Apathy: Signs, Causes, & Treatments

What Is Apathy?

Apathy is an unwanted and problematic mental health symptom characterized by changes in thinking and behavior patterns. Behaviorally, a person with apathy will display lower levels of motivation and drive. With these areas being diminished, they will be less focused on setting, working on, and achieving their goals. Rather than being a motivated and energetic person, apathy will seem to zap their resources and produce a person who is still and stagnant.¹

Cognitively, an apathetic person will have less emotional responsiveness. This effect limits their reactions to outside events and emotional changes. If a very positive situation presents, the person will not experience a high level of happiness, enjoyment, or excitement. Similarly, when a negative situation occurs, they will not experience extreme sadness, sorrow, or anger. They may feel numb, cold, and uncaring.¹

A person with apathy may recognize that their behaviors and emotions are restricted, or they could struggle to understand the changes people see in them. They may look at others as people who are overreacting and overly emotional.

Apathy Is a Spectrum

Like most mental health symptoms, apathy falls on a continuum. If an apathetic person is on one side, a person who is overly reactive would be on the other end. A reactive person may show serious mood, thinking, and behavioral changes triggered by small or imagined situations.

Types of Apathy

Although the term is often used globally and generally, apathy is categorized into its own subtypes. It’s possible to have more than one type, and it’s also possible to experience different types at different points in life. The severity of the apathy is based on several factors, including the individual’s personality and current mental health status.

Types of apathy include:

• Behavioral apathy: Behavioral apathy refers to a lack of self-initiated behaviors, such as completing daily, routine tasks.
• Social apathy: Social apathy refers to a lack of connectivity or pleasure in relationships.
• Emotional apathy: Emotional apathy refers to lack of both positive and negative emotions and often presents as a general form of numbness.
• Situational apathy: Situational apathy refers to apathy tied to a specific situation, such as work or school.

Apathy Symptoms

While other mental health symptoms could look very differently depending on the individual, the intensity of the symptom, and the source, apathy will present in a consistent and uniformed way. A person with apathy will seem uncaring, unconcerned, and disinterested to almost all aspects of life. In addition, their energy and motivation will be very low.

Apathy can affect both males and females from all age groups.

Potential signs of apathy include:¹

• Feeling flat, blunted, or numb emotionally: A person experiencing apathy may display their state through a flat or blunted presentation. Often, their face may appear blank or expressionless.
• Lack of emotional reaction: Building on their restricted facial reactions, people with apathy will have limited emotional reactions. If a person gives them great news, they may return with a brief smile or nothing at all. Bad news may be met with a shoulder shrug and a blank reaction.
• Low energy and motivation levels: An apathetic person may behave in a very slow and deliberate way. They will not move quickly or productively. When apathy is high, the person may lack the energy and motivation to get out of bed, complete simple household tasks, and practice good self-care techniques. These people will struggle to succeed at work or school.
• Lack of goal setting: With low energy and motivation, the apathetic person will not accomplish any goals. Worse, they will not see value in planning or setting goals because it would seem pointless or too challenging.
• Less interest in pleasurable activities, hobbies, and relationships: With apathy, nothing seems to matter, so people cannot muster any effort to devote towards anything. The important people and things around them will deteriorate.

Apathy may be easy to identify in most adults, but noting the symptom in teens or older adults can be difficult because others may assume the changes are a normal consequence of the age. People may expect teenagers to be ambivalent, demotivated, and lazy, so they will blame the age, instead of apathy. The same people may view less energy, lower activity levels, and limited goal setting as a normal part of aging in seniors, but it could be apathy related to a neurological condition.

Symptoms Related to Apathy

People may experience common symptoms related to apathy while feeling apathetic. Other times, symptoms might occur without the presence of apathy (even though they look like apathy). It’s important to understand the subtle differences and similarities in these symptoms to best understand your situation or seek the appropriate treatment.

Symptoms similar to apathy are:

• Anhedonia: Anhedonia refers to limited or no pleasure when doing things, whereas apathy refers to the lack of energy to do things. They can both coexist with one another.
• Lethargy: Apathy generally coincides with mental health conditions, whereas lethargy refers to excessive physical or mental fatigue or sluggishness that may not inherently be connected to a mental health condition.

What Causes Apathy?

