Living with Apathy: "Because I Just Don't Want To!"
I have heard a lot of children say, “I don’t want to,” when asked to eat their vegetables or pick up their toys. The follow-up question, “Why don’t you want to?” often brings an emphatic “Because I just don’t want to!” I had younger siblings. I babysat. I was a teacher. If you have any experience with kids, I bet you can picture the pout, arms across the chest, and a sad or defiant glint in the eyes. Are they testing boundaries? Talking back? Afraid?
I started writing this post about apathy months ago. Since then I have opened the document, made a small change here, added a sentence there, but never finished it. Tonight, I thought about it once again when I opened my laptop and saw that little document icon labeled “apathy” taunting me. What has kept me from getting this written?
Was the little voice in my head saying, “Because I just don’t want to?” I do not think I was testing any boundary. There was no one but me to talk back to and I was not in a mood to argue. I might have been afraid of failure to write something of interest. After all, there is a lot of information available about apathy. I looked at my computer screen again and said “okay, challenge to complete this post accepted!”
Is it apathy or depression?
Apathy, typically defined as a lack of interest or malaise, is not the same as depression. A diagnosis of depression requires that multiple criteria must be present over a somewhat short period of time. Lack of interest in daily activities is only one of those criteria. Depressed individuals may say they feel fatigued, worthless, and have difficulty thinking. They may feel very pessimistic and may benefit from speaking with a professional.1,2
A person experiencing apathy may not know what behaviors or emotions to look for, let alone what questions to ask. They may simply say they feel “blah.” They turn down opportunities to be with other people or engage in an activity like exercise or a lunch date. Like many other things in the PD world, apathy can present in more than one way and thus far there is no universal diagnostic tool or single treatment.3
One person experiencing a minor lack of motivation for the first time may recognize that they need an external motivation and seek it. Another person who has lost interest in many things over time may not have the ability, let alone the interest, to figure out why they feel “blah.” A loved one, friend or doctor may recognize this person’s lack of motivation and look for ways to address it. Apathy is a serious non-motor symptom in persons with Parkinson’s. When prolonged, it has a negative effect on quality of life.3
Lack of motivation to do anything vs motivation to do nothing
I used to think the lack of motivation to do anything equaled motivation to do nothing, but that is like saying you do not want to choose what to do, which is, itself, a choice. I have heard my inner voice say, “But I just don’t want to!” more often than I care to admit.
“I do not want to pay attention to timing my medications and meals.”
“I do not want to do chores.”
“Attend a birthday party? Sounds nice, but I do not want to do anything!”
Today’s climate seems a likely contributor to some frustration. What if we listen to what is meant, not what is said? I work in the world of exercise and try to keep myself motivated as well as those around me. This includes many persons with Parkinson’s from the local community. “I do not want to exercise,” may mean “I feel like nothing I do will help me feel healthy and avoid the coronavirus. So, why exercise?”
Exercise your willpower muscle
Perhaps it is important to undertake a package deal of physical and mental exercise. Willpower is like muscle power in several ways. The more you exercise it, the stronger it will get. Start small just like you would walk shorter distances before walking a mile or two non-stop.
Skip asking yourself “why?” and ask, “what if?” Such re-phrasing is a mental exercise that requires you to take another look at how you feel, what action you will take, and the consequences. For example, counter “Why should I exercise?” with “What if I exercise?” and “What if I do not exercise?”
What if you DO exercise?
You contribute to your short- and long-term physical well-being. You remind yourself that many research studies indicate that regular exercise helps delay the progression of Parkinson’s. You are happy, and there is actually a reason for that – many reasons in fact. They are called endorphins, which are chemicals that act like little painkillers telling your brain that your body is doing just fine. Perhaps you keep a training log. Seeing that list of daily exercise contributes to mental and emotional well-being.
What if you do NOT exercise?
If short-term, then you may find it difficult to motivate yourself the next day too, but you get around to a few days of exercise that week. If long-term, you may procrastinate a week or more until it has been months since you last went for a walk or lifted anything heavier than your dinner plate. You may gain weight, develop high blood pressure and experience guilt because you know you should exercise but you just do not want to. How to translate what we know to action?
Do you listen to yourself?
It can be beneficial to assess your self-talk when you or someone else has recognized your lack of motivation about life in general, let alone about exercise. Are you your own cheerleader or naysayer?
Take a piece of paper and draw a line down the middle from top to bottom. Label one column “positive” and one column “negative.” Write down each type of self-talk for a day or two. Positive self-talk includes “I can do this” and “I am doing a good job.” Negative self-talk sounds more like, “Okay, Stupid, why did you do that?” or “I just cannot do it.” You may be sinking into apathy when you tell yourself “I give up, there is no use.”
Make a conscious effort to mindfully reverse your negative self-talk or “I don’t want to” moments. Such mental resistance training can bring about a stronger response over time to help you achieve positive benefits.4 For those of us who like effective shortcuts, you might try this question and answer version of willpower training.
Q: Do I want to exercise today?
Next step: Apply mental resistance training and change that answer to yes. You do not have to reason why. You do not have to like your exercise but more often than not you will feel better physically and emotionally after your workout. Then reward yourself with positive self-talk such as “Yes! I got it done!”
Mental resistance training and monitoring my daily self-talk helps me keep apathy at bay. It helps me feel motivated to focus on the positive things in life because I like the reward of saying “I want to!” to the opportunities that come with each day.
Have you or your loved one had issues with medication timing?