Adrenal fatigue and weight gain – What to do?

For many individuals, unusual weight gain, fatigue, irritability, anxiety, and depressive disorders tend to be connected with a thyroid condition. While I am a functional medicine practitioner that specializes in thyroid health, I happen to equally see a countless number of patients who believe their thyroid may be the culprit when they are actually experiencing adrenal issues.

The adrenals are often associated with weight gain, which is not a thing that is mentioned practically enough. The fat gain is typically right exactly where we don’t want it — right in our waistline!

Normally, this is connected to a cortisol imbalance, which is a stress hormone created by the adrenal glands. Cortisol is unveiled from those glands while we are experiencing stress. Along with excessive cortisol loading on the weight right where the majority of us are planning to lose it, cortisol imbalance and adrenal dysfunction can also be the cause of many other unwanted symptoms, such as fatigue, anxiety, and depression.

Stress and Adrenal Fatigue

Facing continuous stress, our adrenal glands shift to overdrive so that they can generate plenty of cortisol to deal with the “threats.” While our system is well-equipped to take care of temporary triggers, long lasting exposure inhibits the body’s normal stress response – incorporating those of the adrenal glands. More specifically, an essential “shut down” mechanism of the adrenal glands (initiated by the brain) is reduced. This can result in a state known as Adrenal Fatigue.

Here are some common signs and symptoms of Adrenal Fatigue:

– Mild depression or anxiety

– Lethargy and lack of energy

– More effort needed to complete tasks

– Less ability to handle stress

– Dry or thinning skin

– New or worsening allergy symptoms

– Sugar or salt cravings

– Cognition problems (such as “brain fog”)

– Decreased libido

Adrenal Fatigue and Weight Gain

(Make sure you do not disregard the significance of the abovementioned information – as we consider it essential to understanding the mechanisms of stress-related weight gain.)

Alright, now it’s time to explore the real concern at hand: is adrenal fatigue causing you to gain weight? Here are some indications that the disorder is present and is generating added pounds:

1. You have been facing high stress levels for a long time.

Earlier we mentioned chronic stress may stimulate an impulse that impairs adrenal gland function. To speculate whether or not any weight gain is a side product of Adrenal Gland Fatigue, must identify if you have Adrenal Gland Fatigue. The first step is to measure the level and duration of your exposure to stress.

2. You frequently crave sugar or salty foods.

“Stress eating” generally entails the intake of sugar or salt-laden foods. Sugar pangs are the direct result of a blood sugar imbalance, which is the outcome of unexpected blood sugar crashes. The distinguishing symptoms of a blood sugar crash are coexisting feelings of hunger and irritability. Salt cravings are the result of the inadequate delivery of sodium to the adrenal glands.

3. Fat is erratically stored in the midsection.

Simply because the caloric intake of sugary and fatty food goes up, an individual with Adrenal Gland Fatigue will notice a disproportionately pudgier abdomen. This is because belly fat hastens the breakdown of fatty acids, which can be brought to the liver quicker than other areas of the body.

4. There’s a family history of Metabolic syndrome

Metabolic syndrome (MetS) is a therapeutic expression used to describe a set of specific circumstances. Among these conditions are “increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels – that happen collectively, upping your likelihood of heart disease, stroke, and diabetes,” according to the Mayo Clinic. Metabolic syndrome is associated with cardiovascular diseases and type 2 diabetes. MetS “has a significant genetic component,” and is linked to Adrenal Fatigue.

5. You have a thyroid condition

Enhanced cortisol levels over a prolonged time may lead to thyroid gland disorders. A thyroid disorder may range from a goiter to cancer. The most frequent thyroid trouble is hyperthyroidism (excessive generation of thyroid hormones) and hypothyroidism (underproduction of thyroid hormones). An association has been found out between thyroid conditions and Adrenal Fatigue.

How to check weight gain by normalizing adrenal function?

1. Support Blood Sugar Levels

The most significant points you need to work on happens to be blood sugar support. This is essential no matter what sort of hormone discrepancy you may be struggling with. Blood sugar balance is so crucial because when our blood sugar levels drop, we are more vulnerable to going through anxiety, and our systems often go into this fight-or-flight response.

Hypoglycemia (low blood sugar) can also be a risk element by itself for high cortisol levels and any other body hormone imbalance. This is the absolute final thing we desire when we making the effort to bring back regular cortisol function.

Assisting blood sugar levels with diet is one of the first actions you can take. Make an effort in getting rid of processed and sugary foods and beverages from your diet, and stay with anti-inflammatory food products with lots of fiber and healthy fat.

Also steer clear of eating any carbohydrates alone. We suggest eating carbs with some protein and healthy fat to avoid a spike in blood sugar.

2. Support a Healthy Circadian Rhythm

Having enough sleep is a crucial step in assisting adrenal health and managing cortisol levels. With a healthy and balanced circadian rhythm, cortisol levels will be higher in the morning hours, after that gradually decrease during the day and drop when it is time to sleep.

When you are coping with chronic levels of stress and your cortisol levels are out of whack, you will probably find it hard to sleep at night, and then once you do get to bed, you may feel worn out when you wake up.

By minimizing stress, consuming a far more balanced diet, and applying some of the steps below, you need to be able to help bring back a more regular circadian rhythm to help you get a better night’s sleep.

3. Avoid Blue Light at Night

Blue light is the light that arises from items like our cell phones, TVs, and computers, and often, we are subjected to these resources of blue light all day. Receiving an excessive amount of contact with blue light at night can cause our circadian rhythm to be tossed off harmony. These lights may well trick our system into thinking it is still daytime rather than night, continuing to keep our cortisol levels too high to let us to go to sleep. Our systems will generate more cortisol rather than melatonin. To prevent this, stay away from all sources of blue light at nighttime. If you have to use your phone or computer at night, there are some blue light reduction apps to minimize your exposure.

