Tuesday, January 6, 2009

Comments to Apathy Matters

Opening of article

You know what it’s like. Someone has seemingly pulled the plug and the power drains out. Your get up and go just got up and went. Life, the universe, everything – nothing matters as you shuffle through the clutter on the floor and flop into an unmade bed, your only refuge in a world you have given up on, that has seemingly given up on you.

Apathy is also used to describe indifference, such as to politics or NASCAR racing, but in a psychological context we are talking more like the opposite of motivation, the lack of will to go on and the inability to care about the consequences. ...

Return to article


  1. This was an excellent article.

    Every time I hear people talking about depression, it angers me because it is always about those who just feel a bit sad yet are perfectly functional and more than capable of cheering up with a dose of snake oil and a couple of meaningless platitudes.

    I only feel anger or irritation if other people are around me, horror and panic at the thought of having to do anything or go anywhere.

    I don't feel anything else, I have no interest in anything or anybody, I can't feel excitement, amusement, curiosity, happiness. I can't even feign interest anymore. I just want to avoid the world.

    It is too late to do anything, I've been like this for years, becoming progressively worse over the last five. I've lost everything, even if they could fix me in the morning, I would have nothing to get up for so why would I bother?

    It is like being paralysed in the brain, then your life evaporates and there is nothing left. You can't rebuild with nothing. You just get more disconnected as time goes by.

    I can't muster up the energy to care, it is over anyway. Just got to accept it.

  2. Hey, Bridget. I finally felt like I met someone who understands me. Paralysed in the brain, life evaporates - I can definitely relate. I suggest reading the article on dopamine in the Science section of my site. Targeting serotonin doesn't work for all depressions. Your brain may be needing an energy boost rather than a mood boost. It's something to ask a smart pdoc about.

    Welcome to McMan and keep posting.

  3. What if an afflicted individual doesn't want the so-called magic bullet(s)? I was (supposedly) diagnosed with BMD 10 years ago. I initially tried the drugs which I felt failed in getting to the root of the problem. At one point, it dawned on me that I was just a guinea pig for "shrinks" whose only method of aiding mentally/emotionally challenged individuals was linked to corporate drugdealers. I lived alone with this problem for 10 years now with no rainbow at the end of this damned yellow-bricked road in sight. I've contemplated, and attempted self-termination on several occasions and decided to try life once more. I went to college, got a degree and still I find myself stuck in the same spot of this stupid road. What's worse, is this so-called malady has allowed me to see the world, and it's virus-like occupants, perceptively different. This "truth" to which I, and a very select few, have been enlightened by has only fueled, or provided me with yet another justification for my suicidal thoughts/plans. I wanted to add that though I feel completely apathetic to life, I do not lack any emotion. Actually, it's the quite the opposite. I feel too emotional, but not for myself. I am completely apathetic to whatever happens to me. But I feel so much anger, frustration, and resentment over not being able to make a difference with all that is wrong with this world. What's worse is that there is no one I can talk to. People around me don't want to know what I am feeling, or planning. Doesn't anyone out there no how to help people like me without the damn drugs? I want to cry uncontrollably, but I don't know why!!!

  4. Its so fricken good to hear that i am not the only one out there feeling apathetic. my saying goes, "apathy is the sympathy of my sanity." But of course thats not very true, or maybe its only partially true. i feel so damn blank. i cant even think of why i like dont like something or someone. not to mention knowing what i even do like in the first place. indecision has been weave into my brain without my approval. i know no life without its grasp on my opinions. but were talking about apathy not indecision or blankness. i feel nothing for my girlfriend when shes upset. I have to think, with my indecisive mind, "how am i supposed to think and how am i supposed to feel right now???" then i act upon whatever i decide im supposed to feel, if i ever do decide. bu ti know its all fake and tahts what kills me, i hate fake people. And look at me, the fakest of the fake!!! the opther day, my girlfriend said to me, "you should know how you feel. why dont you know how you feel???" she said some ohter stuff that, out of apathy, i don't remember. thats the other thing. i have the HARDEST time remembering important stuff. such as names, what i told who, what who told me, and when, and more that, well, i cant remember right now. i was in therapy yesterday, and i was asked why i liked my girlfiend so much. hell, i know theres a long list, but i couldnt say much more than, "shes really nice". okay, i think im done now...it felt so good to get that out there, even though noone will ever really take the time to read this, most likely...

