Signs, Symptoms, and Causes

Ashley Ertel, a peer consultant with Talkspace says some signs and symptoms of apathy can include no longer feeling joy, pleasure, anger, or sadness towards people or things that used to elicit an emotional response from you.

“You no longer feel excited or concerned for things,” she explains. “Long story short, apathy attacks your motivation and pleasure responses.”

Apathy and the eldery

Areview from 2009looked at apathy and its impact on the elderly and concluded that this common feeling is easy to overlook, especially since it’s often mistaken for, or related to, depression. Apathy is often associated with a number of brain disorders that involve the frontal lobes and their associated subcortical structures. It is often related to a number of adverse outcomes, including apparent cognitive impairment, decreased daily function, poor insight into one’s own functional and cognitive impairment, and poor outcome from rehabilitation treatment. It also has the potential to significantly add to a caregiver’s burden.

However, treatment of apathy depends on understanding it from a biomedical, psychological, and socio-environmental perspective.

Apathy and disease

Apathy can be used as a clue that pinpoints bigger problems in a patient’s health. Alzheimer’s disease, dementia, Parkinson’s, and Huntington’s disease are some of the illnesses that can trigger apathy as a result of their occurrence. Here is what some of the research says about apathy and illness.

Areview from 2005titled “Apathy: Why Care?” looked at data that examined apathy across a number of disorders. It found that apathy wasn’t only common but also linked with significant problems, like reduced functioning, decreased response to treatment, poor illness outcome, caregiver distress, and chronicity.

A 2018 studyused apathy as a model for investigating behavioral and psychological symptoms in dementia. It looked at interactions between the person with dementia, their caregiver, and possible environmental triggers for the behaviour, in the context of underlying neurodegeneration. It found that the disordered physiological processes associated with apathy is not a single mechanism, but rather it is multifaceted. Furthermore, the study found that “it may be possible to identify selective impairments in goal-directed behavior which may contribute to different clinical phenotypes or subtypes of apathy.”

A 2006 longitudinal studyof apathy in Alzheimer’s disease found that it was significantly associated with older age, and a higher frequency of minor and major depression. Apathy was the starting point and was a significant predictor of depression and was associated with a faster cognitive and functional decline in patients.

“Apathy is one of the most common symptoms in patients with frontotemporal dementia. It is linked to functional decline, decreased quality of life, loss of independence and poorer survival,” said Maura Malpetti, a cognitive scientist at the Department of Clinical Neurosciences, University of Cambridge. “The more we discover about the earliest effects of frontotemporal dementia, when people still feel well in themselves, the better we can treat symptoms and delay or even prevent the dementia.”

Parkinson’s disease is another progressive disease where apathy can be observed amongst its symptoms. A2002 studylooked at the level of apathy in 45 patients with the disease. It found that those with the disease were more likely to experience apathy as a direct result of physiological changes rather than a psychological reaction or adaptation to disability. It also found that there could be a possible role of cognitive mechanisms in the expression of apathy.

Anotherstudy from 2009looked at the clinical presentation of depression and apathy in patients with Huntington’s disease, an illness that causes degeneration of nerve cells in the brain. It found that apathy in Huntington’s disease was associated with neurodegeneration and connected to cognitive dysfunction and functional decline. It featured prominently in patients with early- and middle-stage Huntington’s disease. Based on its major effect on daily functioning and quality of life, the research found apathy could be an important target for therapeutic interventions in the future.

Diagnosis and Treatment

There are several ways that apathy can affect your life and those around you.

“Apathy, when presenting as the loss of enjoyment, can really take a toll on relationships and your self-esteem,” says Ertel. “It is easy to wonder ‘what’s wrong with me?’ and ‘will I ever get back to who I was?’”

Apathy can cause you to lose motivation to engage in the health habits you had committed to. But on the other hand, apathy can also be useful if it helps you to move past drama into a space of no longer allowing chaos to control your emotions.

How is apathy diagnosed

There is no official clinical diagnosis of apathy, rather it is often a symptom or sign associated with a mental health condition. You can easily self-identify the symptoms of apathy, however. When trying to drill down to the root cause of how you’re feeling, and why, it might be helpful to discuss your experience and feelings with a professional to rule out any underlying depression or diseases like Parkinson’s or Huntington’s.

How is apathy treated?

It depends on what’s being treated on a larger scale. Astudy from 2010that looked at dysthymia and apathy found that there is no consensus about treatment for apathy. Any medical or therapeutic treatment for apathy generally relates to a larger condition for which it is presenting. For example, dopamine agonists seem to work in patients with Parkinson’s disease, while atypical antipsychotics, used inschizophrenia, have been reported to help treat apathy in Alzheimer’s disease and other dementias. It concluded that the treatment of apathy should be considered according to the biology and pathology of the patient.

Speaking to a professional can also be a useful strategy to work through feelings of apathy. WithTalkspace online therapy, you can speak to a licensed therapist today from the comfort of your home. It’s an inexpensive and convenient way to start feeling better today.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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