What is apathy – an independent disease, a condition or a symptom of some other psychosomatic disease? When does it occur, what are its symptoms and treatments? These questions are answered by the Chief Physician of the Health Harmony Medical Center, a psychiatrist, narcologist and psychotherapist Vladislav Sipovich (read more about the difference between a psychiatrist, a psychologist and a psychotherapist in our article).
What is meant by the term apathy?
Translated from Greek, apathy means impassivity (ἀ is the negation of “without”, and π άθος means passion, excitement). In the scientific understanding, apathy is a psycho-emotional state, the main manifestations of which are indifference, indifference, detachment from ongoing events, lack of emotions and inaction. Among the people, apathy is most often interpreted as laziness, i.e. reluctance to do or do anything. In fact, people take into account only external manifestations of apathy that directly concern them and often irritate those around them. Who would like a creature in the house or at work that is not interested in anything, inactive and detached from worries. And this at a time when you are making incredible efforts to keep your family, business and work for yourself and “that guy” afloat? But everything is not so simple, apathy for life is not a fault, but a misfortune of a person gradually entering this state.
Many scientists view apathy as the initial stage of depression, which can eventually lead to catastrophic changes in a person’s personality. Without professional psychological help, it is quite difficult and almost impossible to return interest in life to an apathetic person. Therefore, treat the laziness of a loved one as a serious violation of his psycho-emotional state and seek help from specialists as soon as possible.
At the same time, it must be remembered that apathy can also be observed in healthy people, for example, it can be a special character trait in a melancholic or aging person. In these cases, reduced social and psycho-emotional activity can be considered the norm. First of all, the unexpected and inexplicable passivity of a very recently active, sociable and hardworking person should be alarming.
According to the ICD-10, apathy is referred to as “symptoms and signs of deviation from the norm in the cognitive sphere, behavior and emotional state.”
What are the most common symptoms of apathy?
Symptoms of the state of apathy can be of varying degrees of intensity – from a mild decrease in the emotional background to complete lack of will (aboulia), adynamia, refusal to eat, and even the fulfillment of natural physiological needs.
Somatic manifestations of apathy are slightly expressed, except when it is a consequence of an exacerbation of chronic ailments or an underlying disease. Then the whole symptom complex corresponds to the symptoms of the underlying disease.
External symptoms of an apathetic state are:
• Poor facial expressions. • Automatism in movements. • Monotonous speech. • Slow reaction, including answers to questions. • Decreased sociability. • Loss of interest in work and outdoor activities.
At the same time, a person continues to fulfill his duties – to go to work, communicate with friends, work with children, i.e. perform their social functions, but all this is rather out of habit, without inner desire and pleasure. Interest in life is gradually fading away, and a person does not have the strength and mental energy to overcome laziness and growing melancholy. By the way, the phenomenon of melancholy in the modern interpretation corresponds to a state of depression, although at the household level it is often understood as apathy.
Mental symptoms are much more significant and include the following symptoms: • Weakness up to complete impotence. • Quick fatigue even from the simplest actions. • Feeling of constant fatigue when even doing nothing becomes tiring. • Decreased or complete lack of interest in previously beloved activities and hobbies, including games and entertainment. • Reduced or depressed mood. • Closure, desire for solitude. • Severe drowsiness even after a full night’s sleep. • Discomfort in sensations with a predominance of gloomy thoughts, hopelessness and depression. • Decreased appetite, sometimes irritation from the smell, taste and appearance of certain foods or dishes. • Problems with memory and concentration. • Lack of initiative in all areas of life, even in sexual relationships.
It is important not to confuse low mood in a healthy person with symptoms of apathy. If in the first case the deterioration in mood is of a short transient nature, then the apathetic state is permanent or predominant. If it lasts more than 2 weeks – it’s time to sound the alarm. Moreover, it is simply impossible not to notice changes in a person with apathy, they are so striking. The feeling is that all the vital forces leave the person.
The patient believes that nothing depends on him in this life, it is pointless to do and fight something, all his attempts to solve something or achieve something are doomed to failure. So why try, it is better to hide from reality, do nothing and not worry about anything. Such a psycho-emotional departure from life can eventually lead to physical extinction of body functions and premature death. After all, life is movement in any of its forms – emotional and behavioral reactions, physical activity, normal metabolism with a balance of energy expenditure and synthesis. All this is movement at different levels – social, organismal and molecular. And vice versa, apathy is weakness in any location, and in extremely neglected cases, it is coding of the body for self-destruction.
What are the causes of apathy?
The reason for the development of apathy in a healthy person is most often the repeated inability to solve problems that arise in the family, team, business, creativity or other areas of activity. For example, unsuccessful and long going to the authorities, unsuccessful job searches, problems with raising difficult children in adolescence, etc. Constant failures in people with an untempered psyche lead to a desire to give up on everything, decide that the problem is not so important and stop fighting. Only strong-willed people are able to withstand negativity and stress, while many simply give up, become convinced of the senselessness of their actions and move away from reality into a state of apathy.
I can name the most common causes of apathy in people. These are phenomena such as: • Constant and prolonged mental stress. • Lack of proper rest. • Abrupt, unforeseen or unpleasant changes in life – death of relatives and friends, dismissal, divorce, retirement, moving to another place of residence, etc. .p.• Occupational burnout.• Premenstrual syndrome.• Pregnancy and childbirth.• Constant guilt and shame for any kind of socially disapproved needs, including gambling, alcohol addiction, being LGBT, etc.• Long waiting times an important event (diagnosis, court order, critical review, awarding a title, decision of the attestation commission). • Taking hormonal, contraceptive, antiallergic and sedative drugs. • Psychological pressure from loved ones and superiors. to the achievement of the ideal, and the idea that everything in the world should be perfect. Sooner or later, a perfectionist is faced with an imperfect reality and the futility of his attempts to improve it. And this is a direct path to apathy.