4. Get Enough Sunlight During the Day

There is certainly something special in being outside which makes us feel a lot better! Nobody desires to be stuck up inside or behind a desk at work. Get outdoors for at least 15 to 20 minutes on a daily basis to get some fresh air and sunlight. Sunshine allows you enhance your vitamin D levels, that may be vital for mood and hormone balance, but you might also observe that good quality old fresh air assists in cutting your overall stress levels. You would be amazed how getting outside for even half of your lunch break will have you feeling revitalized when it comes time to get back to work.

5. Try Mindfulness Training

Mindfulness techniques are a terrific way to help educate you to ultimately just be in the present moment without objective viewpoint and thinking. This can assist in ignoring any unneeded stress and just aid you in recombine a bit to take on whatsoever is ahead of you for the rest of the day. To rehearse mindfulness, just sit in a comfy location and just be present with the thoughts. If any judgment sets in, just let it go. Simply by exercising mindfulness daily, you can actually help yourself be a little more mindful in other areas of your life as well, which can be often very helpful when it comes to stress lowering. You may also carry out some deep breathing daily, which can be superb for overall relaxation and helps to kick in the parasympathetic nervous system, which can help naturally relax the body.

6. Try Adaptogenic Herbs

Adaptogenic herbs are awesome because they help the body restore balance. They can be utilized for either high or low cortisol, as they reply to whatever the situation demands in the body and make it possible for stability and balance to take place when it comes to the hormones. They can especially lower inflammation, which are both equally key to evening out cortisol levels. Good adaptogenic herb options include ashwagandha, astragalus, and holy basil. Read more on these in this article.

There are several wonderful natural steps to assist in supporting ideal adrenal health. Nevertheless, it’s always a good idea to do proper testing to see if you are addressing either high or low cortisol, as both can be an issue.

There are so many great tests available today that will tell you exactly what is going on with your cortisol levels.

This will help in supporting your hormones and adrenals . . . and start off slimming down naturally and being your best! For the time being, start some of these tips on controlling your cortisol levels naturally to find out just how much of an improvement it can make in your health.


Carnahan, J. M.D. (2015, May 17). Signs You Might Have Adrenal Fatigue. Retrieved May 13, 2017, from
Grohol, J. (2012). What’s the Purpose of the Fight or Flight Response?. Psych Central. Retrieved on May 13, 2017, from
Mayo Clinic Staff. (2016, March 19). Metabolic syndrome. Retrieved May 13, 2017, from
Stancakova, A., & Laakso, M. (2014). Genetics of metabolic syndrome [Abstract]. Reviews in endocrine & metabolic disorders, 15(4), 243-252. doi:10.1007/s11154-014-9293-9
Thomsen, A., M.S., R.D., L.D.N., (2014, April 29). Is Adrenal Fatigue Making You Fat? Retrieved May 13, 2017, from
WebMD. (2017). Understanding Thyroid Problems – the Basics. Retrieved May 13, 2017, from

Best adrenal fatigue supplements to support adrenal function

Health supplements offered to increase energy, reduce stress and other manifestations caused by “adrenal fatigue” may contain a variety of ingredients, including vitamins and minerals, herbs (such as ashwagandha, ginseng, holy basil, rhodiola, and schisandra), and/or dehydrated adrenal gland tissue from animals (often from bovine source, i.e., cows).

Although some of these substances have on their own been proven to decrease fatigue or symptoms of stress, there is presently very little evidence that “adrenal support formulas” do the same or improve adrenal gland function.

On top of that, a comprehensive research on well-known adrenal support supplements on the market discovered that a huge percentage of them all were contaminated with small quantities of thyroid and steroid hormones, which could possibly cause negative effects or interfere with blood test results.

Although no research completely demonstrates the effectiveness of adrenal support supplements, there are medical experts like Dr. Lam and Dr. Axe who testify with absolute conviction that such adrenal support supplements can be quite effective.

There are many people in the world already taking a formula and have tracked the effectiveness through lab work and their adrenals are gradually healing.

However, not every formulation will work for everybody; it is a matter of choosing the best one for your specific constitution.

For some people, they have had tangible results from Apex Energetics Adaptocrine or Dr Berg Adrenal & Cortisol Support, or even Genf20 Plus (that focuses on Growth Hormone aspect of stress control and has helped a lot of people tremendously, especially aging population).

Whatever you do, make sure you don’t make these mistakes while taking an adrenal fatigue supplement. Another useful tip is that you should measure you cortisol levels, and then decide which supplement is best for you depending on whether you have high cortisol or low cortisol.

If you find you have high cortisol and you often suffer from any kind of stress, our number one supplement recommendation would be Genf20 Plus. It’s an hGH enhancing supplement that works wonders to beat stress and help optimize general hormonal issues.

Read more about it and HGH supplements here.

Taking Adrenal Fatigue Supplements and Herbs

One crucial big key to conquering adrenal fatigue is taking the correct supplements using supporting herbs. We usually recommend consuming the right foods to recover your body. Nevertheless, it can always be difficult task to get plenty of of every nutrient that you require on a daily basis.

So, it could be beneficial to sensibly use dietary supplements for vitamins and minerals specifically fundamental for adrenal support.

Furthermore, there are certain herbs, spices and essential oils that will allow you to combat adrenal fatigue and assist an energetic, vibrant life.

