Burnout, Compassion Fatigue, and Vicarious Trauma

In the simplest terms: burnout occurs when the stress we experience exceeds our capacity to cope with that stress. Some individuals may be able to thrive – at least in the short term – under high stress. However, chronic stress without relief eventually begins to take a toll on even the most resilient individuals.

Everyone has a different capacity to tolerate stress. Thanks to two things:

• 👫 Physiological factors – some bodies may have a genetic predisposition to handling stress better, or to be relatively unhindered by aging, chronic illness, or poor sleep quality.
• 🧠 Psychological resiliency – adults who experienced a high number of Positive Childhood Experiences, for example, have an increased capacity for handling stress as adults.

Other individuals have less resistance to stress, such as trauma survivors, people living with chronic pain, or people experiencing difficulties in other areas of life (personal relationships, etc). This impacts our body’s ability to bounce back from both specific stressors and chronic stress. When the body begins to lose the ability to bounce back after stress, the road to burnout is well underway.

The Difference Between Burnout and Depression

Although burnout and depression share some commonalities, they are different diagnoses with different treatments. While the World Health Organization recognizes burnout as a legitimate diagnosis, it’s not yet in the diagnostic manual that clinicians (including doctors and mental health professionals) use in the United States, while depression is. This results in burnout (a cluster of symptoms that often resemble depression) being often diagnosed as “simply” depression.

While untreated burnout can lead to depression, the relationship between burnout and depression looks a little bit like this Venn diagram. Burnout can include depression but isn’t quite the same thing – nor are depression and burnout always linked.

Burnout May Happen in Days, Weeks, or Years

Burnout looks different for every individual. Essentially, burnout occurs when we no longer have the tools to cope with the stress we experience. For some, burnout may happen quickly in response to enormous amounts of stress. Imagine: a disaster response aid worker working 18-hour days for just a few weeks in a place where they feel isolated from anyone to process the experience with. For others, the process can happen very slowly. For example: a teacher who used to love their job but loses their enthusiasm, interest, or even empathy for teaching students over the course of years.

Both types of burnout (and the entire spectrum in between) are serious. Though, for many, it’s far more difficult to recognize burnout when the onset is gradual.

Burnout, Anxiety, and Panic Attacks

Many psychotherapists have noted a connection between a person’s attachment style and how burnout manifests.

• 😕For individuals with an avoidant attachment style, symptoms of burnout often take on the form of depression, lethargy, and fatigue.
• 😬 For individuals with a preoccupied attachment style, it’s more common for them to experience anxiety, panic attacks, and highly emotional disturbances when they experience burnout. (Click here to read more about attachment styles.)

This difference occurs because each human has a tendency towards responding to overwhelming stimuli with either hypoarousal (shutting down) or hyper-arousal (getting very upset). Although, many individuals have a wide capacity to tolerate many experiences between the two extremes.

Getting Treatment for Burnout

In my clinical work with women experiencing professional burnout, I’ve seen how burnout impacts every individual differently. As a result, recovery from burnout looks different for every individual. Just like how burnout can set in over the course of many years or just a few weeks, the duration and recovery period for people experiencing burnout can also vary widely.

For some individuals experiencing burnout, a season of rest and reduced stress can be enough to relieve the symptoms of burnout. However, most individuals experiencing moderate to intense burnout may need to find ways to change or exit the system in which they burned out. (This may mean a job change, negotiating for responsibilities to be delegated, or more support being offered).

Often, relief from the initial cause is not enough to reduce or eliminate the symptoms of burnout. For these individuals, medical or psychological treatment of individual symptoms (such as depression, insomnia, or panic attacks) may be needed to recover from burnout fully.

Why Burnout Shouldn’t Be Ignored:

One factor in burnout treatment that can complicate and slow recovery is the flexibility of brains. In psychotherapy and psychology, we are excited about how flexible adult brains are. It means that even adult brains can heal and recover in ways that psychiatrists 50 years ago didn’t believe was possible. However, this flexibility of brains is one good reason to treat burnout ASAP. The longer brains remain in a burnout state, the more likely it is that the brain patterns involved in the symptoms of burnout become increasingly ingrained and difficult to recover from.

Just like how researchers now recommend that individuals who’ve experienced long-term or multiple recurrences of depression should remain on antidepressant medication indefinitely, many experts in burnout believe that a brain that has remained in the burnout state longer may have a more difficult road to recovery than a brain experiencing burnout with a rapid-onset and immediate treatment.

Download a Printable PDF of this Burnout Educational Resource:

Symptoms of Burnout:

Burnout is a slow depletion of mental and physical resources. The symptoms include:

• procrastination
• chronic fatigue
• cynicism
• pessimism
• loss of imagination for the future
• reduced (frequency of) happy moments
• job dissatisfaction
• doubting core beliefs

Burnout happens slowly, which makes us think that we have changed instead of realizing we are sick.

Vicarious Trauma

Vicarious trauma happens quickly. Trauma is contagious. Suffering trauma symptoms without firsthand trauma is often vicarious trauma.

Vicarious trauma occurs via:

• 👂🏼 Listening (like therapists, dispatchers, or aid workers)
• 👀 By seeing (like first responders and witnesses to someone else’s trauma), and
• 💻 Even through consuming media (for example: excessive seeking out of raw coverage of a violent crime or disaster can result in vicarious trauma).

In the type of burnout that comes with vicarious trauma, guilt is often at play. There are three types of guilt:

• guilt for doing something bad
• guilt for not doing something good
• guilt for being okay when others are not okay [a.k.a. survivor guilt]

Tips for Dealing with Burnout

• 🧖🏽 relaxation
• 👩🏼‍🤝‍👩🏾 social support
• 🥳 spend time celebrating wins
• ✨ trust the recovery process (you can’t fix it, but you can do your part)