What is fatigue?

Fatigue refers to the issues that arise from excessive working time or poorly designed shift patterns. It is generally considered to be a decline in mental and/or physical performance that results from prolonged exertion, sleep loss and/or disruption of the internal clock. It is also related to workload, in that workers are more easily fatigued if their work is machine-paced, complex or monotonous.

  • Rubbing of the eyes
  • Forgetting instructions
  • Long eye blinks
  • Yawning
  • Not talking to co-workers
  • Inability to solve routine work problems
  • Irritability
  • Sleepiness (including involuntary sleep onset)
  • Inability to concentrate or memorize
  • Lack of motivation
  • Headaches

If you recognise any of these signs or symptoms within yourself or others that is effecting how you feel, you can have a free, confidential chat with us. Call 01908 724227 or email keepingwell.blmk@nhs.net

Fatigue is a significant problem in modern society, largely because of high workplace demands, long duty periods, disrupted circadian rhythms, social and societal demands, and insufficient sleep (Luckhaupt, 2012). It is a complex phenomenon that occurs as a function of time awake, time-of-day, workload extremes, health, and on-the-job and off-duty responsibilities and lifestyle. 

Things you can try to combat fatigue:
  • Eating often and well – Keeping your energy up throughout the day is important, especially if you are on your feet often (e.g. nurses, social workers, police officers etc.) Eat regular meals or a healthy snack every 3 to 4 hours. Visit our eating well and nutrition page for more.
  • Moving and exercise – If your role is more sedentary, in particular those who are working from home, consider some bodyweight exercises (squats/lunges/pushups/pullups) for 15 minutes. Regular exercise will make you feel less tired overall, with small amounts initially and then gradually increased. Even taking a break to walk helps! Vist our page on looking after your physical health
  • Weight management – Sometimes excess weight can be exhausting to carry and put a strain on the cardiovascular system. If possible, it is something to consider in managing fatigue and general wellbeing.
  • Cutting out caffeine or alcohol – This may be difficult but a gradual decrease in these substances may show a positive effect. It’s always good to try as your body may have built up a tolerance which could also be affecting your fatigue. Visit our alcohol support page
  • Talking therapies – This could help people who constantly feel exhaustion. Cognitive behavioural therapy can support those who feel like their fatigue is more chronic. Get in touch with one of our advisors for more information.
  • Drink more water – It may seem obvious, but we can all forget to stay properly hydrated. Carry a water bottle with you while at work or download an app that will remind you to drink.

Compassion fatigue refers to the “emotional cost of caring for others or their emotional pain”, whereby the individual struggles emotionally, physically and psychologically from helping others as a response to prolonged stress or trauma.

It is often commonly confused with stress and burnout however it is not the same; burnout is a psychological response which involves emotional exhaustion, depersonalisation and reduced personal accomplishment due to occupational stress. However, compassion fatigue arises from dealing with individuals who are in psychological distress or have been psychologically traumatised.

How does compassion fatigue impact on health and social care staff?

Compassion fatigue develops over time, with healthcare workers being at high risk. Although compassion fatigue is not a mental health condition, it is associated with worsening mental health rates amongst caregivers and has led to more nurses leaving the profession (Nolte et. al, 2017). It also negatively affects the individual’s deliverance of care to others and their performance of occupational tasks.

The term was first defined in the early 1990s when it was considered a “unique form of burnout”. While compassion fatigue has been shown to be reversible and potentially preventable with recognition, understanding and permission for recovery (Johnson Moore, 2016), it is important to recognise its early warning signs, seek support and implement practical strategies to decrease the risk of burnout and development of other mental health conditions.

What are the signs of compassion fatigue?

The Canadian Centre for Addiction and Mental Health have identified many common warning signs of compassion fatigue:

  • feelings of helplessness and powerlessness in the face of patient suffering
  • reduced feelings of empathy and sensitivity
  • feeling overwhelmed and exhausted by work demands
  • feeling detached, numb and emotionally disconnected
  • loss of interest in activities you used to enjoy
  • increased anxiety, sadness, anger and irritability
  • difficulty concentrating and making decisions
  • difficulty sleeping and sleep disturbances like nightmares
  • physical symptoms like headaches, nausea, upset stomach and dizziness
  • increased conflict in personal relationships
  • neglect of your own self-care
  • withdrawal and self-isolation
  • an increase in substance use as a form of self-medication

If you recognise any of these signs in yourself or another person, you can talk to our wellbeing practitioners for a free, confidential chat.

Research on compassion fatigue is relatively recent and requires more investigations. Based on emerging evidence, the Canadian Centre for Addiction and Mental Health have a list of some recommended tips and strategies for helping with compassion fatigue. You can also watch the TED talk by Patricia Smith on her experience of Compassion Fatigue and recommended coping strategies.

  • Johnson Moore, K. (2016). “Compassion fatigue among nurse leaders.”, Doctor of Nursing Practice Thesis. Drexel University.
  • Nolte, A. G., Downing, C., Temane, A. & Hastings-Tolsma, M .(2017) “Compassion fatigue in nurses: A metasynthesis”, Journal of Clinical Nursing
  • Compassion Fatigue Awareness Project
  • Cocker, F., & Joss N. (2016) “Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review."
What is burnout?

Burnout is a state of physical and emotional exhaustion. It can occur when you experience long-term stress in your job, or when you have worked in a physically or emotionally draining role for a long time.

