Apathy and Avolition: What You Need to Know

Medically Reviewed by Jabeen Begum, MD on April 02, 2024
6 min read

Apathy is when you lack motivation to do things or just don’t care much about what’s going on around you. Apathy can be a symptom of mental health problems, Parkinson’s disease, or Alzheimer’s disease. It often lasts a long time. You may lack the desire to do anything that involves thinking or your emotions. The term comes from the Greek word "pathos," which means passion or emotion. Apathy is a lack of those feelings.

Empathy vs. apathy

Empathy is your ability to understand the experiences of other people and relate to them. It's thought to have two parts: cognitive and affective. Cognitive empathy is your ability to see things from another person's perspective. Affective empathy is the ability to share another person's emotions or imagine yourself in their situation. Apathy is more than just a lack of empathy. It's a general lack of interest or motivation. Apathy as a medical condition is something you can't control. You're not choosing to feel this way.

Apathy and depression

Apathy isn't the same thing as depression, though it can be hard to tell the two conditions apart. Feeling "blah" about life is common in both conditions. It isn’t sadness or anger, either. Rather than feeling these emotions, you don't feel much of anything. Things that used to make you happy don't excite you anymore. You no longer feel motivated to achieve your goals. You can have apathy and depression at the same time.

Everyone loses interest in things at one time or another. But when it happens a lot, it can affect your relationships, your job, and your ability to enjoy life.

Avolition can look similar to apathy, but it's more intense. Avolition is a total lack of motivation that makes it hard to get anything done. You can't start or finish even simple, everyday tasks. Getting off the couch to wash the dishes or driving to the supermarket can feel like climbing Mount Everest. You might not:

  • Respond when friends call, text, or email
  • Put in any effort at work or school
  • Pay bills or take care of other everyday tasks
  • Wash or groom yourself

Avolition is not a condition itself. It's most often a symptom of schizophrenia, a mental disorder that affects how you think, feel, and act. It can also be a sign of serious depression or a side effect of certain medicines. Some of the antipsychotic drugs you may take to treat schizophrenia can cause it.

Avolition could also be a symptom of:

  • Bipolar disorder
  • Persistent depressive disorder (dysthymia)
  • Premenstrual dysphoric disorder (PDD)
  • Posttraumatic stress disorder (PTSD)
  • Traumatic brain injury
  • Alzheimer's disease

People who don't get enough mental stimulation can also have avolition. For example, you could get it if you sit alone in bed all day because of an illness. It could also happen to prisoners in solitary confinement.

If you don't get treatment for the problem that's causing it, avolition can affect every part of your life, from your relationships to your job.

You might think of avolition as more of a behavior and apathy as more of a feeling (though it can affect behavior). The American Psychological Association (APA) defines apathy as a "lack of motivation or goal-directed behavior and indifference to one's surroundings." It defines avolition as "failure to engage in goal-directed behavior."

Sometimes, you can recognize and change things in your life that are making you feel apathetic, such as an unsatisfying job or relationship. But with avolition, you may not even notice the symptoms are happening. A friend or family member might have to point them out to you. And you may not be able to change your behavior even if you want to.

A doctor might diagnose apathy if you're no longer motivated and you:

  • Lack the effort or energy to do everyday things
  • Depend on other people to plan your activities
  • Have no desire to learn new things, meet new people, or have new experiences
  • Don't care about your own problems
  • Feel no emotions when good or bad things happen

To count as apathy, your symptoms must be serious enough or happen often enough to affect your social life, job, or other parts of your life. And they can't be due to drugs, alcohol, or any other substance you take.

A problem with areas in the front of your brain that control your emotions, goals, and behavior can cause apathy. It's often one of the first symptoms of Alzheimer's disease and other forms of dementia, which damage the brain. Up to 70% of people with dementia have this loss of interest.

Apathy can also be a symptom of other brain disorders, such as:

  • Brain injury from a strong hit to the head
  • Depression
  • Stroke
  • Parkinson's disease
  • Schizophrenia
  • Huntington's disease
  • Cerebral small vessel disease
  • Corticobasal degeneration
  • Progressive supranuclear palsy
  • Tumors in certain parts of the brain

Doctors most often see apathy in people with dementia, depression, or stroke . But you can have apathy without having another medical condition along with it.

Before you can treat apathy, see your doctor for a diagnosis to be sure about what's causing your symptoms. Your exam may include:

  • Full medical history, including any neurological or psychosocial conditions you’ve had
  • Questionnaires that measure your motivation levels, personality, and behavior
  • Imaging tests such as MRI, CT, or PET scans to look for any changes in your brain
  • Going over what medications you take, including antidepressants such as SSRIs, that may cause apathy as a side effect
  • Ruling out other psychiatric disorders whose symptoms may mimic apathy

Although apathy can be hard to diagnose and treat, there are ways to manage it. Some people with Alzheimer's disease feel more motivated when they take drugs called cholinesterase inhibitors, such as donepezil (Aricept), galantamine (Razadyne), or rivastigmine (Exelon). Antidepressants don't seem to help, and they may even make apathy worse. Stimulants including methylphenidate, the key ingredient in Ritalin have shown positive effects in some cases.

Transcranial magnetic stimulation (TMS) is also being studied as a treatment for apathy. TMS is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in your brain. A coil is placed against your scalp, and it sends magnetic pulses into your brain. TMS has already been approved by the FDA for the treatment of severe depression, migraines, and obsessive-compulsive disorder, and to help people quit smoking.

You can also try these tips to help you or a loved one manage apathy:

  • Push yourself to get out and spend time with friends, even if you don't feel like going.
  • Do things you used to love, like going to concerts or watching movies with loved ones.
  • Take a music or art therapy class, which has been shown to help with apathy.
  • Try to exercise every day.
  • Break big tasks into smaller ones so that you feel a sense of accomplishment.
  • Reward yourself whenever you finish an activity.
  • Get plenty of sleep every night.
  • Join a support group for people with apathy.

Apathy is a lack of motivation or lack of interest in things around you. It can be a symptom of neurological problems such as Parkinson's disease or Alzheimer's disease. It also can be the result of a mental health problem such as schizophrenia. Although the symptoms can look the same, apathy is different from depression. If you have apathy, you don't feel much of anything. Avolition is a more intense version of apathy. You may find yourself unable to complete the simplest tasks. Treatment for your underlying condition can help with apathy and avolition. Some people with Alzheimer's can benefit from drugs called cholinesterase inhibitors. Stimulants can also help some people.

What is an example of apathy?

If you have apathy, you might sit for long periods with no expression and no interest in things around you.

How do you fix apathy?

It's important to understand that apathy can be a symptom of a medical problem, not a behavior you're choosing. The first step is to see a doctor to find out if you have an underlying medical or mental health condition that's causing apathy. If your apathy is the result of Alzheimer's disease, some medicines might help. Stimulants might help if your apathy is caused by certain neurological issues. You and your loved ones can use self-care tips to help improve your symptoms.

What drugs treat apathy?

If you have Alzheimer's, a type of drug called a cholinesterase inhibitor might help. In people with Parkinson's, Alzheimer's, and other forms of dementia, stimulants similar to Ritalin have shown some promise. Antidepressants may help some people, but they can also make apathy worse.

What is an example of avolition?

If you have avolition, you may not be able to take care of simple, everyday tasks, such as taking a shower and getting dressed.