Compassion Fatigue - When the Emotional Tank Runs Dry

Exposure to other people's trauma and distress is often part of the job. But sometimes, empathising with others' experiences without taking care of your own mental wellbeing can take a real toll. This is where compassion fatigue can begin and researchers have found that, unlike burnout, it can develop quite suddenly rather than building up gradually over time.

What is compassion fatigue?

Compassion fatigue is more than just having a tough day. The term was first used back in the early 1990s by a nurse educator who described it as the loss of ability to nurture patients. It's since been studied extensively across healthcare, and is now understood as the physical, emotional and mental exhaustion that can affect people who are regularly exposed to others' suffering through their work.

While it's closely linked to burnout, researchers are still debating exactly how the two connect. Some believe compassion fatigue can lead to burnout, others see burnout as one part of a broader compassion fatigue picture. What most agree on is that compassion fatigue is more specifically connected to the emotional demands of caring for, responding to and supporting people in distress, while burnout tends to relate to the broader grind of a job such as the workload or the system.

As Dr Tanveer Ahmed, Medical Superintendent and Consultant Psychiatrist at Kellyville Private Hospital, explains:

"Psychiatry reminds us that mental health is never just about the brain. The same is true of compassion fatigue. We protect carers not only by helping individuals cope, but by nurturing the social bonds, moral purpose and shared institutions that make caring possible in the first place."

Signs to look out for

Compassion fatigue can show up faster and more intensely than the slow burn of traditional burnout.  While burnout tends to build gradually over months or years of accumulated stress, compassion fatigue can develop suddenly, sometimes triggered by one particularly distressing case or a run of emotionally heavy work. Clinicians often describe it as retaining the ability to do the job, just not the emotional capacity to do it the way they used to.  

Knowing what to look for, in yourself and in colleagues, is one of the best forms of early intervention.

Some of the common signs researchers and clinicians point to include:

• Emotional exhaustion - feeling drained, flat or numb, even after time off
• Reduced empathy - struggling to feel the same level of care or connection with patients or clients that you once did
• Irritability or cynicism - a shorter fuse, or a growing sense of detachment from the people you're helping
• Physical symptoms - fatigue, headaches, trouble sleeping, or a general sense of being "worn down"
• Avoidance - procrastinating on patient contact, or withdrawing from colleagues
• Questioning your purpose - a nagging sense of "why am I even doing this?" that wasn't there before

The tricky part? These signs are easy to dismiss, minimise, or mistake for "just a rough patch." 

Dr Ahmed says this growing awareness reflects a broader question about the emotional demands placed on clinicians and carers: 

"Psychiatrists spend their working lives carrying other people's suffering. The fact that we're talking so much about burnout and compassion fatigue isn't just about doctors becoming more fragile- it's asking whether modern society has become emotionally more demanding, less communal and less forgiving."

How to manage and reduce compassion fatigue

The good news is that compassion fatigue isn't something you just have to push through. There's a growing body of research, including several Australian studies looking at what actually helps and a few clear themes keep coming up.

1. Mindful self-care practices: A study trialling a brief mindfulness and self-care program with nurses at an Australian tertiary hospital found that even a short, structured intervention improved measures of compassion fatigue, self-compassion and self-efficacy. The takeaway isn't that you need hours of meditation each day; it's that small, consistent practices genuinely move the needle.
2. Peer support and shared reflection: Talking about the emotional weight of the job properly and not just in passing, matters. One long-running approach in general practice is the Balint group model, where GPs meet regularly to reflect on difficult doctor-patient relationships with a facilitator. The idea isn't to solve every case, but to create a space where clinicians can process what they're carrying, rather than carrying it alone. Structured peer-support debriefs have shown similar promise in critical care settings.
3. Building psychological resilience: Research on Australian nurses has found that individual psychological resilience is one of the strongest protective factors against burnout and secondary traumatic stress and importantly, resilience isn't a fixed trait. It can be built. This might look like therapy, resilience training, or simply developing better awareness of your own stress responses before they escalate.
4. Structured psychological support (CBT and ACT): For a more formal approach, cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT) are increasingly being used to directly treat burnout and compassion fatigue.
5. Values alignment: Interestingly, some research has found that burnout isn't just about workload, it's also tied to how well someone feels their personal values are being fulfilled, both at work and in life more broadly. That's a helpful reframe, because sometimes managing compassion fatigue isn't only about doing less, but about reconnecting with why you're doing the work in the first place.

Knowing when to seek professional support

Self-care strategies matter, but they're not a substitute for professional help when compassion fatigue is significant or persistent. If you're noticing several of the signs above and they're not easing, speaking with a GP, psychologist or psychiatrist is a reasonable and often necessary next step.  

References

Bhugra, D. (2025). Compassion fatigue: Result or cause of burnout? And do doctors get it? Journal of the Royal Society of Medicine, 118(4), 138–140. https://doi.org/10.1177/01410768251320166

Thapa, D. K., Levett-Jones, T., West, S., & Cleary, M. (2021). Burnout, compassion fatigue, and resilience among healthcare professionals. Nursing & Health Sciences, 23(3), 565–569. https://doi.org/10.1111/nhs.12843 

Garnett, A., Hui, L., Oleynikov, C., & Boamah, S. (2023). Compassion fatigue in healthcare providers: A scoping review. BMC Health Services Research, 23, Article 1336. https://doi.org/10.1186/s12913-023-10356-3

Craigie, M., Slatyer, S., Hegney, D., Osseiran-Moisson, R., Gentry, E., Davis, S., Dolan, T., & Rees, C. (2016). A pilot evaluation of a mindful self-care and resiliency (MSCR) intervention for nurses. Mindfulness, 7, 764–774. https://doi.org/10.1007/s12671-016-0516-x

Benson, J., & Magraith, K. (2005). Compassion fatigue and burnout: The role of Balint groups. Australian Family Physician, 34(6), 497–498. RACGP - AFP 2005 Back issues 

Hegney, D. G., Rees, C. S., Eley, R., Osseiran-Moisson, R., & Francis, K. (2015). The contribution of individual psychological resilience in determining the professional quality of life of Australian nurses. Frontiers in Psychology, 6, Article 1613. https://doi.org/10.3389/fpsyg.2015.01613 

Prentice, S., Benson, J., Need, P., Elliott, T., & Pitot, M. (2023). Burnout, wellbeing and how they relate: A qualitative study in general practice trainees. Medical Education, 57(3), 243–255. https://doi.org/10.1111/medu.14931