Crisis Fatigue: A Form of Burnout

 I recently came across a term I hadn't heard before, "crisis fatigue" Crisis fatigue occurs when our ability to be resilient (or "bounce back") is flooded with an ongoing series of intense, energy-consuming or traumatic experiences. As best as I can tell, it's a form of burnout. Crisis fatigue, like burnout, is a response to ongoing and intense stress, like that faced by people trying to survive war or armed conflict, economic or financially stressful conditions, political instability, natural disasters, or - yes - a pandemic. Based on what I'm hearing from my colleagues and patients, many of us are facing crisis fatigue.

Photo Credit: Nataliya Vaitkevich, from: https://www.pexels.com/photo/matchsticks-on-pink-surface-6837623/

Crisis fatigue involves signs and symptoms similar to burnout: feeling intense stress with little ability to affect ones circumstances or conditions, increased frustration, decreased sense of empathy or compassion, and difficult regulating mood and behavior. It begins with a stress response, including increased heart rate and respiration, increased blood pressure, tension in the muscles, decreased ability to concentrate or focus, slowed digestion, changes to sleep, ongoing emotional distress or numbness, and decreased immune response. When the stress goes on for too long, the body starts breaking down; essentially, our "fight, flight, or freeze" response has become our new normal until our bodies and minds simply can't maintain it anymore. Intensely stressful events can cause this reaction, and when they're followed by continued intense stress, we simply can't function as well. For example, in regard to the Covid pandemic, many people experienced intense stress and fear around getting sick. When this fear doesn't decrease, our bodies and minds can't adjust as quickly to other things going on in our environments, including other stressors or stressors that are secondary to the initial stress (for example, long Covid, grief, or financial or occupational consequences of illness.) 

For healthcare workers, whether first responders or not, the stress has been going on for close to 2.5 years at this point. At first, there was appreciation for them - the "heroes work here" signs and buttons, the clapping or singing from windows, etc. However, as the pandemic became more politicized and people became increasingly tired of restrictions and the chronic nature of the pandemic, healthcare workers started to experience pushback on basic health precautions, being berated or attacked for trying to enforce restrictions in clinics and offices, and derision for continuing to wear masks. As we approach our third year of this pandemic, many of us are simply worn down, with a good case of emotional whiplash from the political back-and-forth we've experienced from the beginning of the pandemic to now. On top of all this, we're all struggling with increased prices for food, gas, and other necessities, fear regarding our own safety, continued political unrest (in the United States and elsewhere), and all the ongoing detritus of our personal lives. In addition to the pandemic, those of us in the US also endured a hotly contested presidential election complete with lies regarding election fraud and a stolen presidency, an insurrectionist attack on the Capitol Building, months of news regarding the outcome and potential consequences of that attack, the overturning of a 50-year precedent allowing access to abortion, and uncertainty regarding what's going to happen next. It feels like a constant rollercoaster of emotions with no way to get off the ride.

Frankly, we're simply exhausted. Bone-deep, soul-worn, exhausted. And yet, here we are. Regardless of your political beliefs, the past year has affected us all intensely and deeply. How do we take care of ourselves, whether we're in healthcare or not? These suggestions are drawn from the excellent article on crisis fatigue by Steph Coelho at https://www.medicalnewstoday.com/articles/crisis-fatigue. 

