A Season in Hell: Recognizing Compassion Fatigue


Compassion Fatigue

Do you find yourself helping other people in difficult situations, such as taking care of a family member, or  someone recovering from an accident? As you might know, helping others can, over time, cause feelings of helplessness, anxiety, anger and irritability. This response is known as “compassion fatigue” and it is quite common among family caregivers, social workers, psychologists and counselors.

Without treatment, compassion fatigue can lead to exhaustion and long-term mental health problems (e.g., depression).  If you, or someone you know, works with victims of traumatic events, then you can take steps to minimize the incidence of these effects.

What is compassion fatigue?

This is a term that is used to describe emotional responses to  stress from chronic care giving. It is regarded as being in the same family of “secondary post-traumatic stress” that therapists and social workers experience when they assist trauma patients. Symptoms eventually interfere with a person’s personal life and work.

Who is at risk for compassion fatigue?

Caregivers and Individuals that work directly with trauma victims are essentially vulnerable. Clinicians and caretakers are at a higher risk if they carry unresolved trauma in their own lives and/or if they are currently going through a traumatic event themselves.

Compassion fatigue does not happen to everyone who helps others. At the same time, it does not mean that you are weak or frail if you do develop this condition. Stress or anxiety are not necessarily signs of compassion fatigue, and can indicate that you are simply tired and need some rest.

Compassion fatigue does not happen overnight. It develops gradually over the course of months or years.

Signs of compassion fatigue

  • Being overly strict with yourself. Some examples include, “I will never leave her alone” or “I ought to always make time for John”. Being inflexible with yourself puts you at a greater risk for compassion fatigue.  Taking care of a loved in need is not easy, and it takes courage and  tremendous compassion to care for someone  every day, but if your health is starting to suffer, then you are at risk of burning out.
  • Depression. You feel sad regularly. You can’t remember the last time you had a happy moment. In fact, you start to think that it is wrong to feel happy when the person you are trying to help is so sick.
  • Everyone assumes you’ll step forward.  You feel that the burden of responsibility to care for a friend, patient, or relative (parent, sister) always rests on your shoulders. Family and friends might even rationalize why they don’t help and say, “That’s your thing”, or  “You have more time anyway”.
  • Poor self-care. If you notice that you are gaining weight, and friends are becoming concerned about your appearance, then you know that you are not focusing on yourself.
  • Anger. Feeling anger and irritability towards others. Becoming argumentative with friends or relatives. Feeling that “life is not fair”.
  • Frequent mood swings. Feeling well one moment and then suddenly feeling depressed or anxious. Frequent crying spells.
  • Flashbacks. “Re-living” past traumatic events when you hear about  experiences from trauma victims.
  • Difficulty concentrating.   Making frequent mistakes at work, or becoming increasingly forgetful, such as forgetting to lock your car.
  • Poor self-esteem. Feeling as if you are not doing enough. Feeling powerless to relieve a loved one’s suffering.
  • Isolation. Becoming distant from family and friends. Avoiding talking about your emotions.

Other symptoms….

  • Poor sleep, decreased appetite and a lack of interest in sex. Also having frequent  nightmares related to the traumatic events.
  • Experiencing physical problems, such as migraines, frequent flu like symptoms, dizziness, migraines and cramps.

Coping and finding help

It is important to recognize the early signs of compassion fatigue before it impairs your work and your life. First, get help if you feel overwhelmed by your work stressors. Remember that there is nothing shameful with finding help, even if you are a clinician.

