The apathy Can be defined as a neuro-behavioral syndrome characterized by lack of will or interest in daily and leisure activities, and by a loss of Motivation, which is also reflected in the decrease in affective response (emotions and feelings).
Apathy refers both to cognitive and affective aspects and to certain behaviors, which together result in an important Reduction of self-generated behaviors with a specific purpose.
In other words and for you to understand it well, the apathetic person has little initiative to perform activities and also shows a decrease in their feelings and emotions.
Apathy can be considered as a syndrome with its own clinical criteria, but it usually means that there are other diseases present in the patient.
Often patients with Alzheimer disease , Parkinson's , schizophrenia , Major depression , Brain trauma or Accidents Cerebrovascular diseases may present apathy.
Main symptoms of apathy
The ones that you will read next are the criteria that have to be taken into account for the diagnosis of apathy:
- Loss of motivation, in relation to the previous situation of the person, according to their age and their customs or preferences.
- Reduced productivity.
- Reduction of effort.
- Decreased time spent on activities of interest.
- Loss of initiative or perseverance.
- Decreased social life and leisure activities.
- Loss of general interest.
- Little interest in learning new things or living new experiences.
- Decreased interest in one's own health.
- Loss of emotional response to positive or negative events.
If these symptoms are not due to an intellectual or cognitive deficit, some type of emotional disturbance or a decrease in the level of consciousness, Then it is probably a case of apathy.
Diseases that can cause apathy
Apathy is frequently associated with other diseases or as a result of certain situations, among which the following should be noted:
- Dementia .
- schizophrenia .
- Depression .
- Cerebral stroke.
- Abstinence from cocaine or other drugs.
- Parkinson's Disease .
- Antipsychotic medication .
- Loss of environmental stimulation: institutionalization, loss of role.
- Sensory or motor limitations.
- "Apathetic"hyperthyroidism.
Other possible causes
If you are lacking motivation and initiative in your life but you do not have any disease, your condition may not be strictly cataloged As"apathy".
Anyway, you can take action to remove this lack of interest that is negatively influencing your life.
But , What is it that can be causing your apathy? Here are some possibilities:
- Fatigue
If you are working too much and resting little, then in your brain there may be chemical changes that favor apathy. - Sleep disorders
During sleep the brain rests and produces neurotransmitters that make you feel good. If you are not having enough sleep, You may feel apathetic. - Boredom
If you do not do recreational or leisure activities you may feel lacking in interest and motivation. - Little social and affective life
Active social life, family and affection can be important vaccines against apathy. - Stress
The chemicals that are released in your body if you have chronic stress with able to cause fatigue, irritability and apathy. - Menopause
Hormonal changes can also lead to reluctance. - Alcohol consumption
If you drink too much alcohol, your brain will be affected. You will lack lucidity and you will probably also feel unmotivated. - Medicines.
Some antiallergics, antidepressants and blood pressure medications can cause fatigue and restlessness.
How to overcome apathy in these cases?
If you think that stress is one of the causes of your apathy, then The techniques of breathing and relaxation , Such as yoga and the meditation They can help you. And of course, try to avoid the cause of your stress.
As to lack of sleep , What you have to do is sleep more and better. Always lie down at the same time. Your room must be silent, dark And fresh, so that you can rest better. Before going to bed, leave the PC, turn off the TV and perform relaxing activities, such as reading or listening to music quiet.
Avoid the Alcohol consumption Or other drugs. If you think a medication is the cause of your apathy, consult your doctor.
There are also other things you can do to Increase your motivation , Especially your apathy is an occasional situation or is related to a Aspect in particular of your life.
Look at what you can do about it:
- Say goodbye to pessimism and start Think positive .
- Start a new hobby, learn a new language or do some new activity.
- Take small goals: read a book, take a walk in the park on Sunday, go out once to meet new people.
- Do some kind of physical activity.
- Change your posture: Stand up straight and keep your forehead up. It is proven that the body posture you adopt directly influences your State of mind.
Apathy for tyrosine deficiency
Another frequent cause of lack of energy and motivation is the deficiency of an amino acid called Tyrosine , Which is a precursor of the Dopamine and the Noradrenaline , Neurotransmitters that maintain brain Active, focused and alert.
If you find it hard to start the day without a cup of black coffee or some other stimulant drink, if you feel weak, lacking strength or you just get excited about things, You may need to pay more attention to your tyrosine intake.
As mentioned at the outset, tyrosine is the precursor of Catecholamines , Chemicals that have several effects on the brain.
Did you know that the most extroverted people have higher levels of catecholamines, while the more quiet and introverted people have levels Lower?
