For decades, nurses, first responders, social workers and other clinicians in helping professions who are regularly exposed to traumatic events and other people’s pain have reported reaching a point of debilitating physical and emotional exhaustion. Known as compassion fatigue, this secondary traumatic stress disorder can make it difficult to empathize or feel compassion for others and can profoundly diminish the quality of care a person is able to provide.

With an aging population and more family and friends stepping in as caregivers, it’s become clear that compassion fatigue isn’t unique to health professionals. Unpaid family caregivers can also experience cynicism, numbness, apathy and other difficult symptoms of compassion fatigue.

Different from burnout—although the two can co-exist—attending to a loved one’s pain and suffering without opportunities to recharge can impact a caregiver’s ability to empathize with others. This can also increase the risk for other mental health conditions and in some cases even lead to uncharacteristic abusive behaviour like hitting or neglecting the person in their care. By recognizing the early warning signs and taking the necessary steps to remain a healthy and empathetic carer, compassion fatigue is both preventable and treatable.

Signs and Symptoms of Compassion Fatigue

Compassion fatigue may develop over time or can come on very suddenly, but some of the common signs include:

• Feeling detached, numb and emotionally disconnected
• Increased anxiety, sadness, anger, guilt and irritability
• Chronic physical and emotional exhaustion
• Doubting caregiving abilities or feeling resentful
• Sleep difficulties and disturbances like nightmares
• Weight loss
• Isolation, withdrawal and relationship conflict
• Loss of interest in the activities once enjoyed
• Difficulty concentrating or making care-related decisions
• Physical symptoms like headaches, stomach pain, nausea, heart palpitations and dizziness
• Substance abuse to self-medicate

Your risk of compassion fatigue does increase if your loved one’s illness is chronic or severe, or if you lack a support network or the resources for professional care. Many of the signs of compassion fatigue overlap with depression, anxiety and other mental health disorders, so always speak to a health professional for an accurate diagnosis.

Prevention and Treatment of Compassion Fatigue

It’s very common for caregivers to focus on helping others before themselves and to feel guilty when they take steps to address their own needs. However, ignoring these symptoms can cause depression, panic attacks and be a safety risk for the person in your care. If you are noticing any concerning signs of compassion fatigue, speak to your health care professional immediately. Here are some other strategies to help you prevent or heal from this type of exhaustion:

• Be realistic. Caregivers often struggle to acknowledge their limits. It is important to recognize that at times we all fail at certain tasks, let people down, make mistakes and lose our temper. Treat yourself with the same kindness and understanding you would offer a loved one in a similar situation. Focus on what you can change, set boundaries and try to recognize all the good you are doing for the person in your care.
• Prioritize you. Often the most effective remedy for this type of fatigue is also the hardest: taking care of your own needs. Are you getting enough sleep, drinking water, moving your body, eating fruit, vegetables and protein-rich food and getting regular health check-ups? Find ways to connect with other friends and family and get involved in stress-reducing activities like walking, meditation, journaling or a favourite hobby.
• Reach out. Find a caregiver support group either in the community or online. It can be helpful to see yourself as a part of a larger group of people who give their time and energy to help others and experience many of the same challenges. Mental health clinicians can also help you find healthy coping mechanisms and challenge negative thoughts.
• Accept help. It may surprise you how much support you can get from friends and family by just asking. Respite care provided by professional caregivers can also give you a chance to rest and return to caregiving with more energy and empathy. If you have the means, you may also consider outsourcing some of the tasks not directly related to your caregiving. This could mean trying a meal delivery service, hiring someone to help with cleaning or paying for snow removal or yard maintenance.

VHA Home HealthCare’s Enterprise Health Solutions team may help you find more balance in your care. Call (416) 489-2500 ext. 4649 or by email at ehs@vha.ca for more information.