One of the outcomes of the pandemic has been an increased awareness of how negative mental health and stress impact the body. More than ever before, widespread conversations are happening about mental health and self-care. In Ontario, the spread of COVID-19 has had a significant impact on our health care system – including our front-line workers. The burden the pandemic has put on our frontline workers, including isolation from their families, gruelling working hours and being at a high risk of infection due to a lack of PPE is serious. During such a difficult time, it can be hard to suss out and understand the different impacts these working conditions might have, how exactly they are manifesting, and what sort of support is needed to manage them. Depending on what a frontline worker is experiencing, we might be looking at burnout, compassion fatigue, and/or PTSD. Each one may require a different strategy to manage, but how can we identify which one we are experiencing? Let’s take a look.

Burnout

Burnout can be experienced in any profession (but especially for frontline workers), and typically involves a general sense of feeling worn out. Stressors in our life can impact us physically, and signs of burnout may include fatigue, anger, irritability or short temper, and/or withdrawal to name a few. Burnout has a tendency to build up over time and requires healthy coping strategies such as:

• Delegating work and saying no when you need to

• Working reasonable hours for you

• Taking breaks

• Opening up to talk to a supportive person in your life

• Maintaining enjoyable activities

• Seeing a mental health professional

• Letting go of imperfection

Of course, not everyone may be in a position to have such control over their schedule. It’s important to work toward learning how to set and maintain boundaries in our working lives.

Compassion Fatigue

Compassion fatigue is something that can be anticipated with certain professions such as being a frontline worker, health care provider, mental health professional, social worker, etc. While it has similar symptoms as burnout, it involves also taking on the trauma and emotional stress of those being served. It can be described as the ‘prolonged exposure of working with those suffering from the consequences of traumatic events. Frontline workers are taking this on every day. Nurses and doctors are witnessing sick patients alone, unable to see or be supported by their families because of COVID-19. Mental health professionals are experiencing compounded COVID-19 stressors as they take on the stressors of their clients. Social workers are operating in a high crisis mode, trying to provide for those who are most vulnerable right now. Our frontline workers are trapped in a state of high alertness, often referred to as the fight, flight or freeze response. This can create a significant physical manifestation of the stress including (but not limited to):

• Digestive problems

• Muscle tension

• Headaches

• Psychological distress

• Disturbances in relationships

• Poor concentration, focus or judgement.

While burnout can be managed and worked through with healthy coping strategies, the long-term impacts of compassion fatigue require a different approach. Just as the body has been involved in the trauma, so too does the body have to be involved in the healing process. Somatic therapeutic approaches incorporate our physical selves and can be particularly valuable for frontline workers, given the deep entanglement between the mental and physiological impacts.

Post Traumatic Stress Disorder (PTSD)

In a review of studies on the impact of severe epidemics on health care workers, the “most common psychiatric disorders diagnosed were post-trauma stress syndrome (PTSS), depression and anxiety.” It also identified that during the pandemic, somatization (the body responding physiologically) has been reported by 42% of health care workers. Some of the signs and symptoms of compassion fatigue and PTSD overlap, however, PTSD is more related to the traumatic stress of events happening to or witnessed by a person whereas compassion fatigue is about taking on the secondary stress of the person(s) being served. It is a severe psychological disorder and requires professional help. Somatic therapy can also be helpful in this situation.

Identifying What You’re Going Through

Being able to identify and name what you’re going through is powerful, and often a step towards learning how to cope and heal from the experiences. The Professional Quality of Life Assessment might help to get you started, but if you are unsure you should speak to a professional.

Thank You, Frontline Workers

From the community at New Pathways Centre, we want to say a big, resounding THANK YOU to all of our frontline workers for their tireless efforts during the pandemic, and every day.