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Navigating Apathy and Depression
Marris Adikwu
When you sit down to video chat with your friends, you might expect to feel happy and excited. When your partner needs help making a tough decision at work, you want to feel sympathetic and supportive. But instead, you might not feel anything. Apathy can come in related but distinct forms, from disinterest to lack of motivation. It can make it difficult to perform daily activities, complete projects at work or school, and keep up social relationships.
These are some of the same issues that characterize depression, but are apathy and depression the same thing? No, though apathy can be a sign that you're experiencing depression. If apathy has become a persistent challenge in your life, read on to learn how it relates to depression and other conditions and how to find effective treatment.
What Is Apathy?
We have a natural inclination to seek out stimuli—new challenges, hobbies, and relationships that satisfy our curiosity. If you feel no desire to partake in these experiences or you suddenly lose interest in activities you previously enjoyed, it may be a sign of apathy.
Apathy is a lack of emotion, interest or concern for daily activities or events going on around you. Apathy may be situational and temporary, or it may be persistent and ongoing. It is normal to go through moments where you lose interest in things due to acute stress, but if this happens more frequently or at atypical times, it can prevent you from enjoying life, impede your work, or challenge your connections with other people.
While apathy on its own is not a clinical condition, one psychologist characterized it as an "attitude" that can indicate an underlying condition. For example, apathy may be a sign of a neurodegenerative condition, as persistent apathy can be caused by issues with the region of the brain that regulates emotion and behavior. In one study, 45 percent of people with dementia experienced a lack of interest amounting to apathy. Apathy, in addition to memory loss, is also a primary symptom of Alzheimer's disease.
Apathy can be a sign of other conditions, such as
Parkinson's disease,
schizophrenia,
post-traumatic stress disorder, and
Huntington's disease—as well as depression. Doctors who note apathy in their patients will often take steps to determine whether an underlying medical condition can be treated to improve symptoms. Experiencing disinterest in daily activities is also a sign of anhedonia, which makes it easy to confuse it with apathy. However, they are distinct. A person with anhedonia mainly experiences a lack of pleasure in their daily activities, without the lack of motivation that is common in apathy. That said, in some cases you may experience apathy and anhedonia at the same time.
Does Depression Cause Apathy?
It can be easy to confuse depression with apathy, as both can cause you to experience disinterest in daily activities. Feeling unexcited about life in general is a common occurrence with both, as is a lack of motivation to achieve your goals.
Just as apathy can indicate the neurodegenerative and other disorders described above, it can also be a symptom of depression. According to one study that aimed to define diagnostic criteria for apathy, apathy was a characteristic in 94 percent of depressive episodes. Based on those criteria, these symptoms must last for four weeks or longer to qualify as apathy.
Apathy may be diagnosed as a symptom of depression if you experience it alongside other symptoms of depression, including physical indicators like pain and fatigue and emotional indicators like sadness, hopelessness, or guilt. To understand whether the apathy you are experiencing is tied to depression or to a different underlying condition—and how best to treat it—talk to your doctor about any other symptoms you may be feeling.
Seeking Treatment
If you persistently feel apathetic and unhappy, it's important to consult a doctor or mental health professional for diagnosis and treatment, even if you do not think you have depression. You may be able to address apathy with psychotherapy such as cognitive behavioral therapy (CBT), individual therapy, or prescribed medication. These methods are also frequently recommended for treating depression. However, because everyone with depression experiences the condition differently, certain treatments may be more effective for some people than for others. In fact, one in three people still experience depression symptoms after trying two medications.
Transcranial Magnetic Stimulation (TMS) therapy is another option when first-line treatments have not worked. TMS is FDA-cleared for the treatment of Major Depressive Disorder when medications have not been effective, TMS is a non-invasive, non-drug treatment that uses gentle magnetic pulses to stimulate specific areas of the brain to improve symptoms of depression and help you regain the motivation and emotional response you have been missing. To learn more about whether TMS is right for you,
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. 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Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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