Apathy: Why is he socially withdrawing and being home all day? 

Apathy is lack of interest and emotional expression . Apathy can be a symptom or complication of several neurological conditions, like  Alzheimer’s disease, Parkinson’s disease and stroke.

The apathy presents an in depth exploration of apathy, aiming to enhance our understanding of its dynamics, consequences, and potential interventions. Apathy, defined as a lack of interest, enthusiasm, or concern, is a complex psychological and societal phenomenon that has generated increasing attention across various fields.

Pathological apathy is characterized by extreme forms of apathy, and is now known in many different brain disorders, including neurodegenerative conditions often associated with dementia such as Alzheimer’s disease, Parkinson’s disease, and psychiatric disorders such as schizophrenia. Although many patients with pathological apathy also have depression, several studies have shown that the two syndromes are dissociable. 

Apathy was developed in the year 1991 by Robert Marin, the Apathy Evaluation Scale was the first method developed to measure apathy in clinical populations. Centered around evaluation, the scale can either be self-informed or other-informed. 

Addressing apathy requires understanding its causes and implementing appropriate strategies. Treatment approaches may involve psychotherapy medication, lifestyle changes, and social support. Developing self-awareness, setting goals, and finding meaningful activities can also be helpful in combating apathy.

Causes

The causes of apathy . It may not always have a clear-cut cause, but it can happen as a symptom of many different neurological and psychiatric conditions.

  1. Emotional trauma : Traumatic experiences, such as physical or emotional abuse, can lead to apathy as a defence mechanism. The emotional pain may become overwhelming, causing individuals to disconnect from their emotions to reduce distress.
  2. Social isolation: Lack of social connection and meaningful relationships can contribute to apathy . Humans are inherently social beings and when individuals feel isolated or disconnected from others they may lose interest in engaging with people around them.
  3. Stroke : It is a medical condition that occurs when the blood supply to the brain is interrupted or reduced, resulting in a lack of oxygen and nutrients to brain cells. A stroke can have various effects on an individual, including physical, cognitive, and emotional changes.
  4. Physical health conditions : Certain physical health conditions, such as chronic pain, chronic fatigue syndrome, or hormonal imbalances, can lead to apathy. When individuals experience persistent physical discomfort or exhaustion, it can affect their emotional state and motivation levels.
  5. Mental health conditions: Apathy can be a symptom of mental health disorders such as depression, bipolar disorder, schizophrenia, or certain neurological conditions like parkinson’s disease or alzheimer’s disease.
  6. Chronic stress and burnout: Prolonged exposure to high levels of stress or experiencing burnout from activities. When individuals feel overwhelmed or emotionally drained, they may withdraw and develop apathetic techniques as a protective response.
  7. Dorsal anterior cingulate cortex is a region of your cerebral cortex that helps with cognition and movement control.
types of apathy.

Types of Apathy

In a 2019 study published in the journal PLOS One, researchers identified and described distinct subtypes of apathy: 

  • Emotional apathy, characterised by a lack of both positive and negative emotions.
  • Behavioural apathy, characterised by a lack of self-initiated behaviours.
  • General apathy, characterised by less motivation, poor emotional responses, and lack of social engagement

Symptoms

  1. Disengaging or withdrawing from work, hobbies or spending time with loved ones. However, people with apathy appear to enjoy spending time with loved ones if they’re pushed or persuaded to do so.
  1. A lack of concern that they’ve disengaged from activities they used to enjoy. Family members and loved ones are more likely to notice the change in their behaviour and be concerned about it.
  1. Relying on others to help them fulfil daily activities. This isn’t because they’re mentally or physically unable to do the tasks (like brushing their teeth or paying bills, for example) but because they lack the self-directed motivation to do them.
  1. A decrease in or lack of expression of both positive and negative emotions (emotional blunting). They may not feel strong emotions or emotionally react to situations as expected.
  1. Apathy may often be a symptom of depression, but the two are not the same thing. Depressive disorders are categorized in the “Diagnostic and Statistical Manual of Mental Disorders.”
  1. Anhedonia: The root words of anhedonia are the prefix an-, meaning “without,” and the Greek he done, meaning “pleasure.” Thus, it means being in a state where you don’t enjoy things you usually like to do. It is similar in some ways to apathy, but apathy is broader in scope than anhedonia.
  2. Lethargy: Lethargy can be a state of body or mind or both. In both cases, the core component is slowness or sluggishness. Being unusually drowsy, tired, or fatigued can be aspects of lethargy.

    Treatment Options

Treatments for apathy depend on the underlying causes. People may be able to manage general feelings of apathy through lifestyle changes and self-care, but symptoms caused by underlying medical or psychiatric conditions need to be addressed by your healthcare provider. For many conditions, this may involve medication, psychotherapy, or a combination of the two.

