Apathy: causes of indifference, weakness and loss of energy

You wake up and don't want anything — you're not sad and not angry, just empty. Apathy is not laziness or a bad character, but a symptom that can have various causes.

What apathy is and how it differs from fatigue

Apathy is indifference and detachment, a distant attitude to what is happening, and a lack of striving for any activity. There is neither a positive nor a negative attitude to reality, and there are no external emotional manifestations. Combined with abulia, it forms apathetic-abulic syndrome; combined with adynamia, it forms apathetic-adynamic syndrome. In depression, fatigue, a feeling of emptiness, loss of interest, and sleep and appetite disturbances are singled out separately among the symptoms.

In depression, loss of interest in favorite activities is one of the key symptoms, and it persists almost every day for at least two weeks.

Psychological causes of apathy: stress, losses, burnout

Psychological factors are among the possible causes of depression, along with genetic, biological and environmental ones. Trauma or stressful life events increase the risk even more. In addition, depression occurs in people who have a close relative with the same disorder.

Apathy in mental disorders

Apathy can be a clinical variant of depression and a manifestation of negative symptoms in schizophrenia. Depression is a serious mood disorder: it affects thinking, feelings and daily life, and basic tasks such as sleeping, eating or working become difficult. Symptoms do not always look like sadness: adolescents may have excessive drowsiness, and men may have irritability or anger.

Somatic causes: illnesses, hormones, COVID

Apathy can be a symptom of somatic and neurological diseases: dementias, endocrine disorders, brain lesions, and also a side effect of certain medications. Apathetic dementia due to damage to the frontal regions is distinguished separately. Some illnesses and medications produce a picture similar to depression, so a doctor may order tests to rule out other causes — including checking thyroid function.

Apathy during pregnancy and maternity leave

Depression is more common in women, including because of hormonal changes during menstruation, pregnancy, the postpartum period and menopause. So apathy during pregnancy and maternity leave is not "whims" but a reason to take a closer look at your condition.

When apathy requires seeing a doctor

If indifference and loss of energy last for weeks and interfere with life, talk to a doctor or mental health specialist. Diagnosis includes taking a history of symptoms and family history, a medical examination, tests and an assessment of mental state.

• a feeling of emptiness or low mood almost every day
• loss of interest in things that used to bring joy
• too much or too little sleep and food
• pain, headaches, digestive problems without an obvious cause
• thoughts of death or suicide

Apathy by itself is not a reason to call an ambulance. Call 103 or 112 if there are thoughts of death or suicide, and also if there is a threat to life — as with serious injuries, stroke or heart attack.

This material is for reference and does not replace a doctor's consultation — if in doubt, it is better to ask a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer