Compassion Fatigue vs. Burnout: What’s the difference & what to do

If we were professional athletes, our work would take a toll on us physically — soreness, fatigue, and injury all come from regularly pushing your muscles past their limits. But the tools of the veterinary trade are not our muscles (well, sometimes — looking at you Saint Bernards). Veterinarians and technicians regularly push their minds and, even more so, their hearts to their limits and beyond. This can result in the veterinary workplace hazards of burnout and compassion fatigue, which are unfortunately way too commonplace. 

Problematically, when comparing compassion fatigue vs. burnout, there's a lot of overlap (especially when we’re only looking at outward signs and symptoms), and both are common in caregiving professions. This can lead to them getting lumped together, very often in the same sentence, which I am going to be quite guilty of here. Sorry. However, they are different things with different root causes and somewhat different solutions. So if we want to drill down and fix these all too common problems before they start, we’re going to have to begin with a basic understanding of:

What’s the difference between Compassion Fatigue and Burnout?     

Family therapist Kaitlyn Hensley, LMFT explains the difference between these two mental health concerns very succinctly:

• “Burnout, simply put, is struggling due to working too much.”

• “Compassion fatigue, simply put, is struggling from caring too much.”

Both present with symptoms such as exhaustion, anxiety/depression, and a lack of empathy where there was once a lot of empathy. Yikes, that’s a veterinary professional’s superpower, which makes burnout and compassion fatigue pretty much veterinary Kryptonite. Kaitlyn goes on to explain that with compassion fatigue, “Your empathy struggles to hold boundaries, and there’s a pressure to take on someone else’s pain or feel you need to be the one to ‘fix’ it for them.”

Further complicating this, “In a helping/caregiving role, it can be more likely that these two will show up in the same person,” says Kaitlyn. Having compassion fatigue does not mean you’re also experiencing burnout (and vice versa), but both can occur at the same time. 

So what are the major differences? “Burnout tends to be characterized by physical exhaustion, whereas compassion fatigue is more emotional,” according to an article by Duke Health. Another big difference: “In compassion fatigue, patient care doesn’t suffer,” says Jennifer Lycette, MD, “We continue to be there for our patients, but that’s when we and our families can suffer.”

Like any medical condition — and both compassion fatigue and burnout should very much be treated as such — it’s important to diagnose the problem correctly so we can be sure we’re using the right treatment.

Symptoms of Compassion Fatigue vs. Burnout

Symptoms of Burnout can include: 

1. Exhaustion that is predominantly physical
2. Decline in work performance
3. Cynicism towards work, feeling detached and distant from your job with changing sentiments of the importance of it

Symptoms of Compassion Fatigue can include: 

1. Exhaustion that is predominantly mental
2. Work performance may not to decline
3. Recurring thoughts of a patient or situation
4. Physical symptoms like headaches, nausea, upset stomach and dizziness.
5. Feelings of helplessness and powerlessness in the face of patient suffering

Symptoms that overlap: 

1. Lack of empathy where there was once a lot of empathy
2. Irritability, snappiness with others 
3. Isolation or withdrawal (one of the most problematic symptoms and sometimes an indicator of larger issues)
4. Lack of sleep or too much sleep

How to treat and prevent compassion fatigue

The trick to managing compassion fatigue is realizing that empathy is a finite resource that can be depleted. “Acknowledge that you are human," says Dr. Dike Drummond. “Recognize that rest is not a sign of weakness, and give yourself the ability to recharge.”

The American Psychological Association suggests making self care part of your routine that includes “adequate sleep, healthy nutrition, physical activity, relaxation and socializing. The schedule should also include five minutes for a self check-in each morning to assess tension in the body and worries in the mind.”

But it’s not just about taking care of yourself, many veterinarians and technicians will also have to change their attitudes toward self care. According to the APA, many caregivers view self care as selfish, which prevents them from gaining any benefits from the self care efforts they make. For example, “They engage in behaviors such as worrying about work on a day off.”

The APA also recommends creating a supportive community around yourself. Having a strong support network and a safe person to talk with can go a long way towards preventing both compassion fatigue and burnout.

The Canadian Medical Association recommends being mindful of your thoughts and emotions throughout the day. “When you start to feel anxious, help yourself calm down by focusing on your breath and slowing down your breathing rate. If you feel overwhelmed and out of control, take a moment to think about what you do have control over and what you can change.”

It’s about giving your empathy muscles a chance to rest and recover and establishing healthy habits to keep those muscles strong in the first place. 

How to treat and prevent burnout

Burnout is caused by the workplace stress and being overworked, so naturally, many of the solutions come from improving your work environment, your personal work habits, and your overall work-life balance.

We recently discussed a number of ways veterinary leaders can make the workplace more fun, which can have a huge impact on preventing burnout preemptively. Additionally, in the most recent Economic State of the Profession Report, the AVMA suggests practice owners can promote healthier work environments by offering flexible hours, ensuring breaks, and encouraging employees to use their sick time and vacation leave.

For non-owner veterinarians, the AVMA suggests choosing a practice that will consider and support your mental well-being and work-life balance, which we realize may not always be something you can control. 

How can you possibly know if a practice will be a supportive work environment before starting there? One way is to sample a bunch of hospitals before committing through relief work. By working just a shift or two at a number of places, it’s easy to find a practice that’ a good culture fit before jumping in full-time. And for ultimate work-life balance, vets can elect to become full-time relief professionals whom the AVMA found have the lowest rates of burnout amongst all veterinary professionals.

Getting even more granular, when it comes to things within your control that you can do in your personal life to prevent burnout, Kaitlyn Hensley says it often comes down to setting and holding boundaries. “We tend to push ourselves past our limits even when we’re really lacking on energy,” she says, “And we can see the negative impact that has on ourselves and our relationships.” 

Kaitlyn suggests the best response is taking a break — either a mental health day or a vacation. Of course, this isn’t always an option. Practicing good self care (getting enough sleep, exercising, eating healthy) can be helpful for burnout as well, and leaning on your support system is a great way to get relief even if you’re just venting or engaging in a fun activity. 

Healthy habits, firm boundaries, and a strong support system can insulate you from both burnout and compassion fatigue

Thankfully, it’s not only the symptoms that overlap, the treatment for burnout and compassion fatigue have a lot of overlap as well. Be kind to yourself, adding self judgment on top of feelings of burnout or compassion fatigue only adds guilt and anxiety that snowball these negative emotions.

Develop a good self care routine: Eating healthy, exercising regularly, and getting plenty of sleep will be helpful for your mood and well-being in general, and this can help you build up somewhat of a resistance to these common mental health issues.

Finally, establishing boundaries is a crucial step to protect your mental health, albeit you’ll need different kinds of boundaries for each. To prevent burnout, it’s best to set boundaries between your work and personal life. For compassion fatigue, it helps “to set emotional boundaries without barricading yourself from the world.”

If it gets bad and you find yourself sinking into a negative place, take mental stock of your own emotions to identify these conditions taking hold, and reach out or ask for help early if you need it. Rely on your support network and have a conversation with a trusted, safe friend, family member, or colleague. Just talking about these emotions will reduce their hold over you.

Of course, it’s always helpful to smile and to laugh. Take a break. Do something fun. To provide the best care to our patients, we need to make sure we’re taking good care ourselves.