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“Hate is not the opposite of love; apathy is.”
Originally declared by existential psychologist Rollo May and later adapted by Nobel laureate Elie Wiesel, this sentiment has been popularly applied to romance, benevolence, and the fervor with which we pursue our dreams. We can all agree that at one point, whether for a day, a year or more, we have felt or will feel apathetic towards a person, a cause, or life in general.
The philosophical musings on apathy are somewhat parallel to its neuropsychiatric conceptualization: motivational impairments or deficits in goal-directed behavior. We can all also agree that in order to do something purposeful, we must first feel something meaningful.
Semantics aside, clinical apathy as a syndrome accompanies a broad range of neurological and psychiatric conditions, including Parkinson’s disease, Alzheimer’s disease, stroke, multiple sclerosis, and depression (of note: apathy is not depression).
Apathy’s anatomy: What does an apathetic brain look like?
Neuroimaging research has shown us that, across disorders, there are various parts of the brain that have differences associated with apathy. These brain regions are gathered in a network thought to be involved in motivated behavior. Disruptions within or between the components of this network are strongly associated with apathy throughout brain disorders. These differences can be in the form of altered metabolism in the brain or changes in actual brain structure.
The apathetic patient
Neuroscientists who have studied pathological apathy in patients with brain disorders have split apathy into multiple subtypes:
- Cognitive: reduced goal-directed behavior; impaired action planning.
- Emotional: inability to establish the necessary link between feeling and behavior, thus leading to emotional neutrality.
- Behavioral: lack of motivation to initiate behavior or respond to environmental stimuli.
Basically, patients with apathy feel as if there is nothing worth working for; the mental, physical, emotional energy they once had for accomplishing something is no longer present. Symptoms that are specific to apathy include loss of motivation, lack of persistence in activities, diminished emotional reactivity, and reduced social engagement.
Why should we study apathy?
Because apathy is present in a broad range of disorders, uncovering its neurobiological underpinnings will affect countless patients, from those who experience it occasionally, to those who are constantly burdened by feelings of emptiness. More research needs to be done to define aspects of goal-directed behavior that are impaired in apathy, to develop more effective treatments for motivation, and to delineate what might account for apathy in otherwise healthy people. There is currently no generally approved pharmacological intervention for apathy.
The detection of and solution for this type of demotivation is important for healthy life outcomes, personal happiness, and fulfillment. Apathy, whether experienced in the philosophical or the psychiatric sense, can be a dangerous thing—unless you feel apathy towards an ex-lover, which is absolutely fine (mic drop).