In addition, apathy may be the result of certain mental and somatic diseases:
• Depression. • Schizophrenia and other diseases of the central nervous system. • Endocrine disorders leading to hormonal imbalance. • Different types of dementia. • Alzheimer’s disease. • Immunodeficiency states, such as AIDS. • Oncological diseases and brain injuries.
As you can see, there are many reasons for the appearance and development of the state of apathy, but in any case, it requires a thorough examination, differential diagnosis and competent treatment by a specialist. With a mild form of apathy, you can limit yourself to a visit to an endocrinologist and a psychologist, with more pronounced symptoms, observation and treatment by a psychotherapist will be effective.
How is apathy treated?
If apathy is of a short-term (no more than 2 weeks) and transient nature, and a person understands its causes, then to restore a normal mental state it is enough to simply give yourself a break, take a break from vigorous activity for a while, rethink the circumstances that caused apathy, look on the situation from the outside and choose the right course of action. Good sleep, proper healthy nutrition with enough vitamins and minerals, switching attention to hobbies and outdoor activities can restore a person’s vigor, active life position and the desire to solve problems that have arisen, and not brush them off.
If the state of apathy lasts more than 2 weeks, then even people with a strong will will not cope with it on their own. In this case, the help of a doctor becomes simply necessary. Treatment should take place consistently and under the supervision of a specialist. This is especially important if the patient has slow speech, inadequate emotional reactions, impaired thinking and memory.
The desire of individuals to regain their former activity and warm up interest in life with the help of alcohol will only aggravate the situation – a hangover syndrome will also join apathy, which together will finally plunge the patient into prostration. This method of “treatment” is categorically contraindicated, as well as self-medication with antidepressants of the “one friend said” type. The only thing you can afford is tonic teas.
Psychotherapy of apathy combines, first of all, the identification of the root cause of apathy, as well as verbal (verbal) and, if necessary, medical methods of treatment. One of the most common diagnostic methods is Gestalt therapy.
Without finding out the cause of the development of a state of apathy, it is impossible to prescribe the correct treatment. For example, with endocrine disorders, it is necessary to restore the normal balance of hormones, with organic brain lesions, the help of an oncologist or a neurosurgeon may be needed. Without eliminating the root cause, effective treatment of apathetic conditions becomes simply impossible, it becomes purely symptomatic and does not have a long-term stable effect. For the purpose of diagnosis, a psychotherapist can prescribe consultations of other specialized specialists – an oncologist, a neurologist, an endocrinologist, a narcologist, as well as a number of studies: 1. General blood test.2. Biochemical and hormonal examinations (thyroid hormones, adrenal glands, sex hormones).3. MRI of the brain.4. Tests for infections, etc.
Communication with a psychotherapist, the use of modern and proven methods, a competent choice of tactics and treatment strategies are the key to its effectiveness. Medications are connected only under the supervision of a doctor and when he sees the expediency in this.
Among the medicines used to treat apathy are the following:
• Stimulants in the form of nootropics , extracts of lemongrass and eleutherococcus. Assign with general lethargy and weakness.
• Antidepressants are indicated for a combination of apathy and depression, as well as with the threat of apathy turning into a depressive state. • Vitamins as general tonic and stimulating nervous activity. • Diuretic drugs are prescribed as dehydration therapy to relieve cerebral edema in case of traumatic injuries.
• Tranquilizers and antipsychotics are prescribed in cases where there are destructive changes in the behavior and psyche of the patient.
The choice of drugs is dictated primarily by the cause and severity of the condition, individual characteristics and the predominance of one or another symptomatology.
Much also depends on the patient and his environment. First of all, this is a normal good sleep, proper nutrition, lack of stress, complete or at least partial rejection of bad habits, adherence to diet, work and rest, moderate physical activity.
In a word, it is called a healthy lifestyle.
are apathy and depression really one of the main manifestations of the post-COVID syndrome?
First of all, let’s find out what is meant by post- covid syndrome. This is the whole complex of complications observed after a cure for a covid infection. Mental disorders are only part of the whole symptom complex, but lasting for months and affecting the life of not only the person who has been ill, but also his environment. The apathy that develops after discharge from the hospital is described by patients as sinking into deep indifference, the absence of any desires, even sexual ones, complete impotence and fog in the head. At the slightest stress, a person can react with incredible self-pity and tears. The resulting chain of “stress-apathy-depression” often leads to suicide attempts. This is the sad reality of what is happening. It should be noted that during the pandemic, the need for seeking psychological and psychiatric help has increased significantly. Here, lockdowns with forced self-isolation, the whipping up of covid hysteria, financial losses, and a significant restriction of the social circle played their role.
A feature of apathy in post-COVID syndrome is its rapid transition to apathetic depression with pronounced and sharply rolling suicidal moods. Moreover, it is rather difficult for others to notice and assess the severity of the condition. A person seems to behave normally, nothing extraordinary happens, and suddenly – a suicide attempt. Therefore, be extremely attentive to loved ones who have had a coronavirus infection, and if there is the slightest deviation in their behavior, consult a doctor, otherwise the consequences may be unpredictable. As they say, “the virus gets into the head” and it is very dangerous.