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Compassion Fatigue – The Cost of Caring


Compassion fatigue, also known as a secondary stress reaction, is a state of physical and mental exhaustion that stems from helping or wanting to help others.  It was first introduced to the health care community as a form of burnout experienced in caring professions.  However, this article aims to apply this concept and the existing model of compassion fatigue to informal caregivers.

Informal caregivers, such as family members and friends, are concerned and feel motivated to respond when they perceive that the care recipient is suffering.  In doing so, they are prone to the adverse consequences of care if they are unwilling or unable to detach and distance themselves from the suffering. Thus, the cost of caring.

The strong emotional attachments between caregivers who are family members and friends prevent the caregiver from detaching and therefore removes the essential coping mechanism for burnout and stress.   Where formal care providers may take time away from people who are suffering, family caregivers may not have this opportunity.  In addition, informal caregivers often care for long periods of time, and this constant exposure is significantly lengthened for informal caregivers. This places informal caregivers at greater risk for compassion fatigue.

It’s no surprise then that overly meticulous, perfectionist, and self-giving people are predisposed to this second-hand trauma.  Without having a sense of satisfaction in caring, feelings of fulfillment and contentment, informal caregivers are not protected from compassion fatigue.

Over my research, I’ve found that children who have been raised by Asian Parenting exhibit a higher risk of developing this fatigue, no doubt, due to the long-stemmed practice of filial piety – because not only are we caring for our elders, we’re caring for the reputation of our entire family within society. Also, some elders are hard-pressed in their own ways, so although the child wants to help – the elders may not want to receive help due to saving face and ego. Asians are also the highest group not to seek out mental care and wellness to heal and reenergize.

Luckily, if managed early, compassion fatigue has a quick recovery time.


Compassion Fatigue vs Burnout

Although the two stress reactions having overlapping traits, they are not of the same. 

Compassion fatigue has a rapid onset and is caused by exposure to traumatic situations and events where the helper cannot emotionally and physically refuel and regenerate.  

Burnout describes the physical and emotional exhaustion of work related issues and can affect any profession. 

How did I get compassion fatigue?

Being continuously exposed to suffering, loss of life, or becoming excessively preoccupied with these issues, coupled with traumatic memories and/or competing with life demands, is the recipe to self-destruct with compassion fatigue. 

Specifically, those who are continuously hearing, seeing, or witnessing tragedies, pain, and suffering while still providing care, support, and protection will have a higher risk of experiencing this mental issue.

What does compassion fatigue feel like?

The symptoms of compassionate fatigue are comparable to high chronic stress that leads to burnout, anxiety, depression, fatigue, apathy, loss of enjoyment in life, and difficulty with concentration. These symptoms can lead to chronic physical ailments and compulsive behaviours, among other problems. Hopelessness and powerlessness are some of the most significant feelings caregivers will often experience.


Here is a list of signs to look for:

·        Feeling overwhelmed, hopeless, helpless or powerless when hearing of others’ suffering

·        Feelings of anger, irritability, sadness and anxiety

·        Feeling detached, exhausted, or numb from our surroundings or from our physical or emotional experience

·        Physical symptoms such as nausea, dizziness, headaches

·        Reduced empathy


·        Feeling hypersensitive or insensitive to stories we hear

·        Limited tolerance for stress

·        Self-isolation and withdrawal

·        Relationship conflict

·        Feeling less efficient or productive at work

·        Reduced pleasure in activities we used to enjoy


·        Difficulty sleeping and nightmares

·        Difficulty concentrating, focusing or making decisions

·        Self-medicating and increase in substance use

What are the stages of compassionate fatigue?

Stage one: 
Enthusiasm.  You are willing and excited to help and are committed to make a difference.

Stage two: 
Stagnation.  You’ll notice that you’ll sometimes avoid contact with the care recipient.  You may cut corners, lose ability to concentrate, and become crabby.

Stage three: 
Frustration.  You’ll exhibit symptoms like irritability and withdrawal.

Stage four: 
Apathy.  Your irritability slips into insolence.  You may notice yourself feeling hopeless and even anger.


How to recover from compassion fatigue?


By becoming aware of where you are within the 4 stages you’re already beginning to heal, being aware of your state of mind prevents you from no longer ignore your exhaustion. 

Self love and care

Consistent self-care and love are at the root of alleviating the impact of compassion fatigue.  This commitment ensures that caregivers fill their own emotional cups while nourishing others. This is utterly important as you cannot give water from an empty well. Many caregivers tend to feel guilty for putting themselves first, and thus, self-care is rarely ever acknowledged. 

  • Honor your emotional needs
  • Surround yourself with a support network that you can talk to
  • Take time for yourself every day
  • Journaling or mediation
  • Seek resources for counselling and/or training.

Set Emotional Boundaries

Caring for those who are healing from trauma requires empathy and emotional involvement on the caregiver’s part. These qualities make such support so powerful, but they can also pull us off center if we become over-involved. 


It is necessary to establish boundaries between ourselves and those we are helping to not carry their pain and experiences as our own. This can be difficult to do, particularly when much time is spent together or when a deep relationship exists between family members. 

The hurdle is to stay compassionately connected while still identifying that each of us is a different and separate person.  In doing so, this will also allow you to maintain balance in your life and will anchor and prevent you from becoming worn out.

Support yourself with kind words, loving thoughts, and empowering acts.