Compassion Fatigue: Warning Signs and Symptoms

Symptoms of compassion fatigue can appear gradually or suddenly depending on the individual’s circumstances.  The Professional Quality of Life Scale (ProQOL) version 5 (2009) developed by Dr. Beth Hudnall-Stamm can be used to measure compassion satisfaction, burnout and secondary traumatic stress (compassion fatigue).  This self-assessment is available as a resource on our website.  Below you will find warning signs and symptoms of compassion fatigue according to Dr. Angela Panos.  If you experience compassion fatigue symptoms and/or have any concerns regarding your personal scores on the ProQOL you should consult with a physician or mental health professional.

Compassion Fatigue:  Warning Signs and Symptoms

  • Feeling estranged from others
  • Difficulty falling or staying asleep
  • Outbursts of anger or irritability with little provocation
  • Startling easily
  • While working with a victim thinking about violence or retribution against the person or person who was victimized
  • Experiencing intrusive thoughts or flashbacks of sessions with difficult clients or families
  • Feeling there is no one to talk with about highly stressful experiences
  • Working too hard for your own good
  • Frightened of things traumatized people and their families have said or done to you
  • Experience troubling dreams similar to a client of yours or their family
  • Suddenly and involuntarily recalling a frightening experience while working with a client
  • Preoccupied with a client or their family
  • Losing sleep over a client and their family’s traumatic experiences
  • Felt a sense of hopelessness associated with working with clients and their families
  • Have felt weak, tired, rundown as a result of your work as a caregiver
  • Unsuccessful / find it difficult to separate work life from personal life
  • Felt little compassion toward many of your co-workers
  • Thoughts that you are not succeeding at achieving your life goals
  • Feel you are working more for the money than for personal fulfillment
  • A sense of worthlessness / disillusionment / resentment associated with your work


Panos, A. Understanding and preventing compassion fatigue – A handout for professionals, Retrieved August 22, 2014 from

Stamm, B (2009).  Professional quality of life:  compassion satisfaction and fatigue subscales, R-IV (ProQol).  retrieved August 22, 2014 from


What is Self-Care?

A focus on self-care is becoming increasingly important as the demands within caregiving professions seem to be intensifying.  Self-care is any activity of an individual that is done with the intention of improving or maintaining wellness.  Professional self-care can be defined as the incorporation of skills and strategies by caregivers to preserve their personal, familial, emotional and spiritual needs while serving the needs of their clients (Newell & MacNeil, 2010).

Categories for self-care can include 1) physical:  body work, exercise, adequate sleep, nutrition:  2) psychological:  effective relaxation time, contact with nature, forms of creative expression, balance between work and recreation;  3) social/interpersonal:  supportive relationships and knowing when/how to obtain help;  and 4) professional:  balancing work and home life, setting boundaries and limits, and getting help/support through peers, role models, and supervisors (Charles Figley interview, 2005).

Self-care has been identified as the greatest strategy to prevent or reduce the undesirable effects of Compassion Fatigue, Secondary Traumatic Stress, Vicarious Traumatization and Burnout.  Professional caregivers are at much higher risk than other professionals of experiencing compassion fatigue due to the nature of our work (Radey & Figley, 2007).

Compassion is a very important element in the success of a caregiver engaging clients in direct practice work.  In order to gain the trust of the clients we mush develop a positive working relationship and be able to empathize with the client.  “Sometimes our hearts go out to the clients to the point where we feel their pain and suffering, which can lead to mental, physical and emotional fatigue” (Radey & Figley, 2007).  Chronic exposure to others’ traumatic events is also a factor that puts caregivers at higher risk of experiencing compassion fatigue.  Compassion fatigue can lead to burnout, a condition of emotional, physical, psychological, and spiritual exhaustion that results from practicing with people who are vulnerable or suffering (Newell & MacNeil, 2010).


Compassion fatigue:  An expert interview with Charles R. Figley, (2005).  Retrieved 4/15/14 from

Newell, J., & MacNeil, ., (2010).  Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue:  a review of theoretical terms, risk factors and preventative methods for clinicians and researchers.  Best Practices in Mental Health 6(2), 57-68.

Radey, M., & Figley, C., (2007).  The social psychology of compassion.  Clinical Social Work Journal 35(1), 207-214.