Apathy: What It Is, Symptoms and Signs of an Apathetic State

Sometimes the morning begins not with fatigue but with a flat indifference: things bring no joy, plans do not move you, and even what once affected you seems to pass by. This state is called apathy — and it deserves attention, not a reproach for laziness.

What apathy is and how it differs from laziness and fatigue

Apathy is a symptom that manifests as indifference, unconcern, a detached attitude toward what is happening around, an absence of striving for any activity and of external emotional expressions. Combined with abulia, it constitutes the apathetic-abulic syndrome, and with adynamia — the apathetic-adynamic syndrome.

Apathy is a symptom that can have various causes; more about them below.

Main symptoms and signs of apathy

The signs of apathy are easy to mistake for quiet fatigue, but they last longer and affect daily life. A person may look calm, yet inside there is emptiness and a lack of motivation.

• indifference to what once brought joy or concern;
• absence of striving for any activity;
• paucity of external emotional expressions;
• a feeling of emptiness and loss of interest in usual activities.

Similar manifestations occur in depression: loss of interest in favorite activities, a feeling of fatigue, a sense of emptiness. Therefore, behind a calm face there is sometimes a condition that is better discussed with a specialist.

Why an apathetic state arises: possible causes

The causes can be various. Apathy can be a clinical variant of depression, a manifestation of negative disorders in schizophrenia, a symptom of somatic and neurological diseases — Pick's disease, Alzheimer's disease, various dementias, endocrine disorders. It can occur with organic damage to the brain, especially the frontal lobes, and as a side effect of certain medications.

In depression, the factors are also diverse: genetic, biological, environmental and psychological. Sometimes no clear cause is found. Apathy can also be observed in healthy people — as a personality trait with low social and professional activity, as well as within normal development and aging.

Is apathy a disease or a symptom of another condition

Apathy is a symptom that can accompany other conditions — depressive, neurological, endocrine. The doctor assesses how long the manifestations last, how much they interfere with life, and whether there are other complaints. If depression is suspected, the specialist collects the history of symptoms and family history, may order tests and an examination to rule out other causes, and also conduct an assessment of mental state.

How long apathy lasts and when it becomes "eternal"

The duration depends on the cause. In depression, symptoms must be present most of the day, almost every day, for at least two weeks, and one of them is depressed mood or loss of interest. In persistent depressive disorder, the manifestations are less pronounced but usually last at least two years. "Eternal apathy" is more a feeling than a timeframe: if indifference does not pass and interferes with daily life, this is a reason to find out what lies behind it.

When to see a doctor

You should see a doctor or mental health specialist if indifference does not pass and interferes with working, eating, sleeping, communicating, if thoughts of death have appeared, or if drinking alcohol and other substances has become a way of coping. Help at an early stage helps manage symptoms.

Apathy by itself is not a reason to call an ambulance. You should call 103 or 112 in life-threatening conditions, for example if a stroke or heart attack is suspected.

This material is for reference and does not replace a doctor's consultation: if you recognized yourself in the description, calmly discuss it with a specialist.

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