Apathy: symptoms and causes of this feeling

Most of us have ever been unmotivated, not wanting to do anything despite having to do it. Although we do act and carry out what we have to do, we do it with a very low level of motivation, without enthusiasm or interest, almost as if we were robots.

These kinds of everyday experiences are examples of one of the most unpleasant feelings: apathy. In this article we will see what exactly its psychological bases are and the causes for which it can arise.

Apathy concept

Apathy is a condition or state of lack of motivation or of interest by the different aspects of life, generally associated with a state of discomfort or hopelessness. There is an indifference both on a cognitive and affective level to most stimuli, and the desire to act is conspicuous by its absence.

On the other hand, the main characteristics of this symptom are affective flattening or dulling, lack of perseverance and the reduction of self-generated thoughts and behaviors.

Thus, not only is the initiative lost to a greater or lesser degree, but the linking of events with emotions happens at a much lower level. This can cause

that the person decreases their performance and level of effort in order to carry out different types of behavior, which in turn feeds back the demotivation of the subject. When apathy occurs to a maximum degree in which it does not allow us to act normally, making it difficult to take making decisions or making it impossible to start or continue the performance of tasks, it can come to be called abulia.

Apathy can be found primarily as a syndrome without necessarily having an associated disorder. However, as a general rule it is considered a symptom indicative of other mental and physical disorders.

Possible causes of apathy

Apathy can have a lot of different causes, both biological and environmental.

Biological causes

At the brain level, the existence of a correlation between the presence of apathy and alterations in the connection between frontal lobe Y basal ganglia, which explains the difficulty in connecting emotion and thought, as well as the reduction in behavioral initiative. Another notable association with apathy occurs in the presence of lesions in the dorsolateral prefrontal and associative areas. These injuries can explain the appearance of apathy in various physical and mental disorders, such as dementias.

Another possible cause can be found in the consumption of substances with psychoactive effects, which by modifying the transmission of neurotransmitters it can alter the normal functioning of the brain. For example, excessive cannabis use can cause known as amotivational syndrome, characterized by the presence of apathy, decreased memory, and reduced impulse and self-directed activity. Something similar occurs with typical antipsychotics, which by reducing the dopaminergic activity of the entire brain cause not enough dopamine to circulate through the mesocortical route, which can cause the increase or generation of negative symptoms such as allergy and apathy.

Environmental causes

At an environmental level, apathy has been found in people under constant stress or exposure to aversive stimulation. The absence of sufficient positive reinforcement can also end up generating a deterioration in the ability to take an interest in the environment. The existence of defenseless attitudes and depresogenic thinking schemes, with a negative vision of the self, of the world and the future, it also contributes to wearing down the mood and motivation of the person, causing apathy and even abulia.

Another element linked to apathy is the tendency to set goals that are difficult to achieve, which exceed one's ability to carry them out and which often lead to frustration.

Some associated disorders

As we have seen, apathy is a frequent symptom of different disorders both organic and psychological. We will see some below.

1. Depression

One of the disorders in which apathy can most frequently be seen is depression, in which different cognitive biases are present that make the subject see the world, their own future and themselves in a hostile and negative way. The despair and discomfort generated can lead to feelings of apathy, being in fact one of the common symptoms that can help make the diagnosis.

• Related article: "Are there several types of depression?"

2. Dementia

In this type of disorder, apathy has a clearly organic etiology, being generated by the degeneration of brain structures or ways mentioned above.

• You may be interested: "Types of dementias: forms of loss of cognition"

3. Anxiety, stress and negative or traumatic experiences

The wear and tear caused by the continued experience of a state of tension can generate the presence of apathy, whether it is linked to a specific aspect of reality or to a general level. Situations from which we cannot escape and which generate hopelessness and a feeling of lack of control They usually generate a certain apathetic state if they are maintained over time.

4. Anemias

The absence in the body of different nutrients such as vitamins or glucose can cause cognitive and behavioral alterations, including apathy. This anemia can come from a poor diet or metabolic disorders.

5. Serious infections and illnesses

Different infections and diseases can generate states of apathy in the subjects who suffer from them, both for organic causes such as degeneration of brain structures and the fact that suffering from them can be a severe blow at a psychological level that ends up generating apathy. Examples are cancer or HIV infection.

Treatment

Apathy is a symptom whose treatment will depend largely on the aspects or disorders that cause it. However, at a general level, different strategies can be established.

In psychological therapy

In therapy, the apathetic subject will benefit as a general rule from those strategies that help him to generate goals plausible and achievable, at first with some ease and over time progressively requiring a little more than effort. Cognitive restructuring It can also be effective in order to modify possible dysfunctional beliefs that may be affecting the subject's vision of the world and of himself, as well as therapies such as Rehm's self-management, so that realistic and achievable goals can be set. In general, increasing self-esteem and doing pleasant tasks is also very useful.

Changes in lifestyle

Since stress and negative experiences can be other causes of apathy, time management is also essential. For this reason, it is necessary to contribute to realizing specific schedules that leave room for relaxation spaces, as well as the performance of different exercises and techniques that facilitate it.

A healthy lifestyle It is of great help when it comes to improving symptoms. The control of the feeding can allow to fill different deficits that can help to generate apathy. In the same way, physical exercise is known to help generate endorphins so that its performance can be useful both in this aspect and in reducing the level of anxiety and frustration that can be behind some cases.

Also social support and reinforcement of the initiative by others is a great help in overcoming states of apathy, especially in the face of disorders such as depression. The use of psychoactive substances, especially of the depressant type, can have detrimental effects and help maintain and even generate apathy. In this way consumption of these types of substances should be reduced and controlled.

Intervention with psychotropic drugs

At a pharmacological level, the use of different anxiolytic or antidepressant drugs, like SSRIs. Other drugs that help to improve the circulation of neurotransmitters are also effective, such as noradrenaline and dopamine. All this as long as it is prescribed by a specialist.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.

• Marin, R. S. & Wilkosz, P. TO. (2005). Disorders of diminished motivation. Journal of Head Trauma Rehabilitation, 20 (4).

• Levy, R. & Dubois, B. (2006). Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cereb. Cortex; 16 (7).: 916-28.

• Santos, J.L. (2012). Psychopathology. CEDE PIR Preparation Manual, 01. CEDE. Madrid.