  5. Psychiatry is nearly worthless. It may help some but they and the medical community in general insist on medicating nearly everyone without an accurate understanding of what it is they are medicating in the first place. I say this out of first hand experience. It does not matter if the patient says the medication does not work. Doctors will medicate individuals without even speaking to them first. Apathy to a degree can be a sign of depression but it can exist in it's own right. True apathy, if anything, does exist solo. Humanity itself creates apathy for those who look at it objectively.

  6. Thanks for the article on apathy. I've had two decades of depression and anxiety. Two years ago, I was able to release anxiety, by letting go. It's a simple technique which I would have scoffed at had it not worked for me.

    Similarly, I have been able to release the unhappiness of depression, with awakening.

    What remains though is apathy. It's a sense of detachment. There is little motivation to do anything. I don't enjoy or not enjoy anything. I am not unhappy. But completely passive, unenergetic and apathetic.

    So, at least by my own experience, apathy is a separate thing from depression.

    Exercise and abstinence from alcohol can help. But these things take a small amount of motivation.

    What I am trying now is to allow whatever mental state that wants to come up, and I watch it, passively. This helps to extent that often these disturbing states get much worse with resistance.

  7. I am anonymous because the other profile selections don't apply.

    Having been there in a Major way twice, I posit that the three factors of anxiety, depression, and apathy are very much interrelated and overlapping but can be expressed in a simple sense to be that anxiety is fear of the unfamiliar changes brought by depression, depression is the illness, and apathy is the body's protective response to the pain of the illness.

    As an example, consider the similarities to the experience of shell shock (a World War I term), with its anxiety due to the fear of death, the experience of near-death, and the resulting apathy called shell shock. The battle experience is done in the realm of the overtly observable and noble, and therefore the medical result is considered a legitimate illness, whereas depression occurs with less unobservable and acute environmental and internal conditions. If more observable, it is now called nervous fatigue; if more acute, it is called PTSD. Consider these early versus late 20th century expressions:

    1a. After abandoning the remainder of her Red Cross endeavors, she was became reclusive."

    1b. "After canceling the remainder of her tour, her spokesperson said that she is suffering from nervous exhaustion."

    2a. "After the accident, he behaved as if he were shell shocked."

    2b. After the accident, he was found to be suffering from PTSD."

    These terms are functional rather than structural attributes that would appear to be best studied by the functional subset of neurological imaging. The practice of medicine is very much still evolving but we are fortunate enough that many of us are maintained well enough to read and comment on this article. Progress is being made on many important aspects of brain malfunction. I refer to, and do not have any affiliation with:


    Additionally, my experience is that apathy is both the scab and the scar of this insidious illness, which has claimed 33 of my 60 years. I still try to find intact skin within those scabs and scars.

  8. hi all. thanks for the author for this article and those commentators who shared their experience.

    i am a graduate student studying a chemistry related research topic. i had been in depression starting about 6 years ago. i was in immense pain, hopelessness, helplessness and my life was filled totally with sorrow and grief because of a personal loss or inability to get something that i loved most and got hurt by that. let me call it a 'crisis'. i did not have any control of things that were happening to me and happening in my life. to add to this, i am a stammerer from childhood; that kept me away from others both actively and passively from childhood, but that never demotivated me from my dream to become a scientist and to study science. i had been far more competent in my intellectual ability but not in speaking and socializing abilities. but after the crisis, i developed inferiority complex and lost hope in life. result: i had to quit my first research opportunity in a good institute. but i did not bother. i left it out of pain and grief. from this point, started the apathy.

    i was still in grief, pain, hurt and was inconsolable. i isolated myself physically from my family and friends. i sought alcohol and care-free lifestyle to get out depression. then slowly time healed my pain and slowly i found my way to research again. but the apathy inflicted by pain and depression still remains with me. now i am not able to do any productive work. now i am happy and i forgot the crisis and the past. but i am unproductive, not caring my pathetic condition and the disgrace it is bringing to me, not improving my abilities, not concerned about my development and growth. i lost interest in many things that i was so much interested 6 years ago. now i feel a lot of emptiness. i wake up daily, bath, eat, go here and there, read things not related or useful for my life. but i am not able to do any job/work related to my career, job and research. i don't know how to get rid of this sloth behavior, the way i call it. i have a close friend who is suffering from the same sloth behavior, he is not doing any job. is it because of him, i am like this? or vice versa. i don't know.

    any how i learned recently that being 'sloth' is a one of the deadly sins. knowing this, and since interested in spiritual stuff, now i want to drive myself out of this sloth nature. so i hope spiritual thoughts and faith can somehow reverse apathy. i am awaiting the results.

