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Apathy

Tuesday March 01, 2022

Of the many symptoms of Parkinson’s disease, apathy may scare me the most. What is apathy?  It is the sense that nothing matters, and that there is nothing wrong with feeling that way. It is one of the many possible non-motor symptoms of PD. 

 

Apathy is closely related to depression. The two are easy to confuse. Either can leave patients listless and subdued. The difference is the depressed person feels miserable, characterizing their malady as “The Black Dog of Depression” or “The Noonday Demon”.  The apathetic person feels nothing. They couldn’t be bothered to come up with poetic names for their affliction. In fact, they would just as soon not talk about it, or anything else. Not that they are embarrassed or ashamed, they just don’t care.

 

The misery of depression can be self-limiting. Motivated by the pain, people seek relief, and get treatment for it. The apathetic have no such driver. They don’t care that they are apathetic, and don’t suffer for it. This leaves them with no motivation to deal with the problem, aside from an abstract knowledge that things are not right. 

 

To be fair, apathy is very tough to treat. This plays into the apathetic view, why try when it’s so difficult to make progress? 

 

Apathy is hard on caregivers and other family members. Parkinson’s with its catalog of woes is bad enough. To watch a loved one being dragged under and doing nothing to save themselves, or at least prolong their precious time with those they care for and about can be a unique and maddening form of pain. 

 

It’s easy to forget this is the sickness at work and at its most devious .It simultaneously destroys the patient and the memory of the patient held by those in the circle of care. Apathy replaces the vibrant being who once inspired love with a ghost who didn’t care to remain human. 

 

Especially maddening is we now know that there are things we can do to modify the course of Parkinson’s. Apathy once did not have the same psychological impact it has now because there wasn’t anything to be done about the relentless progression of the disease. One had no option except to endure decline to the best of one’s ability 

 

But we now know early intervention with exercise or medication makes for better long-term outcomes, extending quality of life for patients for significant amounts of time. We know  implementation of an exercise program at any point in your progression can be beneficial. Multiply the benefits of early active intervention to the patient times the benefits to their families and you have a powerful formula for limiting the slow-motion catastrophe that is Parkinson’s disease.

 

Isn’t that great? Exciting? 

 

Not if you are apathetic. With apathy, it’s just one more thing not to care about. This is what I find so frightening about this symptom. It undermines our ability to take measures to cope with this disorder. It causes us to forgo agency. We surrender the city before the siege sets in. But if you are apathetic, you just don’t care about that.

 

Which brings up this question: Isn’t it likely among those those things the apathetic don’t care about is this post? Why am I even writing about this? 

 

The answer is that I believe that somewhere inside the person with Parkinson’s, the caring continues. It’s like retrieving a word that is on the tip of your tongue, You know it’s in there, the challenge is in getting it out. For now, how to get that sense of caring back remains one of the urgent mysteries of Parkinson’s Disease.

Peter Dunlap-ShohlPeter Dunlap-Shohl
NWPF Blogger

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