Adaptogenic herbs ashwagandha, rhodiola rosea, schisandra and holy basil: Study shows that adaptogen herbs might help to reduce cortisol levels and mediate stress responses within the body. (18, 19, 20) By making use of these kinds of herbs in food preparation, you can relieve some of the stress on your adrenal glands.

Licorice root: This spice is for sale in extract form and enables increasing DHEA levels in your body. (1) Licorice root is connected with some adverse reactions though and may sometimes be avoided by taking DGL licorice. (2) Pregnant women and those with heart, liver or kidney problems should avoid licorice root. Don’t take it for more than four weeks at a time. (3)

Fish oil (EPA/DHA): There are a lot of health advantages of supplementing with fish oil (or, for people on vegan or other plant-based diets, algal oil). A number of these consist of counteracting several adrenal fatigue-related signs of illness and issues, which can include diabetes, mental dysfunction, arthritis, immune system function, skin issues, weight gain and anxiety/depression.

Magnesium: For years, magnesium has been recognized as among the crucial nutrients for combating adrenal insufficiency. (4) While the details on how it supports adrenal function aren’t completely grasped yet by the experts, you may definitely reap the benefits of supplementing with magnesium if you are struggling with adrenal fatigue.

B-Complex vitamins: Studies have observed that vitamin B12 deficiency may be connected to stress on the adrenal cortex in some animals. (5) Vitamin B5 is one more frequently deficient vitamin in patients suffering from adrenal stress. Particularly if you’re cutting down or eliminating meat from your diet to be able to fight adrenal fatigue, it may serve you well to take a high-quality B-complex vitamin supplement.

Vitamin C: Referred to as a “stress-busting” nutrient, vitamin C has been discovered to reduce the effect of stress on people as well as decrease the time required to recover from stressful events. (6)

Vitamin D: Besides retaining homeostasis between magnesium and phosphorus in the human body and assisting strong bones, Vitamin D has also more ended up to be seen to have effect on other types of conditions, such as adrenal dysfunction and disease. (7)

Selenium: At least one animal research has identified that selenium deficiency can adversely influence adrenal function.(8)

Lavender oil: Human and animal research shows that lavender essential oil has a soothing impact that can decrease stress. (9) Research also indicates that it may lower high cortisol levels when inhaled.

Rosemary oil: Rosemary essential oil (along with lavender) will help lower cortisol concentrations and minimize oxidative stress on cells. (10)

Whole-food-based supplements from reputable companies and using only 100 percent, therapeutic grade, USDA Certified Organic essential oils are recommended.

Adrenal supplements vs Drugs

An oral dose of 20 milligrams of hydrocortisone is proposed by some medical doctors for consistent management of cortisol levels, while an occasional dose of 50 milligrams may be recommended but must not be taken regularly or in larger doses.

Your physician or endocrinologist should help you to be aware of likely negative effects of this and any other prescription they recommend.

Here is more reviews by patients on

How Long Does It Take to Recover from Adrenal Fatigue?

It isn’t really an easy query to answer, mainly because adrenal fatigue recovery time has never been researched. Recovery for adrenal fatigue might take some time, nonetheless. All things considered, it was a little while until, maybe years, your adrenals started wearing out; so it definitely requires a bit of time to develop their strength again. For full adrenal recovery, you can expect it to take:

6–9 months for minor adrenal fatigue
12–18 months for moderate fatigue
Up to 24 months for severe adrenal fatigue

The ideal strategy is to make sound changes to your way of living for long lasting results. A lot of people notice a positive change in their overall well-being after just a couple of weeks of better diet that helps with cleansing of the body and that is supported with adrenal fatigue supplements.

If you strive for a balanced lifestyle with a healthy level of sleep, exercise, fun and an optimistic environment, then you are almost certainly to keep your adrenal system heading healthy and balanced!


Most doctors are thinking about adrenal fatigue diagnoses and their legitimacy, simply, because they rarely want people to wrongly “treat” themselves for a condition and finish up even worse than they were to begin.

First of all, keep in mind that any new diet regimen or addition of supplements in your lifestyle should be integrated under the expert guidance of a physician/naturopath you have confidence in.

On the whole, bringing out more plant-based foods into your lifestyle and getting rid of stimulant medications, sugary foods and refined items with a ton of sodium or chemical substances put into them is going to help you feel and live better, no matter what medical conditions you may or may not have.

The bigger and more important dilemma comes when bringing up herbs, spices, supplements and essential oils used to fight adrenal fatigue.

Always retain these precautions in mind and don’t blindly make use of these without therapeutic supervision or proper education on how, how much, how often and how long to use these supplements.

Medicinal Mushrooms: As a result of the way mushrooms such as cordyceps and chaga connect to the body and different prescription drugs, it is suggested that pregnant or nursing mothers by no means use them. Furthermore, a person with autoimmune conditions, diabetes or a bleeding disorder must not employ medicinal chaga or cordyceps. These is one particular case report of chaga supplementation causing kidney damage in a woman with liver disease who took chaga every day for six months. This mushroom also is made up of oxalates and may prevent some nutrient absorption in large doses.

Adaptogen Herbs: Plenty of medical experts advise only using one adaptogen herb at a time (and not every day), then transitioning over to a different one. As a result of insufficient evidence about their wellbeing during pregnancy, adaptogen herbs can never be utilized by pregnant or nursing mothers.

Rhodiola rosea continues to be infamous for (uncommonly) causing allergy, insomnia, irritability, increased blood pressure and chest pain. It may interfere with psychotropic drugs, birth control pills, diabetic and thyroid medication, as well as add to the stimulant effects of caffeine and affect platelet aggregation.

