelessness, and emotional exhaustion. Another common symptom is decreased concentration, characterized by difficulty staying focused and maintaining attention on tasks, leading to reduced productivity and effectiveness in work or daily activities. Individuals may also experience a sense of emotional detachment or disconnection from others' suffering, accompanied by a profound feeling of powerlessness or a loss of purpose in helping others. This can result in a decline in personal fulfillment and dissatisfaction with their work or caregiving role.

Individuals with compassion fatigue may become more irritable and exhibit mood swings or heightened emotional responses to minor stressors. Withdrawal from social interactions or activities that were once enjoyable are other common symptoms. This withdrawal can stem from a sense of emotional exhaustion or a desire to avoid further emotional strain. Individuals with compassion fatigue may struggle to cope with the physical and emotional demands of their work or caregiving responsibilities, resulting in more frequent absences or decreased productivity. Lastly, physical symptoms of compassion fatigue include headaches, chronic fatigue, muscle tension, or gastrointestinal problems. 

How is compassion fatigue diagnosed?

Diagnosing compassion fatigue typically involves a comprehensive evaluation by a healthcare or mental health professional, which may involve assessing the individual's symptoms, experiences, and their impact on the individual’s overall wellbeing. 

Professionals working in high stress fields may be asked to complete self-assessment tools or questionnaires, such as the Professional Quality of Life (ProQOL) Scale, which are specifically designed to assess compassion fatigue. These tools provide insights into the individual's emotional wellbeing, level of burnout, and compassion fatigue. A mental health professional may also conduct a psychological evaluation, which involves in-depth discussions and assessments of the individual's emotional state, coping mechanisms, and overall mental wellbeing. This evaluation helps to identify any underlying mental health conditions or contributing factors to the symptoms. Open and honest discussions between the healthcare professional and the individual are crucial. This allows for a comprehensive understanding of the individual's unique circumstances, challenges, and concerns related to their work or caregiving experiences.

It's important to note that the diagnosis of compassion fatigue does not involve traditional medical tests like lab work, imaging, or biopsies. Instead, the focus is on understanding the individual's symptoms, experiences, and their impact on overall functioning in order to provide appropriate support, interventions, and treatment.

How is compassion fatigue treated?

Treating compassion fatigue includes interventions ranging from self-care to psychoeducation. In mild cases, individuals can focus on self-care practices and increased awareness of their wellbeing, which includes setting boundaries; practicing stress management techniques (e.g., relaxation exercises or mindfulness), maintaining a healthy lifestyle with proper nutrition and exercise, and engaging in activities that promote personal rejuvenation.

Psychoeducation, such as counseling, can be beneficial as it involves learning about compassion fatigue, its symptoms, and its impact on individuals. Support can be found through professional counseling, support groups, or peer discussions. These resources provide a platform to share experiences, gain insights, and learn coping strategies from others facing similar challenges. Therapeutic interventions, including cognitive behavioral therapy (CBT) or mindfulness-based approaches, may help address negative thought patterns, develop healthy coping strategies, and enhance overall well being. Eye movement desensitization and reprocessing (EMDR) therapy might be considered in cases where post-traumatic stress disorder contributes to compassion fatigue symptoms.

In severe cases or when symptoms of depression or anxiety coexist with compassion fatigue, medication may be considered. Antidepressants or antianxiety medications (e.g., SSRIs) prescribed by a healthcare professional can help manage underlying mental health symptoms. 

What are the most important facts to know about compassion fatigue?

Compassion fatigue is a term that refers to the emotional and physical exhaustion that results from caring for others. Also known as secondary traumatic stress, it hampers one’s ability to empathize and show compassion towards others, and it is especially prevalent amongst medical professionals. Compassion fatigue arises from direct involvement with victims of disasters, vicarious trauma, or illness. Symptoms of compassion fatigue include decreased concentration, irritability, feelings of being emotionally overwhelmed, and withdrawal. Diagnosing compassion fatigue typically involves a comprehensive evaluation by a healthcare or mental health professional and treatment can involve a multifactorial approach.

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Related links

Post-traumatic stress disorder
Trauma- and stress-related disorders: Pathology review

Resources for research and reference

Clay R. Are you experiencing compassion fatigue? Apa.org. Published June 11, 2020. Available from: https://www.apa.org/topics/covid-19/compassion-fatigue

Cocker F, Joss N. Compassion fatigue among healthcare, emergency and community service workers: a systematic review. Int J Environ Res Public Health. 2016;13(6):618. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4924075/

Compassion Fatigue. In: American Bar Association. Available from: http://www.americanbar.org/groups/lawyer_assistance/resources/compassion_fatigue.html

Lombardo B, Eyre C. Compassion fatigue: a nurse’s primer. Online J Issues Nurs. 2011;16(1):3. doi:10.3912/OJIN.Vol16No01Man03

Valent P. Diagnosis and treatment of helper stresses, traumas, and illnesses. In: Figley CR, editor. Treating Compassion Fatigue. Brunner-Routledge; 2002. pp. 17–37.