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General WellnessRelationships and Support

Compassion Fatigue

by Ariela Paulsen February 3, 2022March 24, 2022
written by Ariela Paulsen
Compassion Fatigue

This morning, my breakfast was interrupted by a family member looking to vent to me about something that had kept him up all night.  It was a topic I’d heard about on repeat for weeks.  As I looked down at my half-eaten oatmeal, I found I didn’t have any patience or empathy for him. What I found, rather, was annoyance and an overwhelming desire to run away.

I fought down the urge to smirk and make a snarky comment, reflecting instead on why I felt this way.  It was a familiar feeling, one I’m not proud of, but that always comes from compassion fatigue.  

With this realization, I politely interrupted and said, “Sorry to cut you off, but I just can’t hear this right now.  It is stressing me out and I need to eat my breakfast.”  Once I had self-regulated a bit (both my emotions and my blood sugar levels), I sought him out to explain that I actually don’t want to hear about that topic anymore.  I understand that he is still processing it, and other people may be able to help him with that, but unless there is something tangible I can do to help the problem, all hearing about it is doing for me is chipping away at my mental health.  

Compassion fatigue is a very common phenomenon.  It is when your emotional capacity to care and feel empathy runs out.  The result?  You find yourself avoiding situations that require these emotions.  If confronted with them, your response may be cynical, even angry.  It is our mind’s way of putting up walls so that we don’t crumble from the weight of other people’s problems.  As a Highly Sensitive Person in a helping profession, I experience this fairly often.  Yet as a person with chronic illness, I am also frequently on the receiving end.

When you have a bad cold or flu, people have empathy and want to help take care of you.  They put in extra energy to say nice things and bring you soup and blankets.  When you recover, things go back to normal, and they recover any emotional energy lost.  When you have a chronic illness, it’s not so simple.  The first few days of a flare up, people send you compassion and offer to help.  After a few days the help dries up.  If you stay sick longer than a week or two, people start to avoid you.  Even longer, and they may even become hostile.  I always found this response flabbergasting — a few weeks ago you were extra kind and told me how sorry you were that I feel sick.  I still feel just as bad, plus I have had to suffer through not living my life for weeks, and now somehow you’re angry with me?  It feels infuriating, isolating, and – frankly – traumatic to see all of my support people turn on me.

But learning about compassion fatigue has helped me understand.  They are not turning on me.  They are not bad people.  They are simply fatigued from caring too much, so their brain has flipped a switch.  Added to this, of course, are our society’s views on chronic illness, that people who don’t simply get better must somehow be at fault; that if we were really trying hard enough, our condition would improve.  It’s hard for caregivers to not absorb this messaging in some way, even if they are generally great advocates and believers in our situation.

If you have experienced compassion fatigue — from either direction — here are some tips that have helped me understand and productively move forward:

the more you care, the more it hurts

The conclusion I often jump to when someone stops showing me compassion is that they simply don’t care about me enough to stick around when I’m in rough shape.  It is actually the exact opposite.  The more we care about someone, the more it hurts to see them in pain.  So we hit the threshold of compassion fatigue quicker with those we love most. We may push ourselves to still show up longer when it’s someone we love, but the fatigue is there and we will eventually burn out if we don’t address it.

helplessness 

Another factor that can bring on compassion fatigue is helplessness.  If a friend is struggling but there are active things you can do to help, your emotional stamina will be buoyed by the direct impact you are able to have.  It feels so much worse when there is nothing tangible you can do.  One way to stave off compassion fatigue is to find specific ways to help or to show appreciation when people’s actions do have a positive impact.

context matters

No one’s emotional state exists in a vacuum. Compassion fatigue hits hardest when we are already worn out by strong emotions.  If you already have something challenging going on in your life, then you will be starting with a deficit and will become fatigued much faster.  This is also true for broader emotional strains.  For example, stress about climate change or politics or, say, the grief of living through a pandemic, can contribute greatly to your overall sense of heartbreak.  When seeking support, be patient with those who are already dealing with a lot.  If you are someone who feels weighed down by the world, be kind to yourself if you are unable to be as empathetic as you would like.

we all need breaks

If you find yourself or your support people becoming fatigued, remember that it is ok to take breaks!  It can be a good idea to rotate support — even to schedule it out logistically.  We see this in meal trains for new parents.  If a few people all help out at once and then burn out, the person in need will feel the sudden lack of help.  If each person chips in for short bursts and then trades off, they will get a breather and the person in need will have longer, more consistent care.  If all of your people become fatigued, or if you are worried about taxing them too much, consider hiring professionals.  Think about the support you are needing — someone to vent to, someone to cook or clean, etc.  Getting a therapist, house cleaner, or meal service could mean that your favorite people are able to show up when you need them most.

name it

The best thing you can do for compassion fatigue is to name it.  If you feel your own fatigue, tell the person that you care about them but that you notice compassion fatigue is starting to set in.  Make it clear that it’s not their fault, that you love them and will be there for them again in the future, but you need time to recharge your emotional battery before you can be a source of support and empathy again.  If you have already said or done something hurtful due to burnout, apologize for it and make sure they know that it was not how you really feel, but just a product of your brain’s defense mechanisms.  Set a time to check in later, but then make your boundaries clear for the time being.  You may be able to still hang out, but just be clear that only lighthearted fun is ok for now.

If you notice signs of compassion fatigue in your support people, let them know!  Tell them you can see they are wearing thin and that it’s ok if they need a break.  They might feel guilty asking for a breather, but the longer they hold out, the worse it will get for your relationship. 


Compassion fatigue is natural, reversible, and hurts on both sides.  So whichever side you find yourself on, try to be kind to yourself and each other.  Remember that it isn’t anyone’s fault and that it doesn’t mean a lack of love or of wanting to help.  Take time for yourself, encourage those you love to do the same, and remember that this too shall pass ♡

For more information and resources, check out the Compassion Fatigue Awareness Project here.

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Ariela Paulsen

Ari struggled with a wide array of health problems for decades before being diagnosed with EDS/POTS/MCAS/etc at age 25. She began writing as a way to heal while spreading information and helping others through their own journeys. She loves being part of the Mighty Well team, sharing the stories and strengths of spoonies everywhere!

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