COVID-19 Information for Veterans and their Families Report
You may experience stress as a result of the COVID-19 pandemic, particularly if you are working on the front lines. The consequences of this stress can include compassion fatigue, burnout, separation anxiety, and moral injury.
Compassion fatigue occurs after witnessing crises and empathizing with others’ pain. It is seen primarily among military personnel, police, firefighters, paramedics, caregivers, mental health workers, and other healthcare professionals. It can be caused by a single event or the cumulative effects of prolonged exposure to pain and trauma. Individuals who are getting continuous news updates about COVID-19, witnessing first-hand the effects of the virus, and dealing with operational and community challenges may be at risk of developing compassion fatigue. This can lead to psychological effects, including feelings of helplessness and confusion, as well as physical effects that can make it hard to function.
Burnout is similar to compassion fatigue in that it is caused by being overwhelmed by home and workplace conditions. However, it is more general in that people can develop burnout if chronic stressors are left unaddressed. Burnout usually appears as a lack of interest in work, exhaustion, and a reduction in work abilities.
You and your loved ones may experience separation anxiety during the pandemic. Whether you are at home or working on the front lines, changes in the amount of time you usually spend with loved ones can induce separation anxiety.
Spending more time with a loved one may lead either of you to feel anxiety when you separate, even if it is only for a few hours. On the other hand, spending less time with a loved one may also lead either of you to feel more anxious. For Veterans on the front lines, COVID-19 safety protocols may limit your ability to connect and check in with your loved ones during work hours. Physical distancing protocols may also force you to remain separated from loved ones you do not live with, thus resulting in distress.
You may also be experiencing separation anxiety from your peers and regular supports — whether that is from your Legion or an informal Veteran social group. Evidence has shown that Veterans have unique experiences of loneliness and isolation — which is currently intensified.
Moral injury is a condition that can occur by doing something that goes against your deeply held moral beliefs or by having to make a morally difficult choice. A health crisis like COVID-19 can put Veterans, particularly those who work on the front lines, at risk of moral injury if resource constraints force them to make triaging decisions that may lead to worse outcomes for some people. If you are a Veteran working on the front lines, you may also feel that your efforts are not worth the risks, or your efforts are not worth the benefits they produce. This feeling may be worse if you also have dependants or family that you feel need your help more.
Parents and caregivers may be forced to make tough decisions regarding their loved ones. For example, parents and caregivers may experience anxieties related to making decisions about their children’s schooling situation — to send them to in-person school or keep them at home. Such decisions may result in changes in typical roles, as some individuals may have to put a hold on their work life to stay home with children. Such swift changes in identity can be distressing for both parents/caregivers and children.
See the Guide to Moral Injury for more information.
Some signs of compassion fatigue, burnout, separation anxiety, and moral injury
Recognizing the warning signs of these types of stress is critical because they can negatively impact your personal, social, and occupational performance. The warning signs can include:
- Physical and/or emotional exhaustion
- Emotional numbness, lack of emotion
- Feelings of being overwhelmed
- Feelings of powerlessness, especially in relation to causes of stress and suffering
- Changes in sleep patterns, including sleeping too much or difficulty sleeping
- Changes in the clutter and cleanliness of your personal space
- Physical symptoms, such as headaches, nausea or stomach aches
- Substance use, either prescribed or not
- Increased anger, irritability or anxiety
- Avoidance, withdrawal, or self-isolation
- Decline in performance at work and home
- Difficulty making decisions
- Relationship difficulty with co-workers, friends or family
- Reduced empathy for others
- Reduced career satisfaction
This is not an exhaustive list of all potential signs and symptoms of stress. Be sure to monitor your reactions, thoughts and feelings, and reach out to your supports if you feel that you need help.
Strategies to reduce the symptoms of compassion fatigue, burnout, separation anxiety, and moral injury
The following strategies can help you reduce the impact of the unique stresses caused by the pandemic:
- Recognize the signs and symptoms of stress.
- Be compassionate and try not to judge yourself or your response to pandemic-related situations. Give yourself time to understand your reactions and why you may be feeling stressed.
- Seek friends and supports to confide in. Be innovative and creative to ensure you respect physical distancing guidelines.
- Turn off social media and news about the pandemic if it becomes too much. You may find it helpful to schedule specific times to check media/news coverage (e.g., once or twice a day).
- Make a list of coping strategies that work for you and schedule time to use them. These could include:
- Physical activities
- Creativity, such as music or art
- Reading for pleasure
- Maintaining your personal space
- Focus on the things you have control over and identify a few positives every day.
- Eat healthy foods. Resist the temptations of cravings and comfort food.
- Familiarize yourself with the resources available to you if you have questions or feel overwhelmed due to the stress of the pandemic.
- Prepare yourself and your loved one for instances of separation by talking about them and building opportunities for virtual check-ins when possible.
- Create a “new normal” for connecting with loved ones you do not see on a daily basis: video calls, phone calls, emails, texts, physical letters, and chats from a safe distance are all ways to keep in touch with family, friends, neighbours, and other important people in your life, like spiritual leaders.
- Canadian Institute for Public Safety Research and Treatment. (2019). Glossary of terms: A shared understanding of the common terms used to describe psychological trauma (version 2.1). Regina, SK: Author. http://hdl.handle.net/10294/9055.
- Sinclair, S., Raffin-Bouchal, S., Venturator, L., Mijovic-Kondejewski, J., & Smith-MacDonald, L. (2017). Compassion fatigue: A meta-narrative review of the healthcare literature. International Journal of Nursing Studies, 69, 9–24. https://doi.org/10.1016/j.ijnurstu.2017.01.003.
- Litz, B.T., Stein, N., Delaney, E., Lebowitz, L., Nash, W.P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706. https://doi.org/10.1016/j.cpr.2009.07.003
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- Centre for Disease Control and Prevention. (2020, April 1). Stress and coping. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
- Keluskar, J., Reicher, D., & Crowell, J. (2020). Separation Anxiety during the COVID-19 Pandemic. https://www.stonybrookmedicine.edu/SeparationAnxietyCOVID19_keluskar_reicher_crowell
- Wilson, G., Hill, M., & Kiernan, M. D. (2018). Loneliness and social isolation of military veterans: systematic narrative review. Occupational medicine, 68(9), 600-609.