The causes of apathy encompass a long list of internal and external stressors that may be obvious or more covert. As with other symptoms, the situations that trigger apathy in one person may not create the same reaction in another. Some people may tend to be more prone to the causes of apathy due to certain biological and hereditary traits that put people at greater risk.

There is a bidirectional relationship involved with apathy. Apathy may be a side effect caused by a mental or physical health condition, or apathy may be the main effect that grows and builds to create a new mental health condition.²

Countless situational and environmental stressors could feed into apathy, including:

• Loss of a job, a relationship, or a loved one
• Ongoing medical issues
• Intense political or social issues in the community, country, or world
• Being denied acceptance into a team, club, job, or other organization
• Increased expenses due to car repairs, home repairs, or unexpected bills

External stressors impact apathy, but the way a person responds to the situation can increase or decrease symptoms.

Thought patterns that worsen apathy include thinking:²

• The world is against you
• There is a black cloud hanging over your head
• You are cursed or unlucky
• No one really cares about you
• You are powerless to change your situation
• The world is hopeless and meaningless

Mental Health Conditions Related to Apathy

When apathy is associated with a mental or physical health condition, the condition is fueling apathy, rather than apathy fueling the condition. Examples of this include depression, neurocognitive disorders, addictions, and schizophrenia.

The Connection Between Apathy & Depression

Depression is not just one condition. It is a group of mental health disorders affecting many people in different ways, but in most cases, they are capable of producing apathy.

Depressive episodes are marked by the presence of symptoms like:¹

• Low mood or irritability
• Low motivation
• Low energy and fatigue
• Limited interest in activities that were previously pleasurable
• Changes in sleeping and diet habits
• Feeling worthless and guilty
• Poor concentration and decision-making skills
• Feeling sped up or slowed down
• Thoughts of dying and suicide

Although not all of these fit into the concept of apathy directly, it makes sense to use apathy as an umbrella symptom to include several items from the depression symptom list. Treating depression will lower apathy, and treating apathy should lower depression as well.

The Connection Between Apathy & Substance Use Disorders

Substance use disorders are noteworthy for periods of apathy that emerge, either during intoxication or withdrawal. In these situations, the alcohol and other drugs will be dictating the levels of motivation, hope, and energy a person experiences.

The Connection Between Apathy & Schizophrenia

Schizophrenia may be known for creating intense and distressing hallucinations, delusional thoughts, and disorganization, but the condition will also bring a host of effects marked by the absence of thoughts, perceptions, and behaviors. Called negative symptoms of schizophrenia, apathy is one of the best examples.

Other negative symptoms connected to schizophrenia include:³

• Inattention and being easily distracted
• Limited speech
• Anhedonia where the person experiences little pleasure
• Blunted affect where the person is less expressive in their facial reactions

Alzheimer’s, Dementia, & Parkinson’s

Alzheimer’s disease and other neurocognitive disorders are intertwined as the progression of the physical health conditions create new and worsening levels of apathy. With these conditions, apathy is linked to an increased risk of cognitive decline.⁴

Apathy is very common among these disorders:⁴

• Apathy is reported by up to 89% of people with frontotemporal dementia
• 88% of people with Alzheimer’s disease
• 51% of people with Parkinson’s disease

These connections show how both mental health and physical health factors contribute.

How Does Apathy Affect Someone’s Mental Health?

Apathy may be a fleeting experience of disinterest and low motivation, or it could become a lasting problem. The sum of apathy plus time can result in negative impacts to a person’s mental health and well-being. Apathy has the power to affect energy, motivation, interest, pleasure, and optimism. These symptoms are all related to depression and major depressive episodes.

In the case of schizophrenia and neurocognitive disorders, apathy is an effect, not a cause, but in the case of depression, it can be either cause or effect. People must work to identify and resolve this type of apathy before it can build towards depression.

When to See a Doctor for Feelings of Apathy

Occasional apathy is fairly common, and it does not necessarily mean you have a certain mental health condition. But persistent or worsening apathy is worth addressing. Apathy can affect daily functioning and make it challenging to complete daily tasks. In more serious forms, it can impair employment, relationships, and basic self-care.

