By pathological apathy, medicine means a symptom of various diseases characterized by apathy, insensitivity to stimuli, and lack of excitability. It is most common in dementia patients.
What is apathy?
Apathy is characterized by nonresponsiveness, lack of response to all external stimuli, apathy, and an apparent lack of feeling. Apathy is characterized by nonresponsiveness, lack of response to all external stimuli, apathy, and an apparent numbness. The disorder affects the central nervous system and is a sign of serious illness. Along with apathy, dejection, loss of appetite, sleep disturbances, and changes in judgment usually occur. All age groups can be affected by apathy, but it is primarily a symptom of advanced dementia and thus considered particularly common in the elderly. Approximately 92% of frontotemporal dementia sufferers, 72% of vascular dementia sufferers, 63% of Alzheimer’s disease sufferers, and 57% of Lewy body dementia patients show signs of apathy as the disease progresses. Other diseases in which apathy is common include rabies, marked hypothyroidism, and mental illnesses such as autism, severe anorexia nervosa, and depression. If symptoms of apathy can be detected in young children, they are usually due to severe infectious diseases with high fever.
Causes
The causes of apathy cannot be named in general terms; a distinction must be made according to the underlying disease. The following is a rough overview of the causes of the major diseases that have apathy as a symptom. Too little research has been done on the triggers of mental illnesses to be able to make concrete statements. An interplay of congenital and social influences is suspected. Dementias can be traced back to various causes based on underlying diseases, vascular damage or genetic predisposition. To date, however, it has not been possible to investigate the causes more precisely; only accompanying symptoms are clear. Rabies is an infectious disease in which apathy is a warning sign of aggressive phases. It is transmitted to humans by bites from rabid animals and travels rapidly from the wound to the central nervous system. There it initially causes flu-like symptoms and later meningitis, central nervous symptoms such as increased aggressiveness, apathy and hallucinations.
Diseases with this symptom
- Creutzfeldt-Jakob disease
- Yellow fever
- Common cold
- Botulism
- Poisoning
- Heat stroke
- Adrenocortical-
insufficiency
- Dementia
- Brain tumor
Diagnosis and course
Apathy is manifested in the symptoms already indicated apathy, non-responsiveness and lack of response to absent stimuli. Specifically, it is noticeable that those affected always seem absent, no longer make eye contact, no longer eat or drink, and sleep disturbances are evident. If there are signs of apathy, relatives or caregivers should notify a doctor or take the affected person to a hospital. If the diagnosis of apathy is considered confirmed there, investigations into the cause are necessary. It must be said, however, that this is usually already determined before the onset of apathy. Only in rare cases do patients suffer from apathy without a cause being suspected or diagnosed in advance. With extensive testing, blood work, and imaging, underlying conditions can be diagnosed. Treatment cannot be initiated until the cause is determined. The course of apathy must be differentiated according to the underlying diseases.Thus, in mild infectious diseases with high fever, good chances of recovery can be indicated. However, in rabies and dementia diseases, the prognosis is unfavorable, since good treatment methods are still lacking today.
Complications
Apathy can lead to a number of psychological and physical complications. For example, the stress associated with apathy can promote diseases of the cardiovascular system. Hypertension, heart failure, or coronary artery disease are the result.This also affects other organs, such as the liver and kidneys, which are particularly susceptible to disease during apathy. Endocrine diseases of the thyroid or kidneys as well as viral infections are the result of untreated apathy or lethargy. As the disease progresses, various infectious diseases such as tuberculosis or chlamydia may be added. Likewise, diseases of the nervous system, which manifest themselves in the form of neuroses, depression or myasthenia gravis and vary depending on the age and constitution of the patient. Finally, apathy may lead to anemia, i.e., a lack of blood, and thus to secondary symptoms such as dizziness and feelings of weakness. In general, mental and physical well-being decreases as a result of apathy, favoring a variety of other complications that are often difficult to attribute to apathy as a cause. Moreover, the lack of motivation can also lead to malnutrition in those affected and thus to secondary diseases such as anemia. Patients who experience apathy should therefore consult a physician as soon as possible to avoid the development of the multiple complications associated with apathy.