Although comprehended as fairly safe when taken on the temporary basis, ashwagandha has not been researched for long lasting usage effects. Too-large doses may lead to digestive disorder symptoms including nausea, diarrhea and vomiting. People with diabetes, irregular blood pressure, stomach ulcers, autoimmune diseases, thyroid disorders or upcoming/recent surgery should not use ashwagandha.

Holy basil, an Ayurvedic treatment gold mine, is considered to be safe and sound for up to 6 weeks, while long term results are unidentified. Additionally, you should not take holy basil before or after surgery because it could raise your risk of bleeding.

Essential Oils: Learning the ins and outs of essential oils can be a large task, but the two generally suggested for adrenal support, lavender and rosemary, are relatively simple. Neither have been tested on pregnant women and therefore should not be used while carrying a baby or nursing.

Lavender oil shouldn’t be applied along with any other sedatives. Lavender oil is also acknowledged as safe when it comes to oral use (when looking at 3 drops at a time diluted in water).

Rosemary oil should never be applied internally, as it may cause vomiting and spasms. You may inhale it, or use it topically at a 50:50 dilution of a carrier oil.

Psychosocial stress and stressors and treatment strategies

Biologists describe stress as an unfavorable perception you go through when your body does not adequately react to a threat. Psychosocial stress is the term for a particular type you go through that arises from any type of interaction or discussion with people. Stress may present itself in many different ways, such as high blood pressure, sweating, rapid heart beat, dizziness and feelings of irritability or sadness.

Causes of psychological stress, referred to as psychological stressors, can be categorized as chronic or acute.

Psychosocial stress impacts the majority of us from time to time and can have a whole lot of toll. It is the consequence of a cognitive assessment (your mental interpretation) of what is on the line and what may be done about it. Basically put, psychosocial stress happens if we examine a perceived social hazard in our lives (real or even imagined) and be aware of it may call for tools we don’t have.

Different kinds of psychosocial stress range from any situation that equates to a perceived threat to our social status, social esteem, respect, and/or approval within a group; danger to our self-worth; or a hazard that we presume we have no control over. All of these risks can result in a stress impulse in the body. These can be probably the most challenging stressors to deal with, as they can make us come to feel unsupported and alone. This can make it harder to manage.

When psychosocial stress activates a stress impulse, the body system launches a number of stress hormones incorporating cortisol, epinephrine (or adrenalin) and dopamine, that leads to a rush of energy along with other changes in the body (see this article on the fight-or-flight response for more.) The modifications caused by stress hormones can be of help temporarily, but can be detrimental over time.

To illustrate, cortisol could very well enhance the body’s performance by strengthening available energy (so that fighting or fleeing is more feasible) but can bring about reductions of the defense mechanisms in addition to a host of other effects.

Epinephrine can also mobilize energy source, but also produce unfavorable psychological and physical effects with continuous exposure. For this reason it’s crucial to take care of psychosocial stress in our lives so that the stress impulse is only brought on when required. It’s important too to understand stress relief strategies to efficiently invert the stress response so we don’t encounter continuous states of stress or chronic stress.

List of psychosocial stressors

Acute Present Stressors

Psychosocial stress can be brought on by distressing events that took place to or around you recently. Instances of these recent stressful situations include a recent natural catastrophe, just like an earthquake or hurricane in your area, or an unexpected medical condition in yourself or somebody you care about. The National Institutes of Health state that if you undergo a dreadful condition or a loved one dies in an incident, severe psychosocial stress can happen. Breathtaking events such as a pregnancy, breakup or divorce can also induce serious psychosocial stress.

Acute Past Stressors

Although present-day upsetting events unquestionably place stress on you, incidents from your history can also still influence you in the course of your life. The Initiative Exposure Biology Program published an article in 2006 titled “Field-Deployable Tools for Quantifying Exposures to Psychosocial Stress” that demonstrates the need for testing people about situations in their lifetime that could have caused substantial nerve-racking effect on them, such as child abuse, bullying, violence, or trauma like a war or earthquake.

Chronic Stressors

Generally, psychosocial stress is not attributable to solitary events, but by recurring complications. The Modified Life Events Section of the Psychiatric Epidemiology Research Interview, used by doctors since 1977, is a series of concerns made to evaluate people’s activities and feelings. It demands conditions that could cause continuing stress, such as war, discrimination, violence, illness or poverty. Furthermore, it recognizes family problems, such as taking care of a suffering parent or disabled child, as chronic psychosocial stressors. Poverty, divorce or pediatric issues may also come under this category.

How to deal with psychosocial stress?

There are numerous approaches to deal with psychosocial stress, since it entails elements on the outside (what we’re dealing with) and the inside (our insights about it), and can affect multiple areas of our lives. Here are a few techniques and strategies that can help.

Develop Your Conflict Resolution Skills

Conflict is an almost unavoidable part of a relationship. Everyone is likely to have disagreements and are gonna desire different things. The way we deal with conflict may produce whole lot of psychosocial stress, but if you can focus on your conflict resolution abilities, that can help at least half of the equation: you can actually transform what you bring to the specific situation, you can dissipate some of the negativity, and you can style healthier behavior. This can greatly minimize the stress felt by all involved.

Try these healthy conflict resolution techniques.

Concentrate on Friends That Are Encouraging; Avoid Drama

If you consider this, you already know who you can put your confidence in to support you and who you can’t. Basically devoting more time with individuals who help you further and reducing time spent with people who leave you feeling exhausted can cut down on a lot of the psychosocial stress you experience. It won’t eliminate all of the drama you go through, but it can stop a lot of it.

