If you are in a helping profession (like a therapist, nurse, teacher, etc.) or have ever cared for someone during an illness or another difficult period, you know how difficult can be to bolster others when you are running on empty. That is why it is so, so important not to let yourself get to that point.

I usually counsel my clients to try to operate at 80% capacity for most of their life so that if there is a crisis or something that will take up energy, you have the reserves to deal with it. But it seems like a lot of people operate at 100% capacity all the time. That is ALL we have to give, and it is obvious why giving everything all the time would lead to burnout. If you want to keep helping others, you have to help yourself.

How do you know if you are burned out? Well, if you are experiencing compassion fatigue, you may notice:

  • Depression
  • Anxiety
  • Exhaustion
  • Irritability
  • Physical illness (e.g., hypertension, high blood sugar, excess body fat, abnormal cholesterol levels, cardiovascular events, musculoskeletal disorders)
  • Insomnia or difficulty staying asleep, or decline in quality of sleep
  • Low motivation to go to work or get things done at home
  • Increased alcohol, caffeine, or technology use
  • Avoidance
  • A decline in pro-health behaviors such as healthy meals, hydration, and going to the doctor
  • Loss of interest in hobbies or passions we usually enjoy

For caregivers, when these symptoms start cropping up and there is not another clear-cut reason, we need to think of burnout.  Sometimes, the caregiver needs to handle something in their own life differently. Sometimes, we can stave it off with self-care activities. But most of the time, what needs to change is our mindset. We cannot help everyone all of the time. We cannot work harder than the person we are trying to help. And if the help we are giving is not working, we need to try something else.

This is usually the part of the discussion where we talk about different kinds of self-care. I do not want to undermine the importance of self-care, but it is more than a pedicure or mindfulness meditation or time management. We all know the things that we should be doing to manifest the healthiest versions of ourselves. And we all know that we have a duty to take care of ourselves in order to continue to effectively help others. But frequently, the way to do it is not self-care, it is to let go of the idea that everything is within our control.

As a therapist, I know that we only have a few choices in any given situation, which I use the acronym SCAM to describe – we can Solve the problem, Change the parameters of the problem, Accept the situation as it is, or stay Miserable.  When something is beyond out control, we really only have the A or M options. Do we want to accept it or be miserable? I know which one I would pick in any given situation. The “cure” is the idea of Radical Acceptance – that we cannot change the things that have happened in the past, and really have no choice but to accept them or be miserable. Fighting that will only make you suffer more.

But to accept is to admit we do not have control.

Therapists who are the most effective know that you cannot help everyone all of the time. Sometimes, our personality or style are not a good fit for someone. There is nothing wrong with that – sometimes, you cannot solve the problem. Maybe they need a different therapist, or they need to change something they are unwilling to change. Maybe we, as caregivers, need to accept our limitations. Because we certainly do not want to be miserable.

We all need to admit that we do not have control over others’ choices.

Once we wrap our heads around that, our batteries will be easier to recharge, and we will be able to function more effectively, even in crisis situations.

To recharge those batteries, we still need to engage in self-care, not just critical thinking. To make that happen, you need to find the things that engage and stimulate you as well as those that relax and calm you, because every good self-care routine will have elements of both. And eating well, exercising, sleeping, and taking care of your physical body will always be important. Some of my must have self-care activities are walking in my neighborhood with my dogs, doing various creative activities like craft projects, art  & writing, using all five of my senses in meditation & soothing exercises, having social time every week with family or friends, keeping TV and social media to reasonable levels,  and making sure that my home remains as clutter free as is reasonable & possible.

Whatever recharges and soothes you is what you want to do – as long as it is healthy. Abusing any of the things that soothe us in the right amounts can depress or over-stimulate you if you are doing too much of them. Answering some of the following questions might help.

  • What kind of spiritual activities are helpful for me?
  • How much sleep do I need every night to function well the next day?
  • How much alone time do I need? Down time?
  • How many and what type of social engagements are reasonable in a week?
  • How much and what kind of exercise makes me feel positive and energized?
  • How much screen time shifts my attitude to the negative?
  • Is social media helping bring me up or is it bringing me lower?
  • What about my home/office/car/room makes me happy? What about that space annoys or drains me?
  • How often and how much do I need to eat to maintain energy and feel satisfied?
  • How do I work on gratitude and acceptance every day?
  • What boundaries do I need to set (with work, relationships, family, friends) to feel more energy?
  • What do I really enjoy doing?

Answering those questions – and following through on making the answers your reality – will help you stay alert to burnout and remedy the situation more quickly when things start to get out of those bounds.

Caregivers tend to avoid asking for help when they need it but are much better at advocating for others. Sometimes we need to talk through these issues with someone to clarify what changes can or need to be made – family, friends, or someone impartial like a therapist can all be helpful. If you have trouble answering these questions or want to talk through the answers, please reach out.


Kendra Wilson, MSW, LCSW, CEDS-S, DBT-C is a licensed clinical social worker and the Clinical Director for Chrysalis Center’s Intensive Outpatient Program. 

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