Dealing With Caregiver Stress and Compassion Fatigue: How to Move Forward

Written by: Angela Derrick, Ph.D. & Susan McClanahan, Ph.D.

Date Posted: January 23, 2025 2:29 am

Dealing With Caregiver Stress and Compassion Fatigue: How to Move Forward

Caregiver Stress: Why am I Always So Tired?

If you are the primary caregiver for a sick or aging loved one, work in a helping profession, or deal with the mental health issues of a family member or significant other, then you are likely struggling with some form of caregiver stress, compassion fatigue, or burnout.

As a caregiver, balancing important relationships, work pressures, and financial responsibilities can feel impossible, even more so if you are a single parent with difficulty making ends meet. What makes matters even more challenging is how quickly friends and family members may grow tired of hearing about your situation, making long-term support and understanding difficult to obtain. Adding to the emotional toll, well-wishers generally check up on the individual who is sick but not so much on the person doing the caregiving. The subsequent build-up of stress is a pressing issue that can manifest in various ways, including constant exhaustion and persistent feelings of anger and resentment. 

If you are feeling the strain, friends and loved ones may have started encouraging you to get help or take steps towards self-care, but this can initially increase stress and trigger resistance. The idea of adding one more task to an already enormous list can be intensely uncomfortable and unwanted.

What do we do to treat or prevent caregiver burnout under these conditions? How do we begin to treat ourselves with more tenderness and love under these very real and challenging circumstances? Is it okay to feel angry? Do we need to “fix” ourselves, or might there be a more compassionate way forward?

The range of emotions caregivers experience is surprisingly universal. How we feel is not wrong or shameful and we are never alone. Just check out this recent article in New York Magazine’s The Cut, where 11 people share their own caregiving journeys with vulnerability and generous honesty.

Common Symptoms of Caregiver Stress

Let’s start by identifying common symptoms that indicate elevated stress levels.

Emotional Symptoms

• Anxiety: Feeling overwhelmed or worried that we are not doing enough or afraid that we are not capable of successfully meeting the demands of caregiving. Anxiety can worsen if we are taking care of someone in cognitive decline, and they are lashing out or are unable to show appreciation for the help we give to them.
• Depression: Feeling persistent sadness, hopelessness, or loss of interest in activities that were formerly enjoyable. There is a level of grief that is inherent in the caregiving process, and depression can worsen if we try to bypass or numb our feelings. There may also be an irrational fear that if we allow ourselves to feel and process the grief, we may go down for the count and not be able to get back up again.
• Irritability & Mood Swings: Experiencing increased frustration or anger over minor issues. We may feel we are on a razor’s edge between safe, sane, and complete chaos. One seemingly small incident can throw us into emotional dysregulation, and this loss of control can feel alarming.
• Feelings of guilt: We might have thoughts that we believe are negative or uncharitable towards the person in our care or our situation, which causes feelings of guilt. Or, we worry that we are not doing enough or the right kinds of things. No matter how much we try, our inner critic (or a very real critic in the form of a family member) is never satisfied. This guilt saps our energy and mental resiliency.
• Loneliness: We often feel isolated from friends, family, or social support. Loneliness is a widely shared symptom among caregivers. A deep sense of aloneness can leave us feeling disconnected, hopeless, and at risk for depression, anxiety, substance abuse, and more. Mutual aid and support among those in similar circumstances can provide much-needed understanding and connectedness. We may not be able to get the support we need from the people we want it from most, so we can seek others to fill the deficit, and it works.

Physical Symptoms

• Fatigue & Sleep Problems: We may be constantly tired despite getting enough sleep. We may have difficulty falling asleep, staying asleep, or sleeping too much.
• Headaches & Body Aches: Frequent tension headaches or migraines can be signs of intense stress. Muscle pain, joint pain, or general physical discomfort can also accompany stress and burnout.
• Weakened Immunity: Our bodies may be run down, increasing our susceptibility to colds or infections.
• Weight changes: Another sign we may be experiencing overwhelm is significant weight loss or gain due to stress-eating or loss of appetite.

Cognitive Symptoms

• Difficulty Concentrating: We may have trouble focusing on tasks or remembering details, and we might attribute this to getting older or a life transition like perimenopause, but difficulty concentrating can also result from caregiver stress and burnout.
• Forgetfulness: Forgetting appointments, tasks, or responsibilities can be troubling as we observe our capacity slipping. We may feel less capable in areas we have never previously struggled with and wonder what is wrong.
• Indecisiveness: Struggling to make decisions, even minor ones. This one is incredibly frustrating as balancing our life, work, financial well-being, relationships, and caregiving responsibilities requires an enormous amount of decision-making. When stress causes indecisiveness, it can grind our days to a near stop and skyrocket our anxiety or sink us into depression.

Behavioral Symptoms

• Neglecting Self-Care: Stress symptoms include skipping meals, not exercising, or foregoing personal hygiene routines.
• Withdrawal: We might avoid social interactions or previously enjoyed activities.
• Substance Abuse: We may notice increased use of alcohol, tobacco, or drugs in order to cope with the stress.
• Overworking: It’s possible that we may be focusing excessively on caregiving to avoid addressing personal feelings or facing our own issues.

Serious Indicators that Stress May Have Progressed to Burnout

• Emotional Numbness: Feeling detached or apathetic about caregiving.
• Cynicism: Having negative feelings toward the person we’re caring for or the situation.
• Complete Exhaustion: Feeling like we can’t continue our caregiving responsibilities anymore.