Here is de-stressing a stressful relationship and here is the link on how to cut out stressful relationships.

Try A Shift In Perspective

Oftentimes we come to feel angered or endangered by things that no longer have an effect on us that much, and the stress we feel as an outcome isn’t required. Reforming how you look at anything, or simply transferring what you give attention to produces a difference in your stress levels–it can make a thing that appears to be a big deal feel less so. When placed in a different point of view, everything can feel less stressful.

Here are some ways to change your perspective to minimize stress. Here is its application on work stress.

Find Stress Management Strategies That Work For You

Getting ways to deal with your overall stress level can guide you to be less reactive to psychosocial stress, or any particular stressor. The key is to find a thing that works well for you and something that fits well in your life and with your individuality.

Is it guided imagery, or is it relaxation or a myriad of other stress management strategies.

Other peoples’ experiences and advice can help too.

Burnout compassion fatigue self test

According to the Compassion Fatigue Awareness Project, “denial is one of the most detrimental symptoms” because it prevents those who are experiencing compassion fatigue from accurately assessing how fatigued and stressed they actually are, which prevents them from seeking help.

To see where you fall on the compassion satisfaction/fatigue continuum, take the Professional Quality of Life (PROQOL) questionnaire, which was developed by Dr. Beth Hundall Stamm, one of the world’s leading experts on compassion fatigue. In addition to English, the PROQOL has been translated into 17 different languages, all of which can be found here. Although the measure was originally developed for professional “helpers,” it can provide important feedback about compassion fatigue, burnout, and life stress for anyone who spends a good deal of time helping others.

Taking the Compassion Fatigue self test

If it seems that you have scored high on the compassion fatigue scale (or any of the others), there is reason for optimism. Like burnout or any other stress-related disorder, compassion fatigue is not fatal, but it undoubtedly makes a difference to the quality of your daily routine, and consciousness is the first step to restoration. Dr. Stamm points out that through recognition and healthy self-care, individuals who encounter compassion fatigue can begin to be aware of complexity of the sentiments they’ve been “juggling and, most likely, suppressing.”

  • Improve your awareness with understanding of the condition
  • Recognize where you stand on your path at all times
  • Share info and emotions with individuals who can validate you
  • Explain your very own boundaries—what works for you and what doesn’t
  • Be kind to yourself
  • Talk about what you need verbally, and
  • Undertake positive actions to alter your environment.

If your compassion fatigue score is low or average, that’s great, but you need to take measures to shield yourself. To assist in preventing compassion fatigue, Dr. Sood recommends:

  • Limit how much day-by-day media you watch or read about
  • Make an effort to fully understand the fact that pain and suffering are concrete realities of life over which we have little if any control
  • Be thankful for what is good in the way you live and in the world
  • Look for some meaning in the affliction you see around
  • In the event you must pin the fault on something, blame the situation, not the person
  • Display empathy to yourself by being kind, relaxing, and comforting to yourself

Citing studies from the University of Michigan and the University of Rochester Medical Center that discovered that in comparison to the late 1970s, empathy amongst students has dropped by more than 40 percent, Dr. Sood affirms that we live in an environment that frantically requires more compassion.

So, the last thing we need is for those who are most good at offering and expressing compassion to lose that gift to something totally avoidable.

When you are conscious of the indicators of compassion fatigue, you can protect against it and always do what you do best—change experiences for the better with one act of closeness at a time.

Figley compassion fatigue: Definitions and Treatment Approach – Accelerated Recovery Program

Accelerated Recovery Program (ARP) For Compassion Fatigue

“The professional work centered on the relief of the emotional suffering of clients automatically includes absorbing information that is about suffering. Often it includes absorbing that suffering as well” (Figley, 1995, p. 2).

The only resource we had to help us cope with this emotional, physical and spiritual distress was ourselves” (Bloom, 1997, p.112) .

In Dr. Figley’s crucial book Compassion Fatigue, he came up with an issue that has bothered many clinicians, emergency response workers, and other care-givers who work with disturbed multitude of folks in caregiving industry. This work offered the language for the feelings of these challenged service providers. It then became exceptionally clear that the next step was providing ideas for addressing our own needs when we become victimized by our work.

Compassion fatigue (Figley, 1995) is the convergence primary traumatic stress, secondary traumatic stress (Stamm, 1995) and cumulative stress/burnout in the lives of supporting professionals and other care providers. When assisting others precipitates a bargain in our own well-being we are enduring Compassion fatigue.

The manifestations often mirror, to a lesser degree, those of our clients.

Vicarious traumatization (McCann & Pearlman, 1990) is an applicable term that also describes this tendency of the transmission of traumatic stress by observation and/or being a witness to the experiences of painful events.

Secondary traumatic stress happens when one is subjected to intense events directly experienced by another and is overpowered by this secondary exposure to trauma (Figley & Kleber, 1995).

More than a few theories have been offered but none have been able to effectively illustrate the system which accounts for the transmission of traumatic stress from one individual to another. Figley (1995) hypothesizes that the caregiver’s empathy level with the traumatized person has a vital role in this transmission.

Burnout, or cumulative stress, is the state of physical, emotional, and mental exhaustion caused by a depletion of ability to cope with one’s environment resultant from our responses to the on-going demand characteristics (stress) of our daily lives (Maslach, 1982).

High levels of cumulative stress in the lives of caregivers negatively affects their resiliency therefore making them more susceptible to compassion fatigue.

The Silencing Response (Baranowsky, 1997; Danielli, 1984) is an inability to attend to the stories/experiences of our clients and instead to redirect to material that is less distressing for the professional.

