Home page Psychology blog Bad Habits Altered Mental States Losing the will to live: apathy as a disease

Losing the will to live: apathy as a disease

19.03.2019 Author: psiholog pavel horoshutin

Some people say that indifference is worse than hate or anger. We spend a lot of time and effort to fight negative emotions, like grudge, irritation, anger, but when we encounter apathy, the total lack of emotion, we may get stuck.

If you have experienced this sense of total indifference towards the world around you and the state of absolute inability to make yourself do anything, you know exactly what apathy is. Or at least, you can imagine it.

Let’s see how apathy is expressed and how we can handle it.

Contents:

  1. What is apathy
  2. Check-list: do you have apathy?
  3. Signs of apathy
  4. Causes of apathy
  5. Development of apathy
  6. Stages of apathy: from fatigue to loss of meaning
  7. Apathy and depression
  8. Consequences of apathy
  9. Getting rid of apathy: diagnosis and treatment

What is apathy

Apathy has been attracting more and more attention from psychiatry since the 90ies as a separate clinical disorder.

Apathy [1] is a state of reduced emotional, physical and willful activity. It is described by indifference, emotion simplification, loss of interest towards usual activities, anhedonia (reduced ability or inability to receive pleasure). It can also be accompanied by physical fatigue, drain, negative mindset: “I’m tired, I don’t want to do anything”, “Life is boring”, “I live with the flow”. This state can be short-term and long-term.

The word “apathy” comes from ancient Greek and is related to word “pathos” (passion). Prefix “a-” is negative, so the word, translated directly, means “lack of passion”. Indifference, detachment and ataraxy are the synonyms and close friends of apathy. [2]

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However, this term is often used to describe the state of patients which is quite different from the definition above.

  • For example, apathy can be related to people with schizophrenia is a state of emptiness, loss of interest, social contacts and general emotional decline.
  • Patients with depression can express strong negative emotions or maintain their hobbies and interests.

A combination of complete indifference and total loss of interest towards life is typical only for extreme cases.

According to R. Marin, the main feature of apathy is the reduced amount of directed, or motivated behavior. Clinically, apathy is simply the lack of motivation, lack of initiative, ambitions and persistence while maintaining the same intellectual and physical abilities. [3]

It can happen that a person does not display any difference in their lifestyle and activities, but feel that all their actions have become meaningless and perform them out of sense of duty. [4]

Check-list: do you have apathy?

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“I know apathy well. I had it in winter and at the end of spring. I lost interest to everything, I couldn’t even do anything. I was extremely bored, so I just lied on my sofa and watched TV to kill the time.”

– Elena, occasionally suffers from apathy

Scientists have suggested a special method for diagnosing this state: Apathy Evaluation Scale (AES).

As you may have already noticed, apathy does not equal exhaustion or laziness, it is a disorder accompanied by the loss of will to live, desire to move on and develop further.

If you agree with at leas 5 of the following statements, you are likely to have apathy.

  • You feel a general decline of mental and physical activity.
  • You used to be initiative, but now you avoid any additional workload.
  • You are speaking slower than before.
  • You move less than before.
  • You avoid talking to others much more often.
  • You feel that you intellectual potential has decreased.
  • You find it hard to focus on something.
  • You are no longer entertained by pleasant things.
  • You have a pessimistic outlook.
  • You have noticeably less self-confidence.

If you found any signs of apathy, it is worth to think about solving this problem.

Signs of apathy

In order to confirm or dismiss your suspicions, let’s take a closer look at the signs of apathy.

In 2009, a group of French scientists started to work on developing criteria for diagnosing apathy. Nowadays, there are multiple interpretations and descriptions of this mental state, but some signs are common for all of them. As the result, those scientists have established three main criteria: [5]

  • lack of motivation for at least 4 weeks;
  • decrease in directed cognitive activity, directed behavior or emotional response (at least one of these must be present);
  • noticeable functional decline (general mental block, slower speech).

Other than these, apathy also has the following signs:

  • sense of chronic fatigue and weakness without any other disorder to be the cause;
  • constant drowsiness that doesn’t disappear after a good sleep;
  • laziness, lack of desire to do anything, including not only work or study related activities, but also leisure;
  • sense of boredom and sadness which make the world look pale;
  • lack of expressed emotion, both positive and negative;
  • desire to stay alone, avoiding any social communication, even with friends and relatives;
  • getting locked into own thoughts, lack of faith in oneself;
  • negative mindset, for example: “I don’t need anything”, “I’m tired of living like that”.

Other signs that facilitate the diagnosis of apathy are general mental block, robotic movements and lack of facial expressions.

Causes of apathy

Feelings and emotions are an essential part of our activities. However, constant and extreme emotions can lead to exhaustion. A person cannot experience emotions “all the time”. Decline in emotional activity leads to indifference, but this is not yet apathy.

Apathy appears when we experienced too strong and too bright emotion for too long. This results in a state of emptiness that can last between several days and several weeks.

There are three main causes of apathy, related to our emotional state: physical exertion, learned helplessness and emotional burnout.

1.     Apathy can often be a result of physical exertion. When a person has to deal with a stressful situation for a prolonged period of time, it damages them, and in this case apathy becomes a protective means, a kind of a safety bag. Thanks to this, an exhausted person can save some energy, without wasting it in emotional experiences during stress, resulting in burnout.

2.     State of feebleness can also come from learned helplessness, when a person feels that any attempt to change a traumatic situation are meaningless. In that case, a person simply gives up and goes with the flow. Meanwhile, apathy, like any other learned behavior pattern, can be defeated.