If your levels are too low, you probably feel indifferent and do not react very strongly to positive or negative events, Which is one of the symptoms of apathy.
You may also have trouble paying attention and Low level of concentration.
How to increase your level of tyrosine in a healthy and natural way?
Be sure to include in your diet a significant proportion of protein-rich foods, such as chicken or fish, lean red meats and Eggs.
The tyrosine present in these foods has an anti-stress, antidepressant and revitalizing effect and therefore helps to combat and prevent apathy.
Another option is to take rich dietary supplements the L-tyrosine.
The real apathy
Real apathy, the true apathy, is only possible to diagnose it after a deep neuro-psychological evaluation that contemplates environmental aspects and Physical conditions of the patient.
In addition, it is also true that there is a great variability in the objectives, activities, interests and emotional expressiveness in each person, aspects that Are strongly influenced by cultural factors, individual experiences, education, socio-economic level, etc.
All these factors must be taken into account to make a diagnosis of apathy.
Today there are several guides with criteria for the diagnosis of apathy, such as Apathy Evaluation Scale for example. Of course, the doctor Should also evaluate the presence of other diseases, such as depression, schizophrenia or Alzheimer's, to properly target the treatment.
Differences between apathy and depression
It is important to differentiate depression from apathy, because they are really different conditions that should receive differentiated approaches and treatments.
The abulia , Loss of initiative and interest appear in both diseases, and sometimes, a person may have depression and also apathy.
But beware, be aware that not all people with depression are apathetic, not all people with apathy have depression.
How to differentiate both diseases then?
In depression, the person is sad almost always, has feelings of guilt And despair, is very self-critical and pessimistic.
Instead, apathy is characterized by a loss in emotional response and therefore, the person will not have feelings of guilt or sadness.
Apathy in people with Alzheimer's disease
The apathy syndrome is quite frequent in people with a certain degree of cognitive impairment, such as occurs in the Alzheimer disease (EA).
Cognitive deficit in itself is not enough to generate apathy, as many people with senile dementia do not actually have this syndrome. But what is certain is that apathy is more frequent in this type of patients.
A 2007 study evaluated the incidence of apathy in 319 people with AD in 117 people with depression and 36 healthy individuals.
According to data obtained using the Apathy Scale , Apathy was present in 37% of people with AD, in 32% of people with depression and In any of the healthy people.
People with AD who were also apathetic showed more serious alterations in the performance of their daily activities and in their functions Cognitive aspects.
At the same time, patients with depression and apathy had the most severe depressive symptoms.
But returning to patients with AD, when apathy occurs in these people is an indicator of the severity that the disease will have in the future.
People with AD and apathy have greater behavioral problems and more rapid cognitive and functional impairment.
Although apathy is a fairly common problem in people with dementia, there is not much to do about it. Some people think that Acetylcholinesterase inhibitor medications may be helpful in these cases.
Some of the drugs tested for this type of situation are metrifonate, rivastigmine, galantamine and tacrine.
Other options to improve apathy in these patients are:
- Cognitive communication program, associated to pharmacological treatment.
- Music Therapy With live, interactive music.
- Multiple sensory stimulation.
In summary, the treatments of apathy in patients with AD have not been deeply studied, but the options can be used anyway Which were mentioned above.
Apathy in Parkinson's disease
The apathetic syndrome occurs very frequently also in patients with Parkinson's Disease (PD), with a prevalence of 16 to 48%.
There are several types of apathy that affect PD patients differently: cognitive apathy, emotional apathy, and apathy for Autoactivation.
In all cases, it is important to clearly differentiate the patient with PD who also has apathy or depression from the one who does not, because this has repercussions Directly on the quality of life of the patient.
Assessment of the presence of apathy should be performed in conjunction with assessment of cognitive impairment and the presence of depression.
If the patient with PD is apathetic too, they are likely to lose interest in their physical exercises and other treatments and thus, their symptoms Could advance more quickly.
If you have a family member with PD, it is important that you notice the following symptoms of apathy:
- He seems indifferent most of the time.
- He has no interest in everyday activities.
- He has lost motivation and initiative.
Then you probably have apathy. Acetylcholinesterase inhibitor drugs may also be useful in these cases, in conjunction with
Cognitive behavioral therapy .
It is also important to keep in mind that patients with dementia or PE who also have apathy can cause great exhaustion and stress in the People who must care for them, provoking the famous caregiver syndrome.
In short, there is a big difference between what people commonly call apathy and true apathy, which usually occurs in patients with other mental diseases.
But in both cases there are solutions that can improve the quality of life of people with these symptoms.
What is your experience with apathy? What did you do to overcome it? Your opinion will help readers. Thanks!