Have you ever felt like doing nothing? No bathing, no cooking, no cleaning, no socializing? This is what we refer to as “apathy;” it conveys a sense of having no desire to live in the moment or to seek gratification. Those of us who suffer with a chronic illness have experienced this at some point.
Lack (insufficient dose) of levodopa
Over my many years of living with PD and treating patients, I have realized that most common culprit for this lack of care and interest is an inadequate dose of levodopa. One can see the mood fluctuations as the levels wax and wane over a day. This is more pronounced when our body is forced to consume larger quantities of this chemical to keep up with the physical, emotional, or mental demands. However, some may experience these feelings come on suddenly or perhaps last all day as the disease advances, or when levodopa doses are decreased for other reasons. Unlike apathy due to depression, in those with lack of levodopa, they are aware of the problem and would like to be engaged but just can’t muster enough will power to overcome the feeling of being ‘blah’. Before resorting to a diagnosis of depression or the use of antidepressants, I would talk to my doctor about giving a trial of higher levodopa if the case warrants it. For me, adjusting the level of levodopa seems to always do the trick.
Medications, mood altering drugs or sleep aids in particular, can potentially cause either depression, daytime drowsiness as well as hypotension. These side effects give a sense of being only ½ awake; not fully functioning because there is either not enough blood flow to the cerebral cortex, or frontal lobe activity is being masked by sleep aids. Hence, the result is that we don’t want to do anything, even move from our favorite couch, chair or bed. Moving about may cause us to be dizzy, unsteady, lightheaded, nauseated, headachy, at times even experience tinnitus and vertigo. Of course when our brain is foggy, we just want to be left alone- no demands, no interactions, no going out, and certainly no putting on make-up, shaving or getting dressed. The episodes of aloofness and withdrawal are always associated with intake of one of these meds. Therefore it is important to always bring all medicines (supplements and prescription drugs) to review with your doctor periodically.
Sign of dementia
This apathy does not wax and wane but rather progresses and is permanent. It begins first with losing interest in favorite hobbies, foods, friends, activities, reading, even watching news, followed by not caring about hygiene, and nutrition. This is usually seen in combination with memory deficits, hallucinations and psychosis. Although there is no cure for dementia, early recognition can prevent worsening with adequate treatment. Patients are advised to undergo testing to evaluate other causes like thyroid, vitamin deficiencies and strokes.
Because there is more than one common reason for experiencing apathy, it is important to know what causes the problem in order to receive the best possible treatment; as well as determine if this is a sign of something more ominous like dementia.