• Take a break: If you can, take a brief "mini-vacation" from work and other obligations. A day, or even a half-day to help yourself recharge can do wonders for your well-being. Do something you enjoy, go somewhere fun or special, take yourself out on a date for lunch or a movie. Make a commitment to yourself to not give in to the temptation to check on work, coworkers, (or if you're in healthcare), patients unless absolutely necessary.
• Disconnect from the world and Reconnect with yourself: If you can, turn off your cell phone, don't check email, stay off social media, and don't watch the news. Find something that you can do slowly and mindfully, such as reading a book (a real book, if possible), or do a jigsaw puzzle. Color some pictures, or spend time in nature. Try to slow down and really notice what is going on immediately around you and within you. You might actually find this uncomfortable if you're used to being on the go or plugged in during your waking hours. Sit with the discomfort and see what your body, mind, and soul are telling you.
• ​Talk with someone and/or Ask for help: Whether a friend, family member, or professional counselor, it helps to process your stress with someone. It also helps to know you're not alone. As Ram Dass famously said, "We're all just walking each other home." While it can be difficult to open up, doing so can help you release some of the stress, pain, fear, or other emotions associated with crisis fatigue. Many employers have EAP services available, and connecting with someone who can help you and reassure you can be immeasurably valuable. You don't have to get through this alone!
• Move: Moving your body is good for the soul and mind as well as the body. Find an activity that you enjoy, and move! Whether it's a formal workout program or routine, or something less structured, moving joyfully can relieve stress both short-term and help build resiliency. Try something new, if you're brave enough, or contact a friend and buddy-up to help both of you! Dance to music in your living room, play in the water like a dolphin or little kid, jump on a trampoline or jump rope, try roller-skating, go for a bike ride - the possibilities are endless! Stop when you're tired, pace yourself, and create challenges for yourself if it helps.
• Do something interesting: Pick up a hobby or activity you haven't done for a long time, or learn something new. Maybe think about signing up for a class at your local craft or art store, work in a garden, volunteer at a pet rescue, research places you want to visit. As with moving, the possibilities are endless!
• Establish a routine: When I work with patients experiencing insomnia, we talk about how important an evening routine is. Creating and maintaining a relaxing evening routine or a stimulating morning routine will not only help you reduce stress, it can also improve your sleep and overall well-being. While having a routine is important, staying flexible when needed also helps. For evening, you might consider getting your clothes ready for the next day, thinking about what you want to have for your breakfast, doing something relaxing as evening progresses, and working to establish healthy sleep hygiene and bedtime behaviors. A light snack can be helpful (the key idea is light - too much food can cause sleep problems), as can listening to music, an audiobook, or relaxing music. Pay attention to how you react to the things you do - if they're too stimulating or keep you alert, they are not likely to help with sleep, even if the activity is mentally relaxing (like reading, for example.)
• Respect your limits: We all have limits. We push and push and push ourselves, sometimes past what is healthy for us, and then try to push ourselves more. We regularly run out of energy and spend days in either a caffeinated frenzy or fog of fatigue. Somedays, we may end up with both, depending on the time of day. Pay attention to when you start feeling tired or stressed, and plan to take care of yourself when you do notice. Self-care doesn't have to be expensive or time-consuming; sometimes getting up and getting a drink of water, stretching, or simply not cutting your allowed breaks short can make a big difference in well-being. Creating, maintaining, and enforcing healthy personal and professional boundaries is also critical; you may need to set limits with others in order to respect your own well-being.
• ​Prioritize your well-being: While it would be wonderful if our employers, co-workers, friends and acquaintances, and family members would say, "hey, it's ok to take a break," or ask, "What do you need to do to take care of yourself?" the reality is, they are likely in the same boat as you are to some degree. In the U.S., the corporate culture we have doesn't tend to be very forgiving of human needs such as fatigue, burnout, stress, depression, or other consequences of ongoing stress. That means that we will, in all likelihood, need to be the ones to assert our needs and advocate for what we need. Many of us, whether from cultural values, the roles we take on, or other reasons, tend to put our needs on the back burner. Women especially tend to do this, as the majority of child-care and household chores still tend to be laid at our feet. However, advocating for your needs and taking care of yourself as a regular practice are some of the most fruitful and self-respectful things we can do. We NEED to prioritize our self-care if we want to continue meeting all the demands on our time and energy.

All told, these suggestions boil down to take your needs seriously, take care of your well-being, reach out for help if you need, and respect your needs and limits. Please, take care of yourself - you are worth it!

​Please Note: The content on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, please call 911 for 988 or immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. Email me at: [email protected] if you want to set up an appointment.