Apathy and Fatigue
Finding it hard to get-up-and-go, or you’re simply not interested? You may be experiencing apathy, a common Non-motor Symptom of Parkinson’s Disease.
Apathy causes a general lack of motivation and interest, as well as a dampening of emotional expression. Hobbies and social activities may no longer bring enjoyment, and daily routines may require more energy. Basic tasks may be difficult to start and complete.
Apathy can be misinterpreted as laziness, poor initiative or depression. And while it often is a feature of depression, apathy may occur on its own in Parkinson’s.
Apathy affects up to 40 percent of people with Parkinson’s disease (PD) and is likely due, at least in part, to lack of the neurotransmitter (brain chemical) dopamine. It can impact anyone at any time in the course of their disease, but those with depression, anxiety or impaired cognition (memory and/or thinking abilities) are more susceptible. Older age and more severe motor symptoms also seem to put people at higher risk of developing apathy.
Apathy Has Many Potential Consequences
Apathy can have wide-ranging effects. For the individual experiencing it, apathy may lead to less physical activity (which can worsen already impaired mobility) and fewer social interactions (which could lead to depressive symptoms). Apathy has also been shown to correlate with a poorer adherence to medication regimens and/or response to treatment (as after deep brain stimulation surgery, for example).
The friends and family of someone with apathy are also impacted — relationships may be stressed as loved ones take on more caregiving efforts.
Treatment of Apathy Focuses on Behavioural Adjustments
People with apathy usually don’t realise there is a problem. Instead, friends and family notice behaviour or personality changes and bring these to the doctor’s attention. It’s important to do so because the physician can do tests and have you fill out questionnaires to figure out if the symptoms are due to apathy, depression and/or another medical condition.
Apathy is defined as an absence or suppression of emotion, feeling, concern, or passion; an indifference to stimuli found generally to be exciting or moving.
If the diagnosis of apathy is confirmed, lifestyle adjustments may be recommended:
- Maintain a regular sleep and wake schedule. Go to bed and get out of bed at the same time each day. If you snore loudly, act out your dreams, or feel excessively sleepy during the day, ask your doctor if you need a sleep evaluation.
- Create a schedule that incorporates physical, social and cognitive (memory and thinking) activities. List what you will do each day and at what time.
- Set personal goals. Start small, with objectives you are confident you can achieve. As you reach these, you will set and accomplish bigger goals. Involve others at every step of this process — this will strengthen existing bonds and build new relationships.
- Exercise. Physical activity is probably the last thing you want to do when you’re tired and unmotivated. It sounds counterintuitive, but exercise is actually helpful for apathy. Listen to your body and know your limits (i.e., stop if you feel pain, don’t push yourself to the point of exhaustion, etc.) but try to do something active every day — a short walk around the block or, if you have poor balance, stretching exercises on the floor. You might even want to look into group exercise classes — many are offered specifically for people with Parkinson’s or older adults.