Conquering Apathy
Suketu M. Khandhar, MD, Medical Director, KPNC Comprehensive Mvt Disorders Program
Dr. Beverly Chang, Geriatric Psychiatry, Private Practice
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​Apathy is not just the lack of motivation. Apathy doesn’t just occur out of hopelessness. Apathy is defined as the reduction in goal-oriented behavior as a result of lessened interest and lessened emotional response. It is often mistaken for depression but can occur independently in the context of neurologic disorders. Doctors are seeing more and more of this especially during these trying times.
Those with Parkinson’s disease are more susceptible to developing apathy. Once someone has apathy, they are less likely to feel motivated in doing anything, including things that are known to help improve symptoms or delay progression like exercise or being socially engaged.
Prolonged apathy can be a harbinger of further executive dysfunction and cognitive decline. This can be terribly frustrating to a loved one or a care partner who recognizes the apathy but feels powerless to help.
Here are a few things that you can do to help overcome apathy and not derail a patient.

1. Recognize the symptoms of apathy and bring this to the attention of the neurologist or a mental health provider.
2. Understand that one does not “choose” apathy, therefore try not to become angry with the affected individual or yourself.
3. Consider trying to help motivate a patient by constructing a list of quantifiable GOALS rather than SYMPTOMS. For example, “my goal is to get back on the golf course” rather than “my goal is to reduce my tremors.”
4. Try to keep a routine schedule of activities that provide sensory stimulation.
5. Consider anti-depressant medications that elevate serotonin levels to treat any underlying mood issues that can exacerbate apathy.
6. Socially Engage, Socially Engage, Socially Engage – via video or physically distanced when in-person – reach out to your local PANC support group. 

COVID-19: There is still limited information about the effects of COVID-19 specifically regarding Parkinson’s disease, having said that, given the frailty associated with Parkinson’s disease, it would be prudent to be cautious, prepared and follow the precautions recommended by public health departments/ CDC.   During these challenging times, it cannot be emphasized enough the need for all, PD community specifically and the
​community at large, to reach out to each other, offer support and assistance to those most vulnerable and share our resources.