Apathy

What is apathy?

Apathy means a lack of emotion, feeling, concern or passion. It means you don't have any interest in anything that is usually thought to be interesting or exciting. Apathy is more common in teenagers and also in the elderly.

There are different types of apathy, which include:

• Emotional apathy, which causes less motivation and poor emotional responses.

• Behavioural apathy, which leads to a lack of self-initiated behaviours.

• Social apathy is a reduction in a person’s initiative in proposing or engaging in social activities or interactions.

• Bystander apathy, when a person has indifference or apathy to the other person's difficulty.

• Compassion fatigue, when a person starts out caring deeply about something, only to become feeling burned out and exhausted when things become too much.

There is a strong link between apathy and mental health disorders. For example:

• Apathy is a main symptom of schizophrenia. Many people with schizophrenia express little interest in the events surrounding them.

• Apathy can also occur in depression. For example, people who are depressed often feel numb to events occurring around them and do not get any pleasure from experiences that they once found enjoyable.

• Apathy is also associated with various other conditions, including various types of dementia, Parkinson's disease and multiple sclerosis, and following a stroke.

However apathy is common without having any underlying mental health problem. Apathy may be caused by many different life situations, including:

• Having negative thoughts about yourself.

• Feeling very pessimistic about your future.

• Fear of failure or rejection.

• A feeling of being inferior, incompetent, inadequate or worthless.

• A recent life event that has badly affected you or someone very close to you.

• Something that has left you feeling demoralised, pessimistic and hopeless.

• Something that has made you feel cynical and feeling that you are unable to make any difference.

• Feeling very bored and tired by daily routines and a feeling that there's nothing to look forward to. Feeling resigned to a lifetime of routine and boredom.

The diagnosis of apathy is made by a health professional based on:

• Your medical and medication history, including any neurological or psychosocial conditions you’ve had, to consider any underlying condition associated with apathy, or any mental health condition whose symptoms may mimic apathy.

• Questionnaires that measure your motivation levels, personality, and behaviour.

You may also have other tests, such as a MRI or CT scan, to look for any changes in your brain.

Apathy is often temporary and mild. Friends may be able to help you develop an interest in things. Your attitude is very important. People who want to overcome apathy have a much higher chance of success than people with a completely negative attitude. However, this can be difficult because it's often hard to feel positive when you're feeling apathetic.

The most important initial step to resolve apathy is to change your mindset and to focus on how to change how you feel. Fighting against apathy can be extremely hard but failing to act can further lower your self-esteem, and lead to feelings of apathy and worthlessness becoming worse and ever harder to resolve. Some ways to help overcome apathy include:

• Determine where your apathy is coming from and try to see things from a different perspective. Give yourself more compassion, empathy and understanding. Try to move beyond the negativity you feel about yourself.

• If you are feeling passive, move towards a problem-solving attitude. Try to find solutions to what's making you feel apathetic and negative. For situations you can't change, try to accept them and move on.

• Try new things. Routines can become dull and boring. Consider new activities, or even a career change. Consider anything that might give you a new lease of life.

• Think about what you enjoyed before you became apathetic, such as friends you enjoyed being with or places that you enjoyed going to. Try returning to these activities and getting back in touch with old friends.

• Focus on a goal you can pursue now. Don't choose anything that's too complex and makes you feel overwhelmed.

• Consider seeking help, not only from friends but perhaps a counsellor or a psychologist.

Apart from support, the treatment of more persistent apathy will depend on whether you have any underlying mental health condition, such as depression or schizophrenia. Apathy will often improve if the underlying condition improves with treatment.

The outlook (prognosis) for anyone with persistent apathy will depend both on the amount of support available, such as close family and friends, and on the nature of any underlying cause.