The NHS Staff Survey 2021 results indicate that NHS staff are experiencing high levels of burnout. Research by The King's Fund shows that NHS staff are 50 per cent more likely to experience chronic stress, a known contributor to burnout. Factors such as staff shortages, high workload, and pressures to maintain high quality patient care all contribute to burnout in NHS staff. According to the British Medical Journal (BMJ), burnout significantly impacts the retention of our highly valued NHS workforce, with more staff thinking about leaving the NHS.

Whilst burnout is a type of stress with overlaps in symptoms, the main difference is that stress is associated with a feeling of ’too much’, whereas burnout relates to a feeling of ’not enough’.  

Physical signs and symptoms of burnout
  • Feeling tired and drained most of the time.
  • Lowered immunity, frequent illnesses.
  • Frequent headaches or muscle pain.
  • Change in appetite or sleep habits.
Emotional signs and symptoms of burnout
  • Sense of failure and self-doubt.
  • Feeling helpless, trapped, and defeated.
  • Detachment, feeling alone in the world.
  • Loss of motivation. Increasingly cynical and negative outlook.
  • Decreased satisfaction and sense of accomplishment.
Behavioral signs and symptoms of burnout
  • Withdrawing from responsibilities.
  • Isolating from others.
  • Procrastinating, taking longer to get things done.
  • Using food, drugs, or alcohol to cope.
  • Taking frustrations out on others.
  • Skipping work or coming in late and leaving early.

Burnout isn’t something which goes away on its own. Rather, it can worsen unless you address the underlying issues causing it. If you ignore the signs of burnout, it could cause further harm to your physical and mental health in the future.

If you're feeling any of these common signs, or notice these signs in others. Please feel free to talk to us, we can help support. Call 01908 724 227 or email keepingwell.blmk@nhs.net.

Reference: helpguide.org

Burnout may be the result of unrelenting stress, but it isn’t the same as too much stress. Stress, by and large, involves too much: too many pressures that demand too much of you physically and mentally. However, stressed people can still imagine that if they can just get everything under control, they’ll feel better.

Burnout, on the other hand, is about not enough. Being burned out means feeling empty and mentally exhausted, devoid of motivation, and beyond caring. People experiencing burnout often don’t see any hope of positive change in their situations. If excessive stress feels like you're drowning in responsibilities, burnout is a sense of being all dried up. And while you’re usually aware of being under a lot of stress, you don’t always notice burnout when it happens.

Stress vs Burnout
Stress Burnout
Characterised by over-engagement
Characterised by disengagement
Emotions are overreactive
Emotions are blunted
Produces urgency and hyperactivity
Produces helplessness and hopelessness
Loss of energy
Loss of motivation, ideals, and hope
Leads to anxiety disorders
Leads to detachment and depression
Primary damage is physical
Primary damage is emotional
May kill you prematurely
May make life seem not worth living


If you recognise feelings of stress rather than burnout, it might be helpful to visit our coping with stress  page for further information and resources.

Stress may be unavoidable, but burnout is preventable. Now is the time to pause and change direction by learning how you can help yourself overcome burnout and feel healthy and positive again. Dealing with burnout requires the “Three R” approach:

  • Recognise - Watch for the warning signs of burnout
  • ​​​​Reverse - Undo the damage by seeking support and managing stress.​​​​​​
  • Resilience - Build your resilience to stress by taking care of your physical and emotional health.

Following these steps may help you reduce burnout from getting the best of you and regain your energy, focus, and sense of wellbeing:

  • Turn to other people: Reach out to those closest to you, such as your partner, family, and friends. Opening up won't make you a burden to others. Be more sociable with your coworkers. Developing friendships with people you work with can help buffer you from job burnout. Limit your contact with negative people. Hanging out with negative-minded people who do nothing but complain will only drag down your mood and outlook. 
  • Reframe how you look at your life and work: Try to find some value in your work. Focus on aspects of the job that you do enjoy, even if it’s just chatting with your coworkers at lunch. Find balance in your life. If you hate your job, look for meaning and satisfaction elsewhere in your life: in your family, friends, hobbies. 
  • Take time off: If burnout seems inevitable, try to take a complete break from work. Use the time away to recharge your batteries and pursue other methods of recovery.
  • Reevaluate your priorities: Set boundaries. Don’t overextend yourself. Learn how to say “no” to requests on your time. Take a daily break from technology. Set a time each day when you completely disconnect. Put away your laptop, turn off your phone, and stop checking email or social media. Set aside relaxation time. Relaxation techniques such as yoga, meditation, and deep breathing activate the body’s relaxation response, a state of restfulness that is the opposite of the stress response. Practice good sleep habits. Feeling tired can exacerbate burnout by causing you to think irrationally. Keep your cool in stressful situations by getting a good night’s sleep.
  • Eat a balanced diet: Eating a healthy diet filled with omega-3 fatty acids can be a natural antidepressant. Adding foods rich in omega-3s like flaxseed oil, walnuts, and fish may help give your mood a boost.
  • Make exercise a priority: Not only is exercise good for our physical health, but it can also give us an emotional boost. Stretched for time? You don’t need to spend hours at the gym to reap these benefits. Mini-workouts and short walks are convenient ways to make exercise a daily habit.
  • Reduce smoking and alcohol:  Smoking when you're feeling stressed may seem calming, but nicotine is a powerful stimulant, leading to higher, not lower, levels of anxiety. Alcohol temporarily reduces worry, but too much can cause anxiety as it wears off. For tips to help you cut down visit our drug, alcohol and tobacco support page.

Reference: Healthline and helpguide.org

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If you are unsure about needing further support, you might want to complete the self-assessment questionnaires on low mood to find out more about your symptoms, click below.