  9. Being on the internet & finding sites like yours is helpful. I was diagnosed w dysthmia almost 24 years ago. I cant even remember the name of the drug I took back then but it wasnt pleasant although kept me functioning but still unhappy and flat. I stopped taking it after maybe 2 or 3 years and then 6 yrs ago I got really low, flat, apathetic and was put on Cymbalta by my Gen. Prac. Doc cause I simply told her I felt a "little sad". It has helped some. I find consolation & hope in reading the articles about anhedonia and apathy. I have always wondered exactly what it is that's going on in my brain. I would be very interested in future studies and even participating in an apathy/anhedonia study. Thanks for sharing your experiences and knowledge Mr. McNanamy. I will visit your blog often.

  10. The article was interesting as it shows some correlations between apathy and other debilitating disorders. How though dose it explain apathy in people who have no disorders/illnesses, have a comfortable and prosperous life but are majorly apathetic because it is easier to make a quick buck than to care.

  11. I don't understand if I am apathetic or not. Things have started to not bother me anymore. I don't have any interest in performing in my academics or in my daily life. I did not even fill in the examination forms and also did not try to appear for the college examinations. I don't talk about my life to my family or to my friends anymore. Nothing seems to be so worth now. However I experience emotions like rage, sadness, loneliness. When I am with someone, I try to cover up these emotions. I don't know how to handle this. Can you please help me?

  12. Mr. McManamy

    Thanks for the article.

    I suffered an injury to the left side of my forehead as a child and there was a marked personality change that occurred as a result.
    I still suffer horribly from a lack of interest and antisocial behavior.

    The AES seems lacking as a diagnostic test the Myers-Briggs is almost better at determining personality types and that could lead one in the direction of diagnosing Apathy.

    Do you know if there is more information regarding Apathy and what I could do to treat it.


  13. I found your post looking up anhedonia. Thanks for the interesting article.

    I have been off and on antidepressants since I was 24 (am now 40). When I first went on them, it was because I was very unhappy, ultra-sensitive to everything around me. I went back and forth between being actively in pain and anxious and being the type of depressed where you just want to lay in bed. Sleep was always my drug, and I longed for a pill that would take my pain away. I was a live wire, like everything affected me too much. I felt alien in the world, lonely... and deeply in fear of being abandoned. I started going to therapy and that helped. The idea of taking meds came up. I tried Paxil first, since it had worked for my sister, but it made me too anxious. Then I tried Zoloft, and it was like someone kicked the crutches out from under me and I walked for the first time. I felt so much more in control, and positive, and energetic and alive. I was no longer so scared about doing stuff, and felt more open.

    Over the years for various reasons I tried other drugs. Eventually I found my magic combo was a low dose of Zoloft and Wellbutrin. So I find it interesting what you mention about dopamine and pleasure.

    Recently I went off my meds again because I wanted to get pregnant. I've been off meds for 6 months now, and recently in addition to being depressed and sensitive and anxious like I was before, I'm suffering from a pronounced anhedonia. I feel like before when I was off meds I was in pain. I could want to end things but usually it was because I felt so overwhelmed and everything seemed like a tragedy (I used to measure my depression by things like... hmm... if it seems like a TRAGEDY that I have to brush my teeth every day, I must be depressed). I certainly felt lack of pleasure in activities, but nothing like what I'm (not) feeling now. The pain made me want to claw my way out of where I was, and I still sought something... love, care... something.

    Now what I am feeling is different somehow. More dead. I feel like I want to end things because I feel like I've completely lost my desire to do anything. I can't imagine the shape of happiness. It's like my desire was a light bulb, and it's burned out completely. Nothing gives me pleasure. I really related to what you were writing about making crafts. Normally I love making paper mache, and silly videos for my niece, and playing board games, and video games, and watching movies. None of those things gives me any pleasure now. I want to do nothing but sleep, but I don't even get any pleasure out of the sleeping!

    I've lost touch with what I want, and start panicking that I don't want to be in the relationship I'm in, or have a baby, or work. I'm working at home now and it is so hard to motivate to do anything. I'm trying hard to just do things even if I get no enjoyment out of them. Or sense of accomplishment. I used to feel good if I did what I was supposed to do in a day. I had feelings of accomplishment from cooking and washing the dishes, doing laundry, organizing my apartment. Now it seems none of that matters. I don't like this me.

