Most of us have ever been unmotivated, not wanting to do anything despite having to . Although we do act and carry out what we have to do, we do it with a very low level of motivation, without illusion or interest, almost as if we were robots.

These kinds of everyday experiences are examples of one of the most unpleasant feelings: apathy . In this article we will see exactly what its psychological basis is and why it can arise.

Concept of apathy

Apathy is a condition or state of lack of motivation or interest in different aspects of life, usually associated with a state of discomfort or hopelessness. There is an indifference both at the cognitive and affective level to most stimuli, and the desire to act is conspicuous by its absence.

On the other hand, the main characteristics of this symptom are the flattening or emotional dullness, the lack of perseverance and the reduction of self-generated thoughts and behaviours.

Thus, not only is the initiative lost to a greater or lesser degree, but the linkage of events with emotions occurs at a much lower level. This may cause the person to decrease his/her performance and level of effort in order to carry out different types of behaviour, which in turn feeds back into the demotivation of the subject. When apathy occurs to a maximum degree in which it does not allow us to act normally, making it difficult to make decisions or making it impossible to start or continue carrying out tasks, it can be called abulia.

Apathy can be found primarily as a syndrome without necessarily having an associated disorder . However, it is generally considered to be a symptom indicative of other mental as well as physical disorders.

Possible causes of apathy

Apathy can have a lot of different causes, both biological and environmental .

Biological causes

At the brain level, a correlation has been shown between the presence of apathy and alterations in the connection between the frontal lobe and the basal ganglia, which explains the difficulty in connecting emotion and thought, as well as the reduction in behavioural initiative. Another remarkable association with apathy is the presence of lesions in the dorsolateral prefrontal and associative areas . These lesions may explain the appearance of apathy in various disorders, both physical and psychological, such as dementias.

Another possible cause can be found in the consumption of substances with psychoactive effects, which by modifying the transmission of neurotransmitters can alter the normal functioning of the brain. For example, the excessive use of cannabis can cause the so-called amotivation syndrome , characterized by the presence of apathy, decreased memory, and reduced impulse and self-directed activity.Something similar occurs with the typical antipsychotics, which by reducing the dopaminergic activity of the whole brain cause not enough dopamine to circulate through the mesocortical pathway, which may lead to the increase or generation of negative symptoms such as alogia and apathy.

Environmental causes

At the environmental level, apathy has been found in people subjected to constant stress or exposure to aversive stimulation . The absence of sufficient positive reinforcement may also end up generating a deterioration in the capacity to take an interest in the environment. The existence of defenseless attitudes and depressive thought patterns, with a negative view of the self, the world and the future, also contributes to wear down the person’s mood and motivation, causing apathy and even abulia.

Another element linked to apathy is the tendency to generate goals that are difficult to achieve, that exceed one’s capacity to carry them out and that often lead to frustration .

Some associated disorders

As we have seen, apathy is a frequent symptom of different disorders both organic and psychological. We will now look at some of them.

1. Depression

One of the disorders in which abulia can be seen most frequently is depression, in which different cognitive biases are present that make the subject see the world, their own future and themselves in a hostile and negative way. The despair and discomfort generated can lead to feelings of apathy, being in fact one of the common symptoms that can help in making the diagnosis.

2. Dementia

In this type of disorder, apathy has a clearly organic etiology, being generated by the degeneration of brain structures or previously mentioned pathways.

3. Anxiety, stress and negative or traumatic experiences

The wear and tear caused by the continuous experience of a state of tension can generate the presence of apathy, whether this is linked to a specific aspect of reality or at a general level. Situations from which we cannot escape and which generate despair and a feeling of lack of control usually generate a certain state of apathy if they are maintained over time.

4. Anemias

The absence in the body of different nutrients such as vitamins or glucose can lead to cognitive and behavioural disorders , including apathy. Such anaemia may result from a poor diet or metabolic disorders.

5. Severe infections and diseases

Different infections and diseases can generate states of apathy in the subjects who suffer from them, both due to organic causes such as the degeneration of brain structures, and because suffering from them can be a hard blow on a psychological level that ends up generating apathy. Examples of this are cancer or HIV infection.

Treatment

Apathy is a symptom whose treatment will depend largely on the aspects or disorders that cause it . However, on a general level, different strategies can be established.

In psychological therapy

In therapy, the apathetic subject will generally benefit from those strategies that help him/her generate plausible and achievable goals, at first with some ease and over time progressively requiring some more effort. Cognitive restructuring can also be effective in modifying possible dysfunctional beliefs that may be affecting the subject’s vision of the world and of himself, as well as therapies such as Rehm’s self-control, so that realistic and achievable goals can be set. In general, increasing self-esteem and performing pleasant tasks is also very useful.

Lifestyle changes

Since stress and negative experiences can be other causes of apathy, time management is also essential . For this reason, it is necessary to contribute to the creation of specific schedules that leave room for relaxation, as well as the performance of different exercises and techniques that facilitate it.

A healthy lifestyle is of great help in improving symptoms. The control of the diet can make up for different deficiencies that can help generate apathy. Similarly, physical exercise is known to help generate endorphins so that its performance can be useful both in this aspect and in reducing the level of anxiety and frustration that can be found behind some cases.

Social support and reinforcement of the initiative by others is also a great help in overcoming states of apathy, especially in the face of disorders such as depression. The use of psychoactive substances, especially depressants, can have harmful effects and help maintain and even generate apathy. In this way the use of this type of substance must be reduced and controlled .

Intervention with psychopharmaceuticals

At the pharmacological level, the use of different anxiolytic or antidepressant drugs , such as SSRIs, may be useful. Other drugs that contribute to improving the circulation of neurotransmitters such as noradrenaline and dopamine are also effective. All of this is provided that it is prescribed by a specialist.

Bibliographic references:

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
  • Marin, R. S. & Wilkosz, P. A. (2005). Disorders of diminished motivation. Journal of Head Trauma Rehabilitation, 20(4).

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  • Levy, R. & Dubois, B. (2006). Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cereb. Cortex; 16 (7).: 916-28.
  • Santos, J.L. (2012). Psychopathology. CEDE PIR Preparation Manual, 01. Madrid.