Specialties

Burnout & Compassion Fatigue

What is burnout?

If you're feeling stressed out at work, you're not alone. 83% of US workers suffer from some kind of work-related stress. As more people work from home, work-related stress may increase as the boundaries between work and home life blur. If this stress becomes overwhelming, it can cause burnout.

Burnout is a type of work-related stress. The World Health Organization (WHO) lists burnout as an "occupational phenomenon" in the 11th revision of its International Classification of Diseases (ICD-11). Though it is not considered a medical condition, the WHO notes that it can influence your health and cause you to reach out to health services.

"Burnout describes the thoughts and feelings associated with feeling overwhelmed and fatigued by life circumstances," says Rachel O'Neill, Ph.D., Director of Clinical Effectiveness at Talkspace. The Maslach Burnout Inventory (MBI), published in 1981 by psychology professor Christina Maslach and Susan E. Jackson, is still used today by health professionals as the main way to assess burnout, and it is the basis for the WHO's definition of the condition.

If those two definitions sound like they're describing different things, they are. The WHO's applies only to work: it says explicitly that burnout "refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life." The reasoning behind that boundary is sound as far as it goes — keeping burnout tied to the workplace keeps the focus on working conditions that can actually be changed, rather than treating exhaustion as a personal failing.

In practice, though, I find O'Neill's broader framing closer to what people actually walk in with. The same pattern the MBI measures — exhaustion, growing cynicism, a sense that you're no longer any good at something you used to do well — shows up in people whose demands aren't a job at all. Researchers now study it in parents and in family caregivers, and those are exactly the people the compassion fatigue section below is about. Someone caring full-time for a parent with dementia is not covered by the ICD-11 definition, and would still recognize every symptom on this page. If your exhaustion comes from unpaid, unrelenting demands rather than an employer, it counts here.

Burnout symptoms

While burnout includes many of the same symptoms as stress, three specific feelings set it apart:

  • Feeling tired or exhausted
  • A lack of enthusiasm and increased negativity toward your job
  • Decreased ability to perform your job

Often, burnout results in depressive symptoms such as sadness or a lack of hope. But it can also contribute to a wide range of negative emotions and even physical symptoms, such as:

  • Frustration or anger
  • Irritability or annoyance
  • Anxiety, agitation, or restlessness
  • Physical signs of stress, such as headaches, stomach issues, body pains, or fatigue

Causes of work burnout

A 2018 Gallup study of nearly 7,500 US workers showed that employees suffering from burnout are 63% more likely to take a sick day, have 13% lower confidence in their performance, and are 2.6 times as likely to be actively seeking a different job. The top reasons for burnout included:

  • Unfair treatment at work
  • Unmanageable workload
  • Lack of clarity in one's role
  • Not enough communication or support from a manager
  • Unrealistic time pressure

A selection of studies from the American Institute of Stress found that the biggest sources of stress at work were ineffective communication (80%), too much workload (39%), demands from a manager or supervisor (35%), and unclear expectations (31%). — The American Institute of Stress

What is compassion fatigue?

Compassion fatigue is a broadly defined concept that can include emotional, physical, and spiritual distress in those providing care to another. It is associated with caregiving where people or animals are experiencing significant emotional or physical pain and suffering.

The American Psychological Association describes compassion fatigue as a construct with two dimensions: burnout — the gradual emotional exhaustion described above — and secondary traumatic stress, the more acute distress of absorbing someone else's trauma. Burnout isn't a milder problem that sits alongside compassion fatigue, then. It's one of the two components compassion fatigue is built from, which is part of why the two are so often experienced together.

Causes of compassion fatigue

Feeling empathy for those you care for may seem like a given — it may even be the reason you do what you do — but this empathy can sometimes go too far, leading you to feel the symptoms of compassion fatigue as you take on another person's trauma.

That second dimension — secondary traumatic stress, also called vicarious trauma — is a caregiver experiencing trauma after witnessing another's physical, emotional, or spiritual pain. Concept pioneers McCann and Pearlman define it as "a process through which the caregiving individual's own internal experience becomes transformed through engagement with the client's trauma" (1990).

According to the Compassion Fatigue Awareness Project, anywhere from 25–50% of healthcare workers experience symptoms of compassion fatigue. Everyone from long-term care workers to family caregivers to emergency room nurses to police officers may find themselves taking on others' trauma.

Symptoms of compassion fatigue

  • Feelings of failure, guilt, self-doubt, sadness, and powerlessness
  • Loss of sleep
  • Reduced sense of efficacy on the job
  • Difficulty concentrating
  • Feeling overwhelmed by obligations
  • Apathy and emotional numbness
  • Secretive addictions or self-medicating
  • Isolation and withdrawal
  • Exhaustion
  • Intrusion symptoms in thoughts, dreams, or nightmares
  • Bottled-up emotions
  • Pessimism

— Compassion Fatigue Awareness Project

References

  • American Psychological Association. Addressing compassion fatigue. Read it here
  • Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behaviour, 2(2), 99–113.
  • McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3(1), 131–149.
  • Occupational Safety and Health Administration. Workplace stress. U.S. Department of Labor. Read it here
  • Wigert, B., & Agrawal, S. (2018, July 12). Employee burnout, part 1: The 5 main causes. Gallup. Read it here
  • World Health Organization. (2019, May 28). Burn-out an "occupational phenomenon": International Classification of Diseases. Read it here

Ready when you are

Schedule a consultation and let's start this journey together.

Request Appointment