What Is Apathy?
Apathy is a lack of interest in
life activities and/or interacting with others. It can affect a person’s
ability to keep a job, maintain personal relationships, and enjoy life.
All people experience apathy from
time to time. A person may occasionally feel unmotivated or uninterested in his
or her daily tasks. This type of situational apathy is normal. Apathy becomes
more dangerous when someone is unmotivated to treat a chronic condition such as
diabetes or mental illness.
Apathy is a symptom of a number
of neurological disorders, including Alzheimer’s disease. Apathy also can be a
syndrome in and of itself.
What Causes Apathy?
Apathy is a symptom of a number of psychiatric and
neurological disorders. Examples include:
- Alzheimer’s disease
- dysthymia or chronic mild depression
- frontotemporal dementia
- Huntington’s disease
- Parkinson’s disease
- progressive supranuclear palsy
- vascular dementia
A person can also experience
apathy even without an underlying medical condition.
Doctors have found lesions in the
frontal lobe of the brain in patients with apathy symptoms (Ishizaki, J., et
al., 2011). This leads researchers to believe that the brain’s apathy center is
located in the front of the brain. If a person has a stroke that affects this
part of the brain, apathy may result.
Teenagers are likely to
experience periods of apathy. This typically passes with time. Long-term
emotional detachment and apathy is not normal in teens.
What Are the Symptoms of Apathy?
Apathy sufferers have a lack of passion or motivation.
Apathy affects a person’s behavior and his or her ability to
complete daily activities. The main symptom is a lack of motivation to do,
complete, or accomplish anything. People with apathy typically have low energy
Emotions, motivation, and willingness to act are often lower
or diminished. Activities or events that normally interest a person will create
little to no response.
Apathetic people express disinterest in many aspects of
life. They are usually indifferent when they meet new people or try new things.
They show no interest in activities or in addressing personal problems or concerns.
Facial expressions do not seem to change. They exhibit a lack of effort,
planning, and emotional response. They tend to spend more time in solitary
Continued apathy affects a
person’s ability to maintain personal relationships and perform well at work.
Apathy is not the same as
depression, though they share some similar symptoms, such as disinterest. People
with depression may also have feelings of hopelessness and guilt. Suicide may
be a risk in patients suffering from depression. Apathy sufferers do not have
How Is Apathy Diagnosed?
Healthcare practitioners use four criteria to diagnose
apathy. People with apathy meet all four.
decrease in or lack of motivation: A patient displays diminished motivation
that is not consistent with his or her age, culture, or health status.
thinking, or emotional changes: Changes in behavior may make it difficult
for patients to engage in conversations or perform daily tasks. Changes in
thinking include a disinterest in
the news, in tasks that require deeper thinking, or in social events.
- Affect on
quality of life: The changes in behavior negatively affect a person’s professional
life, personal relationships, or other facets of life.
changes in behavior are not caused by other conditions: The changes in
behavior are unrelated to physical disabilities, substance abuse, or an affected
level of consciousness.
Patients must have these symptoms
for four weeks or longer.
How Is Apathy Treated?
Apathy treatments depend upon the underlying cause.
Medications and psychotherapy can restore interest in life. However, patients
with progressive disorders such as Parkinson’s or Alzheimer’s may show chronic
medications for apathy according to the underlying condition.
- antidementia agents, which treat Alzheimer’s
disease, such as donepezil (Aricept), galantamine (Razadyne), and rivastigine
- antidepressants, such as paroxetine (Paxil),
sertraline (Zoloft), and bupropion (Wellbutrin, Zyban); a group of
antidepressants called SSRIs can make apathy symptoms worse in the elderly
- cerebral circulation and metabolism stimulants that
treat symptoms of stroke, such as nicergoline (Sermion)
- dopamine stimulants, which treat Parkinson’s
disease, such as ropinirole (Requip)
- antipsychotic agents, which are used to treat
- psychostimulants, which are often used to treat
apathy with no known underlying cause; examples include methylphenidate
(Ritalin), pemoline (Cylert), and amphetamine
benefit from a supportive network of family and/or friends. These support
networks can help them regain interest in their surroundings.
professionals can discuss concerns with patients. They can also help patients re-establish
a more positive outlook on life. A combination of therapy and medication is
usually more effective for apathy sufferers than each treatment alone (Ishizaki,
J., et al., 2011).
continues on other potential treatments for chronic apathy. An example is
cranial electrotherapy stimulation (Ishizaki, J., et al., 2011). This approach
may help patients who suffer from apathy after a traumatic brain injury that
affects the frontal lobe. A doctor applies a brief, low-voltage electric
current across the forehead to stimulate the brain. The treatment is painless.
Another potential therapy
is cognitive stimulation therapy. This approach is used for Alzheimer’s
patients. Patients participate in group activities to stimulate brain waves.
Examples include games or looking at pictures to recognize facial expressions.