Here are several signs that it’s time to seek help for apathy:

• Your apathy is persistent and won’t go away despite making lifestyle changes
• You feel hopeless about feeling better
• You’re spending excessive time sleeping
• You’re abusing drugs or alcohol to feel “better” or feel “something”
• You are withdrawing from typical social support
• You are experiencing suicidal ideation

Diagnosing Apathy

Mental and medical health providers will work to assess and point out apathy whenever it emerges, but since apathy is a symptom, not a diagnosis, no psychiatrist, therapist, psychologist, or physician will offer apathy as a diagnosis.

Instead, the professionals will aim to understand where the apathy is stemming from and make the appropriate diagnosis based on that information. Some people will have short-term apathy that is only connected to situational stress and life circumstances. These people will not receive any diagnosis.

Treatments for Apathy

Treatment for apathy is a broad category of professional therapies, medication interventions, and lifestyle changes. Since apathy stems from numerous environmental, medical, and mental health issues, the treatments will vary greatly based on the source.

Medication for Apathy

The psychiatrist, neurologist, nurse practitioner, or physician will have a tall task in differentiating the source of a person’s apathy. The medications used for depression, schizophrenia, and neurocognitive issues are different from each other, so the medication will depend on the apathy’s underlying cause.

Depending on the cause of apathy, available medications include:⁵

• Antidepressants: For apathy linked to depression or dementia, antidepressants are a great choice. Although there are many options, drugs like Desyrel (trazodone), Zelapar (deprenyl), and Luvox (fluvoxamine) have been proven effective in studies.
• Psychostimulants: This class of medications, frequently used for attention-deficit/ hyperactivity disorder, help to increase wakefulness and decision-making skills. They can assist with apathy, also. Studies show methylphenidate (Daytrana, Ritalin, Concerta) is one stimulant capable of reducing apathy.
• Antipsychotics: Over the years, both typical and atypical antipsychotics have been studied for their possible benefit on apathy. Only one, risperidone (Risperdal), has been proven helpful for apathy and social withdrawal.
• Acetylcholinesterase inhibitors: These medications help reduce the levels of choline and acetate in the body. Some helpful drugs from this class include donepezil (Aricept) and rivastigmine (Exelon).
• NMDA receptor antagonists: Drugs from this group help to calm abnormal brain activities. Examples like memantine (Namenda) can help reduce apathy in some situations, although results have not been as significant as other medicines. Memantine is also available in a combination product with donepezil (Namzaric).

As always, people should practice caution and consistency when starting a new medication, follow the prescriber’s recommendations, and communicate their concerns quickly. Never stop taking a medication without discussing the process with your prescriber.

Therapy for Apathy

Mental health therapy may not accomplish a lot when it comes to dementia, but in the case of depression and schizophrenia, therapy can make a positive change in the symptom. By changing the thoughts and behaviors linked to apathy, the therapist and client can boost motivation and passion for life.

Psychotherapy usually involves meeting with a therapist for one-on-one, group, or family sessions to inspect and address mental health symptoms. Therapy can take place in an agency, school, community setting, doctor’s office, or the comfort of one’s home to resolve the apathy.

Many therapy styles are available, but some of the most helpful for apathy or apathy linked to depression include:⁶

• Acceptance and Commitment Therapy (ACT): ACT centers around the balance of acceptance and change to move a person forward. With a combination of managing unwanted thoughts and behavioral adjustments, ACT helps people live in the present moment.
• Cognitive Behavioral Therapy (CBT): CBT investigates the connections between thoughts, feelings, and behaviors to modify outcomes. By learning about positive self-talk and behavioral activation, CBT can help combat apathy.
• Dialectical Behavioral Therapy (DBT): DBT helps to build helpful skills like mindfulness, communication, distress tolerance, and emotional regulation. When combined, these tools can help undo apathy.
• Interpersonal Therapy (IPT): IPT aims to alleviate depression in teens and adults. By addressing and improving relationship issues, IPT can boost mood, energy, and motivation symptoms.

Depending on the intensity, frequency, and duration of apathy, therapy can improve the symptoms in as few as 12 weekly sessions.⁶

Other Treatment Approaches for Apathy

In addition to medication and talk therapy, many other treatments can be effective for improving or resolving apathy symptoms. The following approaches generally work well as part of an integrative treatment plan. This means that you might engage in them along with therapy, medication, and other adaptive lifestyle changes. 

