Apathy

Apathy is the loss of motivation, desire, or interest. It can occur with or without depression, and is often misinterpreted as laziness, disinterest, or lack of initiative. The cause of Apathy remains unclear, but research indicates that it is due to a chemical imbalance and structural changes in the brain.

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Apathy impacts attitude, and it can also negatively impact your willingness to seek Parkinson's treatment. When you lose incentive to take your medicine or exercise, your motor symptoms can become more problematic.

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Apathy is very frustrating for the care partner as they want to encourage and motivate their loved one to seek things they enjoy or once enjoyed for overall greater well-being. However, apathy tends to work against those requests. Poor sleep practices can also make an impact on apathy.

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Joseph H. Friedman, MD writes about apathy in his book, "Making the Connection Between Brain & Behavior." He states, "Apathy is very challenging to prescribe because it is not well understood, often not recognized, and is usually distressing to the family. Apathy in a patient increases the care partners burden and, perhaps most importantly, decreases the feeling of reward the caregiver experiences. Apathy is very similar to depression due to it causing a loss of motivation and lack of interest. The first thing that is usually lost is socializing, 'because it's hard.' Then it becomes evident that it is not just the effort, physical or mental, but it is also the upset in routine. Apathy is more common in patients who are demented, but not all apathetic patients are demented. The more 'not caring' someone becomes, the less interested they become in their interactions, and then, of course, the more apathetic they feel toward these activities. It is a vicious cycle. Physicians need to determine whether the patient is apathetic, depressed, fatigued or excessively sleepy." 

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John M. Vine, author of a Parkinson's Primer, writes "Many Parkinson's patients have feeling of apathy: lack of interest, low motivation, and indifference. activities that interested such patients before they developed Parkinson's - their careers, their hobbies, and socializing with their friends, for example - no longer interest them. Getting out of bed (or off the couch) to engage in activity requires them to exert considerable effort. some patients refrain from engaging in conversation and become withdrawn and socially isolated. Apathetic patients often appear to others as lazy or uncaring. Some Parkinson's patients do not complain about feelings of apathy, because by definition, they do not care. Often it is the patient's spouse who initially observes that the patient shows no interest in activities or subjects that previously interested the patient quite a lot."

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When apathy is related to depression or sleep disorders, these problems can be treated. Your physician can work with you to determine the best treatment or medication paths for apathy. It does seem to run parallel with cognitive decline which impacts memory loss or depression. Medications for cognitive problems appear to work better when it comes to treating apathy in Parkinson's.

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Tips for Managing Apathy:

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• Try a new restaurant

• Meet a friend for coffee

• Check out your public library

• Walk around the mall

• Go to a thrift-store or second-hand store

• Window shop

• Look up weekly events in your town

• Explore a new hobby

• Attend a poetry reading

• Join a local club

• Make yourself accountable by planning to meet a buddy

• Join a movement or exercise group