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Illustrations by Chelsea Charles

Is compassion fatigue taking a toll on your health?

Burnout is a risk for anyone with a big heart. Here’s how to spot the signs and prioritize your own needs

Tamara worked as an ER nurse for five years at a Scarborough hospital before she started to think about changing fields. At first dealing with the traumas, the frequent flyers and the difficult family members didn’t faze her. But by January 2019, she found herself dreading work and constantly feeling sick. Between juggling the care of her patients at work and of her own ailing mother at home, Tamara hit a wall.

“I wanted to give up nursing,” she says. “My work felt futile. I felt like I couldn’t even care for my own family and I had given up on the health-care system. I found myself walking away from patients’ families because I could no longer tolerate their questions. Patients need you to be strong to take care of them, and I wasn’t feeling strong.”

Tamara’s experience is not unique. A similar experience has been shared by so many that there is a term for it: compassion fatigue. The phenomenon is also known as burnout, vicarious trauma or secondary trauma.

“Compassion fatigue is the physical and mental exhaustion that helping professionals can experience over the course of their career,” says Jamie Tyrell, a Compassion Fatigue Educator, certified by TEND Academy. “It’s important to know that you only get compassion fatigue because you care deeply about others.”

While compassion fatigue is a distinctly different condition from post-traumatic stress disorder (PTSD), there are some symptoms that overlap: emotional numbness, headaches, insomnia, fatigue, irritability and more. Perhaps the most dangerous symptom of compassion fatigue is also the most telling—denial.

“Being exposed to the same type of distressing stories repeatedly or being exposed to one individual’s constant crises can be deeply exhausting,” says Françoise Mathieu, CEO of TEND Academy. “People can react by shutting down in avoidance. They may also go to the other extreme of overexposing themselves to more trauma—such as by binging on the news or obsessively watching crime dramas.”

Illustration of a girl getting her hair done and looking in a cracked mirror

Often, we associate compassion fatigue with front-line workers, but it would be a mistake to assume that it only affects trauma nurses, social workers or police officers. Anyone with a deeply caring personality who is regularly exposed to the needs of others can experience it. That was the case for Zee, who worked as a hairstylist at a busy downtown Toronto hair salon.

“I would know things before other people would, like when a woman told me she was leaving her husband but her husband still didn’t know,” says Zee. “People would tell me their whole life stories. You went through everything they were going through. I had occasions where I would call my clients at home, because I was so concerned about them.”

Eventually the effects crept into her home life. “Come Saturday night, I didn’t talk at home. I wanted to eat, have a glass of wine and sit in front of the television. I didn’t have anything left in me for conversation with my family.”

According to Mathieu, this is a common experience for natural-born caregivers. “If you’ve taken on the role of first responder to others’ problems, you’re at risk for eventual exhaustion. One example I’ve seen is college students who have become so enmeshed in a roommate’s crisis that they’ve lost their own focus.”

What does the road to recovery look like? The details will vary from person to person, but the shift always begins with self-awareness. Understanding what compassion fatigue is and acknowledging it as a reality in one’s life can be a catalyst for positive change.

The ultimate antidote to compassion fatigue lies not in becoming less caring of others, but in becoming more caring for ourselves. Tyrell recommends starting with a self-care plan. This individualized plan can include things like stretching, exercise, mindful body scans, hydration, self-reflection, social connection and a work-to-home transition.

illustration of a person with a bag waving to someone in the distance

A self-care plan should also include setting limits on our compassion. Boundary setting may not go well initially, but it is an essential aspect of recovery.

“To be needed is powerful,” remarks Mathieu. This is why recovery may require a shift in identity, especially if one’s self-esteem is bound up with being the go-to problem solver or emotional support for others. By focusing on how refuelling is an essential step in helping others, this mental hurdle can be gradually overcome.

In order to rise from the abyss of compassion fatigue, sufferers must identify what’s happening and make meaningful strides to set boundaries and reconnect with others. That is exactly what Tamara did, when the combination of nursing and caregiving for her mother finally took its toll. After some self-reflection, she had a candid discussion with her boss, transferred departments and then set about making choices to regain her former sense of well-being and joy. The first one? A plane ticket to reconnect with her best friend.

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