This occurs when client’ experiences/stories are overwhelming, beyond our scope of comprehension and desire to know, or simply spiraling past our sense of competency. The point at which we may notice our ability to listen becoming compromised is the point at which the Silencing Response has weakened our clinical efficacy.

Figley (1996) defines Compassion Fatigue as:

A state of tension and preoccupation with the individual or cumulative trauma of clients as manifested in one or more ways:

  • re-experiencing the traumatic events,
  • avoidance/numbing of reminders of the traumatic event,
  • persistent arousal
  • Combined with the added effects of cumulative stress (burnout) (p. 11).

Compassion Fatigue has many symptoms and often parallel to the symptoms of the traumatized clients with whom caregivers are working. While compassion fatigue has been most often written about in the rubric of psychotherapy as emotional contagion passed from client to clinician, there is growing evidence to support the trans-generational and societal transmission of this condition (Danieli, 1985; Baranowsky, 1997; Bloom, 1997).

Some of the symptoms of compassion fatigue include:

increased negative arousal,
intrusive thoughts/images of clients’ situations/traumas (or clinicians’ own historical traumas),
difficulty separating work life from personal life
lowered frustration tolerance/outbursts of anger or rage
dread of working with certain clients,
marked or increasing transference/countertransference issues with certain clients,
perceptive/assumptive world disturbances (i.e., seeing the world of terms of victims and perpetrators, decrease in subjective sense of safety)
increase in ineffective and/or self-destructive self-soothing behaviors
feelings of therapeutic impotence or de-skilled with certain clients,
diminished sense of purpose/enjoyment with career,
diminished ego-functioning (time, identity, volition)
decreased functioning in non-professional situations.
loss of hope

Any of these symptoms could be signaling the presence of Compassion Fatigue.

The eruption of violence, personal degradation, and physical/ psychological violations disrupt our notions of the sanctity of our assumptive world (Janoff-Bullman, 1992; Rando, 1996). Such traumas can result in symptoms of Posttraumatic Stress Disorder.

Posttraumatic stress effects individuals differently but is identified by three categories of symptoms: (1) intrusive thoughts, images and sensations; (2) avoidance of people, places, things and experiences which elicit memories of the traumatic experience, and (3) negative arousal in the forms hypervigiliance, sleep disturbances, irritability and anxiety.

These symptoms combine to form a state of physical, emotional, cognitive and spiritual volatility in traumatized individuals, families and groups (van der Kolk, 1996; Janet, 1889).

Persons who work closely with these groups and individuals are vulnerable to the contagion of this volatility. Some caregivers appear to be more resilient than others to the transmission of traumatic stress, however, any caregiver who continually works with traumatized individuals is at-risk for compassion fatigue.

Who is at-risk for Compassion Fatigue?

Compassion fatigue may occur in a wide range of persons involved in providing aid to others (Jay, 1995). We have found that it is most prevalent among professionals and personal family members, friends, and associates of trauma survivors (Baranowsky, Gentry & Dunning, 1997; Beaton & Murphy, 1995).

Psychologists, social workers, lawyers, disaster relief workers, nurses, psychiatrists, medical doctors, emergency service professionals, police, crisis phone-line attendants and shelter workers among others, are all susceptible to Compassion Fatigue.

When the therapist has encountered trauma through first-hand exposure this further heightens vulnerability to Compassion Fatigue (Baranowsky, Gentry & Dunning, 1997; Pearlman & McCann, 1995). Yet, in the emerging field of traumatology many of the therapists have such experience.

Just as it is not uncommon to find ex-substance abusers counseling those currently trying to break away from addictions, likewise, it is not uncommon to find those who are personally knowledgeable about trauma trying to aid others who have faced terrible events.

We urge these clinicians and caregivers to develop and maintain good self-care disciplines (see Pathways To Healing) and also complete a periodic self-assessment of compassion fatigue symptoms using the Compassion Fatigue Scale-Revised (1997, Figley, Baranowsky & Gentry).

The Good News : Compassion Fatigue treatment approach based on Figley’s work

The Green Cross Project, under the guidance of Charles Figley, Ph. D. , at Florida State University, has produced a short treatment (5 session) protocol for working people who are enduring the effects of Compassion Fatigue.

We believe from our initial trials with the Accelerated Recovery Program (ARP) that Compassion Fatigue is reactive to involvement and may even be the motivation that brings the improvement of clinical skills and personal life richness in the same way that a catastrophe may precipitate difference and growth in the lives of our clients.

Our perspective has been to improve, refine a program that would not only solve the problems of compassion fatigue for the care-giver but to favorably reinforce their future in their chosen role and improve their personal lives as well. Helping the care-giver to move toward turning into their ideal personal and professional selves so that they may live and work with ethics has always been our mission. We believe that our program supports caregivers toward this objective.

This system was engineered to support the professional to put into action strategies to regain functioning in their personal and professional lives that have been jeopardized due to Compassion Fatigue.

The Accelerated Recovery Program makes a determination to help clinicians and care-givers address and solve both the symptoms and the cause of compassion fatigue while, at once, helping them improve, refine a cutting-edge individual self-care style which boosts future resiliency to compassion fatigue.

Caregivers may learn a requirement to keep going with their work beyond the scope of the Accelerated Recovery Program, however, we have discovered that they will be much better fitted and geared up to deal with the difficult sequelae of primary and secondary traumatic stress soon after the finalization of this program.

