The Hidden Cost of Caring: Recognising Compassion Fatigue and Restoring Balance
"The Hidden Cost of Caring: Recognising Compassion Fatigue and Restoring Balance" — Sally MacDonald
Caring for others is one of the most meaningful things we do.
It’s also one of the most draining — especially when you’re holding space for people in distress, navigating complex needs, or supporting others through illness, disability, ageing, trauma, or significant life challenges.
Whether you work in healthcare, policing, social care, mental health, education, emergency services, local authorities, or any public-sector role — or whether you’re caring for family members at home — there’s a hidden cost that often goes unspoken:
Compassion fatigue.
This blog explores what compassion fatigue is, how it differs from burnout, why it’s so common, and evidence-based ways to start restoring balance, energy, and compassion — for yourself and for those you support.
What is Compassion Fatigue?
Psychologist Charles Figley describes compassion fatigue as “the cost of caring for others in emotional pain.”
Today, the definition is understood more broadly.
Compassion fatigue is the emotional, physical, and cognitive exhaustion that develops from supporting others who have high needs, ongoing difficulties, or suffering — whether due to distress, illness, disability, trauma, ageing, or chronic conditions.
It is characterised by:
Emotional depletion
Reduced capacity to empathise or respond patiently
Feeling numb, detached, or “shut down”
A sense of having nothing left to give
Compassion fatigue can involve elements of burnout (ongoing stress, overwhelm, workload) and secondary traumatic stress (exposure to others’ trauma), but it is not the same as either.
Instead, it is the erosion of your ability to care that occurs when emotional labour continues without enough recovery, support, or replenishment.
And crucially:
Compassion fatigue is not a personal flaw or failure — it is a natural survival response in a system that has been caring beyond its capacity.
How Compassion Fatigue Shows Up
Compassion fatigue can build slowly, or it can intensify after a particularly challenging situation.
Here are some common signs:
Emotional Signs of Compassion Fatigue
Feeling overwhelmed or mentally exhausted
Irritability, frustration, or anger
Resentment — towards work, systems, responsibility, or even the person you’re caring for (often followed by guilt)
Emotional numbness or detachment
Feeling less patient, compassionate, or empathetic
Guilt or shame about “not being yourself”
Physical Signs of Compassion Fatigue
Chronic tiredness or low energy
Headaches or migraines
Muscle tension or pain
Digestive issues
More frequent illnesses or slower recovery
Disturbed sleep or vivid dreams
Appetite or weight changes
A general sense of physical heaviness or depletion
Cognitive and Behavioural Signs of Compassion Fatigue
Difficulty concentrating or making decisions
Forgetfulness or increased mistakes
Avoiding tasks or people
Feeling indifferent or cynical
Relying on coping behaviours — scrolling, overworking, emotional eating, alcohol, or withdrawal
You may still appear strong, capable, and composed to others — especially if you’re a leader, practitioner, or public-sector professional used to “holding it together.”
But inside, your emotional and physical reserves might be running dangerously low.
The Impact of Compassion Fatigue — on you, your work, and those around you
Compassion fatigue affects far more than how you feel.
Impact on your wellbeing
Reduced emotional capacity
Feeling constantly overwhelmed or “on edge”
Difficulty switching off after supporting others
Emotional withdrawal from family, friends, or colleagues
Impact on the people you support
Decreased patience
Reduced capacity to listen deeply
Feeling less able to show warmth, empathy, or compassion
Heightened reactivity or irritability
Increased likelihood of mistakes due to cognitive overload
Impact on Teams, Services, and Workplaces
This is particularly relevant in public-sector roles where emotional labour is constant.
Higher sickness absence
Reduced morale within teams
Increased tension or conflict
Reduced quality of care, decision-making, or support
A ripple effect where dysregulation spreads across systems and relationships
Caring roles — especially in under-resourced environments — carry a high emotional load. Recognising this impact is not about blame; it’s about understanding that you cannot pour endlessly from an empty cup.
Compassion Fatigue, Burnout, and Secondary Trauma — What’s the Difference?
Although they overlap, they are distinct:
Burnout is linked to chronic workplace stress, workload pressure, or system demands.
Secondary traumatic stress arises from exposure to other people’s trauma, suffering, or crisis.