When to Seek Help

If caregiver stress leads to severe physical or emotional symptoms, it may be time to seek professional help from a qualified and experienced therapist or support group. We have included a list of helpful resources at the end of this article.

What is Compassion Fatigue?

Compassion fatigue, often referred to as the “cost of caring,” is a state of emotional and physical exhaustion experienced as a result of prolonged exposure to the suffering of others. This can happen if we regularly take on the responsibility of caring for someone else, whether in a professional role, like nursing or social work, or as a caregiver for a loved one. While admirable, our empathy and desire to help can lead to emotional exhaustion. When we constantly witness pain, distress, or trauma without enough time or support to recharge ourselves, it’s like pouring from a cup that’s not being refilled—eventually, we run out.

Compassion fatigue can arise suddenly through caregiving and the intense emotional labor of absorbing and processing the pain and struggles of others. Other contributing factors include feeling a lack of control over outcomes and being unable to set healthy boundaries between our emotions and the situations we’re witnessing. While empathy is a vital trait for caregivers, constant exposure to distress can deplete us, especially if we neglect our own needs—such as skipping rest, social activities, or self-care.  Seeking support through professional resources or peer networks, mindfulness, physical activity, and maintaining hobbies can help mitigate the effects of compassion fatigue. Recognizing these patterns and taking steps to care for our own mental and emotional health can help us regain balance and resilience.

Self-Compassion as a Solution

Self-compassion plays an essential role in mental well-being and can help relieve the stress associated with caregiver fatigue or burnout. By challenging our inner critic, connecting to others through our shared humanity, building resilience, and taking a balanced, mindful approach to suffering, we can begin to lessen our anxiety.

Below are the three elements of self-compassion that we can practice every day:

Credit to Dr. Kristin Neff from the self-compassion.org website

• Self-kindness vs. Self-judgment: Self-compassion entails being warm and understanding toward ourselves when we suffer, fail, or feel inadequate, rather than ignoring our pain or flagellating ourselves with self-criticism. Self-compassionate people recognize that being imperfect, failing, and experiencing life difficulties is inevitable, so they tend to be gentle with themselves when confronted with painful experiences rather than getting angry when life falls short of set ideals. People cannot always be exactly the way they want. (i.e. the perfect caregiver who is always calm and never short-tempered) When we deny or fight against this reality, our suffering increases in the form of stress, frustration, and self-criticism. When this reality is accepted with sympathy and kindness, we experience greater emotional balance.
• Common humanity vs. Isolation: Frustration at not having things exactly as we want is often accompanied by an irrational but pervasive sense of isolation – as if “I” were the only person suffering or making mistakes. All humans suffer, however. The very definition of being “human” means that one is mortal, vulnerable, and imperfect. Therefore, self-compassion involves recognizing that suffering and personal inadequacy are part of the shared human experience – something we all go through rather than something that happens to “me” alone.
• Mindfulness vs. Over-identification: Self-compassion also requires taking a balanced approach to our negative emotions so that feelings are neither suppressed nor exaggerated. It stems from the process of relating personal experiences to those of others who are also suffering, thus putting our own situation into a larger perspective. It also stems from the willingness to observe our negative thoughts and emotions openly and clearly so that they are held in mindful awareness. Mindfulness is a non-judgmental, receptive mind state in which one observes thoughts and feelings as they are without trying to suppress or deny them. We cannot ignore our pain and simultaneously feel compassion for it. At the same time, mindfulness requires that we not be “over-identified” with thoughts and feelings so that we are caught up and swept away by negative reactivity.

Self-compassion gently dictates that if we need extra help, we can value ourselves and seek it out. There are many resources available. Having an understanding person who can help us process our emotions is invaluable. This person should be nonjudgemental, a good listener, and possibly a professional experienced in treating anxiety and depression. Below is a list of additional resources and information on support groups that can provide help and hope.

Support and Resources

ANNOUNCING: 2025 Hybrid Behavioral Health IOP Program for Adults

SpringSource Psychological Center is now accepting referrals for our Adult IOP Program. We designed this IOP Program to provide intensive support for adults who are struggling with eating disorders, mood and anxiety disorders, life transitions, and relationship issues. ⁠

Our scheduling is mindful of keeping clients in their regular lives by offering hybrid options of attending virtually or in person at our Northbrook Location. We also scheduled sessions at convenient times in the evenings on Monday (5:30-8:30 pm) and Wednesday (5:30-8:30 pm) and on Saturday mornings (10:00 am-1:00 pm).⁠

We provide skills training and support and can offer great flexibility in providing specific help to meet each individual’s needs and create a safe and healing environment.⁠ The group can be attended in person or virtually at our Northbrook location.⁠

Northbrook Location⁠

899 Skokie Boulevard, Suite 300⁠

Northbrook, IL 60062 ⁠

224-202-6260 ⁠

in**@****************er.com⁠

Helpful Links

Family and Caregiver Services—Illinois Department on Aging

Shirley Ryan AbilityLab: Listing: Caregiver Support Resources

Find Local Caregiver Resources Serving Illinois

Family Members and Caregivers | NAMI

About SpringSource Psychological Center

At SpringSource, we strive to provide the most effective and compassionate care for individuals struggling with eating disorders, anxiety, depression, trauma, and relationship issues.

We believe there are many paths to healing, and we can help facilitate your individual recovery journey. With offices in downtown Chicago and Northbrook, Illinois, we offer in-person and virtual support.

Call SpringSource today at 224-202-6260⁠ | in**@****************er.com | We offer free 15-minute initial consultations.