Apathy in PD: What To Know & How to Rekindle Joy

While Parkinson’s disease is often associated with tremors and gait issues, it is also frequently accompanied by non-motor symptoms, including apathy.

Apathy refers to a state of emotional indifference where someone may experience a lack of motivation or interest in things they once found exciting.

Apathy is often confused with depression. While it’s possible for people living with Parkinson’s to experience both, they are different and should be treated separately.

Let’s explore the causes of apathy for people with Parkinson’s and how to harness the spring and summer months to rekindle joy and excitement.

What Does Apathy Look Like for Someone with PD?

Apathy in Parkinson’s disease can be subtle or pronounced. For some, it may appear as a growing disinterest in hobbies, relationships, or activities that once brought joy.

Daily routines may begin to feel like burdens, and initiating everyday tasks like cooking, going for a walk, or making plans may feel overwhelming or pointless. Conversations may dwindle, and a once sociable person might become withdrawn, not out of sadness but out of disinterest or fatigue.

This can be particularly distressing to loved ones and caregivers, as the person may seem “checked out” or disengaged. It’s important to remember that apathy is not a choice; it's a symptom.

What Causes Apathy in PD?

Apathy is believed to result from changes in the brain affecting motivation and emotional response.

In Parkinson’s, the loss of dopamine-producing neurons affects not only movement but also reward and motivation systems. These chemical imbalances, combined with the fatigue and cognitive challenges that often accompany Parkinson’s, can create a perfect storm for apathy to develop.

In some cases, medications used to treat motor symptoms may also contribute to non-motor symptoms, including apathy. That’s why maintaining open communication with your neurologist or MDS is especially important.

What’s the Difference Between Apathy & Depression?

While apathy and depression can look similar on the surface—both may include withdrawal, lack of energy, and reduced engagement—they are different in key ways.

‍Depression typically includes sadness, hopelessness, and feelings of worthlessness. A person with depression often wants to feel better but may feel emotionally burdened or stuck.

Apathy, on the other hand, is more of an emotional flatness. There’s often no sadness, just a lack of interest or motivation.

Understanding the distinction is crucial because the treatments for depression and apathy are not always the same. Antidepressants may not be effective for apathy, and treatment plans should be personalized based on a thorough assessment.

Diagnosing Apathy

Diagnosing apathy can be challenging, in part because it can overlap with depression or cognitive decline.

Currently, no blood test or scan can definitively identify apathy. Instead, diagnosis typically involves a detailed evaluation of behavioral changes, medical history, and caretaker observations.

Doctors may use screening tools or questionnaires to assess motivation levels and emotional engagement. Early recognition allows for better support, both medically and socially.

If you’re experiencing apathy or caring for someone showing signs of apathy, it’s important to engage with your MDS immediately to create an effective course of action.

How Can I Reduce Feelings of Apathy with Parkinson’s?

While there is currently no medical treatment for apathy, there are things you can do to spark engagement and joy, especially as the days grow longer and warmer!

Try these tips for countering the effects of apathy:

• Create a Gentle Routine

A consistent daily rhythm can help reduce decision fatigue. Include short walks, meals outdoors, or gardening time. Having something predictable (but pleasant) to look forward to can increase motivation.

• Make Nature Your Ally

Exposure to sunlight can help regulate mood and sleep, both of which are connected to motivation. Even a short stroll around the neighborhood or sitting on the porch can be uplifting.

• Try Micro-Goals

Instead of planning big outings, focus on small, achievable tasks, like watering a plant or calling a friend. These “wins” can help reignite a sense of purpose.

• Stay Social, Even in Small Doses

You don’t need to attend a large gathering to fill your social cup. A short visit with a loved one, establishing a weekly coffee meetup or lunch date with friends, or joining a local support group can all make a big difference.

• Incorporate Creative Activities

Art, music, or birdwatching are low-effort ways to engage the senses and promote mindfulness.

• Talk to Your Care Team

If you or a loved one is experiencing signs of apathy, speak to your doctor. They may recommend adjustments to medication, therapy, or other interventions.Apathy may be an invisible symptom, but its impact can be profound. Incorporating even a couple of the above tips can do wonders for boosting spirits and countering these debilitating feelings.

Check out PCLA’s calendar of support groups or reach out for further information on resources for managing apathy. We’re here to help you live your absolute best life possible with Parkinson’s!