3.     Apathy can be a consequence of emotional burnout, common for workaholics. Overtime work leads to fatigue, which people tend to ignore. It results in weakness, drowsiness, apathy and fatigue.

Apathy can also be a sign of mental, physical and neurological disorders, as well as a side effect of certain psychotropic medication. There are also people with a disposition towards this state due to their personal traits and personality features, but such people are mostly an exception.

Apathy can develop during adolescence as the result of hormonal changes, troubles in school activities and interacting with peers. Before you blame a teenager or any other person for inactivity, make sure that there are no solid causes for this behavior.

Development of apathy

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R. Levy and B. Dubois studied the mechanisms of apathy development and distinguished three pathogenetic processes that can start it:

  1. Emotionally Affective (disorders in connection between emotional and affective signals and actual behavior).
  2. Cognitive (trouble with planning own activities).
  3. Decreased self-activation (inability to activate own thoughts and reactions). [5]

Which states act as precursors of apathy? Before developing apathy, a person usually passes the following stages:

  • Irritability. A person becomes irritable, annoyed by everything, feels already at their limits yet continues to exert themselves. Their working efficiency goes down, which leads to further troubles.
  • Aggression. Anger and dissatisfaction grow and spread to other life spheres, like family, friends, lifestyle. A person becomes aggressive, explosive, displays harsh reaction to different situations and becomes violently opposed even to minute details.
  • Apathy. A person has no more energy left on anger and aggression, life events do not prompt strong emotions, a person feels chronic fatigue and drain. Everything becomes meaningless.

Stages of apathy: from fatigue to loss of meaning

Apathy, if it remains untreated for too long, can become even stronger. A person can go from decrease in activity and bad mood to absolute indifference.

Mild case

Mild apathy can manifest itself in form of general laziness and bad mood.

Medium case

Medium apathy is characterized by bad mood, sense of fatigue, inability to brace oneself. A person feels that they can never rest properly, and any activities that were easy before become extremely hard. Such ideas are common for this state: “I have no energy”, “I won’t even make it”.

Severe case

Severe cases of apathy can be accompanied by memory loss, depersonalization (“I feel like nothing is real”) and depressed outlook, withdrawal from making any plans, and even loss of meaning in life: “No reason to do anything, tomorrow will be just the same”.

Apathy and depression

apathy

Many people mistakenly think that apathy is the same as depression. [6] Depression is a prolonged mental disorder which can indeed be accompanied by apathy.

However, apathy itself is not yet depression, even though it can turn into one after a long period of time. In other words, apathy can both be a sign and a cause of depression.

Consequences of apathy

Apathy can severely lower the quality of life. A person doesn’t “live”, they “exist”, they don’t get pleasure, don’t develop and achieve their goals.

All these things affect social interactions: person loses all the motivation to communicate with others, while people around them do not generally enjoy interacting with an apathetic and indifferent person. A person with apathy loses any ability to empathize, they can become rude and uninterested in their partner in communication.

A substantial decline of working efficiency can lead to a block, when a person requires more time to perform usual actions and makes more mistakes. This leads to more trouble at work and increased disappointment with oneself.

As the result, a person has problems in relationships, at work, they are disappointed with themselves, and the vicious circle never ends.

Getting rid of apathy: diagnosis and treatment

In order to treat apathy properly it is important to figure out its cause. A person can find it hard to do this on their own, so it is a good idea to consult a specialist.

Different approaches of applied psychology offer different ways to get rid of this unpleasant state.

Sometimes even a proper rest can help. However, if apathy is caused by chronic exertion at work and life, constant overload, then you need to change your lifestyle. Even though we might have great ambitions, our resources are not limitless. As the result, we have to pay for our ambitions by decreased efficiency and poor health.

Apathy can often become a learned mode of behavior, even if it began as a response to overload. A mindset developed during this state will remain even after our bodies recover and we are ready to go on.

7Spsy behavior modification technique can be very effective in treating learned behavior patterns. Our method is based on the traditional behavior psychology founded by I. P. Pavlov, B.F. Skinner etc.

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The course lasts 2-6 weeks. During this time you will change your old behavior pattern to a healthy one, find in yourself the energy to move on and achieve your goals. You can take this course at home whenever you wish, you don’t have to spend the time on commuting and adjust your own schedule.

However, if your apathy is a sign of another mental or physical disorder, we strongly recommend you to consult a medical specialist in-person. Only such a specialist will be able to treat your apathy.

References:

  1. Slovar’ prakticheskogo psihologa. — M.: AST, Harvest. S.
  2. O BEZRAZLICHII-APATII — Gumanitarnye nauchnye issledovaniya. 2012. № 10 [Elektronnyj resurs], Chuklov A. V.
  3. Sindrom apatii — Nevrologicheskij zhurnal, Voznesenskaya T. G.
  4. Depressii v obshej medicine: Rukovodstvo dlya vrachej — Smulevich A. B.
  5. Apatiya v strukture psihicheskih i nevrologicheskih rasstrojstv pozdnego vozrasta. Stat’ya.  — ZHurnal nevrologii i psihiatrii im. S.S. Korsakova. 2014;114(6): 77-85, A. S. Avedisova, A. B. Gekht, K. V. Zaharova, G. K. Dashkina, G. R. Popov.
  6. Psihopatologicheskaya struktura apaticheskoj depressii. Monografiya. — M.: Koshkin K.