apathy

With pathological apathy the medicine means a symptom of various diseases that by indifference, Insensitivity to stimuli and a lack of excitability is characterized. It occurs most often in people with dementia.

What is apathy?

Apathy is characterized by non-responsiveness, a lack of reactions to all external stimuli, indifference and an apparent numbness.

Apathy is characterized by non-responsiveness, a lack of reactions to all external stimuli, indifference and an apparent numbness. The disorder affects the central nervous system and is a sign of a serious illness. Along with apathy, depression, loss of appetite, insomnia and changes in judgment usually occur.

All age groups can be affected by apathy, but it is primarily a symptom of advanced dementia and is therefore particularly common in older people. About 92% of those with frontotemporal dementia, 72% of those with vascular dementia, 63% of those with Alzheimer's disease and 57% of those with Lewy body dementia show signs of apathy during the course of the disease.

Other diseases in which apathy is common include rabies, severe hypothyroidism, and mental illnesses such as autism, severe anorexia nervosa, and depression. If symptoms of apathy can be detected in small children, they are mostly due to severe infectious diseases with a high fever.

causes

The causes of apathy cannot be named in general, a distinction must be made according to the underlying disease. The following is a rough overview of the causes of the most important diseases that show apathy as a symptom.

Too little research has been done on the triggers of mental illness to be able to make concrete statements. One suspects an interplay of innate and social influences. Dementia 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 research the causes in more detail; 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 through bites from rabid animals and quickly migrates from the wound to the central nervous system. There it initially triggers flu-like symptoms and later meningitis, central nervous symptoms such as increased aggressiveness, apathy and hallucinations.

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Diseases with this symptom

• Creutzfeldt-Jakob disease
• Yellow fever
• cold

• botulism
• poisoning
• heatstroke

• Adrenal cortex insufficiency
• dementia
• Brain tumor

Diagnosis & course

The apathy manifests itself in the already mentioned symptoms of apathy, non-responsiveness and failure to react to lack of stimuli. Specifically, it is noticeable that those affected always seem absent, no longer make eye contact, no longer eat or drink and sleep disorders are evident.

If there are signs of apathy, relatives or caregivers should call a doctor or take them to a hospital. If the diagnosis of apathy is considered to be confirmed there, investigations into the cause are necessary. It must be said, however, that this is usually already established before the apathy breaks out. Only in rare cases do patients suffer from apathy without a cause being suspected or diagnosed in advance.

The underlying diseases can be diagnosed with detailed tests, blood tests and imaging tests. Treatment can only be initiated once the cause is established.

The course of apathy must be differentiated according to the underlying illnesses, so that good chances of recovery can be given for mild infectious illnesses with a high fever. In the case of rabies and dementia, however, the prognoses are unfavorable because good treatment methods are still lacking.

Complications

Apathy can lead to a number of psychological and physical complications. The stress associated with apathy can favor diseases of the cardiovascular system. High blood pressure, heart failure or coronary artery disease are the result. It also affects other organs such as the liver and kidneys, which are particularly susceptible to disease during apathy.

Endocrine disorders of the thyroid or kidney and viral infections are the result of untreated apathy or lethargy. As the disease progresses, various infectious diseases such as tuberculosis or chlamydia can develop. Likewise, diseases of the nervous system that manifest themselves in the form of neuroses, depression or myasthenia gravis and differ depending on the age and constitution of the patient. Ultimately, apathy can lead to anemia, i.e. a lack of blood, and consequent symptoms such as dizziness and weakness.

In general, the psychological and physical well-being decreases as a result of apathy and thus favors a large number of other complications, which are often difficult to trace back to the apathy as the cause. The lack of motivation can also lead to malnutrition in those affected and thus to the secondary diseases mentioned, such as anemia. Patients who experience apathy should therefore consult a doctor as soon as possible in order to avoid the occurrence of the various complications that accompany the apathy.

When should you go to the doctor?

Consult a doctor immediately in the event of apathetic behavior that persists for several weeks. In the case of physical lack of energy that lasts for a few days and then spontaneously disappears, an analysis and background research should be carried out. If the causes due to temporary incidents have been clarified and remedied, it is certainly not necessary to see a doctor.

If the state of a lack of interest in normal goals, a lack of personal hygiene or the loss of the will to live persists for days or weeks, a visit to the doctor is highly recommended. This also applies if the triggering event is known. Often the 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 time intervals or conditions this happens.

The symptoms of apathy can coexist with other mental disorders. Only a specialist can make a distinction based on the patient's medical history or assess the course as expected. If motivation disorders occur as a result of skull injuries or brain trauma, those affected must wait to see whether the apathetic behavior continues as soon as the injuries have healed. Nevertheless, the doctor should be informed in good time in order to follow the development of the apathy more closely and to be able to intervene in time.

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Treatment & Therapy

There is no general treatment method for apathy; the underlying disease must be treated.

Psychological causes are treated with psychotherapy and, if necessary, psychotropic drugs. It must be noted, however, that most mental illnesses cannot be cured, only the course of their changes can be changed. A more normal life is possible, a cure for all symptoms is considered therapeutically unlikely.

There are also no promising therapeutic measures for rabies. It must be assumed that the disease is fatal. A modern treatment approach provides treatment with antivirals and simultaneous sedation, but this concept was only successful in two cases.

The course of dementia has been slowed down with medication and memory training for some time, but even here a complete cure is not possible.

Outlook & forecast

The prognosis and prospects with regard to apathy must always be made in relation to the underlying disease. If the apathy is a side effect of drug treatment, the symptoms usually subside on their own after the therapy is over. Apathy as a result of a temporary illness such as an infection also promises good chances of recovery, provided that the underlying disease is treated quickly and comprehensively.

In contrast, apathy in the context of a progressive disease such as dementia can only be treated for a long time or not at all. Long-term complaints are also likely with apathy resulting from a psychogenic disorder.

If the apathy is caused by rabies disease or another serious viral disease, severe accompanying symptoms and sometimes even death of the patient occur. The prognosis and outlook for apathy depends largely on the causal disease, time and type of treatment.

If the underlying ailment is curable, the apathy often disappears as well; in the case of severe infections and psychogenic illnesses, on the other hand, long-term side effects are to be expected. The final outlook and prognosis can only be made by the attending physician due to the many influencing factors.

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prevention

Apathy cannot be prevented, only a few underlying diseases can be prevented with specific measures.

You can do that yourself

Various emergency measures can help with apathy. First of all, it is important to compensate for the emotional emptiness through a fulfilling everyday life. Those affected can alleviate the symptoms through a clearly structured daily routine with a fixed time to get up and scheduled tasks. The feeling of indifference can only be overcome through initiative. In some cases, simple objectives such as meeting a friend or an interview are enough to generate the necessary motivation and thereby gradually alleviate the apathy.

Affected people should generally confide in a friend or family member, as the coping strategies mentioned can be implemented more easily with support. In addition, general measures such as sufficient exercise, a balanced diet and the avoidance of luxury foods help to alleviate accompanying symptoms such as exhaustion and tiredness.

If apathy occurs as a result of schizophrenia or depression, a conversation with a psychologist or psychotherapist can clarify the symptoms and thus help to cope with them. If the apathy persists for several days, a doctor must be consulted, as the symptoms are then often based on a psychological condition such as burn-out, which cannot be treated independently.