When should you see a doctor?
If apathetic behavior persists for several weeks, a physician should be consulted immediately. In the case of a physical lack of energy that lasts for a few days and then spontaneously disappears, an analysis and background investigation should be made. If the causes are clarified and resolved due to temporary occurrences, it is certainly not necessary to consult a doctor. If the condition of lack of interest in normal goals, lack of personal hygiene, or loss of will to live persists for days or weeks, going to the doctor is highly recommended. This is true even if the triggering event is known. Often, apathy is only an accompanying symptom of another and possibly more serious illness. If there is a temporary lack of motivation for 2-3 days, it should be observed whether it occurs repeatedly and at what intervals or conditions this occurs. The symptoms of apathy may be present in parallel with other mental disorders. Only a professional can make a distinction based on the patient’s medical history or assess the course as expectable. If motivational disorders take place as a result of head injuries or brain trauma, affected persons must wait to see if the apathetic behavior persists once the injuries have healed. Nevertheless, the physician should be informed in time to follow the development of apathy more closely and to intervene in time.
Treatment and therapy
There is no general treatment method for apathy; therapy must be given to the underlying disease. Psychological causes are treated with psychotherapy and, if necessary, psychotropic drugs. However, it must be pointed out that most mental illnesses cannot be cured, only their course can be changed. A more normal life is possible, a cure of all symptoms is considered therapeutically unlikely. Promising therapeutic measures are also lacking for rabies. It must be assumed that the disease is fatal. Although a modern treatment approach provides for treatment with antivirals and simultaneous sedation, this concept has only been successful in two cases. The course of dementia can be slowed for some time with medication and memory training, but again, a complete cure is not possible.
Outlook and prognosis
The prognosis and outlook regarding apathy must always be made in relation to the underlying disease. If apathy is a side effect of drug treatment, the symptoms usually resolve on their own after completion of therapy. Apathy resulting from a temporary illness, such as an infection, also promises good chances of recovery, provided that the underlying condition is treated quickly and comprehensively. Apathy resulting from a progressive disease such as dementia, on the other hand, can only be treated for a long time or not at all. Permanent symptoms are also likely in apathy resulting from a psychogenic disorder. If apathy is due to rabies or another severe viral disease, the patient will suffer severe accompanying symptoms and sometimes even death.The prognosis and outlook for apathy therefore depends largely on the causative disease and the timing and type of treatment. If the underlying disease can be cured, apathy often disappears, but in the case of severe infections and psychogenic diseases, long-term concomitant symptoms are to be expected. Due to the many influencing factors, the final outlook and prognosis can thus only be made by the attending physician.
Prevention
Apathy cannot be prevented, only a few underlying diseases with specific measures.
This is what you can do yourself
Several immediate measures can help with apathy. First, it is important to compensate for the emotional emptiness by a fulfilling everyday life again. Affected individuals can alleviate symptoms by following a clearly structured daily routine with a set time to get up and scheduled tasks. The feeling of indifference can only be remedied through personal initiative. In some cases, simple goals such as meeting a friend or going to a job interview are enough to generate the necessary motivation and thus gradually alleviate the apathy. Affected individuals should generally confide in a friend or family member, as mentioned coping strategies can be implemented more easily with support. In addition, general measures such as sufficient exercise, a balanced diet and abstaining from stimulants help to alleviate accompanying symptoms such as exhaustion and fatigue. If apathy occurs as a result of schizophrenia or depression, a discussion with a psychologist or psychotherapist can provide clarity about the symptoms and thus help in overcoming them. If the apathy persists for several days, a doctor must be consulted, as the complaints are then often based on a psychological condition such as burn-out, which cannot be treated independently.
