Losing the will to live: apathy as a disease
Mar 19, 2019
Some people say that indifference is worse than hate or anger. We spend a lot of time and effort fighting negative emotions, like grudge, irritation and 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.
What is apathy?
Apathy has been attracting more and more attention from psychiatry as a separate clinical disorder since the nineties.
Apathy  is a state of reduced emotional, physical and willful activity. It is described by indifference, emotion simplification, loss of interest towards usual activities and anhedonia (reduced ability or inability to receive pleasure). It can also be accompanied by physical fatigue, mental draining and a 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 or 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. 
However, this term is sometimes 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 in a state of emptiness, loss of interest, absence of social contacts and general emotional decline.
- Patients with depression can express strong negative emotions, yet some maintain their hobbies and interests.
A combination of complete indifference and a 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, the lack of initiative and an absence of ambitions and persistence while maintaining the same intellectual and physical abilities. 
It can happen that a person does not display any differences in their lifestyle or activities but feel that all their actions have become meaningless and they perform them out of a sense of duty. 
Check-list: do you have apathy?
“I know apathy well. I had it in winter and at the end of spring. I lost interest in everything, I couldn’t even do anything. I was extremely bored, so I just lay 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: the 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 the will to live or the desire to move on and develop further.
If you agree with at least 5 of the following statements, you are likely to have apathy.
- You feel a general decline of mental and physical activity.
- You used to have 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 your 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 thinking 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 sufferers. As a result, those scientists have established three main criteria: 
- 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 being 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 one’s 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 include a general mental block, robotic movements and a lack of facial expressions.
Causes of apathy
Feelings and emotions are an essential part of our daily activities. However, constant and extreme emotions can lead to exhaustion. A person cannot experience emotions “all the time”. A decline in emotional activity leads to indifference, but this is not yet apathy.
Apathy appears when we experience 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.
- 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 can damage them. In such a case, apathy becomes a protective means, a kind of safety net. Thanks to this, an exhausted person can save some energy, without wasting it on emotional experiences during stress, which could result in burnout.
- A state of feebleness can also come from learned helplessness. This is when a person feels that any attempt to change a traumatic situation is 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.
- Apathy can be a consequence of emotional burnout – common for workaholics. Overtime work leads to fatigue, which people tend to ignore. This results in weakness, drowsiness, apathy and fatigue.
Apathy can also be a sign of mental, physical and/or 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 or poor interaction 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
- Levy and B. Dubois studied the mechanisms of apathy development and distinguished three pathogenetic processes that can start it:
- Emotionally Affective (disorders in connection between emotional and affective signals and actual behavior).
- Cognitive (trouble with planning own activities).
- Decreased self-activation (inability to activate own thoughts and reactions). 
Which states act as precursors of apathy? Before developing apathy, a person usually passes the following stages:
- Irritability. A person becomes irritable and easily annoyed by everything. They feel already at their limits yet continue to exert themselves. Their working efficiency goes down, which leads to further troubles.
- Aggression. Anger and dissatisfaction grow and spread to other life spheres, such as family, friends or lifestyle. A person becomes aggressive and explosive and displays a harsh reaction to different situations and becomes violently opposed even to minute details.
- Apathy. A person has no more energy left for anger and aggression. Life events do not prompt strong emotions, and a person feels chronic fatigue and draining. 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 a small decrease in activity or a bad mood to absolute indifference.
Mild apathy can manifest itself in the form of general laziness and moodiness.
Medium apathy is characterized by a bad mood, a sense of fatigue and the inability to brace oneself. A person feels that they can never rest properly, and any activities that were easy before have become extremely difficult. Such ideas are common for this state: “I have no energy”, “I won’t even make it”.
Severe cases of apathy can be accompanied by memory loss, depersonalization (“I feel like nothing is real”) and a depressed outlook. Additional symptoms include withdrawal from making any plans, and even the loss of meaning in life: “No reason to do anything, tomorrow will be just the same”.
Apathy and depression
Many people mistakenly think that apathy is the same as depression.  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 it after a long period of time. In other words, apathy can both be a sign and a cause of depression.
The consequences of apathy
Apathy can severely lower the quality of one’s life. A person doesn’t “live”, they “exist”, they don’t get pleasure and they don’t develop and achieve their goals.
All these things affect social interactions. A person loses all the motivation to communicate with others, while the people around them do not generally enjoy interacting with an apathetic and indifferent person. A person with apathy loses any ability to empathize and they can become rude and uninterested in communicating with their partner.
A substantial decline of working efficiency can lead to a block. This is when a person requires more time to perform the usual actions and makes more mistakes. This leads to more trouble at work and increased disappointment with oneself.
As a 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 difficult 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 everyday life and constant overload, then you need to change your lifestyle. Even though we might have great ambitions, our resources are not limitless. As a 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.
The 7Spsy behavior modification technique can be very effective in treating learned behavior patterns. Our method is based on traditional behavior psychology founded by I. P. Pavlov, B.F. Skinner etc.
The course lasts 2-6 weeks. During this time you will replace your old behavior pattern with a healthy one. You will 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. You can adjust it to your own schedule.
However, if your apathy is a sign of another mental or physical disorder, we strongly recommend that you consult a medical specialist in-person. Only such a specialist will be able to treat your apathy.
Information from this website cannot be used for self-therapy and self-diagnostics.
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