  • To treat apathy, your healthcare provider will likely ask you about your symptoms to identify the condition that’s causing you to feel apathetic.
  • You may need to complete an assessment for apathy to talk to your healthcare provider about the type of symptoms you have and their severity.
  • Commit to change and believe that it is possible
  • Regardless of the circumstances that led us to feel apathetic, the truth is that this state is maintained due to the perspective we have right now. The past has brought us to where we are, but it is our present mindset that keeps us stuck.
  • Therefore, our most urgent task to overcome apathy is to change our perspective. After all, it is easier to change our perspective than to try to change the world. To achieve this we need to commit to change. The question we must honestly answer is: Am I willing to commit to overcoming apathy, even if it takes great effort and energy?
  • When we commit to ourselves, instead of indifference, involvement begins to grow. That change in attitude may be enough to start activating us.
  •  Discover the source of apathy and make peace with the past
  • A treatment for apathy that ignores its causes would be like putting a band-aid over a wide open wound. If no stitches are given, the wound will not close properly and will reopen at the slightest carelessness. Therefore, it is important to investigate the origin of apathy.
  • A good exercise is to look back and remember all those things that excited and motivated us, things that made us feel alive and happy. At what point did everything go wrong? When do we stop enjoying life? We may discover that the cause of this apathy can be traced back to the loss of a significant person, so that our own life has become meaningless. Or maybe it’s due to personal failure. Or deep disappointment.
  • Whatever the cause, we need to accept what happened and try to turn the page. To overcome apathy we need to make peace with that past so that we can free our attention and focus it on the future. When we have freed ourselves of that weight, we can ask ourselves what makes us excited, to begin to build a life with meaning.
  • Go from passivity to problem solving
  • Apathy locks us in a downward spiral because it makes it difficult for us to take the first step that helps us get out of that state. The good news is that once we get the “engine running,” it’s easier to keep moving.
  • Therefore, we must ask ourselves what is the easiest and most feasible first step we can take to get out of that state of apathy and lethargy in which we have fallen. It can be helpful to create a list of the things that we think are not working in our lives. Then we can review it and choose something small that we can change.
  • It doesn’t have to be anything exceptional. The secret is to light the spark. We must remember that a step does not take us where we want to go, but at least it takes us away from where we do not want to be. It allows us to realise that we can move forward, so that discouragement is left behind and we begin to recharge with new energy.
  • Incorporate something new into your daily routine
  • Even if we have entered a listless state, we may have to continue with our routine. We will have to work anyway, even if we perform the half, and we will have to take care of the housework even if we do not feel like it or fulfil the social commitments that we cannot cancel.
  • On the one hand, this routine keeps us moving and prevents us from falling into the most absolute apathy, but on the other hand it can also reinforce that feeling of indifference and nonsense. Letting the routine envelop us can gradually take us away from passion and desire, generating a state of general apathy.
  • Therefore, it is convenient to incorporate something new into our routine. It does not necessarily have to be something transcendental, small changes that give us back the ability to astonish ourselves or activate our desire to discover new things will be enough. It can be discovering a new corner in the city, trying new dishes, taking a walk in nature or discovering different music. Is it worth considering anything that gives opportunities to your will for living?
natural remedies for apathy.

Natural remedies

  • Rosemary essential oil
  • Rosemary is another essential oil that may relieve pain.
  • Some researchers state that the rosemary plant, Rosmarinus officinalis L., may help treat headache, muscle and bone pain, and seizures. Rosemary may also reduce inflammation, relax smooth muscles, and boost memory.
  • Dilute essential oils in a carrier oil such as olive oil. Use three to five drops of essential oil for each ounce of carrier oil.
  • The researchers suggest that the herb acts on receptors in the brain called opioid receptors, which are involved with the sensation of pain. A 2013 clinical trial.
  •  Peppermint essential oil
  • Peppermint oil comes from the Mentha piperita L. plant.
  • Some research suggests that the peppermint plant has anti-inflammatory, antimicrobial, and pain-relieving effects. The active compounds in peppermint oil include carvacrol, menthol, and limonene.
  • People often use diluted peppermint essential oil as a topical treatment, meaning that they rub diluted oil into the area that feels achy or painful.
  • One 2015 review notes that people have traditionally used peppermint to relieve painful spasms and problems associated with arthritis.
  • The researchers also report that applying peppermint oil to the temples and forehead may relieve tension headache pain.
  • Avoid putting peppermint oil on broken skin. It can cause allergic reactions, so do a spot test before using peppermint oil on a painful area. Do not use peppermint oil around children.
  •  Cloves
  • People have traditionally used cloves, from the Eugenia caryophyllata plant, as a home remedy to relieve pain from toothache.
  •  found clove gel to be as effective as benzocaine gel, which is a topical gel that dentists often use to reduce needle pain.
  • The researchers applied clove, benzocaine gel, or a placebo to the inside of the participants’ mouths. They reported lower levels of pain with both clove and benzocaine gels, but not with placebos.
  • More research is needed to see how effectively cloves could relieve other sorts of pain.
  • Researchers also believe that clove can have antioxidant, anti-inflammatory, antifungal, and antiviral activity.

*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.

Author Information

Author Contribution: Reviewed by Dr. Ram Reddy, MD – General Physician and Rajeshwar Rao, Pharm D.

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