The Road Back Home

We have used the metaphor of “The Road Back Home” to describe our program because Compassion Fatigue seems to rob the professional of their sense of well-being, comfort, purpose, identity and empowerment; all the qualities that one associates with being “at home”. The experiences of being “at home” in our bodies, our work, our thoughts and our spirit seem to diminish as the symptoms of Compassion Fatigue increase. The program we have created is designed with the hope of assisting helping professionals, to move rapidly toward comfort and empowerment in their professional and personal lives. Our program will challenge and assist the helping professional in finding their own personal “road back home”.

Cure helps the helping professional in starting a new relationship with the sense of hope and empowerment with which they joined their chosen field. With this is achieved, we motivating them to learn, appreciate and develop personal strategies for dealing with the difficult experiences which reduce hope and empowerment.

Secondly, the helping professional will be questioned to explore their “Silencing Response” both with their clients and themselves and to improve and refine techniques to navigate though this difficult crisis.

The Accelerated Recovery Program for Compassion Fatigue

The five-session treatment protocol is standardized and directed toward the completion of the following major objectives;

Identify, understand and develop hierarchy of the events, situations, people and internal experiences which trigger symptoms of compassion fatigue in their lives. This will include the creation and discussion of the Professional Life-Line in which the professional will explore the trajectory of their career assessing the experiences which have contributed to Compassion Fatigue.

Review present personal methodologies of addressing these difficulties and begin developing and maintenance of a self-care discipline in the following four areas:

a. Skills Acquisition
b. Self-Care
c. Connection with Others
d. Internal Conflicts

The Accelerated Recovery Program uses this self-help model which the caregiver develops throughout their enrollment in the program. This self-care plan is entitled Pathways To Healing and may be found in the attachments to this paper.

Identify resources (external and internal) available to the professional which can be utilized to develop and maintain resiliency to compassion fatigue.
Learn and master state-of-the-art negative arousal reduction techniques.
Learn and master state-of-the-art grounding and containment skills.
Contracting for self-care, boundary-setting and skills acquisition.
Explore, reframe and reprocess impediments to potency utilizing Eye Movement De-sensitization and Reprocessing (EMDR).
Learn and master video-dialogue, a technique for internal conflict resolution and self-supervision.
Development of self-administered after-care plan (Pathways to Healing).

Program Protocol

Session One: Assessment/Evaluation

A thorough assessment and evaluation is be completed with each care-giver who enrolls in the accelerated recovery program. A full exploration of the symptoms that the professional is experiencing will be discussed along with the events of his/her professional and personal life which have contributed to these symptoms.

We recognize that discussion of these events will be difficult and, often times, intimidating for the professional. With this in mind we have placed the onus of responsibility for disclosure upon the professional and while we will offer the strictest confidentiality we respect any wishes that s/he has to not disclose any information.

The following assessment tolls will be utilized in the Accelerated Recovery Program:

Compassion Fatigue Scale-Revised (Figley 1995; Baranowsky & Gentry, 1997)
Silencing Response Scale (Baranowsky, 1997)
Solution-Focused Trauma Recovery Scale (TRS) (Gentry, 1997)

Between-session: Personal Mission Statement

Session Two: Personal & Professional Time-Line

Welcome and discussion of treatment goals/mission statement.

Categorizing these goals into the following three areas:

a. Skills Acquisition
b. Self-Care
c. Internal Conflicts
d. Connection with Others

Overview of program and informed consent

Progressive relaxation script (Gentry & Schmidt, 1996)

Safe-Place Visualization (Gentry & Schmidt, 1996)

Telling the story

Re-connection with hope and empowerment at beginning of career

a. Inventory of experiences which have combined to create Compassion Fatigue b. Review of past (week, month, year) to assess the specific situations which are triggers and catalysts of Compassion Fatigue.

Between-session Project: Professional Time-Line (graphic narrative)

Session Three: Re-framing & Reprocessing

Review of Session Two

Discussion of Time-Line:

a. Professional Goals
b. Personal Goals
c. Primary & Secondary Trauma
d. Silencing Response
e. Trajectory of Hope

Review of vicarious traumatic situations (triggers & catalysts)

Review of self-regulation strategies for managing these situations (i.e., Thought Field Therapy)

EMDR (Shapiro, 1996) with Target Experience/Memory which encapsulates most salient impediment.

Between-session Projects:

Development/implementation of self-care/NAR plan

Letter from The Great Supervisor

a. Omni-benevolent
b. Omniscient
c. The things the professional most needs/wants to hear from a supervisor.

Session Four: SUPERVISING THE SELF: Externalization

Review of previous sessions.

Identifying areas where professional needs skills acquisition and contracting to acquire these skills.

Identifying areas where professional needs to introduce, practice and master self-soothing/NAR/boundaries/self-care.

Video Dialogue (Holmes & Tinnin, 1995) with internal polarities/conflicts.

a. Read Great Supervisor Letter on videotape
b. Video-dialogue taking the negate stance
c. Continue dialogue towards negotiation

Between-session Project: Complete Pathways To Healing

Session Five: Closure and Aftercare

Review of program/goals

Inventory of incomplete goals

Addressing four Pathways to Recovery

a. Skills Acquisition
b. Self-Care
c. Connection with Others
d. Internal Conflict Resolution

Board of Directors (Baranowsky, 1997) guided imagery exercise



NOTE – It is highly possible that these techniques may exacerbate and/or expose a primary trauma in the history of the helping professional. We will be utilizing a specialized protocol of each brief procedure which, if primary traumatic stress becomes activated, will be designed to contain these experiences and sequelae while refocusing upon Compassion Fatigue Symptom Reduction. The helping professional who experiences the emergence of primary traumatic material will be offered confidential individual treatment for these symptoms if s/he chooses.