• rTMS: rTMS is a medical approach that entails applying recurrent TMS pulses to targeted parts of the brain. This treatment can reduce depression symptoms.
• Cognitive stimulation therapy: Although this therapy is generally used for treating dementia, cognitive stimulation (often known as brain games or stimulated conversation) can improve depression.
• Music and art therapies: Music therapy and art therapy embrace creative expression, which can produce a sense of mindfulness and vitality that offsets apathy.

How to Overcome Apathy

Like with treatments, the best ways to cope with apathy will vary greatly depending on the source of the issue. When the symptom is linked to mental health concerns or life stressors, the best ways to deal with apathy is to understand the root causes, communicate your symptoms to your health team, then build a supportive community and purpose into your days.

Here are 10 tips for how to overcome apathy:

1. Understand the Symptom

Coping with any symptom is nearly impossible if you do not fully understand what apathy is and how it impacts your life. Gather the information about how apathy tends to show itself in your life and in the lives of people like you. Sometimes, people may wonder whether they’re just in a rut, feeling lazy rather than depressed. Apathy linked to depression will create concerns that differ from the apathy linked to schizophrenia. With a better understanding of the symptom and your situation, you can establish expectations that align with the likely future outcomes.

2. Communicate Your Concerns

Now that you know what you are going through, start letting the important people in your life know what you are going through. Your life can improve when parents, friends, kids, siblings, teachers, coworkers, and others know your status. Along the way, be sure to let them know your symptoms are more than laziness or other perspectives that serve to diminish your experience. Use the term “apathy,” and let them know what it means to you.

3. Build Purpose

When apathy is strong, nothing seems important. Nothing seems meaningful, so motivation and hope are low. Recognize that this view is a side effect of apathy and focus on finding a purpose in life. By identifying something you believe in, you can rediscover your passions and purpose.

4. Rebuild Motivation & Set Small Goals

Motivation is one of the first qualities apathy steals away, but you can rebuild it, despite the lack of desire and energy. Start slow by going for five minute walks, vacuuming your bedroom, or making a healthy meal. The process will be challenging and uncomfortable, but it is needed to shift the momentum in your favor.

5. Identify New Sources of Joy

It’s important to regularly seek out joy in your life. If things feel somewhat stale, prioritize your relationships and well-being. Reach out to old friends or make a commitment to meet new ones. If work is an ongoing source of stress, consider if it’s possible to make a change. Remember that even tiny sources of joy, such as mindfully sitting down with a cup of coffee or watching a favorite movie, can bring forth more happiness each day.

6. Change Your Routine

Apathy can occur as a result of feeling stagnant with your daily life. Making small changes to your routine induces a sense of novelty, which can evoke powerful feelings of curiosity, wonder, and meaning. Consider signing up for a new class, pursuing a hobby that you once used to love, or taking time out of your day to intentionally practice more self-care.

7. Try a Social Media Detox

It’s easy to waste hours scrolling through social media. All that screen time, however, may be contributing to feeling apathetic. Sometimes it can be helpful to truly commit to being more present in the real world. A social media detox might sound uncomfortable, but it pushes you to ideally spend your time more productively, which triggers creativity and may cause a greater sense of meaning and purpose.

8. Balance Physical Health Levels

Diet, exercise, and sleep are so important for physical and mental health, but apathy may skew these. Apathetic people may sleep too much, eat too little, and get no exercise. Finding a better balance here can help.

9. Spend More Time With Friends

High apathy levels will lower the interest levels of socialization, but increased time with loved ones will shrink apathy. Be sure to communicate your needs and experience to those closest to you.

10. Avoid Negative Lifestyle Changes

When apathy tells you that nothing matters and life is meaningless, it can be really easy to go down a problematic path. Drugs, alcohol, and other negative lifestyle options may seem tempting, but they only result in worse symptoms.

Healthy lifestyle changes are never very exciting or appealing. They take consistency and hard work, but with time, they can make noticeable improvements with apathy.

Long-Term Outlook for People With Apathy

The outlook for a person with apathy truly depends on the source of the symptom. Someone with apathy triggered by a breakup or another situational stressor could see only short-term and mild experiences with apathy, while a person whose symptom is caused by Alzheimer’s disease or schizophrenia could face a tough journey in the future.

No matter the cause, a person always needs to identify the source of their apathy, so they can accurately plan their expectations. As long as the person keeps their goals realistic, they can have a positive prognosis.