Some tips that can help you:

  • Avoid comparisons to other people. Everyone reacts to stress differently. You might find someone who seems to handle the same problems without as much fatigue, and yet they have a panic attack when they see a spider.
  • Talk to someone. Reach out to someone you trust, such as a close friend, a supervisor or a colleague for a reality check. You can keep it brief at first, and gradually spend more time expressing yourself. Remember, talking can help you feel more empowered and less alone. You might be surprised to find that some people you’d never suspect are in the same boat.
  • Avoid watching the news as much as you can.  The news tends to be depressing, and what you need is some down time to recover. There will be plenty of time to watch the news when you feel better.
  • Work on your boundaries a bit. Say ‘no’ a bit more often when you know you should. Do this gradually, such as saying ‘no, thank you’ a few more times  a day, but don’t over do it. Otherwise, people might accuse you of being  rude since they are not used to hearing this from you.
  • Avoid substance abuse or non-prescription drugs to help you manage stress. Don’t rationalize. Just because you don’t usually drink doesn’t mean that it is fine to drink now.
  • Stay hydrated. You might not notice, but your body can more easily become dehydrated under stress. Take care of yourself, drink plenty of water and eat balanced meals.
  •  Exercise. Your body will appreciate it. The more you keep your body active, the more blood and oxygen flow to the brain, and the better you will feel.
  • Deep breathing. Set five minutes each day to practice on your breathing. Start with breathing slowly and exhaling to a count of five each time. Deep breathing sends a message to your brain that you are safe. Thus, the body relaxes.
  • Journal your feelings. If you have recommended this to others, then use this as a good opportunity to become more acquainted with journaling yourself. It can help to put things in perspective and reduce rumination (excessive thinking).
  • Give yourself room to be flexible and make errors. You are only human.  Be patient with yourself.  There is no such thing as failure as long as you learn from your mistakes. If you make an error, see it as learning experience and move on.
  • Join a support group. Sometimes a nudge from someone who knows how it feels can be very helpful.  If you are not happy with the group you are in, consider another one. Sometimes it takes five tries before you find the right group for you.
  • Recognition and taking breaks.  Give yourself credit, and take breaks as much as  you need to relieve stress. Even if you think you don’t have enough time, make this a top priority! Start small and take it from there. You want to be healthy so you can continue to be there for yourself and for others.

Helping others, or helping friends or relatives, can be rewarding but it can also be overwhelming. If you feel that these tips are not enough, you might want to consider speaking to a professional to better help you.

Remember, not matter what, no matter how large the wave, always be that rock.



Beaton, R. D. and Murphy, S. A. “Working with people in crisis: Research implications”. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized.  NY: Brunner/Mazel, 1995; 51-81.

Kinnick, Katherine N.; Krugman, Dean M.; and Cameron, Glen T. “Compassion fatigue: Communication and burnout toward social problems.” Journalism & Mass Communication Quarterly, 1996; 73:3, 687-707.

Author: Alejandro Adrian LeMon, Ph.D., LMHC

A little about me... I'm a licensed mental health counselor in the state of Florida and the founder of Psychology One. I am also a former college instructor of sociology and I have worked at several not-for-profit agencies & EAP organizations. I currently live with my fiancee and our three cats.

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  1. Been there, my son is BP and in denial. Been a horrendous 3 years, truly a rollercoaster. I just can’t do this when he is rebellious. I know I can’t help him when he wont help himself. I have found that there is a constant sadness just knowing that this will never go away and he may never get stable for any length of time. It is exhausting winding yourself up to be the competent compassionate caregiver all the time. Gave myself permission to tell him to go and let me know when he wants treatment. It is then I will be part of his life again. Until then we will keep our distance. It is hard to come to terms with the fact that it does not mean you do not love your child when you let them go to make their own choices even though you know they are really really bad choices. It just hurts to know what is coming, what it means for you and your child and how much mess there will be to clean up afterward. BTW my beautiful son whom we adopted from Romania 20 years ago is named after my hispanic father “Alejandro”. 🙂 We call him “Al”. His is a treasure

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  2. Deby, thank you for sharing your story! I’m sorry to hear about your son. On a positive note, I know people who have BP and have done wonderful things later in their life. They went through the same stage before they got better. It takes tremendous patience and courage to help someone with BP and I think you’ve done all you can. I hope he gets better. Thank you for telling me about “Alejandro” or “Al”. Romania? I’ve heard it is very beautiful! Have a great weekend

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