Options for Further Work:

All helping professional will be offered the option of continuing individual treatment. This treatment could include:

a. Primary traumatic event/traumatic stress
b. Secondary traumatic stress
c. Grief work
d. Problematic clients/therapeutic impasse
e. Personal blockages/inhibitions
f. Phobias
g. Stress reduction/management

All individual treatment will attempt to employ brief treatment protocols (where applicable) such as EMDR (Shapiro, 1995), TFT (Callaghan, 1994), TIR (Gerbode, 1989), TLTT(Tinnin, 1989, 1994), V/KD (Bandler & Grinder, 1979)

Groups may be offered

Training/consultation in treating traumatic stress may be offered

Assistance in establishing study groups/peer supervision

Opportunity for membership in Green Cross Project

Membership in Traumatic Stress E-Mail Forum

Apply for Registered Traumatologist for assistance in disaster relief and other emergencies Discussion

The Accelerated recovery Program was developed at Florida State University’s Psychosocial Stress Laboratory. It was initially developed as a three (3) session model and sessions One and Five were added as the authors practiced the protocol with each other rotating as client, practitioner and observer. Session One was added when the authors discovered that primary traumatic stress was becoming and important and potentially confounding factor in the treatment protocol. Unresolved primary traumatic stress in the life of the clinician, we soon discovered, significantly negatively impacted the clinician’s resiliency to compassion fatigue. The most difficult challenge that the authors faced in the development of this protocol was to: (a) develop a program which assisted the impaired clinician to address and resolve his/her symptoms of compassion fatigue, while, at once, (b) respectfully addressing and challenging the clinician to resolve any primary traumatic experiences which may be contributing to the symptoms identified in the assessment process.

We resolved this dilemma by offering a program which addresses and assists with the resolution of the etiology of compassion fatigue in the professional life of the clinician: primary traumatic stress, secondary traumatic stress and cumulative stress. However, if the care-giver identifies primary traumatic experiences in his/her developmental trajectory and/or adult life, then we offer and urge this care-giver to continue treatment with the ARP therapist following their completion of the Accelerated Recovery Program to resolve their traumata. The fifth session was added to reinforce this position as well as offering a comprehensive closure and debriefing protocol. The fifth session also serves as a transition from clinician-assisted recovery to self-managed recovery and self-care via The Pathways To Healing.

The Accelerated Recovery Program for Compassion Fatigue was alpha tested (4/97 – 10/97) with ten (10) caregivers who were Marriage & Family doctoral students, nurses, MSW students, trauma therapists (South Africa & Bosnia) and a death-penalty mitigation specialist. All ten (10) caregivers reported improvement in functioning and a lessening of compassion fatigue symptoms. One caregiver experienced an acute and marked decrease in functioning as a primary traumatic event for which she had been previously amnestic became figural in her treatment, however, she was able to regain functioning and reported that the ARP was helpful in her healing process.

More tips

Keep Balance in Your Life

  • Practice excellent self-care
  • Nurture yourself by putting activities in your schedule that are sources of pleasure, joy and diversion
  • Allow yourself to take mini-escapes- these relieve the intensity of your work
  • Transform the negative impact of your work (find meaning, challenge negativity, find gratitude)
  • Get medical treatment if needed to relieve symptoms that interfere with daily functioning- don’t use alcohol or drugs to self-medicate
  • Get professional help when needed to get back on track- we all need coaches and consultants at times

Balancing Exercise

  • List one mini-escape or diversion that worked well to restore and renew you
  • List one thing that brings you joy
  • Name 3 things you feel grateful for today
  • Think of something that has brought you a sense of joy (Make your top ten list)
  • Who do you love that you can reach out to today? (Call them!)
  • What made you laugh today? (Share it!)

Find Your Passion

  • We all have hidden sources of energy and healing power.
  • When you identify the things that fuel you, the things that you have true passion for, your fatigue will disappear.
  • Balancing your life involves putting the things that we value and have passion for in our schedule.

Balance For Your Soul

  • Have quiet alone time in a calm, beautiful place- a safe retreat where you feel renewed
  • Have an awareness of what restores and replenishes you.
  • Find ways to acknowledge loss and grief
  • Stay clear with commitment to career goals or your personal mission
  • Know how to focus on what you can control
  • Look at situations as entertaining challenges and opportunities, not problems or stresses


The Accelerated Recovery Program for Compassion Fatigue combines several trauma brief treatment protocols (Time-Limited Trauma Therapy, Thought Field Therapy, Eye-Movement Desensitization, Video-Dialogue, Visual/Kinesthetic Dissociation, Hypnotherapy) with a comprehensive assessment (Compassion Fatigue Self Test – Revised, Solution-Focused Trauma Recovery Scale, The Silencing Response Scale, Structured Clinical Interview) and self-administered self-care plan (Pathways To Healing). This constellation of treatment/training strategies, distilled into five (5) sessions, seems to have combined to provide an effective means for caregivers who suffer with compassion fatigue to address and resolve many of their symptoms. While there is yet no empirical data on the efficacy, utility and/or safety of this approach, many of the protocols from which the program borrows have shown promise in each of these areas. Therefore, the authors of this program offer this protocol to clinicians who work with caregivers who suffer from compassion fatigue as the first comprehensive treatment program of its kind. We hope that clinicians will join us in beginning to utilize this protocol in treating impaired professionals and assist us in continuing to develop and refine its utility.

In the coming year, we plan to begin systematic outcome research on the efficacy and utility of the Accelerated Recovery Program for Compassion Fatigue.


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