Compassion fatigue is the emotional and relational depletion that comes from caring deeply for others over time.
Many people — especially those in public-facing, high-pressure, or emotionally demanding roles — experience more than one of these simultaneously.
Why Caring Takes a Toll — A Nervous-System Perspective
From a trauma-informed lens, compassion fatigue isn’t just emotional — it’s biological.
Your autonomic nervous system constantly monitors for cues of safety or threat.
When you repeatedly support others who are struggling, distressed, unwell, or dependent on your help, your system may shift into:
fight/flight (hyper-alert, tense, overwhelmed)
or shutdown (numb, disconnected, exhausted)
This is not a sign you’re “not resilient enough.”
It is your nervous system protecting you from overload.
The key isn’t to “push through” — it’s to practise restoration, connection, and regulation.
Evidence-informed Ways to Restore Balance
There’s no single quick fix.
But research consistently highlights several protective factors.
1. Awareness and honest reflection
Recognising compassion fatigue early is one of the strongest buffers.
Supportive practices include:
Checking in with your body
Noticing whether you feel calm, tense, overwhelmed, flat, or depleted.Noticing patterns
Irritability, withdrawal, difficulty concentrating, or feeling “switched off.”Asking simple questions
“What am I carrying today?”
“What’s draining me the most?”
“What do I need in this moment?”
Talking things through with someone safe
A colleague, friend, supervisor, coach, counsellor, or therapist.
This kind of reflection doesn’t require journalling — it’s about pausing long enough to notice what’s happening inside you.
2. Realistic, meaningful self-care
Not bubble baths.
Not perfection.
But small, sustainable habits that support your whole system:
Rest (short pauses count)
Nourishment
Gentle movement
Nature and fresh air
Reducing unnecessary emotional load
Moments of grounding or regulation
Saying no when you need to
3. Self-compassion rather than self-criticism
Research consistently shows that self-compassion reduces the risk of compassion fatigue.
This might sound like:
“This is hard — and I’m doing my best.”
“It makes sense that I’m tired.”
“I deserve support too.”
Self-criticism drains the nervous system.
Self-compassion supports recovery.
4. Connection, co-regulation & professional support
Humans regulate in relationship.
Spaces where you can talk, reflect, or be supported emotionally can make a profound difference:
Supportive colleagues
Reflective practice
Supervision
Coaching for boundaries, resilience, and emotional sustainability
Therapy or counselling for deeper processing and support
Receiving support doesn’t mean you’re not coping.
It’s how you keep coping safely and sustainably.
5. Boundaries, pacing, and shared responsibility
Compassion fatigue intensifies when you carry everything alone.
Boundaries can include:
Clarifying what is and isn’t your role
Sharing responsibility within teams
Protecting your rest time
Communicating capacity honestly
Creating breathing space between emotionally heavy interactions
Boundaries aren’t barriers to caring.
They’re the foundation of sustainable, compassionate support.
6. Body-based regulation (Regulate & Reset)
Because compassion fatigue lives in the nervous system, body-based practices can be especially powerful:
Slow, lengthened exhale breathing
Gentle movement or stretching
Grounding through the senses
Soothing touch (hand on heart, warm drink, weighted blanket)
Orienting to your environment
Simple vagal-nourishing practices
These small practices create moments of safety that help you return to emotional presence and clarity.
If you’d like guidance on where to start, the Regulate & Reset - Nervous System Toolkit offers simple, trauma-informed practices you can weave into daily life.
You Deserve Care, Too
Compassion fatigue is often described as “the cost of caring.”
But that phrase matters, because it reminds us:
You feel this way because you care — not because you don’t.
If you recognise yourself in these signs:
You’re not failing.
You’re not alone.
And it is possible to restore your capacity to care — gently, gradually, and with support.
Perhaps today, you might choose just one small act of care for yourself:
A pause. A breath. A moment of kindness. A softened boundary.
You deserve the same compassion, protection, and understanding that you offer so freely to others.
Support Your Nervous System with Simple, Gentle Practices
If you'd like a supportive starting point, the Regulate and Reset - Nervous System Toolkit offers evidence-informed, trauma-sensitive practices for grounding, calming and restoring your emotional capacity.
Learn more about Strong Horizons at www.stronghorizons.co.uk
