Behavior APATHY Psychiatry may not care about apathy, but that doesn't mean you shouldn't by John McManamy

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.

Andrea describes it this way:

I am so lethargic and cannot find anyway out. ... I cannot seem to make myself do anything. All I want or seem to be able to do to get out of bed is get the newspaper and try and read it, smoke, or open a can of something or eat a box of ice cream, watch TV or surf the internet, and now a new addiction - buying things on E-Bay! Getting expensive!!! ...

I make jewelry and used to love it, but now can't complete anything and am in such a mess with my beads I don't think I'll ever get them straightened out. I've gained 40 pounds, don't care about my appearance, can't clean the house, etc etc. I feel I have all the symptoms of depression, plus I can't feel any excitement about seeing loved ones, can't think of anything, or anywhere I want to be but in my bedroom.

The Prize Patrol could probably show up on Andrea's door with a check for 25 million dollars, and she would still feel flat. Or even if she levitated to the ceiling in exultation, it wouldn't be long before she went back to her current life in a darkened room, even if that room happened to be part of a new mansion in the Hamptons.



What We Know About Apathy and Depression

So is apathy part of depression? The DSM is virtually silent on the topic, as is the depression literature. Depression is generally characterized by too much emotion, but the DSM implicitly acknowledges we can experience too little. One of the two major depression symptoms is loss of interest or pleasure, such as in a hobby. Basically, we stop caring.

What’s missing here is that lack of caring doesn’t necessarily stop at pleasure (see article). We can also become desensitized to grief or to something bad happening, but we’re not likely to see psychiatry weigh in on this any time soon.