    But I had wanted to have a baby... so I don't want to go back on meds. And I worry about being on meds forever, what it could be doing to my brain. If maybe in the end it will make things worse. If maybe where I am now is a RESULT of long term use of antidepressants.

    I wonder if there is a way to stimulate dopamine without meds.

    The worst part about this is the lack of hope... I can't imagine feeling desire, even. Sometimes I try, I compulsively try to do the things that gave me pleasure before, but it only makes me feel emptier.

    I suppose I have to wait and see if anything changes. Maybe I just have to get through having a baby, just do it in automatic since I know that is something I wanted when I still wanted. Just wait it out and then take some Wellbutrin and hope.

  14. Thank you for this needed discussion.

    I have had 3 Major Depressive Episodes in my life and have battled with depression since childhood... I am now 47. I have a BSN so I am extremely well read and well informed and consider myself an expert on MDD. Don't let any doctor tell you what you feel/don't feel and/or whether it is part of the illness. Has your doctor had even 1 MDD??? Apathy/indifference/who cares, is most definitely a part of this illness and I'd take any doctor down (verbally) who said otherwise.

    Until doctors start listening better, which is supposed to be their forte we will not be treated with adequate care. They need to get their egos out of the way...we are the experts, we are the teachers, we know our bodies. After all, there is no currently used blood test in 'clinical practice' to identify your type of depression...perhaps it is coming soon so prescribing meds won't be so willy nilly. So speak up, speak up loudly and trust yourself and your instincts.

    DSM-V?? Are we still in the dark ages waiting for some old fogies with power they shouldn't have to die off?? Not even a mention of apathy as it relates to depression?? There's understanding, comprehension, and accurate empathy for you....Obviously the great psychiatrists are not involved; surely WHO will get it right...I have more faith in them.

    Given the duration of my illness I have had a litany of over 20 different medication cocktails and I have always responded the best to dopamine related drugs, not the SSRI's. I'm glad to hear that more research is happening in that area. Presently, I remain on Parnate which has always worked the best for me. Many doctors remain afraid to even prescribe it. How many doctors even follow the drug algorithm for MDD?

    The trouble with depression is that sometimes we are so apathetic, we can't speak up and fight for ourselves, or crack the whip enough to get the doctor fighting for us. And so feeling defeated before trying, and without hope of any effort being useful, as well as being horribly sad and in PAIN; we give up. When, what we really need is a doctor who listens hard for FEELINGS, and will fight for us until our own fight comes back on board.

    THERE IS NO FIGHT WITH APATHY. Their lack of knowledge about this explains why they are so frustrated when no movement occurs.

    We need a lot of support to push through the apathy to get back out doing things. One of the most helpful things for me was a community support worker, who helped me feel some mastery with practical things at home, (ie; applying for CPPD) as well as started to get me back out into the community and engaging again.

    Another thing that helped me greatly was learning some specific skills around being present and mindful instead of mentally obsessing, ruminating and analyzing about things from the past or future. Also, learning LOTS of self-soothing and comforting skills was essential to coping better . Of course you hear about a bubble bath, go for a walk...but when you suffer from depression you need a HUGE list of self-soothing remedies to draw from. Once you start using them and see that they do work that gives you comfort,mastery, and hope, and puts a dent into the apathy.

    If you don't recognize something that is a main factor of the illness...apathy goes beyond decreased motivation, then you will not be able to treat the illness.

  15. Very good Article. Thanks for bringing attention to it.
    This must be the Absolute WORST long-term 'Disease' on Earth.

    I've also had this Anhonia and Depression like all of you over my entire life ever since I can remember. I'm over 40 Y.O. now. Never married and no kids.(always wanted to) But I am glad I didn't give up because over the last few years I've found out that Protein powder ('Alive' from Swansonvitamin), vitamins, minerals(esp.magnesium and 6mg iodine daily), herbs, Bovine Glandulars (primarily Thyroid and Adrenals), and with specific Amino acids like Tyrosine, Glutamine, Taurine, 5HTP, and Gaba, etc...
    have helped this horrible problem some and given me hope that I can continue to improve with Serotonin and Dopamine in my Brain. Anti-Depressants never helped me at all. (But thats just my particular Brain)

    NEVER GIVE UP -- and keep trying different things!