Had Enough? You Might Be Suffering From Compassion Fatigue

Posted May 1, 2020 by Champlain Valley Physicians Hospital

I. Can't. Even.

If you find yourself muttering these words more and more often as the COVID-19 pandemic wears on, you might be suffering from “compassion fatigue.” Coined three decades ago to describe the physiological toll experienced by nurses, doctors, social workers and other professional caregivers, compassion fatigue has found its way to the greater community as we mark two months living in a state of emergency in New York and Vermont. Aron Steward, PhD, chief of psychology at UVM Health Network's Champlain Valley Physicians Hospital, says no one is immune during this uncertain time when our days are dominated by ceaseless worry about the health and safety of our loved ones, the endless needs of our favorite nonprofits and local businesses, and scary, heart-wrenching news on a 24/7 cycle.

“When people say compassion fatigue, what they really mean, in my experience, is empathy fatigue. It really is a biological and physiological response where you are so exhausted – physically, emotionally, psychologically – that you can no longer have the personal reserve to feel for other people,” she says. “You just feel done.”

Here, she offers some strategies for keeping compassion fatigue at bay.

Why are we at risk for this now?

Right now, we're being exposed to a large volume of news and stories about hardship, pain and sadness. Our brains are built to process all of that information and find solutions, and once we can find solutions to pain and hardship, we start to feel less fatigued. The hard part about COVID-19 is that for a long time now -- for a lasting and longitudinal time -- there haven't been easy solutions.

Who does this happen to?

This can happen to anyone, whether you're a health care worker, a parent with children you are now homeschooling while working remotely, or an adult child with at-risk elderly parents. When you have less personal energy and increased personal fatigue, and then you're required to exert more energy, you're at risk for compassion fatigue. We're all dealing with this right now, so we want to be aware of the symptoms.

What are the physical symptoms?

They're different for everybody, but symptoms are a signal your body produces to alert you when it's not well. Some people get body feelings of fatigue, where you feel like you're carrying around concrete blocks on your feet. Some people get tension and muscle pain. There are stomach symptoms, digestion symptoms, headaches, or chest symptoms (rapid heartbeat, pain, pressure). All of those things can be far more serious things, but they can also be symptoms of anxiety, worry, sadness and compassion fatigue. They can also be symptoms of COVID-19, and we have seen people really believe that they have COVID-19 because of some of these symptoms.

What are the emotional symptoms?

Sometimes, when this is happening to us, it's hard to know that what we are experiencing are normal symptoms of being overtired and having nothing left to give. Feeling exhausted and mentally depleted can make us irritable, restless, sad or tearful. We may have concerns with our, memory, difficulty focusing and concentrating, and we may overuse maladaptive coping strategies like drinking or overeating.

How can we prevent compassion fatigue?

The key is to check in with yourself consistently – and make sure you're being honest and nonjudgmental. Remove all the “shoulds.” For some of us, taking care of other people is replenishing, but we have to evaluate when it is rejuvenating and when it is taxing. Have a conversation with yourself: What do I need right now? What can I give myself? How am I feeling? What's bothering me? What can I do about it? All of those questions are check-ins. You might find that spending extra time with your children and structuring their activities even more and being a super mom or being a super dad is exactly what you need in that moment. You also might find that in that particular moment, what you need is to dial back your giving because you don't have enough reserves. In order to care for ourselves, we have to be open to whatever the message is at any point in time and respond as we would if we were caring for another person.

To prevent and respond to compassion fatigue, we want to think about increasing our personal reserves and decreasing requirements of what we have to do with our energy. Those are the two things that we can always change. Sometimes these changes need to be made on a daily basis, sometimes even an hourly basis, and during COVID-19, sometimes even on a moment-to-moment basis.

What can I do to increase my personal reserves?

• The first thing is to give yourself permission to take care of yourself, to increase your joy. When I talk to somebody who has a lot of compassion fatigue, they often will cite time as being the obstacle, "I don't have time." But underneath time is usually something deeper, like they value other people's wellness more than their own, or they don't feel like they deserve it.
• We also have to accept care from other people.
• We have to increase our boundaries.
• And we have to increase work on our body, and by that I mean movement, meditation, mindfulness, exercise and wellness.

How can I decrease demands on my energy?

Increasing assertiveness, setting boundaries and saying no are a good start. It's also important to ask more often for help and to delegate your tasks, if you can. Sometimes increasing periods of doing nothing rather than something can be counterintuitive but very helpful. Increase the limits on exposure to toxic or draining stimuli, such as social media.  Most importantly, increase moments of putting yourself first, which we can start doing in small increments and practice more and more.

When will I be able to open up again?

When you increase your personal reserves and you decrease the requirements that you are taxed to do, you start to balance out some of that equation which causes compassion fatigue and you regain the feeling of having something to give.

This is going to be with us for the long haul, and we're going to need to lean on one another and pick each other up. In order to make it, we have to both replenish our energy while simultaneously conserving our energy. A helpful phrase that many of the people I work with find to be a good reminder is, this is an endurance race, not a sprint. We have to stay in this together by strengthening the connection to ourselves and being honest and authentic about who we are and what we need. That is the antidote to compassion fatigue and therefore the interim vaccine to COVID-19.